Medical Evidence Supports VA Worker’s Online Training Injury, but not Headaches, Pain

Case File

ECAB decided that some of a V.A. worker's medical evidence supported her claims but not all of them. Simply Research readers have access to the full text of the decision.

Case

P.V. and Department of Veterans Affairs, No. 25-0311 (ECAB 02/27/25)

What Happened

A social worker filed a traumatic injury claim alleging that she injured her leg and experienced breathing issues when she attended an online training while in the performance of duty. She did not stop work.

According to the social worker, she injured her right leg, knee, and ankle when her clothing got snagged on her desk. She also related that she experienced breathing issues and lightheadedness when she was exposed to fumes from glue and other chemicals from a repair area near her desk.

OWCP accepted that the employment incident occurred as alleged but denied the claim, finding that the medical evidence of record was insufficient to establish a diagnosed medical condition in connection with the accepted employment incident.

The social worker submitted additional evidence, but OWCP ultimately denied the claim, deciding that the evidence of record was insufficient to establish a causal relationship between the diagnosed condition and the employment incident.

The social worker appealed to the Employees' Compensation Appeals Board.

Rule of Law

Under the Federal Employees' Compensation Act, the medical evidence required to establish a claimed specific condition an employment incident is rationalized medical opinion evidence. The physician's opinion must be:

+ Based on a complete factual and medical background of the employee.

+ Be one of reasonable medical certainty.

+ Be supported by medical rationale explaining the nature of the relationship between the diagnosed condition and specific employment incident identified by the employee.

What ECAB Said

ECAB found that the social worker met her burden of proof to establish a contusion of the right thigh casually related to the accepted employment incident.

Specifically, the board highlighted:

+ An OSHA record keeper noted that the social worker related that she sustained bruises to her upper thigh when her clothing snagged on her desk.

+ A supervisor noted that during a meeting, the social worker stated she had hit her thigh on her desk and subsequently noticed a contusion that "welted up."

+ A doctor indicated that he performed a physical examination that revealed sings of right anterolateral thigh swelling and bruising, opining, "It is quite clear that she had a contusion of her right thigh musculature."

Thus, ECAB remanded the case to OWCP for payment of medical expenses for contusion of the right thigh.

However, the social worker didn't experience a total victory because ECAB also found that she did not meet her burden of proof to establish an additional medical condition related to pain in her thigh and headaches.

"The board has held that pain is a description, not a clear diagnosis of a medical condition," ECAB wrote.

Additionally, ECAB found that the doctor's opinion that it was "certainly possible that factors such as humidity, temperature, air quality, and potential chemical exposure through inhalation route could have contributed to her headaches" as "speculative or equivocal" and, therefore, "of diminished probative value."

Takeaway

While ECAB doesn't look for absolute medical certainty in determining whether an employee has a condition causally related to an employment injury, the opinion must be of a reasonable degree of medical certainty, not speculative or equivocal.

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