United States Department of Labor 

Employees’ Compensation Appeals Board 

_________________________________________ 

B.W., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

St. Louis, MO, Employer 

_________________________________________ 

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Docket No. 14-69 

Issued: March 18, 2014 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

RICHARD J. DASCHBACH, Chief Judge 

PATRICIA HOWARD FITZGERALD, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On October 2, 2013 appellant filed a timely appeal from the September 12, 2013 Office 

of Workers’ Compensation Programs’ (OWCP) decision denying her request for an increased 

schedule award. Pursuant to the Federal Employees’ Compensation Act1

 (FECA) and 20 C.F.R. 

§§ 501.2(c) and 501.3, the Board has jurisdiction over this issue. 

ISSUE 

The issue is whether appellant met her burden of proof to establish that he sustained more 

than a two percent permanent impairment to her left lower extremity, for which she received a 

schedule award. 

FACTUAL HISTORY 

On August 30, 2012 appellant, then a 51-year-old rural carrier, injured her left knee in the 

performance of duty. She filed a claim for benefits, which OWCP accepted for left knee sprain. 

 1

 5 U.S.C. § 8101 et seq. 
2

OWCP expanded the claim to include exacerbation of medial meniscus tear on the left. 

Appellant underwent an authorized left knee arthroscopy, partial medial meniscectomy and 

chondroplasty microfracture of the medial femoral condyle on November 2, 2012. She returned 

to full duty on December 1, 2012. 

In a report dated February 25, 2013, Dr. Randall D. Roush, a Board-certified orthopedic 

surgeon and treating physician, noted that appellant was seen for her left knee. He advised that 

she was still having pain and could not extend the leg which caused her to limp and tip-toe on 

left side when going down hills (front lawns). Dr. Roush recommended anti-inflammatories and 

possible cortisone injection and to return as necessary. 

In a Form CA-7 dated February 27, 2013, appellant requested a schedule award. 

In a letter dated April 1, 2013, OWCP advised appellant that additional medical evidence 

was required to make a proper determination regarding any possible permanent impairment. 

In a May 28, 2013 report, Dr. Roush noted that he was providing a final rating. He 

indicated that appellant had a complex tear of the medial meniscus and a leaking Baker’s cyst. 

Dr. Roush explained that she underwent arthroscopic knee surgery with partial medial 

meniscectomy, chondroplasty and microfracture of medial femoral condyle. He advised that 

appellant made a gradual recovery but she reported that, during the process of delivering mail, 

she sometimes had a limp and difficulty with full extension of the knee. There were no 

complaints of locking or giving way. Dr. Roush opined that appellant had reached maximum 

medical improvement. He referred to the American Medical Association, Guides to the 

Evaluation of Permanent Impairment, (6th ed. 2009) (hereinafter, A.M.A., Guides) and indicated 

that, pursuant to Table 16-3,2 she had five percent impairment of the left lower extremity for a 

combined meniscal injury and chondral lesion of the femoral condyle. 

 In a September 2, 2013 report, OWCP’s medical adviser noted appellant’s history of 

injury and treatment and referred to the A.M.A., Guides. He noted that Dr. Roush indicated that 

appellant did well following her arthroscopy but occasionally walked with a limp. The medical 

adviser also indicated that appellant had pain with full extension and there was no knee effusion. 

Dr. Roush’s notes reported that all surgical incisions were healed, the knee was stable to anterior 

and posterior stress testing and the McMurray’s test was negative. The medical adviser advised 

that Dr. Roush provided a rating of five percent for both the medial femoral condylar lesion and 

the meniscus tear. He explained that only the most clinically relevant condition was to be rated, 

which in appellant’s case was the meniscal tear. The medical adviser referred to Table 16-33

 and 

determined that she had two percent impairment for a partial medial meniscectomy. Dr. Roush 

considered the net adjustment formula and opined that there would be no change to the rating. 

OWCP’s medical adviser indicated that appellant reached maximum medical improvement on 

February 25, 2013. 

 2

 A.M.A., Guides 509. 

3 Id. 
3

By decision dated September 12, 2013, OWCP granted appellant a schedule award for 

two percent permanent impairment of the left leg. The award covered 5.76 weeks, from 

February 25 to April 6, 2013. 

LEGAL PRECEDENT 

The schedule award provision of FECA4 and its implementing regulations5 set forth the 

number of weeks of compensation payable to employees sustaining permanent impairment from 

loss or loss of use, of scheduled members or functions of the body. However, FECA does not 

specify the manner in which the percentage of loss shall be determined. For consistent results 

and to ensure equal justice under the law to all claimants, good administrative practice 

necessitates the use of a single set of tables so that there may be uniform standards applicable to 

all claimants. For decisions issued after May 1, 2009, the A.M.A., Guides has been adopted by 

the implementing regulations as the appropriate standard for evaluating schedule losses.6

In addressing lower extremity impairments, the sixth edition requires identifying the 

impairment class for the diagnosed condition (CDX), which is then adjusted by grade modifiers 

based on Functional History (GMFH), Physical Examination (GMPE) and Clinical Studies 

(GMCS).7

 The net adjustment formula is (GMFH - CDX) + (GMPE - CDX) + (GMCS - CDX).8 

OWCP procedures provide that, after obtaining all necessary medical evidence, the file 

should be routed to OWCP’s medical adviser for an opinion concerning the nature and 

percentage of impairment in accordance with the A.M.A., Guides, with the medical adviser 

providing rationale for the percentage of impairment specified.9 

ANALYSIS 

OWCP accepted that appellant sustained left knee sprain. It expanded the claim to 

include exacerbation of medial meniscus tear on the left. Appellant underwent left knee 

arthroscopy, partial medial meniscectomy and chondroplasty microfracture of the medial femoral 

condyle on November 2, 2012. 

In support of her claim for a schedule award, appellant submitted a May 28, 2013 report 

from Dr. Roush, who indicated that she had a five percent permanent impairment. Dr. Roush 

noted that appellant had a complex tear of the medial meniscus and a leaking Baker’s cyst and 

that she underwent arthroscopic knee surgery with partial medial meniscectomy, chondroplasty 

 4

 5 U.S.C. § 8107. 

5

 20 C.F.R. § 10.404. 

6

 FECA Bulletin No. 09-03 (issued March 15, 2009). A.M.A., Guides (6th ed. 2008). 

7

 A.M.A., Guides 494-531; see J.B., Docket No. 09-2191 (issued May 14, 2010). 

8 Id. at 521. 

9 See Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, 

Chapter 2.808.6(f) (February 2013). 
4

and microfracture of medial femoral condyle. He stated that appellant sometimes had a limp and 

difficulty with full extension of the knee. Dr. Roush opined that she had reached maximum 

medical improvement. He utilized the A.M.A., Guides and referred to Table 16-3.10 Dr. Roush 

indicated that appellant had five percent impairment of the extremity for a combined meniscal 

injury and chondral lesion of the femoral condyle. The Board notes that this Table indicates that 

the maximum rating for a partial medial or lateral meniscectomy, meniscal tear or meniscal 

repair is three percent. There also is no provision for five percent impairment on page 509 for a 

chondral lesion of the femoral condyle. A medical opinion is of limited probative value if it 

contains a conclusion unsupported by medical rationale.11

Board precedent is well settled that when an attending physician’s report gives an 

estimate of impairment but does not address how the estimate was based on the A.M.A., Guides, 

OWCP is correct to follow the advice of its medical adviser or consultant where he or she has 

properly applied the A.M.A., Guides.

12

In a report dated September 2, 2013, OWCP’s medical adviser determined that appellant 

reached maximum medical improvement on February 25, 2013 and had two percent impairment 

of the left leg. He noted that Table 16-3 at page 509 of the A.M.A., Guides, provided for two 

percent leg impairment for a partial medial meniscectomy. Dr. Roush considered grade 

modifiers and the net adjustment formula but concluded that the net adjustment formula would 

not change the default impairment rating. The medical adviser explained that, while he provided 

a rating of five percent for both the medial femoral condylar lesion and the meniscus tear, only 

the most clinically relevant condition was to be rated, which in appellant’s case was the meniscal 

tear. The Board notes that this is in accord with the A.M.A., Guides, which provides that, if 

more than one diagnosis can be used in a region, the one that provides the most clinically 

accurate impairment rating should be used.13 There is no current medical report of record 

establishing any greater impairment pursuant to the A.M.A., Guides.

On appeal, appellant argued that she should have received a greater impairment based 

upon her physician’s findings. However, as noted above, Dr. Roush’s report did not comport 

with the A.M.A., Guides. 

Appellant may request a schedule award or increased schedule award based on evidence 

of a new exposure or medical evidence showing progression of an employment-related condition 

resulting in permanent impairment or increased impairment. 

CONCLUSION 

The Board finds that appellant has not met her burden of proof to establish that she has 

more than two percent impairment of the left lower extremity. 

 10 Supra note 2. 

11 T.M., Docket No. 08-975 (February 6, 2009); S.E., Docket No. 08-2214 (issued May 6, 2009). 

12 J.Q., 59 ECAB 366 (2008); Laura Heyen, 57 ECAB 435 (2006). 

13 A.M.A., Guides 499. 
5

ORDER 

IT IS HEREBY ORDERED THAT the September 12, 2013 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: March 18, 2014 

Washington, DC 

 

 Richard J. Daschbach, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board