United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.R., Appellant 

and 

DEPARTMENT OF THE INTERIOR, 

BUREAU OF RECLAMATION, 

Truth or Consequences, NM, Employer 

__________________________________________ 

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Docket No. 15-379 

Issued: April 17, 2015 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On December 9, 2014 appellant, through counsel, filed a timely appeal from a 

September 17, 2014 merit decision of the Office of Workers’ Compensation Programs (OWCP). 

Pursuant to the Federal Employees’ Compensation Act1

 (FECA) and 20 C.F.R. §§ 501.2(c) and 

501.3, the Board has jurisdiction over the merits of this case. 

ISSUE 

The issue is whether appellant has established a knee condition causally related to factors 

of his federal employment. 

FACTUAL HISTORY 

On September 8, 2013 appellant, then a 61-year-old heavy duty repairman, filed an 

occupational disease claim (Form CA-2) alleging that he sustained injury to his knees as a result 

 1

 5 U.S.C. § 8101 et seq. 
2

of his federal employment. He identified climbing, walking, crawling, kneeling, and standing as 

the employment factors contributing to his condition. Appellant stated that his federal 

employment caused his left knee to hurt and then after July 8, 2010 his right knee began to have 

problems and had progressively worsened. 

Appellant had two prior claims involving his knees. He filed a traumatic injury claim 

(Form CA-1) for a left knee injury on February 16, 2005, and this claim was accepted for left 

knee internal derangement. Under this claim file appellant received wage-loss compensation. 

The record indicated that he returned to full-time, light-duty work as of January 13, 2014. In 

addition, appellant had filed a traumatic injury claim on May 21, 2013 for a right knee injury on 

July 8, 2010.2 He alleged that his right knee popped as he descended stairs. By decision dated 

August 5, 2013, OWCP denied the claim on the grounds the medical evidence was insufficient to 

establish causal relationship between a diagnosed condition and the employment incident. 

In a letter dated August 12, 2013, appellant stated that his work involved climbing on and 

under equipment, and most of his work was in the field. He noted that parts and tools were 

heavy, and he engaged in pushing, pulling, lifting, kneeling, and squatting while at work. 

Appellant stated that he had a left knee replacement surgery in 2012, but his right knee continued 

to get worse and needed surgery. 

With respect to medical evidence, appellant submitted a report dated May 25, 2012 from 

Dr. David Mansfield, a Board-certified orthopedic surgeon, who provided a history of a right 

knee injury on July 8, 2010, when appellant felt a pop in his knee when going down some stairs. 

He stated that since that injury appellant had pain and swelling in the knee. Dr. Mansfield noted 

that appellant’s job required getting down on his knees and climbing ladders and appellant was 

having difficulty right now with these duties. He provided results on examination and diagnosed 

osteoarthrosis and internal knee derangement. 

In a report dated June 5, 2012, Dr. Mansfield stated that appellant’s right knee showed a 

significant amount of degenerative changes. He further stated, “I do not think that his job causes 

the dis[c] degenerative condition. I certainly think that the fall he has taken at work due to his 

compensable injury has extremely exacerbated and accelerated this condition.” By report dated 

July 3, 2012, Dr. Mansfield stated that appellant had questions about whether his right knee was 

affected by the left knee. He stated that the trouble appellant was having with the left knee, 

including degeneration, medial meniscus tear, arthritis and varus deformity, can sometimes put 

pressure on the right knee. Dr. Mansfield further stated, “Certainly, he is predisposed because of 

that [left knee] condition to have early degenerative changes in the right knee due to that 

problem.” 

In a July 2, 2013 report, Dr. Mansfield stated that appellant had hurt his right knee on 

July 8, 2010, and since that time had significant pain in the knee. He stated that there was no 

doubt appellant had previous degeneration in the knee, but the July 8, 2010 injury had 

exacerbated his condition. According to Dr. Mansfield, he had explained to appellant “that his 

 2

 The record in that claim contained a CA-1 for a claimed injury on July 8, 2010 that was signed by appellant on 

July 13, 2010. 
3

knee was at risk and when he was working he injured it. [Appellant] now has a knee that is 

probably going to need a knee replacement.” 

By decision dated December 16, 2013, OWCP denied the claim for compensation. It 

found the medical evidence was insufficient to establish the claim. 

Appellant requested a hearing before an OWCP hearing representative, which was held 

on July 9, 2014. The hearing representative noted that there was some confusion as to what 

appellant was claiming in the current claim. Appellant’s counsel discussed appellant’s right knee 

and referenced the July 2, 2013 report from Dr. Mansfield. 

By decision dated September 17, 2014, the hearing representative affirmed the 

December 16, 2013 OWCP decision. The hearing representative found the medical evidence 

was insufficient to establish the claim. 

LEGAL PRECEDENT 

A claimant seeking benefits under FECA3

 has the burden of establishing the essential 

elements of his or her claim by the weight of the reliable, probative, and substantial evidence, 

including that an injury was sustained in the performance of duty as alleged and that any specific 

condition or disability claimed is causally related to the employment injury.4 

To establish that an injury was sustained in the performance of duty, a claimant must 

submit: a factual statement identifying employment factors alleged to have caused or 

contributed to the presence or occurrence of the disease or condition; medical evidence 

establishing the presence or existence of the disease or condition for which compensation is 

claimed; and medical evidence establishing that the diagnosed condition is causally related to the 

employment factors identified by the claimant.5 

Causal relationship is a medical question that can generally be resolved only by 

rationalized medical opinion evidence.6

 A physician’s opinion on the issue of whether there is a 

causal relationship between the claimant’s diagnosed condition and the implicated employment 

factors must be based on a complete factual and medical background of the claimant.7

 

Additionally, in order to be considered rationalized, the opinion must be expressed in terms of a 

reasonable degree of medical certainty, and must be supported by sound medical rationale, 

explaining the nature of the relationship between the diagnosed condition and appellant’s 

specific employment factors.8 

 

 3 5 U.S.C. §§ 8101-8193. 

 4

 20 C.F.R. § 10.115(e), (f) (2005); see Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996). 

 5 Ruby I. Fish, 46 ECAB 276, 279 (1994). 

 6 See Robert G. Morris, 48 ECAB 238 (1996). 

 7 Victor J. Woodhams, 41 ECAB 345, 352 (1989). 

 8 Id. 
4

ANALYSIS 

In the present case, appellant filed an occupational claim9 identifying a number of 

employment factors as contributing to a knee condition. On the claim form he identified 

climbing, walking, crawling, kneeling, and standing. In a narrative statement, appellant also 

mentioned lifting, pushing, and pulling. OWCP does not contest that he engaged in such 

activities in his federal employment as a heavy duty repairman. 

It must be noted that appellant had filed prior claims with respect to the knees. As to the 

right knee, he has a claim for a traumatic injury on July 8, 2010. The Board notes, however, that 

the issue of whether appellant sustained an employment injury on July 8, 2010 is not before the 

Board on this appeal. 

Moreover, the issue of whether appellant may have sustained a consequential right knee 

injury from an accepted left knee injury is not before the Board. Appellant has a claim for a left 

knee injury on February 16, 2005. 

The issue in the present case is whether the medical evidence is sufficient to establish 

causal relationship between a diagnosed condition and the identified employment factors. 

Although appellant referred to the left knee on the claim form, he did not submit medical 

evidence on causal relationship between a diagnosed left knee condition and the identified 

employment factors. 

As to the right knee, the medical evidence is also insufficient to establish the claim. 

Dr. Mansfield briefly noted in his May 25, 2012 report that appellant’s job duties included 

kneeling and climbing. However, he did not relate any specific diagnosed right knee condition 

to performing those duties. Dr. Mansfield referred only to a July 8, 2010 injury, and indicated 

that appellant was having difficulty performing such job duties. The July 3, 2013 report is 

similarly deficient with respect to the issue in this case. Dr. Mansfield opined that appellant had 

exacerbated a preexisting degenerative condition on July 8, 2010. He did not provide a complete 

medical history, or discuss the identified employment factors. Dr. Mansfield did not provide an 

opinion, supported by sound medical rationale, on causal relationship between a diagnosed right 

knee condition and the specific identified employment factors. 

Appellant may submit new evidence or argument with a written request for 

reconsideration to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) 

and 20 C.F.R. §§ 10.605 through 10.607. 

CONCLUSION 

The Board finds that appellant has not established a causal relationship between his right 

knee condition and factors of his federal employment. 

 9

 An occupational disease or illness is a condition produced by the work environment over a period longer than a 

single workday or shift. 20 C.F.R. § 10.5(q). 
5

ORDER 

IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ 

Compensation Programs dated September 17, 2014 is affirmed. 

Issued: April 17, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board