United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.F., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Denver, CO, Employer 

__________________________________________ 

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Docket No. 14-2051 

Issued: February 13, 2015 

Appearances: Case Submitted on the Record

Kevin C. Flesch, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA HOWARD FITZGERALD, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On September 29, 2014 appellant, through counsel, filed a timely appeal from a July 10, 

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 met her burden of proof in establishing that she 

sustained a traumatic injury in the performance of duty. 

FACTUAL HISTORY 

On February 20, 2014 appellant, then a 72-year-old mail processing clerk, filed a 

traumatic injury claim alleging that on September 26, 2013 she sustained a right knee meniscus 

tear in the performance of duty. She alleged that she slipped on the pavement and landed on her 

 1

 5 U.S.C. § 8101 et seq. 
2

right knee in a kneeling position as she was sweeping mail at work. Appellant used leave 

without pay from September 27 through 29, 2013 and stopped work again on 

December 19, 2013. 

By letter dated February 27, 2014, OWCP notified appellant that no evidence had been 

received in support of her claim and advised her of the type of evidence needed to establish her 

claim. 

In a February 20, 2014 statement, appellant advised that she was working on a machine 

sweeping mail when she slipped and hit her right knee on the pavement. She noted that her right 

knee swelled that night and that the pain was intolerable. Appellant stated that she was taken to 

an urgent care facility where she was diagnosed with tendinitis. She related that she was later 

diagnosed with a torn meniscus of the right knee, for which she underwent surgery. Appellant 

alleged that she was unaware that she had to file a claim until her insurance provider advised her 

that workers’ compensation was responsible for her claim. 

By letter dated March 5, 2014, the employing establishment controverted the claim 

because appellant filed her claim more than 30 days after the date of injury. 

Appellant submitted medical evidence in support of her claim. In an October 2, 2013 

urgent care report, Dr. Sangeeta Clarke, an emergency medicine practitioner, advised that 

appellant was experiencing right foot swelling that began one week prior. She noted that 

appellant worked at the post office and was on her feet for her entire shift. Appellant diagnosed 

achilles bursitis/tendinitis. 

In a December 24, 2013 emergency room report, Dr. Homi Behram Kapadia, Boardcertified in emergency medicine, diagnosed knee strain and advised appellant to elevate and ice 

her knee. In a December 24, 2013 report, Dr. Ross Goldstein, a Board-certified diagnostic 

radiologist, advised that appellant was experiencing right knee pain. He advised that a right knee 

x-ray revealed mild right knee osteoarthritis and no acute bone abnormality. In another 

December 24, 2013 diagnostic report, Dr. Goldstein advised that an ultrasound of the lower 

extremity revealed a right popliteal fossa cyst and no deep vein thrombosis. 

In a January 3, 2014 report, Dr. Jennifer Arnold, Board-certified in family medicine, 

noted that appellant complained of knee and leg pain, joint stiffness, and swelling. She advised 

that appellant related that her moderate right knee pain began approximately 15 days earlier 

without injury. Dr. Arnold noted that appellant had been off work since December 19, 2013 and 

was set to return the next day, but appellant did not feel she was capable. On physical 

examination she noted that appellant’s gait was affected by a right leg limp and that appellant 

experienced pain with range of motion in the right knee. 

On January 10, 2014 Dr. Frank Crnkovich, a Board-certified diagnostic radiologist, 

advised that a right knee magnetic resonance imaging (MRI) scan revealed vertical through and 

through tearing of the posterior horn medial meniscal root attachment with extension of tearing 

to the posterior horn and into the extruded body segment of the medial meniscus. 

In a January 15, 2014 report, Dr. Wayne Gersoff, a Board-certified orthopedic surgeon, 

advised that appellant complained of right knee pain for the past three weeks. He further advised 
3

that she related that she did not remember a specific injury or trauma. Examination revealed 

mild effusion, tenderness, and pain along the medial joint line. Dr. Gersoff noted that an MRI 

scan showed degenerative tearing of the medial meniscus. He recommended an arthroscopy. In 

a disability status report from that same visit, Dr. Gersoff advised that appellant would be unable 

to work for four to six weeks following her surgery. He also advised that leading up to her 

surgery she would be restricted in the amount of time that she could stand, walk, climb, squat, 

and kneel. In a January 21, 2014 surgery report, Dr. Gersoff noted performing a right knee 

arthroscopy and partial medial meniscectomy. Appellant also provided postoperative treatment 

records from him that noted the course of her recovery. OWCP also received hospital treatment 

and physical therapy records. 

In a March 13, 2014 statement, appellant detailed the treatment that she underwent in 

relation to her right knee. She noted that she did not file her claim until she was informed by her 

insurance provider that her condition could be the result of the fall she sustained on 

September 26, 2014 and would therefore be a workers’ compensation claim. In a March 24, 

2014 statement, appellant’s coworker advised that he and appellant were working on the same 

machine on the day of the injury. He noted that he did not see the injury, but appellant advised 

him that she injured her right knee when she slipped on the concrete floor. 

By decision dated April 8, 2014, OWCP denied appellant’s claim because medical 

evidence was insufficient to establish that the work incident caused the diagnosed condition. 

On May 8, 2014 appellant, through her attorney, requested reconsideration.2

 In support 

of the request, she provided an April 21, 2014 report from Dr. Arnold who advised that appellant 

had an injury that occurred at work on September 26, 2013 slipped and fell on a concrete floor. 

Dr. Arnold indicated that this resulted in a right knee hyperflexion and was a common event “in 

which a person tears a meniscus.” She explained that an urgent care center told appellant on 

October 2, 2013 that she had tendinitis but a later MRI scan confirmed a meniscus tear. 

Dr. Arnold noted that appellant underwent a right knee medial meniscectomy and was improving 

but was still unable to work full time. 

In an April 25, 2014 report, Dr. Gersoff advised that he had reviewed all of appellant’s 

medical records. He noted that, prior to her fall, appellant was not having pain or discomfort in 

her right knee. Dr. Gersoff stated that appellant started having pain after the fall. After an MRI 

scan revealed a tear of the posterior horn of the medial meniscus, surgery was performed on 

January 21, 2014. Regarding the cause of her meniscus injury, Dr. Gersoff stated: 

“It is certainly possible that the meniscus tear may have eventually broken down 

at this point in time. However, if [appellant] had not fallen she would not have 

developed knee problems and symptoms requiring further evaluation that 

 2

 Appellant initially requested a telephone hearing but on May 14, 2014, she withdrew her hearing request. On 

May 20, 2014 OWCP accepted her request for withdrawal of the hearing. 
4

ultimately led to her needing a surgical intervention. I therefore do think that 

there is a relationship between her fall and her knee injury.” 

Appellant also provided an April 4, 2014 duty status report from Dr. Gersoff noting appellant’s 

restrictions and a June 4, 2014 treatment report in which he advised that appellant was improving 

and able to work with less restrictions. Dr. Gersoff anticipated that he would release her from all 

restrictions in four weeks. 

By letter dated July 10, 2014, OWCP denied modification of its April 8, 2014 decision. 

LEGAL PRECEDENT 

An employee seeking compensation under FECA has the burden of establishing the 

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

evidence,3

 including that he or she is an “employee” within the meaning of FECA and that he or 

she filed his or her claim within the applicable time limitation.4 The employee must also 

establish that she sustained an injury in the performance of duty as alleged and that her disability 

for work, if any, was causally related to the employment injury.5

 

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, it first must be determined whether fact of injury has been established. 

There are two components involved in establishing fact of injury. First, the employee must 

submit sufficient evidence to establish that he actually experienced the employment incident at 

the time, place, and in the manner alleged. Second, the employee must submit medical evidence 

to establish that the employment incident caused a personal injury.6

Rationalized medical opinion evidence is generally required to establish causal 

relationship. The opinion of the physician must be based on a complete factual and medical 

background, must be one of reasonable medical certainty, and must be supported by medical 

rationale explaining the nature of the relationship between the diagnosed condition and the 

specific employment factors identified by the claimant.7

ANALYSIS 

Appellant claimed that she injured her right knee when she slipped on the pavement at 

work. The evidence supports that the claimed incident occurred as alleged. Therefore, the Board 

finds that the first component of fact of injury is established. However, the medical evidence is 

 3

 J.P., 59 ECAB 178 (2007); Joseph M. Whelan, 20 ECAB 55, 57 (1968). 

4 R.C., 59 ECAB 427 (2008). 

5 Id.; Elaine Pendleton, 40 ECAB 1143, 1145 (1989). 

6

 T.H., 59 ECAB 388 (2008). 

7 I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345 (1989). 
5

insufficient to establish that the employment incident on September 26, 2013 caused appellant’s 

right knee injury. 

In his April 25, 2014 report, Dr. Gersoff advised that appellant was not having pain or 

discomfort in her right knee prior to her fall. He opined that “it is certainly possible that the 

meniscus tear may have eventually broken down at this point in time. However, if [appellant] 

had not fallen she would not have developed knee problems and symptoms requiring further 

evaluation that ultimately led to her need for surgical intervention.” This report is insufficient to 

discharge appellant’s burden of proof. The Board has held that an opinion that a condition is 

causally related to an employment injury because the employee was asymptomatic before the 

injury but symptomatic after it is insufficient, without supporting rationale, to establish causal 

relationship.8

 Dr. Gersoff did not provide medical rationale to explain how the work incident 

caused appellant’s meniscus tear. As noted, rationalized medical opinion evidence is required to 

establish causal relationship. Dr. Gersoff also failed to explain the apparent inconsistency with 

his earlier January 15, 2014 report in which he advised that appellant related that she did not 

remember a specific injury or trauma.9 Other reports by Dr. Gersoff do not address causal 

relationship and, therefore, are also insufficient to discharge appellant’s burden of proof. 

In her January 2, 2014 report, Dr. Arnold, noted that appellant complained of knee and 

leg pain, joint stiffness, and swelling. She advised that appellant complained of moderate right 

knee pain that began approximately 15 days earlier without injury. This report makes no 

reference to the September 26, 2013 incident and thus does not support causal relationship. This 

is in contrast to Dr. Arnold’s April 21, 2014 report in which she advised that appellant had an 

injury at work on September 26, 2013 when she slipped and fell on a concrete floor. Dr. Arnold 

indicated that this caused a right knee hyperflexion and that this was a common event “in which 

a person tears a meniscus.” This report is insufficient to meet appellant’s burden of proof as 

Dr. Arnold does not explain why her more contemporaneous January 2, 2014 report made no 

mention of the September 26, 2013 incident as a cause of appellant’s conditions. It also fails to 

meet appellant’s burden because she did not provide medical rationale explaining the reasons 

why the September 26, 2013 work incident caused or contributed to a meniscal tear. There are 

no other reports from Dr. Arnold which address whether the September 26, 2013 employment 

incident contributed to appellant’s right knee condition. 

Other medical evidence of record is insufficient to establish the claim because such 

evidence does not specifically address whether the September 26, 2013 work incident caused or 

contributed to a diagnosed medical condition.10 For example, in her October 2, 2013 report, 

Dr. Clarke advised that appellant was experiencing right foot swelling that began one week prior. 

She noted that appellant works at the post office and is on her feet for her entire shift. However, 

Dr. Clarke did not specifically indicate whether any work duties were a cause of appellant’s foot 

condition nor did she diagnose a right knee condition. Likewise, Dr. Kapadia’s report and the 

 8 Thomas D. Petrylak, 39 ECAB 276 (1987). 

9 See Leonard J. O’Keefe, 14 ECAB 42, 48 (1962) (where the Board held that medical opinions based upon an 

incomplete history have little probative value). 

10 See Jaja K. Asaramo, 55 ECAB 200 (2004) (medical evidence that does not offer an opinion regarding the 

cause of an employee’s condition is of limited probative value on the issue of causal relationship). 
6

reports of diagnostic testing do no address whether the September 26, 2013 work incident 

contributed to a diagnosed medical condition. Thus, these reports are insufficient to discharge 

appellant’s burden of proof. 

The Board also notes that appellant submitted physical therapy reports. However, 

physical therapists are not considered physicians as defined under FECA.11 Thus, records from 

physical therapists are insufficient to establish a claim.12 

On appeal appellant’s attorney argues that OWCP abused its discretion by dismissing the 

physician’s opinions that the injury was work related. For the reasons set forth above, the Board 

finds that the medical evidence did not include the necessary medical reasoning explaining how 

the work incident caused or contributed to her diagnosed medical conditions. 

Consequently, appellant has submitted insufficient medical evidence to establish her 

claim. As noted, she has not submitted reasoned medical evidence, based on an accurate factual 

background, explaining why the September 26, 2013 work incident caused or contributed to a 

diagnosed medical condition. Because appellant has not provided such medical opinion 

evidence in this case, she has failed to meet her burden of proof. 

Appellant may submit new evidence or argument as part of a formal 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 10.607.13

CONCLUSION 

The Board finds that appellant did not meet her burden of proof to establish that she 

sustained a traumatic injury in the performance of duty on September 26, 2013. 

 11 Under FECA, a “physician” includes surgeons, podiatrists, dentists, clinical psychologists, optometrists, 

chiropractors, and osteopathic practitioners within the scope of their practice as defined by State law. 5 U.S.C. 

§ 8101(2). 

12Allen C. Hundley, 53 ECAB 551 (2002); Lyle E. Dayberry, 49 ECAB 369 (1998); D.F., Docket No. 12-347 

(issued June 18, 2012). See also Charley V.B. Harley, 2 ECAB 208, 211 (1949) (where the Board held that medical 

opinion, in general, can only be given by a qualified physician). 

13 Appellant submitted new evidence to OWCP after issuance of the July 10, 2014 decision. However, the Board 

lacks jurisdiction to review new evidence for the first time on appeal. See 20 C.F.R. § 501.2(c). 
7

ORDER 

IT IS HEREBY ORDERED THAT the July 10, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: February 13, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board