United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

F.S., Appellant 

and 

DEPARTMENT OF JUSTICE, FEDERAL 

CORRECTIONAL COMPLEX, Coleman, FL, 

Employer 

__________________________________________ 

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Docket No. 15-30 

Issued: February 20, 2015 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On October 7, 2014 appellant filed a timely appeal from a June 12, 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 left knee injury in the performance of 

duty on October 21, 2011. 

FACTUAL HISTORY 

On October 24, 2011 appellant, then a 34-year-old correctional officer, filed a traumatic 

injury claim (Form CA-1) alleging that on October 21, 2011 she sustained a left knee injury. She 

 1

 5 U.S.C. § 8101 et seq. 
2

stated that, while in the performance of duty, she stepped on a crack in the sidewalk and twisted 

her left knee.2

 

In a Form CA-16 (authorization for examination and/or treatment) dated October 21, 

2011, the employing establishment authorized medical treatment at Ocala Regional Medical 

Center. An “emergency physician record” dated October 21, 2011 noted a prior history of a torn 

meniscus. The physician provided a history that appellant had twisted her left knee and 

diagnosed knee sprain/strain.3 A discharge summary of the same date from Dr. Steven Gelovich, 

a Board-certified in family medicine, indicated that appellant should work sedentary duty. 

Appellant underwent left knee surgery on November 8, 2011. Dr. Derek Farr, an 

attending osteopath, described the surgery as left knee arthroscopy with partial medial 

meniscectomy and chondroplasty two compartments. The record contains another emergency 

physician record dated November 13, 2011 indicating appellant reported postoperative knee 

pain. According to OWCP, appellant had a prior claim for a left knee injury on September 5, 

2010 while breaking up an inmate altercation, and a November 30, 2010 prior claim accepted for 

left knee sprain and lateral/medial meniscus tear. 

By decision dated October 2, 2013, OWCP denied the claim for compensation. It found 

appellant had not submitted sufficient factual or medical evidence to establish the claim. 

Appellant requested a review of the written record by letter postmarked 

November 5, 2013. By decision dated November 29, 2013, OWCP denied the request on the 

grounds that it was untimely filed. 

On December 23, 2013 appellant requested reconsideration of her claim.4 She stated that 

she had reinjured her knee on October 21, 2011 and sought medical treatment. Appellant stated 

that she had told Dr. Farr of her injury but he noted she was having surgery in two weeks and he 

would continue to treat her under the old claim. She stated that she thought all of her left knee 

treatment would be taken care of and now she did not understand why she was “facing a claim 

from workers’ compensation” for medical costs. By report dated November 17, 2011, Dr. Farr 

provided results on examination. He diagnosed left knee meniscus tear and chondromalacia 

patella. 

By decision dated June 12, 2014, OWCP reviewed the case on its merits. It denied the 

claim on the grounds that the medical evidence was insufficient to establish the claim. 

LEGAL PRECEDENT 

FECA provides for the payment of compensation for “the disability or death of an 

employee resulting from personal injury sustained while in the performance of duty.”5

 The 

 2

 These claims are not administratively linked to the current claim. 

3

 The signature on the form report is illegible. 

4

 Appellant also requested a review by the Board. In an order dated April 14, 2014, the Board dismissed the 

appeal, noting that she had requested the appeal be withdrawn. Docket No. 14-462 (issued April1 14, 2014). 

5

 5 U.S.C. § 8102(a). 
3

phrase “sustained while in the performance of duty” in FECA is regarded as the equivalent of the 

commonly found requisite in workers’ compensation law of “arising out of an in the course of 

employment.”6

 An employee seeking benefits under FECA has the burden of establishing that 

he or she sustained an injury while in the performance of duty.7 In order to determine whether 

an employee actually sustained an injury in the performance of duty, OWCP begins with an 

analysis of whether “fact of injury” has been established. Generally “fact of injury” consists of 

two components which must be considered in conjunction with one another. The first 

component to be established is that the employee actually experienced the employment incident 

which is alleged to have occurred. The second component is whether the employment incident 

caused a personal injury and, generally, this can be established only by medical evidence.8 

Rationalized medical opinion evidence is medical evidence that is based on a complete 

factual and medical background of reasonable medical certainty and supported by medical 

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

specific employment factors identified by the claimant. The weight of medical evidence is 

determined by its reliability, its probative value, its convincing quality, the care of the analysis 

manifested, and the medical rationale expressed in support of the physician’s opinion.9

ANALYSIS 

In the present case, appellant filed a claim for a left knee injury on October 21, 2011 

when she stepped on a crack in the sidewalk and twisted her knee. Although the current case file 

has not been administratively linked with any other case file, the record indicated that she had a 

prior claim accepted for a left knee lateral/medial meniscus tear. Appellant underwent a partial 

left knee meniscectomy surgery on November 8, 2011. 

The record indicates that appellant was treated on October 21, 2011. Dr. Gelovich 

provided a discharge summary, and there is a physician’s emergency room report as well. As 

noted above, to establish a left knee sprain/strain or other diagnosed condition as causally related 

to the October 21, 2011 incident, appellant must submit rationalized medical opinion evidence. 

In this case the medical evidence is not sufficient to meet her burden of proof. The hospital 

reports dated October 21, 2011 do not provide a clear history of the employment incident. 

Moreover, there is no opinion relating a diagnosed condition to the employment incident. The 

additional medical evidence of record, including reports from Dr. Farr, does not discuss the 

issue. The Board finds that appellant did not meet her burden of proof in this case. 

On appeal appellant states that she felt her left knee injury had been covered and now 

there were unpaid medical bills. The Board does not have jurisdiction with respect to any prior 

left knee claims. The Board notes that the employing establishment issued a Form CA-16 on 

October 21, 2011. Where an employing establishment properly executes a Form CA-16 which 

authorizes medical treatment as a result of an employee’s claim for an employment-related 

 6 Valerie C. Boward, 50 ECAB 126 (1998). 

7 Melinda C. Epperly, 45 ECAB 196, 198 (1993); see also 20 C.F.R. § 10.115. 

8 See John J. Carlone, 41 ECAB 354, 357 (1989). 

9 Jennifer Atkerson, 55 ECAB 317, 319 (2004). 
4

injury, the Form CA-16 creates a contractual obligation, which does not involve the employee 

directly, to pay for the cost of the examination or treatment regardless of the action taken on the 

claim.10 The period for which treatment is authorized by a Form CA-16 is limited to 60 days 

from the date of issuance, unless terminated earlier by OWCP.11 In this case, OWCP made no 

findings with respect to the October 21, 2011 Form CA-16. On return of the case record, it 

should properly address the issue.12

CONCLUSION 

The Board finds that appellant has not established an injury in the performance of duty on 

October 21, 2011. On return of the case record, OWCP should consider the Form CA-16 issued 

in this case. 

ORDER 

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

Compensation Programs dated June 12, 2014 is affirmed. 

Issued: February 20, 2015 

Washington, DC 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board 

 10 Tracey P. Spillane, 54 ECAB 608 (2003). 

11 See 20 C.F.R. § 10.300(c). 

12 See S.L., Docket No. 14-1591 (issued December 24, 2014).