United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.M., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Midwest, WY, Employer 

__________________________________________ 

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Docket No. 15-223 

Issued: March 23, 2015 

Appearances: Case Submitted on the Record

Appellant, pro se 

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 November 12, 2014 appellant filed a timely appeal from an October 9, 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 to review the merits of this case. 

ISSUE 

The issue is whether the November 15, 2012 work incident caused a right knee injury. 

FACTUAL HISTORY 

On November 21, 2012 appellant, then a 61-year-old postmaster relief/replacement, filed 

a traumatic injury claim alleging that he injured his right knee in the performance of duty on 

November 15, 2012 while crawling under desks to shut off and turn on power strips. He stated 

that doing this activity multiple times dislocated his right knee. 

 1

 5 U.S.C. § 8101 et seq.
2

Dr. Robert B. Allaire, a Board-certified orthopedic surgeon, examined appellant on 

November 27, 2012. He noted that appellant had a remote history of a right knee dislocation 

years ago, but basically recovered without difficulties. Appellant occasionally had knee pain, but 

nothing very significant until recently, when he was at work crawling around on his hands and 

knees. Since then, appellant had a lot of pain and swelling in his right knee and was walking 

with a limp, which was new for him. 

Dr. Allaire described his findings on physical examination. Previous x-rays showed 

bone-on-bone arthritis medially. Dr. Allaire found that appellant had end-stage primary medial 

compartment osteoarthritis, “and it was exacerbated at work.” There was no question the 

condition was preexisting, but appellant was not having much difficulty until this recent event. 

Dr. Allaire considered appellant a good candidate for an unicompartmental knee arthroplasty. 

Appellant underwent the procedure on March 21, 2013. 

In a decision dated October 9, 2014, OWCP denied appellant’s traumatic injury claim. It 

found that the November 15, 2012 work incident occurred as alleged, but the medical opinion 

evidence was insufficient to establish that his right knee osteoarthritis was causally related to the 

incident. 

Appellant notes on appeal that all available documentation relating to the injury has been 

submitted. 

LEGAL PRECEDENT 

FECA provides compensation for the disability of an employee resulting from a personal 

injury sustained while in the performance of duty.2 An employee seeking benefits under FECA 

has the burden of proof to establish the essential elements of his or her claim. When an 

employee claims that he or she sustained an injury in the performance of duty, he or she must 

submit sufficient evidence to establish that he or she experienced a specific event, incident, or 

exposure occurring at the time, place, and in the manner alleged. He or she must also establish 

that such event, incident, or exposure caused an injury.3

Causal relationship is a medical issue,4

 and the medical evidence generally required to 

establish causal relationship is rationalized medical opinion evidence. The opinion of the 

physician must be based on a complete factual and medical background of the claimant,5

 must be 

one of reasonable medical certainty,6 and must be supported by medical rationale explaining the 

 2 Id. at § 8102(a). 

3 John J. Carlone, 41 ECAB 354 (1989). 

4 Mary J. Briggs, 37 ECAB 578 (1986). 

5 William Nimitz, Jr., 30 ECAB 567, 570 (1979). 

6 See Morris Scanlon, 11 ECAB 384, 385 (1960). 
3

nature of the relationship between the diagnosed condition and the established incident or factor 

of employment.7

ANALYSIS 

OWCP does not dispute that appellant crawled on his hands and knees in the course of 

his employment on November 15, 2012. Appellant has met his burden to establish that he 

experienced a specific event, incident, or exposure occurring at the time, place, and in the 

manner alleged. The primary issue presented on appeal is whether this work activity caused a 

right knee injury. 

Dr. Allaire, the orthopedic surgeon, noted that appellant had recently crawled around on 

his hands and knees at work. Appellant had a remote history of a right knee dislocation years 

ago, but Dr. Allaire did not find another dislocation on November 15, 2012. Instead, Dr. Allaire 

found that appellant’s end-stage primary medial compartment osteoarthritis was exacerbated at 

work. He reasoned that appellant was not having much difficulty with his right knee until this 

recent event, following which appellant had a lot of pain and swelling and walked with a limp. 

This opinion offers some support for appellant’s traumatic injury claim, but it is not 

particularly well reasoned. Dr. Allaire did not discuss how crawling around on one’s hands and 

knees can exacerbate end-stage primary medial compartment osteoarthritis. He did not discuss 

what findings, either on physical examination or on x-ray review, confirmed an exacerbation, or 

whether he was basing his opinion instead on the history appellant related.8

 

The Board finds that, while Dr. Allaire’s opinion is supportive, it lacks sufficient medical 

rationale to establish the critical element of causal relationship. The Board will therefore affirm 

OWCP’s October 9, 2014 decision. 

Appellant notes that all available documentation relating to the injury has been submitted. 

However as explained above, his claim lacks medical opinion explaining, with sound medical 

reasoning, how crawling on November 15, 2012 exacerbated the diagnosed medial compartment 

osteoarthritis, and what objective evidence exists to document the exacerbation found. 

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 met his burden to establish that the November 15, 

2012 work incident caused a right knee injury. 

 7 See William E. Enright, 31 ECAB 426, 430 (1980). 

8 Id.
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ORDER 

IT IS HEREBY ORDERED THAT the October 9, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: March 23, 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