United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

N.K., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Merrifield, VA, Employer 

__________________________________________ 

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Docket No. 15-1066 

Issued: September 3, 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 H. FITZGERALD, Deputy Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On April 6, 2015 appellant filed a timely appeal of a March 19, 2015 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 

consider the merits of the case. 

ISSUE 

The issue is whether appellant has more than two percent permanent impairment of his 

right lower extremity for which he received a schedule award. 

On appeal, appellant alleged that his physician was entitled to the weight of the medical 

evidence, rather than an OWCP medical adviser. 

 1

 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

On December 22, 2009 appellant then a 57-year-old letter carrier, filed a traumatic injury 

claim alleging that on that date he fell down stairs covered with snow and dislocated his right 

knee. In a report dated December 24, 2009, Dr. Edward C. Rabbitt, a Board-certified orthopedic 

surgeon, noted appellant’s history of a fall on December 22, 2009 and stated that he examined xrays of appellant’s right leg finding no fractures or dislocations. Appellant’s x-rays 

demonstrated a small joint effusion and mild osteoarthritis of the patellofemoral compartment. 

Dr. Rabbitt diagnosed quadriceps tendon rupture. Appellant underwent surgical repair on 

December 28, 2009. 

By decision dated December 31, 2009, OWCP accepted his claim for rupture of the right 

quadriceps tendon. Appellant returned to light-duty work on June 21, 2010. 

In a report dated August 24, 2010, Dr. Rabbitt found that appellant had weakness of the 

quadriceps and a history of his right knee buckling while walking. He found excellent range of 

motion and good quadriceps definition. Dr. Rabbitt noted moderately significant patellofemoral 

crepitus, but stated that appellant did not seem to be particularly painful with range of motion. 

Appellant accepted a modified position as a city carrier on September 3, 2010. 

Appellant requested a schedule award on November 16, 2010. In a report dated 

December 14, 2010, Dr. Rabbitt reported that appellant was doing well, but having difficulty 

descending stairs and building strength with weights. He stated that appellant was not achieving 

significant improvement in his right leg function and strength. Dr. Rabbitt found that appellant 

had excellent range of motion with no swelling. He reported that appellant was capable of 

straight leg raising and had good strength. Dr. Rabbitt noted that appellant exhibited quadriceps 

atrophy and crepitus with the patella with range of motion. He recommended further exercises 

and reexamination. 

OWCP requested on November 30, 2011 that appellant provide medical evidence that his 

condition had reached maximum medical improvement. It stated that it could take no action on 

his claim for a schedule award. 

Dr. Rabbitt completed a report on February 21, 2012 and diagnosed rupture of the 

quadriceps tendon. He found no swelling, instability, subluxation, or laxity with normal 

sensation. Dr. Rabbitt reported crepitus with normal strength and muscle tone. He noted that 

appellant’s right knee continued to buckle and give way while going down stairs. Dr. Rabbitt 

stated that appellant had reached maximum medical improvement. He examined appellant on 

September 7, 2012 and stated that appellant continued to report difficulty descending stairs as his 

quadriceps was not as strong as it was before the accident. Dr. Rabbitt repeated his previous 

findings on physical examination. 

Appellant again requested a schedule award on March 7, 2013. In a letter dated 

March 18, 2013, OWCP informed appellant that in order to establish his claim for permanent 

impairment he should submit medical evidence of maximum medical improvement, detailed 

findings on examination and an impairment rating in accordance with the sixth edition of the 
3

American Medical Association, Guides to the Evaluation of Permanent Impairment (A.M.A.,

Guides).2

By decision dated May 14, 2013, OWCP denied appellant’s claim for a schedule award 

as he failed to submit the necessary medical evidence to establish a permanent impairment in 

accordance with FECA. 

Appellant again requested a schedule award on May 14, 2013. In a letter dated May 20, 

2013, OWCP again informed him of the medical evidence necessary to establish his claim for a 

schedule award. It denied appellant’s request for a schedule award by decision dated 

July 31, 2013. Appellant requested an oral hearing from OWCP’s Branch of Hearings and 

Review on August 5, 2013. 

In a report dated November 6, 2013, Dr. Rabbitt diagnosed work-related quadriceps 

tendon rupture. He reported that he had performed surgery, but appellant continued to exhibit 

static mild weakness in the quadriceps on the right and patellofemoral crepitus following 

maximum medical improvement. Dr. Rabbitt noted that appellant demonstrated mild extension 

lag. He stated, “In regard to his disability rating, I am referencing the A.M.A., Guides sixth 

edition page 509.3 Using the ruptured tendon as well as the modifier for moderate problems, I 

would rate him as having a 20 percent partial permanent disability of his right lower extremity.” 

Appellant testified at the oral hearing on January 16, 2014. He stated that Dr. Rabbitt’s 

report should be sufficient to establish his schedule award claim. The hearing representative 

requested further information from Dr. Rabbitt regarding how he reached his impairment rating 

under the A.M.A., Guides. 

By decision dated April 3, 2014, OWCP hearing representative found that the case was 

not in posture for a decision and directed OWCP to refer Dr. Rabbitt’s report to a medical 

adviser to evaluate the evidence for schedule award purposes. 

In a report dated December 6, 2014, OWCP medical adviser noted that the table cited by 

Dr. Rabbitt did not provide for 20 percent impairment of the lower extremity due to a ruptured 

tendon and that the maximum impairment rating for this condition was 13 percent due to 

moderate motion deficits or significant weakness. He applied the A.M.A., Guides to 

Dr. Rabbitt’s findings on physical examination including static mild weakness in the quadriceps, 

patellofemoral crepitus, and mild weakness. OWCP medical adviser opined that appellant would 

fall in a class 1 category with a default impairment rating of two percent. He stated, 

“Impairments from 5 percent to 13 percent would include motion deficits which were not 

described in Dr. Rabbitt’s report.” OWCP medical adviser concluded that appellant had two 

percent impairment of the right lower extremity based on the medical evidence in the record and 

that he reached maximum medical improvement on January 1, 2012. 

 2 See 20 C.F.R. § 10.404. For impairment ratings calculated on and after May 1, 2009, OWCP should advise any 

physician evaluating permanent impairment to use the sixth edition. Federal (FECA) Procedure Manual, Part 2 -- 

Claims, Schedule Awards & Permanent Disability Claims, Chapter 2.808.5.a (February 2013). 

3

 A.M.A., Guides 509, Table 16-3 Knee Regional Grid. 
4

By decision dated March 19, 2015, OWCP granted appellant a schedule award for two 

percent permanent impairment of his right lower extremity. 

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 for 

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

specify the manner in which the percentage loss of a member shall be determined. The method 

used in making such determination is a matter which rests in the discretion of OWCP. For 

consistent results and to ensure equal justice, the Board has authorized the use of a single set of 

tables so that there may be uniform standards applicable to all claimants. OWCP evaluates the 

degree of permanent impairment according to the standards set forth in the specified edition of 

the A.M.A., Guides.

6

 

In addressing lower extremity impairments, the sixth edition of the A.M.A., Guides

requires identifying the impairment for the Class of Diagnosis (CDX) condition, which is then 

adjusted by grade modifiers based on Functional History (GMFH), Physical Examination 

(GMPE), and Clinical Studies (GMCS). The net adjustment formula is (GMFH - CDX) + 

(GMPE - CDX) + (GMCS - CDX).7

ANALYSIS 

The Board finds that appellant has no more than two percent permanent impairment of 

his right lower extremity for which he has received a schedule award. 

In support of his claim for a schedule award, appellant submitted a series of reports from 

Dr. Rabbitt. On August 24, 2010 Dr. Rabbitt reported that appellant’s right lower extremity 

demonstrated excellent range of motion. In a report dated February 21, 2012, he opined that 

appellant had reached maximum medical improvement with no swelling, instability, subluxation, 

or laxity, and with normal sensation in his right lower extremity. Dr. Rabbitt reported crepitus 

with normal strength and muscle tone. On November 6, 2013 he found that appellant continued 

to exhibit static mild weakness in the quadriceps on the right and patellofemoral crepitus 

following maximum medical improvement. Dr. Rabbitt noted that appellant demonstrated mild 

extension lag. He stated, “In regard to his disability rating, I am referring [to] the A.M.A., 

Guides sixth edition page 509.8

 Using the ruptured tendon as well as the modifier for moderate 

 4

 5 U.S.C. §§ 8101-8193, 8107. 

5

 20 C.F.R. § 10.404. 

6

 For new decisions issued after May 1, 2009 OWCP began using the sixth edition of the A.M.A., Guides. 

A.M.A., Guides, 6th ed. (2009); Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Award and 

Permanent Disability Claims, Chapter 2.808.5a (February 2013); see also Part 3 -- Medical, Schedule Awards, 

Chapter 3.700, Exhibit 1 (January 2010). 

7

 A.M.A., Guides 521. J.B., Docket No. 09-2191 (issued May 14, 2010). 

8 Id. at 509, Table 16-3 Knee Regional Grid. 
5

problems, I would rate him as having a 20 percent partial permanent disability of his right lower 

extremity.” 

OWCP medical adviser reviewed Dr. Rabbitt’s reports and applied the A.M.A., Guides

noting that Table 16-3, which was appropriately cited by Dr. Rabbitt, did not provide for 20 

percent impairment of the lower extremity due to a ruptured tendon.9

 Rather, this table provides 

a maximum impairment rating of 13 percent for a tendon rupture with moderate motion deficits 

or significant weakness. The medical adviser indicated that Dr. Rabbit found that appellant had 

static to mild weakness. Based on that description he placed appellant in the class 1 category 

giving him a two percent impairment rating. The Board finds that Dr. Rabbitt’s reports did not 

support physical findings of moderate motion deficits or significant weakness. Dr. Rabbitt stated 

that appellant had excellent range of motion and repeatedly stated that appellant had normal 

muscle tone with mild weakness. As his impairment rating did not comport with the A.M.A., 

Guides, OWCP properly relied on the findings and conclusions of its medical adviser. It is well 

established that, when the attending physician fails to provide an estimate of impairment 

conforming to the A.M.A., Guides, his or her opinion is of diminished probative value in 

establishing the degree of permanent impairment and OWCP may rely on the opinion of its 

medical adviser to apply the A.M.A., Guides to the findings of the attending physician.10 The 

Board finds, contrary to appellant’s argument on appeal, that the weight of the medical evidence 

in this case rests with OWCP medical adviser who properly applied the A.M.A., Guides to 

Dr. Rabbitt’s physical findings and reached an impairment rating of two percent of the right 

lower extremity. 

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 no more than two percent permanent impairment of 

his right lower extremity for which he received a schedule award. 

 9 Id.

10 Linda Beale, 57 ECAB 429 (2006). 
6

ORDER 

IT IS HEREBY ORDERED THAT the March 19, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: September 3, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board