United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

A.G., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Eagleville, PA, Employer 

__________________________________________ 

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Docket No. 16-0522 

Issued: May 26, 2016 

Appearances: Case Submitted on the Record

Thomas R. Uliase, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On January 27, 2016 appellant, through counsel, filed a timely appeal from an 

October 27, 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 over the merits of this case. 

ISSUES 

The issues are: (1) whether OWCP properly terminated appellant’s wage-loss 

compensation and medical benefits effective June 10, 2015; and (2) whether appellant 

established that he had work-related disability or need for medical treatment after June 10, 2015. 

FACTUAL HISTORY 

On May 28, 2014 appellant, then a 56-year-old letter carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on May 27, 2014 he sustained injury when he twisted his left 

 1

 5 U.S.C. § 8101 et seq. 
2

knee and fell while performing his work duties, and landed on his right knee. OWCP accepted 

appellant’s claim for tear of the posterior horn of the medial meniscus of his left knee. Appellant 

received disability compensation on the daily roll beginning July 12, 2014.2

In a May 28, 2014 report, Dr. David C. Raab, an attending osteopath and Board-certified 

orthopedic surgeon, indicated that appellant was last seen on May 16, 2014. He reported 

physical examination findings and provided new diagnoses of “contusion of knee & lower leg.” 

Bilateral knee x-rays from June 3, 2014 showed “mild bi-compartmental joint space narrowing” 

of both knees and a June 27, 2014 magnetic resonance imaging (MRI) scan of the left knee 

revealed medial meniscal tear, moderate-to-severe medial degenerative joint disease, and mildto-moderate chondromalacia patella. A June 27, 2014 MRI scan of the right knee showed “no 

evidence of meniscal, ligamentous, or tendinous injury,” but did show moderate-to-severe 

patellofemoral articulation, degenerative joint disease, and minimal medial degenerative joint 

disease. 

On a July 23, 2014 prescription pad note, Dr. Raab ordered physical therapy, noting a 

diagnosis of “[right] knee exacerbation [degenerative joint disease]/contusion.” Later notes of 

Dr. Raab showed that he diagnosed “exacerbation of [degenerative joint disease].” On 

August 19, 2014 Dr. Raab performed OWCP-authorized left knee surgery, including partial 

medial and partial lateral meniscectomy. Appellant returned to full-time light duty on 

December 15, 2014. On February 3, 2015 Dr. Raab indicated, “Discussed with patient the need 

for total knee replacement due to continued pain from arthritis.” 

In March 2015, OWCP referred appellant to Dr. Steven J. Valentino, an osteopath and 

Board-certified orthopedic surgeon, for a second opinion examination and opinion regarding his 

work-related residuals. A September 26, 2002 MRI scan of appellant’s left knee was part of the 

medical record provided to Dr. Valentino. The findings showed equivocal tear of the medial 

meniscus, small joint effusion, and a very small Baker’s cyst. The October 14, 2002 report of 

appellant’s right knee surgery was also part of the record provided to Dr. Valentino. An 

August 4, 2003 note from an attending physician revealed the presence of mild degenerative 

joint disease of his right knee at that time. 

In a March 31, 2015 report, Dr. Valentino discussed appellant’s factual and medical 

history, including his work-related injuries in 2001 and 2014. He noted that appellant underwent 

surgical arthroscopy of the right knee on October 14, 2002 and surgical arthroscopy of the left 

knee on August 19, 2014 and reported that he had reviewed the reports of these surgical 

procedures. Dr. Valentino also discussed the diagnostic testing of record, dated between 2002 

and 2014, for both legs. He described his physical examination on March 31, 2015, including 

the results of gait, squat, and lower extremity range of motion evaluations. Dr. Valentino noted 

that appellant stood 5’5” and weighed 240 pounds, demonstrated a normal reciprocal gait 

pattern, and was able to perform half a squat complaining of bilateral knee pain. Examination of 

the lower extremities showed full range of motion in both hips, ankles, and feet, and bilateral 

 2

 OWCP previously accepted under a separate file that on August 18, 2001 appellant sustained a medial meniscus 

tear of his right knee. On October 14, 2002 appellant underwent OWCP-authorized subtotal medial meniscectomy 

and patellar chondroplasty surgery on his right knee. He later returned to regular duty for the employing 

establishment. 
3

knee range of motion was recorded from 0 to 95 degrees. Dr. Valentino noted that 

patellofemoral compression and inhibition tests were negative, and that there was no evidence of 

synovitis or effusion. The neurologic examination revealed that deep tendon reflexes were intact 

and motor and sensory examinations were normal without pathologic reflexes. Dr. Valentino 

diagnosed resolved derangement of the posterior horn of the left medial meniscus and resolved 

right knee contusion. He found that appellant continued with ongoing symptoms secondary to 

preexisting degenerative arthritis of both knees instead of the 2001 or 2014 work injury. The 

need for a knee replacement was not a result of a work injury but rather was related to a chronic 

history of degenerative arthritis aggravated by his body habitus of being 5’5” and weighing 240 

pounds. Dr. Valentino indicated, “Currently he has no residuals from the work-related injury of 

[May 27, 2014] but due to preexisting degenerative arthritis and possible need for knee 

replacement related to preexisting degenerative arthritis, he should be kept at a light-duty 

position. However, I find no restrictions that would be referable to residuals of his work-related 

injury.”3

In an April 16, 2015 letter, OWCP advised appellant of its proposed termination of his 

wage-loss compensation and medical benefits, noting that the proposed action was justified by 

the well-rationalized opinion of Dr. Valentino, the OWCP referral physician. It afforded 

appellant 30 days to provide evidence and argument challenging the proposed termination action. 

In an April 23, 2015 letter, appellant’s counsel argued that appellant’s continuing lower 

extremity problems were due to his accepted 2001 and 2014 work injuries. Appellant submitted 

an April 14, 2015 report in which Dr. Raab diagnosed “exacerbation of [degenerative joint 

disease]” and indicated that he had discussed with patient “the need for total knee replacement 

due to continued pain from arthritis.” 

In a May 8, 2015 report, Dr. Raab described appellant’s May 27, 2014 injury and 

indicated that his clinical symptoms upon initial examination after that injury were consistent 

with the diagnosis of exacerbation of degenerative joint disease and a medial meniscal tear in his 

left knee. He detailed appellant’s medical treatment and indicated: 

“With a reasonable degree of medical certainty [appellant] sustained a medial 

meniscus tear of his left knee and exacerbation of degenerative joint disease of 

both knees as a result of his work[-]related injury that occurred on [May 27, 

2014]. As a result of left knee arthroscopy, [appellant’s] clicking and popping 

symptoms related to his meniscus tear have resolved. Despite physical therapy, 

modification of daily activities, modified work duties, [nonsteroidal antiinflammatory drugs], narcotics, and visco-supplementation (Orthovisc), 

[appellant] continues to experience symptoms related to the exacerbation of 

degenerative joint disease. Bilateral total knee arthroplasty will provide relief of 

his symptoms, improve his ability to perform activities of daily living, and 

improve his work tolerance.” 

 3

 Dr. Valentino completed a work restrictions form on March 31, 2015, but indicated that the restrictions were 

due to preexisting bilateral knee degenerative joint disease and were not related to the May 27, 2014 work injury. 
4

In a decision dated June 10, 2015, OWCP terminated appellant’s wage-loss compensation 

and medical benefits effective June 10, 2015 based on the opinion of Dr. Valentino. It found that 

appellant’s ongoing medical condition was related to the natural progression of a preexisting 

degenerative condition, rather than the 2001 or 2014 work injury. OWCP indicated that 

Dr. Raab did not provide medical rationale in support of his opinion on causal relationship. 

Appellant submitted a May 26, 2015 report in which Dr. Raab diagnosed “exacerbation 

of [degenerative joint disease]” and indicated, “Discussed with patient the need for total knee 

replacement due to continued pain from arthritis.” 

Appellant requested a hearing with an OWCP hearing representative. During the hearing 

held on September 14, 2015, appellant testified that he felt that Dr. Valentino’s evaluation was 

inadequate as “he didn’t look at nothing (sic).” Appellant’s counsel indicated that the statement 

of accepted facts did not mention the October 14, 2002 meniscectomy and chondroplasty. 

Counsel argued that Dr. Valentino misstated the dates of appellant’s early surgeries. He argued 

that Dr. Valentino only mentioned the 2002 and not the 2001 right knee surgeries. As such this 

was a “glaring deficiency in his report.” 

By decision dated October 27, 2015, the OWCP hearing representative affirmed OWCP’s 

June 10, 2015 decision. She found that OWCP’s termination of appellant’s wage-loss 

compensation and medical benefits was justified and that appellant had not shown entitlement to 

compensation after June 10, 2015. 

LEGAL PRECEDENT -- ISSUE 1 

Once OWCP has accepted a claim, it has the burden of proof to justify termination or 

modification of compensation benefits.4 OWCP may not terminate compensation without 

establishing that the disability ceased or that it was no longer related to the employment.5

ANALYSIS -- ISSUE 1 

OWCP accepted that on August 18, 2001 appellant sustained a medial meniscus tear of 

his right knee. On October 14, 2002 appellant underwent OWCP-authorized subtotal medial 

meniscectomy and patellar chondroplasty surgery on his right knee. OWCP also accepted that 

on May 27, 2014 he sustained a tear of the posterior horn of the medial meniscus of his left knee. 

On August 19, 2014 appellant underwent OWCP-authorized left knee surgery, including partial 

medial and partial lateral meniscectomy. 

In a decision dated June 10, 2015, OWCP terminated appellant’s wage-loss compensation 

and medical benefits effective June 10, 2015 based on the March 31, 2015 opinion of 

Dr. Valentino, an osteopath and Board-certified orthopedic surgeon serving as an OWCP referral 

physician. On October 27, 2015 an OWCP hearing representative affirmed the June 10, 2015 

decision. 

 4 Charles E. Minniss, 40 ECAB 708, 716 (1989); Vivien L. Minor, 37 ECAB 541, 546 (1986). 

5 Id.
5

The Board finds that OWCP properly terminated appellant’s wage-loss compensation and 

medical benefits effective June 10, 2015 based on the March 31, 2015 opinion of Dr. Valentino. 

In his March 31, 2015 report, Dr. Valentino discussed appellant’s factual and medical history, 

including both his work-related injuries of 2001 and 2014. He noted that appellant underwent 

surgical arthroscopy of the right knee on October 14, 2002 and surgical arthroscopy of the left 

knee on August 19, 2014 and reported that he had reviewed the reports of these surgical 

procedures. Dr. Valentino also discussed the diagnostic testing of record, dated between 2002 

and 2014, for both lower extremities. He described his physical examination on March 31, 2015, 

including the results of gait, squat, and lower extremity range of motion evaluations. 

Dr. Valentino diagnosed resolved derangement of the posterior horn of the left medial meniscus 

and resolved right knee contusion, and found that appellant continued with ongoing symptoms 

secondary to preexisting degenerative arthritis of both knees instead of the 2001 or 2014 work 

injury. The need for a knee replacement was not a result of his work injury of May 27, 2014, but 

rather was related to a chronic history of degenerative arthritis aggravated by his body habitus of 

being 5’5” and weighing 240 pounds. Dr. Valentino indicated that appellant had no residuals of 

his work injuries but rather his continuing problems and possible need for knee replacement were 

related to preexisting degenerative arthritis. Appellant needed to work in a light-duty position, 

but any work restrictions were not due to a work-related injury.”6

The Board has carefully reviewed the opinion of Dr. Valentino and notes that it has 

reliability, probative value, and convincing quality with respect to its conclusion that appellant 

ceased to have residuals of his 2001 and 2014 injuries by June 10, 2015. Dr. Valentino’s opinion 

provided a thorough factual and medical history and accurately summarized the relevant medical 

evidence. Moreover, he provided a proper analysis of the factual and medical history and the 

findings on examination, including the results of diagnostic testing, and reached conclusions 

regarding appellant’s condition which comported with this analysis.7

 Dr. Valentino provided 

medical rationale for his opinion by explaining that appellant’s continuing problems were due to 

his underlying degenerative condition. 

On appeal, appellant’s counsel argues that Dr. Valentino did not have adequate medical 

records regarding appellant’s medical treatment after suffering the August 18, 2001 work injury 

to render a reasoned opinion. However, the Board finds that Dr. Valentino had adequate 

documents regarding this injury. The October 14, 2002 report for appellant’s right knee surgery 

and other relevant documents were part of the record, a fact confirmed by Dr. Valentino’s 

explicit reference to them in his March 31, 2015 evaluation.8

 

Further, counsel also argued that the reports of Dr. Raab, an attending osteopath and 

Board-certified orthopedic surgeon, showed that appellant still had residuals of his 2001 or 2014 

work injuries at the time of the June 10, 2015 termination action. However, none of Dr. Raab’s 

 6

 Dr. Valentino completed a work restrictions form on March 31, 2015 but indicated that the restrictions were due 

to preexisting bilateral knee degenerative joint disease and were not related to a work injury. 

7 See Melvina Jackson, 38 ECAB 443, 449-50 (1987); Naomi Lilly, 10 ECAB 560, 573 (1957). 

8

 Despite counsel’s assertion at the hearing, Dr. Valentino properly indicated that the surgery occurred on 

October 14, 2002. The statement of accepted facts did not mention the October 14, 2002 surgery, but as noted, 

Dr. Valentino was provided a copy of the surgical report. 
6

reports contains a rationalized opinion that appellant had such work-related residuals at that time. 

In a May 8, 2015 report, Dr. Raab described appellant’s May 27, 2014 work injury and indicated 

that his clinical symptoms upon initial examination after that injury were consistent with the 

diagnosis of exacerbation of degenerative joint disease and a medial meniscal tear in his left 

knee. He noted that appellant continued to have work-related residuals and that, “with a 

reasonable degree of medical certainty, [appellant] sustained a medial meniscus tear of his left 

knee and exacerbation of degenerative joint disease of both knees as a result of his work-related 

injury that occurred on [May 27, 2014].” However, this report is of limited probative value 

regarding work-related residuals because Dr. Raab did not explain what particular findings 

showed a work-related aggravation of appellant’s underlying degenerative condition and 

appellant’s claim has not been accepted for such a condition. The Board has held that a medical 

report is of limited probative value on the issue of causal relationship if it contains a conclusion 

regarding causal relationship which is unsupported by medical rationale.9

For these reasons, the medical evidence does not show that appellant had continuing 

residuals of his 2001 or 2014 work injuries and OWCP properly terminated his wage-loss 

compensation and medical benefits effective June 10, 2015. 

LEGAL PRECEDENT -- ISSUE 2 

 After termination or modification of compensation benefits, clearly warranted on the 

basis of the evidence, the burden for reinstating compensation benefits shifts to appellant. In 

order to prevail, appellant must establish by the weight of the reliable, probative and substantial 

evidence that he or she had an employment-related disability which continued after termination 

of compensation benefits.10

ANALYSIS -- ISSUE 2 

 After OWCP’s June 10, 2015 decision terminating appellant’s wage-loss compensation 

and medical benefits effective June 10, 2015, appellant submitted additional medical evidence 

which he felt showed that he was entitled to compensation after June 10, 2015 due to residuals of 

his 2001 and 2014 work injuries. Given that the Board has found that OWCP properly relied on 

the opinion of the OWCP referral physician, Dr. Valentino, in terminating appellant’s 

compensation effective June 10, 2015, the burden shifts to appellant to establish that he is 

entitled to compensation after that date. 

The Board has reviewed the additional evidence submitted by appellant and notes that it 

is not of sufficient probative value to establish that he had residuals of his 2001 and 2014 work 

injuries after June 10, 2015. Appellant submitted a May 26, 2015 report in which Dr. Raab 

diagnosed “exacerbation of [degenerative joint disease]” and indicated that he had discussed with 

patient “the need for total knee replacement due to continued pain from arthritis.” However, the 

submission of this report does not establish appellant’s claim that he had residuals of his 2001 

 9 C.M., Docket No. 14-88 (issued April 18, 2014). 

10 Wentworth M. Murray, 7 ECAB 570, 572 (1955). 
7

and 2014 work injuries after June 10, 2015 because the report does not contain an opinion on this 

matter. Appellant did not submit a rationalized medical report showing that he had work-related 

disability or need for medical treatment after June 10, 2015. 

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 OWCP properly terminated appellant’s wage-loss compensation and 

medical benefits effective June 10, 2015. The Board further finds that appellant did not establish 

that he had work-related disability or need for medical treatment after June 10, 2015. 

ORDER 

IT IS HEREBY ORDERED THAT the October 27, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: May 26, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board