United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.D., Appellant 

and 

DEPARTMENT OF VETERANS AFFAIRS, 

BAY PINES VETERANS MEDICAL CENTER, 

Bay Pines, FL, Employer 

__________________________________________ 

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Docket No. 16-0475 

Issued: July 14, 2016 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On January 13, 2016 appellant filed a timely appeal from an October 21, 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. 

ISSUE 

The issue is whether appellant established more than three percent permanent impairment 

of the right leg for which she received a schedule award. 

On appeal appellant asserts that her physician was not notified that the sixth edition of the 

American Medical Association, Guides to the Evaluation of Permanent Impairment (hereinafter 

A.M.A., Guides)

2

 was to be used in rating impairment, and requests a left upper extremity 

 1

 5 U.S.C. § 8101 et seq. 

2

 A.M.A., Guides (6th ed. 2009). 
2

impairment. She further asserts that OWCP did not contact her prior physician regarding her 

right knee impairment and improperly based its impairment rating on OWCP’s medical adviser’s 

opinion. 

FACTUAL HISTORY 

On September 19, 2013 appellant, then a 53-year-old sign language interpreter, filed a 

traumatic injury claim (Form CA-1) alleging that she fell in the parking lot at work and injured 

her knees and left upper extremity. She did not stop work, and in October 2013 transferred to a 

position as an Equal Employment Opportunity (EEO) assistant. 

 Dr. Jeff Sellman, Board-certified in family and sports medicine, began treating appellant 

on September 23, 2013. He noted a history that she previously had right elbow, right wrist/hand, 

left shoulder, left foot/ankle arthroscopy, and a right hand fracture repair. Dr. Sellman diagnosed 

left elbow sprain/strain, right knee bursitis and pain, contusion of knee, and wrist sprain. 

On October 11, 2013 OWCP accepted the conditions of sprains of left wrist and elbow, 

contusion of left knee, and bursitis of the right knee. 

On December 5, 2013 Dr. Grant Garlick, a Board-certified orthopedic surgeon, began 

treating appellant’s right knee. He reported September 17, 2013 magnetic resonance imaging 

(MRI) scan findings of a full thickness patellar defect.3

 Dr. Garlick diagnosed right knee 

patellofemoral degenerative joint disease and acute on chronic injury. He recommended 

arthroscopic surgery and advised that appellant could return to her usual job with regard to her 

right knee only. 

On December 8, 2013 Dr. Garlick performed arthroscopic abrasion arthroplasty on the 

right knee. He noted preoperative and postoperative diagnoses of right knee chondromalacia 

patella. Appellant returned to part-time work on January 13, 2014. On January 16, 2014 

Dr. Garlick provided work restrictions with regard to the right knee and advised that they would 

apply for four to eight weeks. Appellant returned to full-time work as a telecommuter on 

January 17, 2014 and to work at the employing establishment on February 14, 2014. 

On March 5, 2014 OWCP informed appellant that left carpal tunnel syndrome and left 

ulnar nerve lesion had been accepted. 

Dr. Garlick provided follow-up right knee care. On April 17, 2014 he reported that three 

months following arthroscopic surgery, appellant had no complaints of pain and denied 

instability or recurrent effusions. Examination of the right knee demonstrated 0 to 130 degrees 

of range of motion, mild patellofemoral crepitation, and no patellofemoral grind. Appellant was 

nontender to palpation in the peripatellar region and about the medial and lateral menisci. 

Neither varus nor valgus laxity were present and the anterior and posterior drawer were negative. 

Dr. Garlick advised that appellant could perform her usual job without restrictions regarding her 

right knee. 

 3

 A copy of the MRI scan report is not found in the case record. 
3

In October 2014 appellant moved from Florida to South Carolina and transferred to a 

Veterans Administration facility there. 

On July 15, 2015 appellant filed a claim for a schedule award (Form CA-7). 

On August 20, 2015 Dr. James W. Dyer, a Board-certified orthopedic surgeon and 

OWCP medical adviser, reviewed the record and advised that maximum medical improvement 

was reached on April 16, 2015. Regarding the right lower extremity, he advised that, in 

accordance with Table 16-3, Knee Regional Grid, appellant had a class 1 impairment for a 

diagnosis of patellofemoral arthritis, which had a default value of three percent.4

 

By decision dated October 21, 2015, appellant was granted a schedule award for three 

percent permanent impairment of the right leg, for 8.64 weeks of compensation, to run from 

May 16 to June 15, 2015.5

 

LEGAL PRECEDENT 

It is the claimant’s burden to establish a permanent impairment of a scheduled member or 

function as a result of any employment injury.6

 

The schedule award provision of FECA7

 and its implementing federal regulations,8 set 

forth the number of weeks of compensation payable to employees sustaining permanent 

impairment from loss, or loss of use, of scheduled members or functions of the body. However, 

FECA does not specify the manner in which the percentage of loss shall be determined. For 

consistent results and to ensure equal justice under the law for all claimants, OWCP has adopted 

the A.M.A., Guides as the uniform standard applicable to all claimants.9 For decisions issued 

after May 1, 2009, the sixth edition of the A.M.A., Guides is used to calculate schedule awards.10

The sixth edition of the A.M.A., Guides provides a diagnosis-based method of evaluation 

utilizing the World Health Organization’s International Classification of Functioning, Disability 

 4

 The record also includes medical evidence and OWCP development regarding appellant’s left upper extremity, 

not at issue in the current appeal. See infra, note 21. 

5

 The Board notes that from the date of injury and for absences around her surgical procedures, appellant received 

compensation for medical and therapy appointments. The last wage-loss compensation received was for two hours 

on June 26, 2014. 

6 See Tammy L. Meehan, 53 ECAB 229 (2001). 

7

 5 U.S.C. § 8107. 

8

 20 C.F.R. § 10.404. 

9 Id. at § 10.404(a). 

10 Federal (FECA) Procedure Manual, Part 3 -- Medical, Schedule Awards, Chapter 3.700, Exhibit 1 

(January 2010); see also Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, Chapter 2.808.5a 

(February 2013). 
4

and Health (ICF).11 Under the sixth edition, for lower extremity impairments the evaluator 

identifies the impairment class for the diagnosed condition (CDX), which is then adjusted by 

grade modifiers based on Functional History (GMFH), Physical Examination (GMPE), and 

Clinical Studies (GMCS).12 The net adjustment formula is (GMFH - CDX) + (GMPE - CDX) + 

(GMCS - CDX).13 Under Chapter 2.3, evaluators are directed to provide reasons for their 

impairment rating choices, including choices of diagnoses from regional grids and calculations 

of modifier scores.14 Section 16.2a of the A.M.A., Guides, provides that if the class selected is 

defined by physical examination findings or clinical studies results, these same findings may not 

be used as grade modifiers to adjust the rating.15

OWCP procedures provide that, after obtaining all necessary medical evidence, the file 

should be routed to OWCP’s medical adviser for an opinion concerning the nature and 

percentage of impairment in accordance with the A.M.A., Guides, with OWCP’s medical adviser 

providing rationale for the percentage of impairment specified.16

ANALYSIS 

The Board finds that appellant has not established permanent impairment greater than 

three percent for the right leg, for which she received a schedule award. OWCP accepted right 

knee bursitis. 

On December 8, 2013 Dr. Garlick performed arthroscopic abrasion arthroplasty for 

preoperative and postoperative diagnoses of right knee chondromalacia patella. In an April 17, 

2014 report, he reported that appellant had no complaints of pain and denied instability or 

recurrent effusions. Dr. Garlick noted no positive physical examination findings and advised 

that appellant was not tender to palpation, had no varus or valgus laxity, and that anterior and 

posterior drawer signs were negative. He concluded that appellant could perform her usual job 

without restrictions regarding her right knee. 

After appellant claimed a schedule award, Dr. Dyer, OWCP’s medical adviser, reviewed 

the medical record including Dr. Garlick’s reports. He advised that maximum medical 

improvement had been reached on April 16, 2015. Regarding the right lower extremity, 

OWCP’s medical adviser indicated that, in accordance with Table 16-3, Knee Regional Grid, 

appellant had a class 1 impairment for a diagnosis of patellofemoral arthritis, which had a default 

value of three percent. This is the only medical report of record that provides an impairment 

 11 A.M.A., Guides, supra note 2 at 4, section 1.3, “The International Classification of Functioning, Disability and 

Health (ICF): A Contemporary Model of Disablement.” 

12 Id. at 494-531. 

13 Id. at 521. 

14 Id. at 23-28. 

15 Id. at 500. 

16 See Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, 

Chapter 2.808.6(f) (February 2013). 
5

evaluation of appellant’s right leg under the A.M.A., Guides. The Board finds that OWCP 

properly found three percent permanent impairment of the right lower extremity. 

As to appellant’s assertion on appeal that OWCP did not contact Dr. Garlick regarding 

her right knee impairment and improperly based its impairment rating on OWCP’s medical 

adviser, as noted above, appellant has the burden of proof to establish that she sustained a 

permanent impairment of a scheduled member or function as a result of any employment 

injury.17 Moreover, OWCP procedures provide that, after obtaining all necessary medical 

evidence, the file should be routed to OWCP’s medical adviser for an opinion concerning the 

nature and extent of impairment in accordance with the A.M.A., Guides, with OWCP’s medical 

adviser providing rationale for the percentage of impairment specified.18 Dr. Dyer did so in this 

case. There is no probative medical evidence establishing a greater degree of impairment.19 

On appeal appellant also requested a left upper extremity schedule award. The accepted 

conditions include left wrist, elbow, and forearm sprains; left carpal tunnel syndrome; and left 

ulnar nerve lesion. Although the record contains evidence regarding appellant’s left upper 

extremity,20 the October 21, 2015 OWCP schedule award decision does not include a finding 

regarding appellant’s left arm. Also, on October 2, 2015 appellant requested that OWCP expand 

her claim to include additional conditions. The record before the Board does not include a final 

OWCP decision on this issue either. The Board’s jurisdiction is limited to reviewing final 

decisions of OWCP.21 

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 failed to establish more than three percent permanent 

impairment of the right leg for which she received a schedule award. 

 17 See Tammy L. Meehan, supra note 5. 

18 See Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, 

Chapter 2.808.6(f) (February 2013). 

19 See M.P., Docket No. 15-383 (issued July 1, 2015). 

20 Supra note 4. 

21 20 C.F.R. § 501.2(c); see J.B., Docket No. 09-2191 (issued May 14, 2010). 
6

ORDER 

IT IS HEREBY ORDERED THAT the October 21, 2015 decision of the Office of 

Workers’ Compensation is affirmed. 

Issued: July 14, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board