United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

R.I., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Lincolnton, NC, Employer 

__________________________________________ 

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Docket No. 17-0920 

Issued: July 21, 2017 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On March 21, 2017 appellant filed a timely appeal from a March 9, 2017 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 met his burden of proof to establish more than 21 

percent permanent impairment of the left leg, for which he previously received a schedule award. 

On appeal appellant contends that he is entitled to 40 percent permanent impairment. He 

notes that, according to his physician, his surgery was a success as he can walk with no pain 

although he cannot do anything else due to his physical limitations. 

 

 1 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

OWCP accepted that on May 5, 2012 appellant, then a 57-year-old city carrier, sustained 

a sprain of other specified sites of the left knee and leg (gastroc strain), tear of the medial 

meniscus of the left knee, and localized unspecified osteoarthritis of the left lower leg when he 

turned around to leave the parcel room from which he had retrieved a gurney. Appellant stopped 

work on May 7, 2012. On November 7, 2012 he underwent authorized left knee arthroscopy to 

repair his medial and lateral meniscus tears. Appellant later underwent authorized total left knee 

arthroplasty performed on June 10, 2014 by Dr. Jason Norcross, an attending Board-certified 

orthopedic surgeon, to treat his advanced left knee osteoarthritis. He returned to full-time, fullduty work as a city carrier on October 6, 2014. By letter dated November 12, 2014, OWCP 

informed appellant that, as his actual wages as city carrier met or exceeded the wages of the 

position held when injured, his wage-loss compensation payments would be terminated, effective 

October 6, 2014. It noted that this decision did not affect coverage of his medical benefits. 

On June 10, 2016 appellant filed a claim for a schedule award (Form CA-7). 

In a June 10, 2016 medical report, Dr. Norcross noted that appellant presented for a 

follow up of his total left knee arthroscopy. Appellant related that his preoperative pain had been 

relieved and his quality of life had improved, yet he noticed limitations with kneeling and stairs. 

He also related that on occasion his knee felt unstable. Appellant noticed pain while using the 

brakes in a vehicle. Dr. Norcross provided findings on physical and x-ray examination of the left 

lower extremity. He found appellant status post June 10, 2014 left total knee arthroscopy and 

determined that appellant had 40 percent permanent impairment due to his left knee arthroscopy. 

By letter dated June 23, 2016, OWCP advised appellant of the deficiencies of his claim 

and requested a medical report from his physician basing any permanent impairment 

determination on the sixth edition of the American Medical Association, Guides to the 

Evaluation of Permanent Impairment (2009) (hereinafter A.M.A., Guides) and establishing the 

date that he had reached maximum medical improvement (MMI). Appellant was afforded 30 

days to submit the requested information. He did not respond. 

On February 16, 2017 an OWCP district medical adviser (DMA) reviewed a statement of 

accepted facts and the medical record, including Dr. Norcross’s June 10, 2016 report. He 

determined that appellant had 21 percent permanent impairment of the left leg under the sixth 

edition of A.M.A., Guides and had reached MMI on June 10, 2016, the date of Dr. Norcross’ 

evaluation. The DMA noted that he was not sure what class Dr. Norcross chose and what 

nonkey modifiers were assigned. In addition, he related that he was not sure whether 

Dr. Norcross used the sixth edition of A.M.A., Guides. The DMA used the accepted diagnosis of 

local unspecified osteoarthritis of the left leg to rate appellant’s permanent impairment. Utilizing 

Table 16-3, Knee Regional Grid - Lower Extremity Impairments, page 511, he determined that 

appellant had a class 2 impairment for total knee arthroplasty with a default value of 25 for a 

good result (good position, stable, functional). The DMA assigned a grade modifier 1 for 

functional history (GMFH) under Table 16-6, page 516 based on no antalgic gait and limitation 

with kneeling and stairs. He reported a grade modifier 0 for physical examination (GMPE) 

under Table 16-7, page 517 based on full range of motion, stability, and no tenderness. The 

DMA advised that a grade modifier for clinical studies (GMCS) was not used as the knee x-ray 
3

showed anatomic alignment of total knee prosthesis. He then used the net adjustment formula 

and calculated a net adjustment of -3, which, under Table 16-3, moved the default grade two 

spots to the left to grade A for 21 percent permanent impairment of the left lower extremity. 

By letter dated February 23, 2017, OWCP provided Dr. Norcross a copy of the DMA’s 

February 16, 2017 report and requested that he provide comments on the DMA’s impairment 

rating. 

In a February 10, 2017 letter, received on February 23, 2017, Dr. Norcross indicated that 

appellant had reached MMI on June 10, 2016, the date of his evaluation. He reiterated his prior 

opinion that appellant had 40 percent permanent impairment of the left leg. Dr. Norcross 

maintained that appellant’s left total knee replacement justified his impairment rating. He noted 

his objective finding of left knee ROM from 0 to 130 degrees, but noted that appellant still had 

minor pain and occasional instability. Dr. Norcross further noted his subjective complaint of 

pain while braking a vehicle. He indicated that appellant had a well-functioning total knee 

arthroplasty prosthesis with near normal range of motion, but concluded that a total knee 

arthroplasty qualified for 40 percent impairment based on section 2 of the North Carolina 

Industrial Commission Rating Guide. 

By decision dated March 9, 2017, OWCP granted appellant a schedule award for 21 

percent permanent impairment of the left leg. The date of MMI was noted as June 10, 2016. 

The award covered a period of 60.48 weeks, from June 10, 2016 to August 7, 2017. The award 

was based on the DMA’s February 16, 2017 impairment rating. 

LEGAL PRECEDENT 

The schedule award provision of FECA2

 and its implementing federal regulations3 set 

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

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

FECA, however, does not specify the manner by which the percentage loss of a member, 

function, or organ shall be determined. To ensure consistent results and equal justice for all 

claimants under the law, good administrative practice requires the use of uniform standards 

applicable to all claimants.4

 The A.M.A., Guides has been adopted by the implementing 

regulations as the appropriate standard for evaluating schedule losses.5 As of May 1, 2009, 

schedule awards are determined in accordance with the sixth edition of the A.M.A., Guides

(2009).6

 The Board has approved the use by OWCP of the A.M.A., Guides for the purpose of 

determining the percentage loss of use of a member of the body for schedule award purposes.7

 It 

 2

 5 U.S.C. § 8107. 

3

 20 C.F.R. § 10.404. 

4 Ausbon N. Johnson, 50 ECAB 304, 311 (1999). 

5 Id. 

6

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

Chapter 2.808.5a (February 2013); Part 3 -- Medical, Schedule Awards, Chapter 3.700, Exhibit 1 (January 2010). 

7 Isidoro Rivera, 12 ECAB 348 (1961). 
4

is well established that in determining the amount of a schedule award for a member of the body 

that sustained an employment-related permanent impairment, preexisting impairments are to be 

included.8

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 

and Health (ICF).9

 Under the sixth edition, the evaluator identifies the impairment class for the 

Class of Diagnosis (CDX), which is then adjusted by grade modifiers based on Functional 

History (GMFH), Physical Examination (GMPE) and Clinical Studies (GMCS).10 The net 

adjustment formula is (GMFH - CDX) + (GMPE - CDX) + (GMCS - CDX).11 

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

should be routed to an OWCP DMA for an opinion concerning the nature and percentage of 

impairment in accordance with the A.M.A., Guides, with the DMA providing rationale for the 

percentage of impairment specified.12

ANALYSIS 

The Board finds that appellant has not met his burden of proof to establish more than 21 

percent permanent impairment of the left leg. OWCP accepted appellant’s claim for sprain of 

other specified sites of the left knee and leg (gastroc strain), tear of the medial meniscus of the 

left knee, and localized unspecified osteoarthritis of the left lower leg. It authorized left total 

knee arthroplasty performed on June 10, 2014 to treat the accepted left lower leg osteoarthritis 

condition. OWCP granted appellant a schedule award for 21 percent permanent impairment of 

his left leg. 

The Board finds that the June 10, 2016 and February 23, 2017 opinions of Dr. Norcross, 

appellant’s treating physician, that appellant had 40 percent permanent impairment of his left leg 

due to the authorized June 10, 2014 left total knee arthroplasty, are of diminished value. 

Dr. Norcross based his impairment rating on the North Carolina Industrial Commission Rating 

Guide. The Board finds that Dr. Norcross’ report fails to address permanent impairment under 

the standards applicable to FECA. The Board has found that, when an attending physician fails 

to provide a rating that conforms to the A.M.A., Guides, his or her opinion is of diminished 

probative value in establishing the degree of permanent impairment.13 As such, the Board finds 

 8 See Dale B. Larson, 41 ECAB 481, 490 (1990); supra note 6 at Part 3 -- Medical, Schedule Awards, Chapter 

3.700.3.a.3 (January 2010). This portion of OWCP procedures provides that the impairment rating of a given 

scheduled member should include any preexisting permanent impairment of the same member or function. 

9

 A.M.A., Guides (6th ed. 2009), page 3, section 1.3, The International Classification of Functioning, Disability 

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

10 Id. at 494-531. 

11 Id. at 521. 

12 See Federal (FECA) Procedure Manual, supra note 6 at Chapter 2.808.6(f) (February 2013). 

13 M.P., Docket No. 13-1225 (issued October 23, 2013); Linda Beale, 57 ECAB 429, 434 (2006). See also James 

Kennedy, Jr., 40 ECAB 620, 627 (1989). 
5

that Dr. Norcross’ opinion is of limited probative value regarding appellant’s left leg impairment 

under FECA. 

OWCP’s DMA reviewed Dr. Norcross’ findings and noted that he was unable to 

determine the class of impairment and nonkey modifiers assigned by the physician. He was also 

uncertain as to whether Dr. Norcross had used the sixth edition of the A.M.A., Guides. The 

DMA chose to rate appellant’s diagnosis-based impairment based on appellant’s accepted 

localized unspecified osteoarthritis of the left leg condition. Based on Dr. Norcross’ findings, he 

utilized Table 16-3, page 511 and found that appellant had a class 2 impairment for total knee 

arthroplasty with a default value of 25 percent impairment for a good result-good position, 

stable, functional. The DMA assessed a grade modifier 1 for GMFH under Table 16-6, page 516 

because appellant had no antalgic gait and a limitation with kneeling and stairs. He assessed a 

grade modifier 0 for GMPE under Table 16-7, page 517 based on full ROM, stability, and no 

tenderness. The DMA advised that a grade modifier for GMCS was not applicable as the knee xray showed anatomic alignment of total knee prosthesis. He calculated a net adjustment of -3, 

which, under Table 16-3, moved the default grade two spots to the left to grade A for 21 percent 

permanent impairment of the left lower extremity. 

OWCP may rely on the opinion of a DMA to apply the A.M.A., Guides.

14 The Board 

finds that the February 16, 2017 impairment rating from OWCP’s DMA represents the weight of 

the medical evidence in this case as he properly applied the appropriate provisions of the 

A.M.A., Guides to the clinical findings of record.15 Accordingly, as the record contains no other 

probative, rationalized medical opinion which indicates that appellant has greater impairment 

based on his accepted left knee conditions pursuant to the A.M.A., Guides, OWCP properly 

granted a schedule award for 21 percent left leg permanent impairment in its March 9, 2017 

decision. 

On appeal appellant contends that he is entitled to 40 percent permanent impairment. He 

notes that, according to his treating physician, his surgery was a success as he can walk with no 

pain although he cannot do anything else due to his physical limitations. As found, however, 

Dr. Norcross’ opinion is of diminished probative value as he failed to utilize the sixth edition of 

the A.M.A., Guides to support an award greater than the 21 percent previously awarded.16

Appellant may request a schedule award or an increased schedule award at any time, 

based on evidence of a new exposure or medical evidence showing progression of an 

employment-related condition resulting in permanent impairment or increased impairment. 

 14 See D.E., Docket No. 16-0979 (issued October 6, 2016); J.G., Docket No. 09-1714 (issued April 7, 2010). 

15 W.M., Docket No. 11-1156 (issued January 27, 2012). 

16 Supra note 13. 
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CONCLUSION 

The Board finds that appellant has failed to meet his burden of proof to establish more 

than 21 percent permanent impairment of the left leg, for which he previously received a 

schedule award. 

ORDER 

IT IS HEREBY ORDERED THAT the March 9, 2017 of the Office of Workers’ 

Compensation Programs is affirmed. 

Issued: July 21, 2017 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees' Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees' Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees' Compensation Appeals Board