United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

A.Y., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Milwaukee, WI, Employer 

__________________________________________ 

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Docket No. 17-0695 

Issued: August 22, 2017 

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On February 6, 2017 appellant filed a timely appeal from a January 19, 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 established more than two percent permanent 

impairment of his left lower extremity for which he previously received a schedule award. 

FACTUAL HISTORY 

On December 17, 2015 appellant, then a 48-year-old letter carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on December 15, 2015 he sustained a left knee injury when he 

was turning around and his foot did not pivot, causing something to pop in his knee. He first 

received medical care and stopped work on December 16, 2015 for which he received wage-loss 

 1

 5 U.S.C. § 8101 et seq.
2

compensation. Appellant sought treatment with Dr. John K. Konkel, a Board-certified 

orthopedic surgeon. 

In a January 12, 2016 diagnostic report, Dr. Bradley Ferguson, a Board-certified 

radiologist, reported that a magnetic resonance imaging (MRI) scan of the left knee revealed 

medial meniscus tear, moderate-to-high-grade chondromalacia in the medial compartment, mild 

chondral heterogeneity in the lateral tibial plateau, mild grade 2 chondromalacia in the medial 

trochlea, and focal edema in the distal lateral prefemoral fat pad. 

By decision dated January 28, 2016, OWCP accepted the claim for left knee tear of 

medial meniscus. 

On February 2, 2016 appellant underwent a left knee arthroscopy with arthroscopic 

medial meniscectomy performed by Dr. Konkel. The surgery was approved by OWCP. 

In a March 25, 2016 work status note, Dr. Konkel released appellant to work with no 

restrictions on March 10, 2016. He diagnosed left acute medial meniscal tear. 

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

By letter dated May 10, 2016, OWCP requested Dr. Konkel submit a report addressing 

appellant’s work-related conditions, the date of maximum medical improvement (MMI), 

objective findings, subjective complaints, and an impairment rating rendered according to the 

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

Guides) (6th ed. 2009).2

 

In a May 18, 2016 medical report, Dr. Konkel reported that a January 12, 2016 MRI scan 

of appellant’s left knee had revealed a torn medial meniscus. He reiterated that on February 2, 

2016 appellant had undergone arthroscopy of his left knee with partial meniscectomy. 

Dr. Konkel reported that the arthroscopy revealed a torn medial meniscus, degenerative changes, 

and chondromalacia. Utilizing page 525 of the sixth edition of the A.M.A., Guides, he 

determined that appellant had five percent permanent impairment of the left lower extremity for 

a meniscal tear. Dr. Konkel reported that this impairment rating was based on appellant’s 

meniscectomy, meniscal injury, and residual chondromalacia. 

OWCP routed Dr. Konkel’s report, a statement of accepted facts, and the case file to 

Dr. Jovito Estaris, Board-certified in occupational medicine serving as an OWCP district medical 

adviser (DMA), for review and a determination on whether appellant sustained permanent partial 

impairment of the left lower extremity and date of MMI. 

In a December 16, 2016 report, Dr. Estaris reported that appellant’s record was reviewed 

for the purpose of determining permanent impairment of the left lower extremity due to a left 

knee tear of medial meniscus. He noted that on February 2, 2016 appellant had undergone a left 

knee arthroscopy and partial medial meniscectomy. Dr. Estaris reported the date of MMI as 

May 18, 2016, the date of Dr. Konkel’s impairment rating. 

 2

 A.M.A., Guides (6th ed. 2009). 
3

According to Table 16-3 (Knee Regional Grid) on page 509, Dr. Estaris identified 

meniscal injury as the diagnosis-based impairment (DBI), class 1 with a default value of two 

percent for partial medial meniscectomy. He noted that there was no available data to perform 

grading for functional history or physical examination. Dr. Estaris further reported that clinical 

studies could not be used in the adjustment as the MRI scan showed a medial meniscus tear and 

was used in classifying the DBI. As there were no adjustments, he determined that appellant 

remained in class 1, grade C for two percent permanent impairment of the left lower extremity. 

Dr. Estaris noted that Dr. Konkel failed to provide detailed calculations to compare the 

differences in the ratings. He speculated that Dr. Konkel added three percent impairment for 

chondromalacia of the joint, yet noted that this was not acceptable in accordance with the 

A.M.A., Guides. Dr. Estaris further reported that Dr. Konkel’s impairment rating was deficient 

with no accompanying history or physical examination at the time of the impairment rating. He 

noted that Dr. Konkel referenced page 525 of the A.M.A., Guides yet this only provided an 

example of a meniscus tear and how it was rated. 

By decision dated January 19, 2017, OWCP granted two percent permanent impairment 

of the left lower extremity. It found that the weight of the medical evidence rested with 

Dr. Estaris serving as OWCP’s DMA. The date of MMI was noted as May 18, 2016. The award 

covered a period of 5.76 weeks from May 18 to June 27, 2016. 

LEGAL PRECEDENT 

The schedule award provision of FECA and its implementing regulations 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.3 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 to all claimants, good administrative practice 

necessitates the use of a single set of tables so that there may be uniform standards applicable to 

all claimants. The A.M.A., Guides has been adopted by the implementing regulations as the 

appropriate standard for evaluating schedule losses. For decisions issued after May 1, 2009, the 

sixth edition will be applied.4

The A.M.A., Guides provide a diagnosis-based method of evaluation utilizing the World 

Health Organization’s International Classification of Functioning, Disability and Health. For 

lower extremity impairments, the evaluator identifies the impairment class for the diagnosed 

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

Functional History (GMFH), Physical Examination (GMPE), and Clinical Studies (GMCS).5

 

The net adjustment formula is (GMFH - CDX) + (GMPE - CDX) + (GMCS - CDX).6 

 3

 5 U.S.C. § 8107; 20 C.F.R. § 10.404. 

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

(January 2010); Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability 

Claims, Chapter 2.808.5a (February 2013). 

5 Supra note 2 at 493-531. 

6 Id. at 521. 
4

Evaluators are directed to provide reasons for their impairment rating choices, including choices 

of diagnoses from regional grids and calculations of modifier scores.7

ANALYSIS 

OWCP accepted appellant’s claim for left knee tear of medial meniscus. It approved 

surgery for a left knee arthroscopy and partial medial meniscectomy, which he underwent on 

February 2, 2016. The issue is whether appellant has more than two percent permanent 

impairment of the left lower extremity, for which he previously received a schedule award. 

The Board finds that appellant has not established more than two percent permanent 

impairment of the left lower extremity. 

In his May 18, 2016 report, appellant’s treating physician, Dr. Konkel, reported that 

appellant sustained five percent permanent impairment of the left lower extremity due to his 

meniscectomy, meniscal injury, and residual chondromalacia. His report did not provide 

functional history or physical examination findings, nor did he identify any grade modifiers to 

explain how he reached his calculation. It is well established that a physician’s opinion should 

include a description of impairment, range of motion of affected members, any atrophy or 

deformity, decreases in strength or disturbance of sensation in sufficient detail so as those 

reviewing the file would be able to clearly visualize the impairment with all its limitations.8

 

Thus, Dr. Konkel’s report is of limited probative value and insufficient to determine the extent of 

permanent impairment.9 

In a report dated December 16, 2016, Dr. Estaris, serving as OWCP’s DMA, reviewed 

Dr. Konkel’s report and determined that appellant had two percent permanent impairment of the 

left lower extremity. According to Table 16-3 (Knee Regional Grid), he identified meniscal 

injury, class 1 with a default value of two percent for partial medial meniscectomy.10 

Dr. Estaris noted that there was no adjustment in the impairment rating because there was 

no available data to perform grading for functional history or physical examination, and clinical 

studies did not apply as the MRI scan was used to identify the class. He deferred to a default 

impairment rating for a meniscal injury by failing to assign grade modifiers for functional 

history, physical examination, and clinical studies. Dr. Estaris explained that the impairment had 

not been properly described by appellant’s physician. 

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

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

 7 R.V., Docket No. 10-1827 (issued April 1, 2011). 

8 See Peter C. Belkind, 56 ECAB 580 (2005). 

9 T.E., Docket No. 11-1805 (issued August 2, 2012). 

10 Supra note 2 at 509. 
5

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

providing rationale for the percentage of impairment specified.11

Dr. Estaris properly explained how he calculated appellant’s permanent impairment, 

given the limited data available. He considered all the reported findings, as well as appellant’s 

partial medial meniscectomy, and gave a sufficient and supportive explanation for his 

determination that appellant had two percent permanent impairment of the left lower extremity. 

The weight of the medical opinion evidence on this matter rests with Dr. Estaris, OWCP’s 

medical adviser.12

Appellant may request a schedule award or increased schedule award at any time based 

on evidence of new exposure or medical evidence showing progression of an employmentrelated condition resulting in permanent impairment or increased impairment. 

CONCLUSION 

The Board finds that appellant has failed to establish more than two percent permanent 

impairment of his left lower extremity for which he received a schedule award. 

ORDER 

IT IS HEREBY ORDERED THAT the January 19, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: August 22, 2017 

Washington, DC 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board 

 11 See supra note 4 at Chapter 2.808.6(f) (March 2017). 

12 L.J., Docket No. 17-0754 (issued June 21, 2017).