United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

V.P., Appellant 

and 

U.S. POSTAL SERVICE, VEHICLE 

MAINTENANCE FACILITY, 

White Plains, NY, Employer 

__________________________________________ 

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Docket No. 17-0752 

Issued: June 5, 2017 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On February 20, 2017 appellant, through counsel, filed a timely appeal from a January 4, 

2017 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to 

the Federal Employees’ Compensation Act2

 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the 

Board has jurisdiction over the merits of this case. 

 1

 In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for 

legal or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. 

§ 501.9(e). No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An 

attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject 

to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation. 

2

 5 U.S.C. § 8101 et seq. 
2

ISSUE 

The issue is whether appellant met his burden of proof to establish a right knee condition 

causally related to the accepted September 18, 2012 employment incident. 

FACTUAL HISTORY 

This case has previously been before the Board.3

 Appellant, then a 50-year-old 

automotive lead technician, filed a traumatic injury claim (Form CA-1) alleging that he injured 

his right knee on September 18, 2012 as a result of stepping out of a vehicle while in the 

performance of duty.4

 He established fact of injury, but on August 12, 2013 OWCP’s Branch of 

Hearings and Review affirmed the denial of the claim because he failed to establish a causal 

relationship between the diagnosed right knee condition and the September 18, 2012 

employment incident.5 Appellant subsequently appealed to the Board. In a decision dated 

July 25, 2014, the Board affirmed the hearing representative’s August 12, 2013 decision.6

 

OWCP subsequently denied a request for reconsideration by decision dated November 13, 2014. 

Appellant, through counsel, timely requested reconsideration. In a March 25, 2015 decision, 

OWCP reviewed the merits of the claim, but denied modification. Appellant, through counsel, 

appealed to the Board. By decision dated October 20, 2015, the Board affirmed OWCP’s 

March 25, 2015 decision.7

 The Board found that appellant had not met his burden of proof to 

establish that his claimed right knee condition was causally related to the September 18, 2012 

employment incident. The facts of the case as set forth in the Board’s prior decisions are 

incorporated herein by reference.8

On October 18, 2016 counsel requested reconsideration. In support of the request, he 

submitted an October 18, 2016 report from Dr. Michael Foreman, a family practitioner. 

Dr. Foreman indicated that he had reviewed appellant’s medical records in order to determine 

whether causal relationship existed between his right knee injury and the September 18, 2012 

work incident. He noted that appellant slipped while stepping out of a vehicle onto the front fork 

of a lift and fell approximately two feet downward, landing on a twisted right knee, which caused 

his joint to buckle and crack. Dr. Foreman found that appellant’s past medical history included 

chronic, intermittent, and mild right knee pain and, according to his medical records, the 

condition was responsive to nonoperative measures. He reviewed two right knee magnetic 

resonance imaging (MRI) scans, dated March 30, 2010 and November 23, 2012, but did not 

 3

 Docket No. 14-306 (issued July 25, 2014) and Docket No. 15-1301 (issued October 20, 2015). 

4

 Appellant stated that his foot slipped off the front rail of the lift and he twisted his right knee. 

5

 The hearing representative noted, inter alia, that there was evidence of a preexisting right knee condition, which 

dated back to at least March 2010. 

6

 Docket No. 14-0306 (issued July 25, 2014). 

7

 Docket No. 15-1301 (issued October 20, 2015). The Board’s review included various diagnostic studies, as well 

as several medical reports from appellant’s treating physician, Dr. Daniel Zelazny, a Board-certified orthopedic 

surgeon. 

8 See supra note 3. 
3

conduct a physical examination.9

 Dr. Foreman opined that appellant’s claim should be accepted 

for right knee lateral meniscus tear, lateral collateral ligament (LCL) sprain, and anterior cruciate 

ligament (ACL) sprain. He based his assessment primarily on appellant’s two MRI scans and an 

article published in the Journal of the American Academy of Orthopaedic Surgeons (AAOS). 

Dr. Foreman opined that the mechanism and presentation described in the medical literature 

mirrored that described by appellant and his treating physician, and was further supported by the 

November 23, 2012 MRI scan findings. He also indicated that appellant’s claim should be 

accepted for aggravation of right knee unilateral primary osteoarthritis, which he based on a 

December 1990 article published in Seminars in Arthritis and Rheumatism. Dr. Foreman 

explained that appellant possessed “two of the three risk factors associated with osteoarthritis of 

the knee, two being occupationally related.” He opined that “repetitive wear” combined with the 

maximal axial load with torsion that occurred at work on September 18, 2012 resulted in an 

exacerbation of appellant’s underlying arthritic condition. Dr. Foreman concluded that 

appellant’s right knee conditions were directly caused and/or exacerbated by acute trauma 

sustained on September 18, 2012. 

By decision dated January 4, 2017, OWCP denied modification of its prior decision, 

finding that Dr. Foreman’s opinion was insufficient to establish causal relationship between the 

diagnosed conditions and the accepted September 18, 2012 employment incident. The senior 

claims examiner found that Dr. Foreman based his opinion on a review of the medical record and 

various medical journals, but had not conducted his own physical examination. 

LEGAL PRECEDENT 

A claimant seeking benefits under FECA has the burden of proof to establish the essential 

elements of his or her claim by the weight of the reliable, probative, and substantial evidence, 

including that an injury was sustained in the performance of duty as alleged and that any specific 

condition or disability claimed is causally related to the employment injury.10

To determine if an employee sustained a traumatic injury in the performance of duty, 

OWCP begins with an analysis of whether “fact of injury” has been established. Generally, fact 

of injury consists of two components that must be considered in conjunction with one another. 

The first component is whether the employee actually experienced the employment incident that 

allegedly occurred.11 The second component is whether the employment incident caused a 

personal injury.12 An employee may establish that an injury occurred in the performance of duty 

 9

 Dr. Foreman also noted having reviewed the Board’s October 20, 2015 decision. 

10 20 C.F.R. § 10.115(e), (f); see Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996). 

11 Elaine Pendleton, 40 ECAB 1143 (1989). 

12 John J. Carlone, 41 ECAB 354 (1989). Causal relationship is a medical question that generally requires 

rationalized medical opinion evidence to resolve the issue. Robert G. Morris, 48 ECAB 238 (1996). A physician’s 

opinion on whether there is a causal relationship between the diagnosed condition and the implicated employment 

factor(s) must be based on a complete factual and medical background. Victor J. Woodhams, 41 ECAB 345, 

352 (1989). Additionally, the physician’s opinion must be expressed in terms of a reasonable degree of medical 

certainty, and must be supported by medical rationale, explaining the nature of the relationship between the 

diagnosed condition and appellant’s specific employment factor(s). Id.
4

as alleged, but fail to establish that the disability or specific condition for which compensation is 

being claimed is causally related to the injury.13

In any case where a preexisting condition involving the same part of the body is present 

and the issue of causal relationship therefore involves aggravation, acceleration, or precipitation, 

the physician must provide a rationalized medical opinion that differentiates between the effects 

of the work-related injury or disease and the preexisting condition.14

ANALYSIS 

OWCP accepted that the September 18, 2012 employment incident occurred as alleged, 

and also accepted that there was a medical diagnosis in connection with the employment 

incident. However, it denied appellant’s traumatic injury claim finding that the medical evidence 

of record was insufficient to establish causal relationship between the diagnosed condition and 

the accepted employment incident. The issue is whether appellant’s right knee condition resulted 

from the September 18, 2012 employment incident. The Board finds that appellant did not meet 

his burden of proof to establish a causal relationship. 

Dr. Foreman’s October 18, 2016 report is the only medical evidence received since 

OWCP’s March 25, 2015 decision. He reviewed the medical evidence of record, including 

appellant’s March 30, 2010 and November 23, 2012 right knee MRI scans, but he did not 

personally examine appellant. Dr. Foreman found that appellant’s past medical history included 

chronic, intermittent, and mild right knee pain. He diagnosed right knee lateral meniscus tear, 

LCL sprain, and ACL sprain based on his review of the diagnostic studies and an article 

published in the Journal of the AAOS. Dr. Foreman opined that the mechanism and presentation 

described in the medical literature mirrored what had been described by appellant and his 

treating physician, and was further supported by the November 23, 2012 right knee MRI 

findings. He also diagnosed aggravation of unilateral primary osteoarthritis of the right knee 

based on an article published in Seminars in Arthritis and Rheumatism. Dr. Foreman opined that 

“repetitive wear” combined with the maximal axial load with torsion that occurred at work on 

September 18, 2012 resulted in an exacerbation of appellant’s underlying arthritic condition. He 

concluded that appellant’s right knee condition was causally related to the September 18, 2012 

work incident. 

The fact that a condition manifests itself during a period of employment is not sufficient 

to establish causal relationship.15 A temporal relationship alone will not suffice.16 

Dr. Foreman’s October 18, 2016 report did not include sufficient medical rationale explaining 

how the September 18, 2012 employment incident either caused or contributed to appellant’s 

current right knee condition. A physician’s opinion must be supported by medical rationale, 

explaining the nature of the relationship between the diagnosed condition(s) and appellant’s 

 13 Shirley A. Temple, 48 ECAB 404, 407 (1997). 

14 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (January 2013). 

15 20 C.F.R. § 10.115(e). 

16 See D.I., 59 ECAB 158, 162 (2007). 
5

specific employment factor(s).17 The need for rationale is particularly important because the 

evidence indicates that appellant had a preexisting right knee condition.18 Additionally, 

Dr. Foreman relied on various medical journals in forming his medical opinion. The Board has 

held that newspaper clippings, medical texts, and excerpts from publications are of no 

evidentiary value in establishing a causal relationship between a claimed condition and factors of 

the employee’s federal employment, as such materials are of general application and are not 

determinative of whether the specific condition claimed is related to the particular employment 

factors alleged by the employee.19 For the above-noted reasons, the Board finds that 

Dr. Foreman’s October 18, 2016 report is insufficient to establish causal relationship between 

appellant’s current right knee condition and the September 18, 2012 employment incident. 

As appellant has not submitted any rationalized medical evidence to support that his 

claimed right knee condition is causally related to the September 18, 2012 employment incident, 

he has failed to meet his burden of proof to establish entitlement to FECA benefits. 

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 appellant has not met his burden of proof to establish that his right 

knee condition is causally related to the accepted September 18, 2012 employment incident. 

 17 Victor J. Woodhams, supra note 12. 

18 See supra note 14. 

19 See D.E., Docket No. 07-27 (issued April 6, 2007). 
6

ORDER 

IT IS HEREBY ORDERED THAT the January 4, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: June 5, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board