United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

W.N., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Springfield, VA, Employer 

__________________________________________ 

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Docket No. 16-1722 

Issued: March 22, 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 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On August 17, 20161 appellant filed a timely appeal from a February 25, 2016 merit 

decision and a July 20, 2016 nonmerit 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. 

ISSUES 

The issues are: (1) whether appellant met his burden of proof to establish that he 

sustained a right knee injury on November 19, 2014 causally related to the accepted employment 

 1

 Under the Board’s Rules of Procedure, an appeal must be filed within 180 days from the date of the last OWCP 

decision. An appeal is considered filed upon receipt by the Clerk of the Appellate Boards. 20 C.F.R. § 501.3(e)-(f). 

One hundred and eighty days from February 25, 2016, the date of OWCP’s decision, was August 23, 2016. Since 

using August 24, 2016, the date the appeal was received by the Clerk of the Board, would result in the loss of appeal 

rights, the date of the postmark is considered the date of filing. The date of the U.S. Postal Service postmark is 

August 17, 2016, which renders the appeal timely filed. See 20 C.F.R. § 501.3(f)(1). 

2

 5 U.S.C. § 8101 et seq. 
2

incident; and (2) whether OWCP properly denied appellant’s request for further merit review of 

his claim pursuant to 5 U.S.C. § 8128(a). 

FACTUAL HISTORY 

On December 16, 2014 appellant, then a 66-year-old mail carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on November 19, 2014 around 10:00 a.m. he sustained a medial 

gastrocnemius tear as a result of his right knee buckling while he was loading mail onto a cart 

and trying to position himself to keep from falling. He stated that he tore a muscle in his right 

leg. Appellant also noted that his right leg was still recovering from a previous total right knee 

replacement. 

By letter dated January 8, 2015, OWCP informed appellant of the evidence necessary to 

establish his claim. It noted that he had not provided sufficient medical evidence to establish his 

claim, because no diagnosis had been provided, and no opinion from a physician as to the cause 

of his alleged injury. OWCP requested that appellant submit additional evidence and afforded 

him 30 days to do so. 

In a report dated November 19, 2014, Dr. Craig H. Phillips, a Board-certified family 

practitioner, examined appellant and diagnosed him with right leg sprain. He noted that at 

around 10:00 a.m. on that date appellant tripped and immediately developed pain in the upper 

right calf. Dr. Phillips noted that appellant’s medical history included a right knee replacement 

on January 22, 2014. He recommended no weight-bearing for the next week. Dr. Phillips noted 

that appellant was followed by an orthopedic surgeon for arthritis in the right knee. 

In a note dated December 4, 2014, Dr. Nicholas R. Harding, a Board-certified orthopedic 

surgeon, examined appellant, stating that his right knee was status post arthroplasty, and doing 

well with good range of motion and a stable joint. On examination of an x-ray he noted that the 

articular surface of the right knee medial compartment was reasonably well-preserved, along 

with the other segments of the knee. Dr. Harding diagnosed internal derangement of the left 

knee on the basis of a physical examination. He further noted that appellant would need physical 

therapy for a right knee medial gastrocnemius tear. 

By decision dated February 9, 2015, OWCP denied appellant’s claim for compensation. 

It accepted that the employment incident occurred as alleged. However, OWCP found that 

appellant had not submitted a medical report containing a well-reasoned medical opinion as to 

how the incident of November 19, 2014 caused a diagnosis of “left” knee meniscus tear. 

On February 20, 2015 appellant requested a review of the written record before an 

OWCP hearing representative. 

By letter dated February 18, 2015, appellant noted that, while he had a separate workers’ 

compensation claim for an injury to his left knee, the present claim was for the gastrocnemius 

tear in his right leg, and as such the February 9, 2015 denial was not accurate. 

By decision dated July 22, 2015, a hearing representative affirmed OWCP’s decision 

dated February 9, 2015. The decision did not address OWCP’s mischaracterization of 

appellant’s injury under the present claim as for his left lower extremity. OWCP found that 
3

appellant had not submitted sufficient evidence to establish that his right knee medial 

gastrocnemius tear was caused by the incident of November 19, 2014. 

By letter dated July 27, 2015, appellant requested reconsideration. In support of his 

request, he submitted numerous reports from physical therapists, urinalysis reports, and a 

prescription slip. 

By decision dated February 25, 2016, OWCP reviewed the merits of appellant’s case and 

affirmed the decision of July 22, 2015. It noted that he had not submitted a report from a 

physician containing a well-reasoned explanation of the causal relationship between his 

diagnosed right medial gastrocnemius tear and the incident of November 19, 2014. 

On April 15, 2016 appellant again requested reconsideration. With his request, appellant 

submitted a direct deposit sign-up form. 

By decision dated July 20, 2016, OWCP denied appellant’s request for reconsideration, 

noting that he had not submitted relevant and pertinent new evidence in support of his claim. 

LEGAL PRECEDENT -- ISSUE 1 

An employee seeking benefits under FECA3

 has the burden of establishing the essential 

elements of his or her claim, including the fact that the individual is an employee of the United 

States within the meaning of FECA, that the claim was filed within the applicable time 

limitation, that an injury was sustained while in the performance of duty as alleged, and that any 

disability and/or specific condition for which compensation is claimed are causally related to the 

employment injury.4 These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated on a traumatic injury or an occupational disease.5

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty it must first be determined whether a fact of injury has been established.6 

First, the employee must submit sufficient evidence to establish that he or she actually 

experienced the employment incident at the time, place, and in the manner alleged.7

 Second, the 

employee must submit sufficient evidence, generally only in the form of medical evidence, to 

establish that the employment incident caused a personal injury.8

 3 Id.

4 C.S., Docket No. 08-1585 (issued March 3, 2009); Bonnie A. Contreras, 57 ECAB 364, 366 (2006). 

5 S.P., 59 ECAB 184, 188 (2007); Joe D. Cameron, 41 ECAB 153, 157 (1989). 

6 B.F., Docket No. 09-60 (issued March 17, 2009); Bonnie A. Contreras, supra note 4. 

7 D.B., 58 ECAB 464, 466 (2007); David Apgar, 57 ECAB 137, 140 (2005). 

8 C.B., Docket No. 08-1583 (issued December 9, 2008); D.G., 59 ECAB 734, 737 (2008); Bonnie A. Contreras, 

supra note 4. 
4

The claimant has the burden of establishing by the weight of reliable, probative, and 

substantial evidence that the condition for which compensation is sought is causally related to a 

specific employment incident or to specific conditions of employment.9 An award of 

compensation may not be based on appellant’s belief of causal relationship. Neither the mere 

fact that a disease or condition manifests itself during a period of employment nor the belief that 

the disease or condition was caused or aggravated by employment factors or incidents is 

sufficient to establish a causal relationship.10

Causal relationship is a medical issue and the medical evidence generally required to 

establish causal relationship is rationalized medical opinion evidence.11 Rationalized medical 

opinion evidence is medical evidence which includes a physician’s rationalized opinion on 

whether there is a causal relationship between the employee’s diagnosed condition and 

compensable employment factors.12 The opinion of the physician must be based on a complete 

factual and medical background of the employee, must be one of reasonable medical certainty, 

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

diagnosed condition and the specific employment factors identified by the employee.13

ANALYSIS -- ISSUE 1 

The Board finds that the medical evidence submitted by appellant is insufficient to 

establish that the incident of November 19, 2014 caused a right knee injury. 

Appellant submitted several medical reports containing diagnoses, but did not submit any 

reports containing a well-reasoned and explicit opinion from a physician as to the cause of 

appellant’s diagnosed right knee condition. In a report dated November 19, 2014, Dr. Phillips

examined appellant and diagnosed him with leg sprain. He noted that at around 10:00 a.m. on 

that date, appellant tripped and immediately developed pain in the upper right calf. Dr. Phillips 

also noted appellant’s medical history of total right knee replacement and arthritis of the right 

knee. However, he did not offer a rationalized medical opinion explaining how appellant’s knee 

buckling while he was loading mail caused a leg sprain. Medical evidence submitted to support 

a claim for compensation should reflect a correct history, and the physician should offer a 

medically-sound explanation of how the claimed work event caused or aggravated the claimed 

condition.14 

In a note dated December 4, 2014, Dr. Harding related that appellant was status post 

arthroplasty of the right knee and that appellant would need physical therapy for a right knee 

 9 Roma A. Mortenson-Kindschi, 57 ECAB 418, 428 n.37 (2006); Katherine J. Friday, 47 ECAB 591, 594 (1996). 

10 P.K., Docket No. 08-2551 (issued June 2, 2009); Dennis M. Mascarenas, 49 ECAB 215, 218 (1997). 

11 Y.J., Docket No. 08-1167 (issued October 7, 2008); A.D., 58 ECAB 149, 155-56 (2006); D’Wayne Avila, 57 

ECAB 642, 649 (2006). 

12 J.J., Docket No. 09-27 (issued February 10, 2009); Michael S. Mina, 57 ECAB 379, 384 (2006). 

13 I.J., 59 ECAB 408, 415 (2008); Victor J. Woodhams, 41 ECAB 345, 352 (1989). 

14 D.D., Docket No. 13-1517 (issued April 14, 2014). 
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medial gastrocnemius tear. This report, while probative on the issue of appellant’s diagnosis, 

does not contain a sufficient biomechanical explanation of how the event of November 19, 2014 

caused or aggravated his right medial gastrocnemius tear. This is especially important given 

appellant’s preexisting right knee conditions of arthritis and total knee replacement.15 

OWCP has also received reports from physical therapists. However, the Board has held 

that reports signed by a physical therapist are not considered medical evidence as these providers 

are not considered physicians under FECA.16 

As appellant has not submitted any sufficiently rationalized medical evidence to support 

his allegation that he sustained an injury causally related to a work-related incident on 

November 19, 2014, he has not met his burden of proof to establish his claim.17

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. 

LEGAL PRECEDENT -- ISSUE 2 

To require OWCP to reopen a case for merit review under section 8128(a), OWCP’s 

regulations provide that the evidence or argument submitted by a claimant must: (1) show that 

OWCP erroneously applied or interpreted a specific point of law; (2) advance a relevant legal 

argument not previously considered by OWCP; or (3) constitute relevant and pertinent new 

evidence not previously considered by OWCP.18 Section 10.608(b) of OWCP’s regulations 

provide that when an application for reconsideration does not meet at least one of the three 

requirements enumerated under section 10.606(b)(3), OWCP will deny the application for 

reconsideration without reopening the case for a review on the merits.19

ANALYSIS -- ISSUE 2 

OWCP issued a February 25, 2016 decision, denying modification of a July 22, 2015 

decision which found that appellant had not submitted sufficient medical evidence to establish 

causal relationship between the November 19, 2014 work incident and his diagnosed right 

medial gastrocnemius tear. 

 15 G.M., Docket No. 1367 (issued November 19, 2013). 

16 See David P. Sawchuk, 57 ECAB 316 (2006) (by individuals such as physician assistants, nurse and physical 

therapists are not competent to render a medical opinion under FECA); 5 U.S.C. § 8101(2) provides that the term 

physician includes surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and osteopathic 

practitioners within the scope of their practice as defined by State law. See Merton J. Sills, 39 ECAB 572, 575 

(1988); P.R., Docket No 14-1007 (issued August 13, 2014). 

17 Supra note 12. 

18 20 C.F.R. § 10.606(b)(3); D.K., 59 ECAB 141, 146 (2007). 

19 Id. at. § 10.608(b); see K.H., 59 ECAB 495, 499 (2008). 
6

On April 15, 2016 appellant requested reconsideration. With his request, appellant 

submitted a direct deposit sign-up form. 

The issue presented on appeal is whether appellant met any of the requirements of 20 

C.F.R. § 10.606(b)(3), requiring OWCP to reopen the case for review of the merits of his claim. 

In his April 15, 2016 request for reconsideration, appellant did not show that OWCP erroneously 

applied or interpreted a specific point of law, or advance relevant new legal pertinent argument 

not previously considered. Thus, he is not entitled to a review of the merits of his claim based on 

the first and second above-noted requirements under section 10.606(b)(3). 

The underlying issue is whether appellant has submitted sufficient evidence to establish a 

causal relationship between the November 19, 2014 work incident and appellant’s diagnosed 

medical condition. A claimant may be entitled to a merit review by submitting relevant and 

pertinent new evidence, but appellant did not submit any relevant and pertinent new evidence in 

this case. The only evidence submitted by appellant on reconsideration of the February 25, 2016 

decision was a direct deposit sign-up form. While this evidence was not previously reviewed by 

OWCP, it was irrelevant to the denial of appellant’s claim. As such, it was insufficient to 

warrant reconsideration of appellant’s claim. 

The Board accordingly finds that appellant has not met any of the requirements of 20 

C.F.R. § 10.606(b)(3). Appellant did not show that OWCP erroneously applied or interpreted a 

specific point of law, advance a relevant legal argument not previously considered by OWCP, or 

submit relevant and pertinent new evidence not previously considered. Pursuant to 20 C.F.R. 

§ 10.608, OWCP properly denied merit review. 

CONCLUSION 

The Board finds that appellant has not met his burden of proof to establish a right knee 

injury causally related to the accepted November 19, 2014 employment incident. The Board 

further finds that OWCP properly denied appellant’s request reconsideration of the merits of his 

claim pursuant to 5 U.S.C. § 8128(a). 
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ORDER 

IT IS HEREBY ORDERED THAT the decisions of the Office of Workers’ 

Compensation Programs dated July 20 and February 25, 2016 are affirmed. 

Issued: March 22, 2017 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board