United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.G., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Milwaukee, WI, Employer 

__________________________________________ 

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Docket No. 17-0600 

Issued: July 5, 2017 

Appearances: Case Submitted on the Record

Appellant, pro se 

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 January 23, 2017 appellant filed a timely appeal from a November 29, 2016 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 to consider the merits of the 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 September 24, 2015 appellant, then a 51-year-old tractor trailer operator, filed a 

traumatic injury claim (Form CA-1) alleging that on that date he twisted his left knee while 

unloading a trailer. On October 28, 2015 OWCP accepted appellant’s claim for unspecified tear 

 1

 5 U.S.C. § 8101 et seq. 
2

of unspecific meniscus left knee. The record indicates that appellant stopped work on 

October 31, 2015. 

On December 2, 2015 appellant underwent surgery performed by Dr. Paul J. Sienkiewicz, 

a Board-certified orthopedic surgeon. Dr. Sienkiewicz listed the procedure as “arthroscopy with 

medial meniscectomy.” He noted mild synovitis throughout the knee with a small clear serous 

effusion. Dr. Sienkiewicz noted mild degenerative changes in all three compartments, but saw 

no exposed bone or large flaking off pieces. He noted that the anterior cruciate ligament and the 

posterior cruciate ligament were intact, that the patella tracked normally, and ligaments were 

stable in all directions. Dr. Sienkiewicz noted a flap tear of the posterior horn of the medial 

meniscus. 

Appellant returned to full-duty work on January 16, 2016. 

On June 14, 2016 appellant filed a claim for a schedule award (Form CA-7). In support 

of his claim, he submitted a May 24, 2016 progress report wherein Dr. Sienkiewicz indicated that 

appellant’s left knee had healed following the medial meniscectomy and that he reached an end 

point of healing with no recent change and no expected change in the immediate future. 

Appellant noted that he was six months post left knee arthroscopy with meniscectomy for workrelated meniscus tear. Dr. Sienkiewicz reported that appellant had returned to full-duty work and 

was doing well, although he had a few knee symptoms, including a slight feeling of looseness 

and occasional medial pain. He noted that appellant walked with no limp and had knee motion 

of 0 to 125 degrees on the left and 130 degrees on the right. Dr. Sienkiewicz further noted no 

effusion, very minimal medial joint space tenderness, and stable ligaments. He opined that 

appellant had five percent permanent impairment of the left knee related to residual symptoms 

including a slight loss of range of motion, some difficulty squatting, and the loss of the meniscal 

cartilage. 

By letter dated June 28, 2016, OWCP asked Dr. Sienkiewicz to provide an impairment 

rating utilizing the American Medical Association, Guides to the Evaluation of Permanent 

Impairment (6th edition 2009) (hereinafter A.M.A., Guides). 

In a July 12, 2016 note, Dr. Sienkiewicz indicated that appellant had reached maximum 

medical improvement as of the date of his last visit on May 23, 2016. He indicated that appellant 

had five percent permanent impairment of the left knee due to the employment-related injury of 

September 24, 2015. Dr. Sienkiewicz noted that elements of impairment included pain, 

weakness, stiffness, and loss of meniscal tissue due to a meniscal tear. 

By memorandum dated September 24, 2015, OWCP requested that a district medical 

adviser evaluate appellant’s claim under the A.M.A., Guides with regard to impairment to his left 

lower extremity. In an October 18, 2016 response, the medical adviser opined that appellant had 

two percent permanent impairment of the left lower extremity pursuant to the A.M.A., Guides, 

Table 16-3, page 509. He noted that, although the operative report of December 2, 2015 listed 

the procedure as an arthroscopy with medial meniscectomy, the body of the report clearly 

indicated that appellant only underwent a partial medial meniscectomy. 
3

By decision dated November 29, 2016, OWCP issued a schedule award for two percent 

permanent impairment of the left lower extremity. 

LEGAL PRECEDENT 

The schedule award provision of FECA2

 and its implementing regulations3 set forth the 

number of weeks of compensation payable to employees sustaining permanent impairment for 

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 to all claimants, good administrative practice 

necessitates the use of 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.4

 The effective date of the sixth edition of 

the A.M.A., Guides is May 1, 2009.5

The sixth edition requires identifying the impairment class for the diagnosed condition 

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

History (GMFH), Physical Examination (GMPE), and Clinical Studies (GMCS).6 The net 

adjustment formula is (GMFH - CDX) + (GMPE - CDX) + (GMCS - CDX).7 

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

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

impairment in accordance with the A.M.A., Guides with the medical adviser providing rationale 

for the percentage of impairment specified.8

ANALYSIS 

OWCP accepted appellant’s claim for tear of unspecified meniscus left knee. It issued a 

schedule award for two percent permanent impairment of the left lower extremity based on the 

opinion of OWCP’s medical adviser. 

The Board finds that the case is not in posture for decision. 

 2

 5 U.S.C. § 8107. 

3

 20 C.F.R. § 10.404.

4 Id. 

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

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

(February 2013). 

6

 A.M.A., Guides 494-531. 

7 Id. at 521. 

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

Chapter 2.808.6(f) (February 2013). 
4

Appellant’s treating physician, Dr. Sienkiewicz, found that appellant had five percent 

permanent impairment of the left lower extremity. With regard to knee impairment, the A.M.A., 

Guides provides a regional grid at Table 16-3.9

 Dr. Sienkiewicz did not reference this table in 

reaching his conclusion, nor did he make any other reference to the A.M.A., Guides. A 

physician must support his impairment rating by specifically referencing tables or other 

provisions of the A.M.A., Guides and explaining the application of the provisions.10 As 

Dr. Sienkiewicz did not properly apply the A.M.A., Guides, his opinion on permanent 

impairment is of diminished probative value.11

Consistent with its procedures,12 OWCP properly referred the matter to a district medical 

adviser for an opinion regarding appellant’s permanent impairment in accordance with the sixth 

edition of the A.M.A., Guides. In an October 18, 2016 opinion, the medical adviser indicated 

that appellant had two percent permanent impairment of his left lower extremity. In reaching 

this conclusion, he applied Table 16-3 of the A.M.A., Guides. Pursuant to Table 16-3, when 

evaluating meniscal injury, different figures are applied depending on whether appellant 

underwent a partial meniscectomy or a total meniscectomy. The medical adviser indicated that, 

although Dr. Sienkiewicz’s operative report of December 2, 2015 noted that he had conducted an 

arthroscopy with medial meniscectomy, the body of the operative report indicated that he only 

conducted a partial medial meniscectomy. There is no rationale or explanation for this 

conclusion as he did not explain how or why the operative report confirmed that the surgery 

performed was limited to a partial medial meniscectomy. 

The Board also finds that while the medical adviser concluded that appellant had two 

percent permanent impairment of the left lower extremity pursuant to Table 16-3 of the A.M.A., 

Guides, he also failed to note and apply grade modifiers as required by the A.M.A., Guides.13 

On remand the medical adviser must also explain how the grade modifiers apply to arrive at 

appellant’s impairment rating. If the medical adviser determines that a second opinion 

evaluation is necessary, OWCP shall refer appellant for a second opinion evaluation.14 

The case will be remanded for OWCP to ask the medical adviser for clarification of his 

opinion, as previously discussed. After such further development as is deemed necessary, 

OWCP shall issue a de novo decision. 

CONCLUSION 

The Board finds that the case is not in posture for decision. 

 9

 A.M.A., Guides 509, Table 16-3; see also S.H., Docket No. 17-0174 (issued May 8, 2017). 

10 T.M., Docket No. 15-1477 (issued October 22, 2015). 

11 D.M., Docket No. 16-1166 (issued October 25, 2016). 

12 Supra note 8. 

13 See Section 16.3, A.M.A., Guides 515-30. 

14 Supra note 8 at Chapter 2.810.9(b)(6) (June 2015). 
5

ORDER 

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

Compensation Programs dated November 29, 2016 is set aside and the case is remanded for 

further action consistent with this decision of the Board. 

Issued: July 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