United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

B.S., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS ADMINISTRATION MEDICAL 

CENTER, Loma Linda, CA, Employer

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Docket No. 18-0770

Issued: December 4, 2018

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 February 28, 2018 appellant filed a timely appeal from a January 4, 2018 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 a left knee, leg, or 

ankle condition caused or aggravated by the accepted June 22, 2015 employment incident.

FACTUAL HISTORY

On June 30, 2015 appellant, then a 54-year-old vocational nurse, filed a traumatic injury 

claim (Form CA-1) alleging that on June 22, 2015 he experienced severe pain in his left knee, left 

 

1 5 U.S.C. § 8101 et seq.
2

lower leg, and at a surgical site on his left ankle after he slipped on a wet floor in the bathroom of 

the employing establishment. He related that he had sustained prior meniscal tears in his left knee 

from an earlier employment injury. Appellant stopped work on June 22, 2015 and returned to 

work on June 25, 2015. OWCP assigned the claim File No. xxxxxx486.

A physician assistant evaluated appellant on June 22, 2015. In an attending physician’s

report (Form CA-20) dated July 1, 2015, she obtained a history of his slipping and falling on his 

left foot and reinjuring his left knee. The physician assistant diagnosed left foot pain. 

On June 24, 2015 Dr. Steven Shin, a Board-certified orthopedic surgeon, indicated that 

appellant was status post an open reduction and internal fixation procedure of the left ankle with 

acute or chronic left knee pain.2 He diagnosed left foot pain and a left bimalleolar nondisplaced 

fracture. 

In a July 24, 2015 report, Dr. Gerald I. West, who specializes in family medicine, obtained 

a history of appellant twisting his left knee after slipping on a wet floor at work. He noted that on 

March 31, 2015 appellant had undergone an open reduction and internal fixation of the left ankle

and had a history of severe left knee degeneration and a lateral meniscus tear. Dr. West reviewed

the findings from a 2014 magnetic resonance imaging (MRI) scan study and recommended another 

MRI scan study “in light of [appellant’s] most recent accident in order to distinguish between an 

aggravation [versus] [e]xacerbation injury.” He diagnosed left knee joint pain, traumatic arthritis 

of the left knee, and derangement of the left lateral meniscus. Dr. West advised that the findings 

were consistent with the alleged injury and that appellant’s history was “within reasonable medical 

probability of causing [appellant’s] present symptomatology.” He provided work restrictions.3 

Dr. West, on July 27, 2015, noted that appellant had slipped on June 22, 2015 twisting his 

left knee and diagnosed joint pain, traumatic arthritis, and derangement of the lateral meniscus of 

the left knee.4 He again asserted that the findings were “consistent with [appellant’s] alleged 

injury.” 

By decision dated August 14, 2015, OWCP denied appellant’s traumatic injury claim. It 

found that he had not submitted sufficient medical evidence to establish that he sustained a 

diagnosed condition causally related to the accepted June 22, 2015 work incident.

Appellant, on August 28, 2015, requested an oral hearing before an OWCP hearing 

representative. 

Dr. West, in a note dated September 1, 2015, discussed his findings from his October 17,

2014 report which noted that appellant had sustained an acceleration of degenerative changes and 

 

2 A portion of the June 24, 2015 report is redacted. In a work status report, Dr. Shin found that appellant was unable 

to work on June 23 and 24, 2015 and could resume his usual duties on June 25, 2015.

3

In a July 24, 2015 Form CA-20, Dr. West diagnosed left knee joint pain. He did not respond to the question of 

whether the condition was caused or aggravated by an employment activity. 

4

In a July 27, 2015 attending physician’s supplemental report (Form CA-20a), Dr. West found that appellant could 

work with restrictions from July 24 through August 31, 2015. 
3

a meniscal tear due to injuries on either December 12, 2013 or April 14, 2014.5 He noted that 

OWCP had denied appellant’s claim for a June 22, 2015 injury. Dr. West related:

“It is within reasonable medical probability that the injury [appellant] sustained to 

his left knee on June 22, [2015] can be considered an exacerbation. Each time he 

reinjures the knee, his functional capacity to walk/stand is adversely affected ... 

similar to the injuries he sustained on December [12,] 2013 and April 13, 2014, the 

injury on June 22, 2015 has accelerated his symptoms of pain, swelling, and 

instability in the knee.”

6

 

In a report dated February 11, 2016, Dr. G.B. Ha’Eri, a Board-certified orthopedic surgeon,

indicated that he had evaluated appellant on October 7, 2015 and January 27, 2016 for left knee 

injuries sustained on December 21, 2013, April 14, 2014, and June 22, 2015. He discussed 

appellant’s history of a 1987 left knee fracture while in the military and left knee injuries on 

December 21, 2013 and April 14, 2014 in altercations with psychiatric patients. Dr. Ha’Eri 

diagnosed left knee osteoarthritis due to the 1987 left knee injury and subsequent surgery, an 

aggravation of the preexisting left knee osteoarthritis due to the December 21, 2013, April 14, 

2014, and June 22, 2015 work injuries, and a left knee torn lateral meniscus “more likely to have 

been caused by the industrial injuries of December 21, 2013 and April 14, 2014.” He related:

“Based on [the] history provided by [appellant], my physical examination and 

review of the medical records, it is the opinion of the undersigned that the industrial 

injuries of December 21, 2013, April 14, 2014, and June 22, 2015 aggravated the 

preexisting condition of his left knee, which was post[-]traumatic osteoarthritis, and 

also caused a torn lateral meniscus.

“The mechanism of the injuries described by [appellant] was consistent with the 

physical altercation with the psychiatric patients dated December 21, 2013 and 

April 14, 2014 and his slip and twisting injury to the left knee dated June 22, 2015 

when he was walking with a walker boot after the surgical repair of his left ankle 

fracture.”

On February 22, 2016 appellant requested a review of the written record in lieu of an oral 

hearing. He asserted that he had sustained an injury on December 21, 2013, assigned OWCP File 

No. xxxxxx153, an injury on April 14, 2014, assigned File No. xxxxxx561, and an injury on 

June 22, 2015 under the current file number. Appellant questioned why OWCP had not combined 

the case numbers as they were medically connected. He noted that an OWCP hearing 

representative had instructed OWCP to further develop the medical evidence in File No. 

xxxxxx561.

 

5

In an August 11, 2015 work status report, Dr. Shin found that appellant should perform modified work on 

August 11, 2015 and could resume his usual employment on August 12, 2015. 

6

In an August 31, 2015 Form CA-20a, Dr. West found that appellant could perform modified employment. 
4

By decision dated April 6, 2016, OWCP’s hearing representative affirmed the August 14, 

2015 decision. She found that the opinion of Dr. Ha’Eri failed to describe in detail the employment 

incident or address the natural progression of appellant’s preexisting condition.

Dr. Ha’Eri, in a report dated March 16, 2017, diagnosed a permanent aggravation of 

preexisting osteoarthritis of the left knee due to December 21, 2013, April 14, 2014, and June 22, 

2015 work injuries. He further opined that appellant had a torn lateral meniscus, but continued to 

work. Dr. Ha’Eri related, “By not undergoing the surgery intervention and continuing to work, 

the injuries of December 21, 2013, April 14, 2014, and June 22, 2015 left [appellant] with 

permanent aggravation of a preexisting condition of his left knee and in fact accelerated the process 

of breakdown of the articular cartilage in his left knee, as well as extending the tear in the lateral 

meniscus.” He indicated that he had reviewed an April 21, 2016 report from Dr. Michael Einbund, 

a Board-certified orthopedic surgeon, and disagreed with his finding that appellant sustained only 

a temporary aggravation of his left knee.7 

On April 4, 2017 counsel requested reconsideration. He related that he was submitting 

January 27, 2016 and March 16, 2017 reports from Dr. Ha’Eri.8 Counsel asserted that OWCP had 

accepted that appellant sustained unilateral primary osteoarthritis of the left knee due to his 

April 14, 2014 work injury in File No. xxxxxx561 based on the report of Dr. Einbund. He 

contended that Dr. Ha’Eri disagreed with the opinion of Dr. Einbund and had provided a reasoned 

explanation why the work injuries accelerated and exacerbated the progression of his preexisting 

left knee osteoarthritis. 

By decision dated January 4, 2018, OWCP denied modification of its April 6, 2016 

decision. It reviewed Dr. Ha’Eri’s March 16, 2017 report and found that he failed to address how 

the June 22, 2015 work incident caused a further left knee injury.

On appeal appellant questions whether OWCP reviewed the merits of his case. He asserts 

that the medical evidence supports that he sustained an injury as alleged.

LEGAL PRECEDENT

An employee seeking benefits under FECA9 has the burden of proof to establish 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 or specific condition for which compensation is claimed is causally related to the 

 

7 The record relevant to the current appeal does not contain an April 21, 2016 report from Dr. Einbund.

8 OWCP received a March 16, 2017 report form Dr. Ha’Eri with the request for reconsideration.

9 Supra note 1. 
5

employment injury.10 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.11

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

performance of duty, it first must be determined whether fact of injury has been established. There 

are two components involved in establishing fact of injury. 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.12 Second, the employee must submit medical evidence to 

establish that the employment incident caused a personal injury.13

OWCP’s procedures provide: 

“Doubling is the combination of two or more case files. It occurs when an 

employee has sustained more than one injury and it is necessary to combine all of 

the records in one case folder. The case records are kept separately but travel under 

one claim number, which is known as the master file.”

14

Regarding when to double cases, OWCP procedures state: 

“Cases should be doubled when correct adjudication of the issues depends on 

frequent cross-reference between files. Cases meeting one of the following tests 

must be doubled 

“(1) A new injury case is reported for an employee who previously filed an injury 

claim for a similar condition or the same part of the body. For instance, a claimant 

with an existing case for a back strain submits a new claim for a herniated lumbar 

disc.”

15

OWCP procedures further provide that cases should be doubled as soon as the need to do 

so becomes apparent.16

ANALYSIS

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

 

10 See E.B., Docket No. 17-0164 (issued June 14, 2018); Alvin V. Gadd, 57 ECAB 172 (2005).

11 See P.S., Docket No. 17-0939 (issued June 15, 2018); Ellen L. Noble, 55 ECAB 530 (2004).

12 See V.J., Docket No. 18-0452 (issued July 3, 2018); Bonnie A. Contreras, 57 ECAB 364 (2006).

13 Id.

14 Federal (FECA) Procedure Manual, Part 2 -- Claims, File Maintenance and Management, Chapter 2.400.8(a) 

(February 2000).

15 Id. at Chapter 2.400.8(c)(1).

16 Id. at Chapter 2.400.8.
6

OWCP accepted that the employment incident of June 22, 2015 occurred as alleged. It 

denied appellant’s claim after finding that he had not submitted sufficient medical evidence 

establishing that he sustained a diagnosed condition as a result of slipping on a wet floor on 

June 22, 2015. 

In reports dated July 24 and 27, 2015, Dr. West indicated that appellant twisted his left 

knee at work when he slipped on a wet floor. He related that he was status post left ankle surgery 

on March 31, 2015 and recommended an updated MRI scan study to determine whether the latest 

injury constituted an aggravation or exacerbation of his condition. Dr. West also noted that 

appellant had severe degeneration of the left knee with a meniscal tear. He diagnosed left knee 

joint pain, traumatic arthritis of the left knee, and derangement of the left lateral meniscus. 

Dr. West indicated that the examination findings were consistent with the alleged injury and 

current symptoms. 

On August 31, 2015 Dr. West advised that appellant sustained an acceleration of a 

degenerative knee condition and a meniscal tear due to either December 12, 2013 or April 14, 2014 

work injuries. He opined that the June 22, 2015 work incident exacerbated his condition and that 

the December 2013, April 2014, and June 2015 injuries aggravated the pain and instability of his 

left knee.

Dr. Ha’Eri, in a report dated February 11, 2016, opined that work injuries on December 21, 

2013, April 14, 2014, and June 22, 2015 aggravated appellant’s preexisting left knee osteoarthritis

and resulted in a lateral meniscal tear. On March 16, 2017 he advised that he had experienced a 

permanent left knee aggravation with an acceleration of the breakdown of left knee articular 

cartilage and an extension of a lateral meniscus tear due to injuries on December 21, 2013, 

April 14, 2014, and June 22, 2015.

The record supports that appellant had claims for prior work injuries on December 21, 2013 

under OWCP File No. xxxxxx153 and April 14, 2014 under OWCP File No. xxxxxx561. Dr. West 

and Dr. Ha’Eri provided medical reports addressing work incidents on December 21, 2013, 

April 14, 2014, and June 22, 2015. OWCP procedures provide that cases should be combined 

when correct adjudication of the issues depends on frequent cross-reference between files.17 If a 

new injury case is reported for an employee who previously filed an injury claim for a similar 

condition or the same part of the body, doubling is required.18 Consequently, for a full and fair 

adjudication of appellant’s claims the files should be doubled. The Board will remand the case to 

OWCP for doubling of File Nos. xxxxxx153 and xxxxxx561 with the current claim, File No. 

xxxxxx486, and to further consider whether he sustained either an injury on June 22, 2015 due to 

the accepted work incident or progression of a previously accepted work injury.19 After such 

further development as deemed necessary, OWCP shall issue a de novo decision,

 

17 See C.R., Docket No. 17-1262 (issued May 21, 2018).

18 See supra note 15; see also M.M., Docket No. 17-1150 (issued January 26, 2018). 

19 See A.V., Docket No. 16-1370 (issued April 14, 2017).
7

CONCLUSION

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

ORDER

IT IS HEREBY ORDERED THAT the January 4, 2018 decision of the Office of 

Workers’ Compensation Programs is set aside and the case is remanded for further proceedings 

consistent with this opinion of the Board.

Issued: December 4, 2018

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