United States Department of Labor

Employees’ Compensation Appeals Board

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R.A., Appellant

and

DEPARTMENT OF HOMELAND SECURITY, 

IMMIGRATION & CUSTOMS 

ENFORCEMENT, Stuart, FL, Employer

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Docket No. 17-0011

Issued: March 20, 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

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On October 5, 2016 appellant filed a timely appeal from a July 27, 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 over 

the merits of this claim.

ISSUE

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

causally related to the accepted February 22, 2016 employment incident. 

FACTUAL HISTORY

On February 25, 2016 appellant, then a 38-year-old deportation officer, filed a traumatic 

injury claim (Form CA-1) alleging that on February 22, 2016 he was handcuffing a noncompliant 

 

1 5 U.S.C. § 8101 et seq.
2

subject when he fell on his knees and right elbow. He noted knee and right elbow abrasions.

Appellant did not stop work. No medical evidence was submitted with the claim.

In a development letter dated March 1, 2016, OWCP requested that appellant provide 

factual and medical evidence in support of his claim. Appellant was provided 30 days to submit 

the requested information.

On March 7, 2016 discharge instructions and patient education material from Martin 

Health Systems, TMC Emergency room dated were received. 

By decision dated April 6, 2016, OWCP denied appellant’s claim as the medical 

component of fact of injury had not been established. It found that he had not established a medical 

diagnosis causally related to the accepted employment incident.

On April 25, 2016 OWCP received appellant’s April 19, 2016 request for reconsideration. 

In a March 7, 2016 Martin Health Systems provider report, Dr. Jonathan J. Polhemus, a 

Board-certified family practitioner, noted appellant’s history of injury at work two weeks prior 

and that he had experienced increasing right knee pain over the weekend while playing with his 

children. Dr. Polhemus explained that appellant had not sustained any new injury since the 

employment incident. Appellant’s physical examination findings were noted including right knee 

tenderness to inferior bursa and mild tenderness to lateral collateral inferior insertion site “but no[t]

obviously with this injury.” X-rays of appellant’s right knee revealed no acute fracture, dislocation 

or focal bone lesion. A right knee strain was diagnosed and a follow-up with an orthopedist was 

recommended. A copy of the March 7, 2016 x-ray report was provided.

By decision dated July 27, 2016, OWCP modified the prior decision to reflect that 

appellant had established a medical diagnosis, but denied the claim as the medical evidence of 

record was insufficient to establish causal relationship between the diagnosed right knee condition 

and the accepted employment incident. 

LEGAL PRECEDENT

An employee seeking benefits under FECA2 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 

employment injury.3 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.4

 

2

Id.

3

Joe D. Cameron, 41 ECAB 153 (1989).

4 See Irene St. John, 50 ECAB 521 (1999); Michael E. Smith, 50 ECAB 313 (1999).
3

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 actually experienced the employment incident at the time, 

place, and in the manner alleged. Second, the employee must submit medical evidence to establish 

that the employment incident caused a personal injury.5

The medical evidence required to establish causal relationship is generally rationalized 

medical opinion evidence. Rationalized medical opinion evidence is medical evidence which 

includes a physician’s rationalized opinion on the issue of whether there is a causal relationship 

between the claimant’s diagnosed condition and the implicated employment incident. The opinion 

of the physician must be based on a complete factual and medical background of the claimant, 

must be one of reasonable medial certainty and must be supported by medical rationale explaining

the nature of the relationship between the diagnosed condition and the specific employment 

incident identified by the claimant.6

ANALYSIS

The Board finds that appellant has not established that his right knee strain was causally 

related to the accepted February 22, 2016 employment incident.

OWCP accepted that the February 22, 2016 work incident occurred as alleged and that 

appellant has been diagnosed with a right knee strain. It denied the claim, however, as the medical 

evidence of record failed to establish causal relationship between the February 22, 2016

employment incident and the right knee condition. 

In a March 7, 2016 medical report, Dr. Polhemus provided a history of injury similar to 

appellant’s account of the work incident. He noted examination and x-ray findings and diagnosed 

right knee strain. Dr. Polhemus however failed to provide a rationalized medical statement 

explaining how appellant’s fall on February 22, 2016 physiologically caused his diagnosed 

condition.7 This is important in light of the fact that appellant did not seek medical care for two 

weeks after the incident and only sought medical care after experiencing increasing knee pain 

while playing with his children. The Board has held that medical evidence which does not offer 

any opinion regarding the cause of an employee’s condition is of limited probative value on the 

issue of causal relationship.8 Accordingly, Dr. Polhemus’ March 7, 2016 medical report is of 

limited probative value.

 

5 T.H., 59 ECAB 388 (2008).

6 See E.B., Docket No. 17-1862 (issued January 12, 2018). 

7 C.S., Docket No. 17-1267 (issued December 18, 2017). 

8 C.B., Docket No. 09-2027 (issued May 12, 2010); J.F., Docket No. 09-1061 (issued November 17, 2009); A.D.,

58 ECAB 149 (2006).
4

The diagnostic testing of record is of diminished probative value as this report does not 

contain a physician’s opinion specifically addressing whether appellant’s employment incident 

caused or aggravated a diagnosed medical condition.9

The other evidence of record, such as the discharge instructions and patient education 

materials are of limited probative value as they are general in nature and not specific to appellant.10

An award of compensation may not be based on surmise, conjecture, speculation, or on the 

employee’s own belief of causal relationship.

11

 Appellant’s honest belief that the February 22, 

2016 employment incident caused a right knee injury, however sincerely held, does not constitute 

medical evidence necessary to establish causal relationship.12 As appellant has failed to provide a 

rationalized medical opinion sufficient to establish causal relationship between his diagnosed 

condition and the accepted February 22, 2016 employment incident, he has failed to meet his 

burden of proof.

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 was causally related to the accepted February 22, 2016 employment incident. 

 

9 S.A., Docket No. 16-1128 (issued November 24, 2017). 

10 C.S., Docket No. 16-0880 (issued March 6, 2017). 

11 D.D., 57 ECAB 734 (2006).

12 S.H., Docket No. 17-1447 (issued January 11, 2018). 
5

ORDER

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

Programs dated July 27, 2016 is affirmed.

Issued: March 20, 2018

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board