United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

L.C., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Kearney, NJ, Employer

__________________________________________

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Docket No. 17-1788

Issued: September 19, 2018

Appearances: Case Submitted on the Record

James D. Muirhead, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On August 21, 2017 appellant, through counsel, filed a timely appeal from an April 10, 

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. 

ISSUES

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

sustained a right knee injury causally related to the accepted January 21, 2012 employment 

 

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

incident; and (2) whether appellant has met his burden of proof to establish a recurrence of 

disability on January 21, 2012 causally related to his accepted May 23, 1991 employment injury.

FACTUAL HISTORY

The case has previously been before Board.3 The facts as set forth in the Board’s prior 

decision are incorporated herein by reference. The relevant facts are as follows. 

On May 23, 1991 appellant, then a 42-year-old mail carrier, filed a traumatic injury claim 

(Form CA-1) alleging that he sustained injury when tripped on a sidewalk and landed on his right 

leg while in the performance of duty. OWCP assigned OWCP File No. xxxxxx082 and accepted 

the claim for right knee sprain.4 

On January 21, 2012 appellant filed a traumatic injury claim (Form CA-1) alleging that on 

that date he suffered a swollen and painful right knee while walking his route. OWCP assigned 

that claim OWCP File No. xxxxxx499.

By development letter dated February 10, 2012, OWCP advised appellant of the type of 

evidence needed to establish his claim. It afforded him 30 days to submit this evidence. 

In a statement dated February 22, 2012, appellant stated that he was delivering mail on a 

snowy day and felt pain in his right knee, and was able to finish the route. He stated that his knee

was particularly painful walking up and down stairs. Appellant noted that his knee started to swell 

and stiffen.

In a February 6, 2012 report, Dr. Teofila A. Dauhajre, a Board-certified orthopedic 

surgeon, noted that x-rays of appellant’s right knee demonstrated tricompartmental knee 

osteoarthritis with spurring of the tibial spine and narrowing of the intercondylar notch region, one 

centimeter loose body in the posterior joint space, small knee joint effusion, and no fractures or 

dislocations. His impression at that time was internal degenerative changes to the medial joint line 

versus a tear of the posterior horn of the medial meniscus of the right knee. In a duty status report 

of February 17, 2012 (Form CA-17), Dr. Dauhajre again noted appellant’s diagnoses and opined

that appellant was totally incapacitated. He referred appellant to physical therapy, and appellant 

also submitted these notes. 

By decision dated March 12, 2012, OWCP denied appellant’s traumatic injury claim as the 

medical evidence did not demonstrate that the diagnosed medical conditions were causally related 

to the accepted employment-related incident of January 21, 2012.

On April 5, 2012 appellant requested reconsideration. 

 

3 Docket No. 15-0436 (issued January 20, 2016). 

4 A June 7, 1991 magnetic resonance imaging (MRI) scan of the right knee was interpreted by Dr. Robert Traflet, 

a Board-certified radiologist, as showing a complete tear of the anterior cruciate ligament (ACL) and anterior horn of 

the lateral meniscus. Appellant underwent arthroscopic surgery on by Dr. Jaffe on September 16, 1991. 
3

In a March 9, 2012 report interpreting a magnetic resonance imaging (MRI) scan of 

March 8, 2012, Dr. Denise McCarthy, a Board-certified radiologist, diagnosed chronic ACL tear,

degeneration and tear body and posterior horn of the lateral meniscus, small joint effusion with 

slightly complex fluid, and tear of the posterior horn medial meniscus adjacent to the meniscal 

root and probable meniscal ossicle.

Appellant continued to submit reports by Dr. Dauhajre. In a March 24, 2012 report,

Dr. Dauhajre reiterated his diagnoses and noted that they were supported by appellant’s right knee 

MRI scan of March 8, 2012. He indicated that appellant had an aggravation of appellant’s 

preexistent degenerative joint disease of the right knee in that appellant was asymptomatic prior 

to the job-related injury of January 21, 2012. Dr. Dauhajre indicated that appellant’s moderate 

degenerative disease was noted on February 6, 2012 x-rays of appellant’s right knee, which 

demonstrated moderate tricompartmental knee osteoarthritis with spurring of the tibial spine and 

narrowing of the intercondylar notch region. 

Dr. Dauhajre further opined in his March 24, 2012 report that the above impressions were 

causally related to appellant’s employment-related activities as a mail carrier. He explained that 

appellant’s job requirements as a mail carrier, requiring ambulation approximately five miles per 

day with weight and climbing up and down hills, were the competent cause for aggravation of his 

1991 preexisting right knee condition that was asymptomatic until January 21, 2012. 

Dr. Dauhajre continued to submit medical reports documenting his treatment of appellant. 

In a statement received by OWCP on May 17, 2012, appellant noted that he originally 

injured his knee while working at the employing establishment on May 23, 1991, and that he 

underwent surgery for a torn ACL and torn meniscus. 

In a decision dated July 6, 2012, OWCP denied modification of its prior decision. It 

determined that the medical evidence of record was insufficient to establish that the diagnosed 

conditions were causally related to the employment incident of January 21, 2012. 

On October 5, 2012 appellant, through counsel, requested reconsideration. Counsel noted 

that appellant was originally injured on May 23, 1991 and that his doctor at that time was Dr. Jaffe. 

In a September 4, 2012 report, Dr. Jaffe opined that, based on his review of appellant’s

record, he aggravated a preexisting condition on January 21, 2012. He noted that it was clear that 

the aggravation would cause progressive degenerative arthritis, and in the future require a total 

knee replacement. 

On December 19, 2012 OWCP found that the evidence of record was insufficient to 

warrant modification of the July 6, 2012 decision.

In a January 7, 2013 report, Dr. Jaffe opined that it was common knowledge that an ACL 

injury would lead to early degeneration and osteotraumatic arthritis. Due to changes in the 

topography of the knee as a result of other injuries and the degenerative change, a chronic meniscus 

tear would have to be ruled out. In a January 22, 2013 note, Dr. Jaffe explained that appellant had

been under his care for many years and had sustained a right knee employment-related injury in

May 1991. He noted that appellant returned to be evaluated on July 26, 2012 after seeing another 
4

orthopedist for problems with his knee sustained in a work-related injury of January 2012. 

Dr. Jaffe noted that appellant had a job which involved driving, that in January 2012 he was 

removed from driving and placed on walking delivery, and that shortly thereafter the affected knee 

became swollen. On examination, appellant was found to have weakness, patella femoral crepitus, 

tenderness and instability. On January 22, 2013 he continued to experience pain and tenderness 

as well as weakness and gait disturbance. Dr. Jaffe opined that, as a result of walking in the snow, 

appellant aggravated a preexisting right knee injury that occurred on May 23, 1991. Since 

appellant was doing fairly well until he began walking a route and given his prior history of injury 

which was quite severe in nature, Dr. Jaffe concluded that appellant aggravated his preexisting 

condition and required arthroscopic surgery as a result of the January 21, 2012 walking incident.

On March 4, 2013 appellant filed a notice of recurrence (Form CA-2) alleging a recurrence 

of the May 23, 1991 injury on January 21, 2012. He stated that for the last several years he had 

been driving a truck, but that on January 21, 2012 he was required to walk to deliver mail and his 

knee then swelled up. Appellant explained that his knee was very badly injured in 1991 and that 

he had developed arthritis, as Dr. Jaffe predicted would occur back in 1991. 

By letter dated March 4, 2013, the employing establishment controverted the recurrence

claim. It noted that appellant called in for sick leave on January 23, 2012, that he never returned 

to duty, and that he retired effective September 22, 2012. The employing establishment noted that,

on January 18, 2012, appellant had a second motor vehicle accident, following a motor vehicle 

accident on October 29, 2011. Appellant’s driver’s license was revoked until he underwent 

remedial training. It noted that appellant was afforded the opportunity to deliver mail since he 

could not drive, pending the remedial training. 

In a March 5, 2012 attending physician’s report (Form CA-20) submitted with the 

recurrence claim, Dr. Dauhajre stated that appellant had an internal derangement of the right knee, 

rule out chondromalacia right knee, and rule out torn medial meniscus. He checked a box marked

“yes” indicating that the condition was caused or aggravated by an employment activity and noted 

that appellant was a letter carrier. 

In a statement dated April 2, 2013, appellant related that he had a severe injury to his right 

knee on May 24, 1991, from which he had never recovered. He stated that he underwent surgery 

for a torn meniscus and torn ACL by Dr. Jaffe on September 13, 1991 and that Dr. Jaffe indicated 

that his knee would never be the same as he would have a permanent injury with some arthritis 

and some instability. Appellant noted that, at the time of the January 21, 2012 recurrence, he had 

been working as a truck driver, for about three years, but that on or about January 20, 2012 the 

employing establishment asked him to deliver mail. He was delivering mail on January 21, 2012 

in the snow when his right knee began to swell. Appellant stated his belief that his right knee 

condition was related to the accepted May 23, 1991 employment injury. He noted that his knee 

had worsened since May 23, 1991 and that he specifically requested the truck driving job so that 

he did not have to walk on the knee. Appellant stated that he had not sought any treatment from 

1991/1992 until 2012, but that he did have right knee pain. He further noted that he had not 

returned to work since January 21, 2012. 

In an April 29, 2013 decision, OWCP denied modification of its July 6, 2012 decision as 

the evidence still did not provide a well-reasoned medical explanation, with supporting objective 
5

findings, from a qualified physician as to how ascending and descending stairs and stepping 

through deep snow while delivering mail on January 21, 2012 directly caused or aggravated a 

medical condition. 

In a May 31, 2013 decision, OWCP denied appellant’s claim for recurrence of disability. 

It noted that even though appellant stated that he had pain prior to the alleged recurrence, the 

medical evidence of record did not substantiate that the accepted condition of the May 23, 1991 

employment injury changed or worsened causing disability. OWCP stated the fact that the new 

traumatic injury claim had been denied did not establish that appellant’s current medical condition 

was related to the May 23, 1991 accepted injury. It also noted that this decision did not affect 

appellant’s entitlement to medical benefits for his accepted condition. 

By letter dated June 19, 2013, appellant, through counsel, requested a telephonic hearing

before an OWCP hearing representative regarding the May 31, 2013 decision. During the hearing 

held on September 11, 2013, he testified that approximately five years prior his knee became 

painful and that he sometimes had a little instability when walking. Appellant was prescribed 

medication by Dr. Svetlana Salerno, a family practitioner, so at that time, he bid on a truck job. 

On September 30, 2013 appellant, through counsel, requested reconsideration. He asked 

that appellant’s case be approved for an aggravation, acceleration, or exacerbation of his 

underlying accepted employment injury. 

In a statement dated October 4, 2013, appellant reiterated the history provided in his 

April 2, 2013 statement. 

In an October 7, 2013 report, Dr. Dauhajre summarized his prior findings of internal 

derangement of the right knee and aggravation of appellant’s preexistent degenerative joint disease 

that was asymptomatic prior to the job-related injury of January 21, 2012. He again opined that 

appellant was totally disabled from work. Dr. Dauhajre reviewed the other medical opinions, 

including the reports of Dr. Salerno dated September 10, 2013 and the reports of Dr. Jaffe dated 

January 7 and 22, 2013. He also reviewed the operative report of September 13, 1991. 

Dr. Dauhajre opined that within a reasonable degree of medical probability that appellant’s current 

right knee condition was causally related to his job-related activities as a letter carrier for the 

employing establishment. He noted that appellant described his job as requiring excessive 

ambulation of 5 to 6 hours a day, ascending and descending stairs for approximately 35 to 45 

minutes a day, repetitive squatting and kneeling on the right lower extremity, and carrying objects 

greater than 50 pounds. In addition Dr. Dauhajre stated that appellant’s prior full ACL tear and 

medical necessity for a partial medial meniscectomy of the right knee on September 13, 1991 

predisposed appellant to joint disease of the right knee that made his knee more vulnerable to 

aggravation and reinjury to his right knee. He explained that appellant’s job duties on January 21, 

2012 resulted in severe swelling and aggravation of his right knee condition as well as a tear of the 

medial meniscus that was noted on clinical examination and by MRI scan of the right knee on 

March 8, 2012. 

By letter dated September 4, 2013, Dr. Jaffe noted that he has reviewed Dr. Dauhajre’s 

notes and his opinion remained unchanged. He noted that he agreed with Dr. Dauhajre that 

appellant should undergo arthroscopy of the knee to assess the internal structures. However,
6

Dr. Jaffe noted that, with the aggravation of the preexisting condition, appellant was going to 

continue to develop progressive arthritis and in the future require the need for a total knee 

replacement. 

By decision dated December 4, 2013, the hearing representative affirmed OWCP’s 

May 31, 2013 decision denying appellant’s claim in OWCP File No. xxxxxx082. He also advised 

OWCP to combine appellant’s files in OWCP File Nos. xxxxxx499 and xxxxxx082. 

By decision dated December 31, 2013, OWCP denied modification of its April 29, 2013 

decision in File No. xxxxxx499. 

In a September 10, 2013 report received by OWCP on August 1, 2014, Dr. Salerno, 

requested approval of a right knee arthroscopic surgery. She noted that appellant has been under 

her care for pain in the right knee since 1991 when he suffered an injury at work which resulted in 

a complete tear of his ACL and anterior horn of the lateral meniscus. Appellant had done well for 

several years and had returned to work, but then began to feel discomfort in his right knee which

progressively worsened which made it painful to bear weight, walk or stand for extended periods,

and climb up and down the stairs. He was treated with anti-inflammatories which provided some 

relief, but he continued to experience pain. 

On March 13, 2014 Dr. Jaffe performed a right knee arthroscopy. He noted diagnoses of 

complex tear of the medial meniscus with prior meniscectomy, lateral meniscus markedly 

displaced and torn complexly, grade 3 to 4 chondromalacia of the lateral femoral compartment and 

lateral tibial compartment and lateral tibial plateau. Dr. Jaffe also noted that appellant had a large 

amount of fibrosis in the anterior chamber. Appellant was treated by Dr. Jaffe who then referred 

him to Dr. Dauhajre for treatment. Dr. Jaffe opined that appellant had an ongoing condition which 

caused constant medial and lateral joint line pain, recurrent effusions and locking and giving out 

of the knee. He noted that appellant was in pain while ambulating, squatting, kneeling, and 

climbing. Dr. Jaffe noted that appellant has been examined by several physicians who agree that 

an arthroscopy is necessary. He opined that appellant he continued to be disabled. 

On OWCP subsequently combined appellant’s recurrence claim and his traumatic injury 

claim, File Nos. xxxxxx499 and xxxxxx082, with the latter serving as the master file.

On December 31, 2013 appellant, through counsel, requested reconsideration of the 

December 31, 2013 decision in File No. xxxxxx499 and the December 4, 2013 decision in File 

No. xxxxxx082. 

By decision dated August 15, 2014 issued in OWCP File No. xxxxxx499, OWCP 

determined that the medical evidence of record was of insufficient probative value to alter the 

December 13, 2013 decision, as it failed to establish causal relationship between the work activity 

of January 21, 2012 and appellant’s medical diagnoses. On August 21, 2014 OWCP reissued the 

August 15, 2014 decision, but instead noted File No. xxxxx082, which was designated as the 

master file for both claims. 

By letter dated July 26, 2012, received by OWCP on October 6, 2014, Dr. Jaffe stated that 

appellant was still having problems with both knees, right greater than left. He stated that he 

treated appellant many years ago. Dr. Jaffe noted that when he examined appellant and repeated 
7

the x-rays, there were only modest degenerative changes, and his examination findings were 

primarily focused on patellofemoral crepitus right and left with no other instabilities or meniscus 

findings. However, at this point, with the evidence that appellant had a degenerative condition, he 

now agreed that appellant had an aggravation of the preexisting condition. Dr. Jaffe noted that 

appellant had a second injury on January 21, 2012 and noted that the findings suggested an 

aggravation of the preexisting condition. 

On December 11, 2014 appellant, through counsel, appealed to the Board.

By decision dated January 20, 2016, the Board found that the case was not in posture for 

decision. The Board found that OWCP only addressed appellant’s appeal in the new injury claim, 

despite the fact that appellant also appealed the December 4, 2013 decision involving his 

recurrence claim. The Board further found that OWCP failed to adequately discuss the facts of 

the case and failed to provide a detailed analysis of the issues.5

On August 10, 2016 OWCP issued a de novo decision denying appellant’s traumatic injury 

claim, finding that the medical evidence of record was insufficient to demonstrate that the claimed 

medical condition was causally related to the accepted work incident. 

Appellant subsequently requested reconsideration. In an August 11, 2016 decision, OWCP 

denied modification of its July 31, 2014 decision. It noted that the new evidence was insufficient

to modify its finding that appellant failed to establish a recurrence of disability on January 21, 

2012 causally related to the 1991 accepted injury. 

On August 15, 2016 appellant, through counsel, requested an oral hearing before an OWCP 

hearing representative. 

During the hearing held on March 2, 2017, appellant noted that he started work for the 

employing establishment around 1989, and injured his right knee in 1991. He noted that he 

returned to delivering mail around 2008 and later bid for a driving job to strengthen his knee. 

Appellant testified that in October 2011 there was a blizzard, and he hit a branch covered with 

snow, but was not injured. In the beginning of January 2012, he had an accident when he tried to 

park on a narrow street, but was not injured. Appellant’s driver’s license was not revoked, but the 

employing establishment was not happy with the fact that he had two motor vehicle accidents, and 

told him that he could not drive, so he had to deliver mail while walking. On January 20, 2012 he 

delivered mail, and the next day there was snow and he developed some problems with his right

knee. Appellant noted that he had retired, but he would have continued working if he was not 

injured. 

On February 20, 2017 appellant had an MRI scan of the right knee without contrast. 

Dr. Daniel Lerer, a Board-certified radiologist, found: (1) severe lateral compartment and 

patellofemoral compartment degenerative arthritis and moderate-to-severe medial compartment 

degenerative arthritis, prior partial medial and lateral meniscectomies, medial meniscal tear, 

 

5

Id.
8

chronic complete ACL tear, chronic ACL sprain, moderate patellar and mild quadriceps tendinosis, 

and small right knee joint effusion; no fractures or dislocations. 

By decision dated April 10, 2017, the hearing representative affirmed the August 11, 2016 

decision. She determined that the medical evidence of record did not provide sufficient rationale 

to support that the January 21, 2012 injury was either a recurrence of the 1991 injury or a new 

traumatic injury. 

LEGAL PRECEDENT -- ISSUE 1

An employee seeking benefits under FECA6 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 timely filed within the applicable 

time limitation period of FECA, that an injury was sustained 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.7 These are the essential elements of each compensation claim regardless 

of whether the claim is predicated upon a traumatic injury or an occupational disease.8

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

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

There are two components involved in establishing fact of injury. First, the employee must submit 

evidence to establish that he or she actually experienced the employment incident at the time, place 

and manner alleged.9 Second, the employee must submit evidence, in the form of medical

evidence, to establish that the employment incident caused a personal injury.10

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

establish causal relationship is rationalized medical opinion evidence. The opinion of the 

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

one of reasonable 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 claimant.11

 

6 Supra note 2.

7 C.S., Docket No. 08-1585 (issued March 3, 2009); Elaine Pendleton, 40 ECAB 1143 (1989). 

8 S.P., 59 ECAB 184 (2007); Victor J. Woodhams, 41 ECAB 345 (1989). A traumatic injury refers to injury caused 

by a specific event or incident or series of events or incidents occurring within a single workday or work shift whereas 

an occupational disease refers to an injury produced by employment factors which occur or are present over a period 

longer than a single workday or work shift. 20 C.F.R. § 10.5(q), (ee), Brady L. Fowler, 44 ECAB 343, 351 (1992). 

9

Julie B. Hawkins, 38 ECAB 393 (1987). 

10 John J. Carlone, 41 ECAB 354 (1989). 

11 See I.J., 59 ECAB 408 (2008); Donna Faye Cardwell, 41 ECAB 730 (1990). 
9

ANALYSIS -- ISSUE 1

The Board finds that appellant has not established that he sustained a right knee injury 

causally related to the accepted January 21, 2012 employment incident. 

In support of his claim, appellant submitted reports from Dr. Dauhajre and Dr. Jaffe. 

Dr. Dauhajre examined appellant on January 30, 2012 and diagnosed internal derangement of the 

right knee, consistent with a probable tear of the posterior horn of the lateral meniscus and a tear 

of the posterior horn of the medial meniscus. He also noted aggravation of the appellant’s 

preexistent degenerative joint disease of the right knee, which had been asymptomatic prior to

January 21, 2012. Dr. Dauhajre opined within a reasonable degree of medical probability that 

these conditions were causally related to appellant’s duties as a mail carrier. He noted that as a 

mail carrier his duties required walking and climbing stairs for five to six hours a day. However, 

in so far as Dr. Dauhajre did not indicate that appellant performed these duties for a short period 

of time in January 2012, his report is not based upon a correct history.12

Dr. Jaffe noted that appellant usually drove to perform his employment duties, but that in 

January 2012 he was removed from driving and placed on walking delivery, and shortly after this 

change in appellant’s assignment, his right knee became swollen. He stated that as a result of 

appellant’s walking in snow, he aggravated his preexisting right knee condition. The Board finds 

that the opinions of Dr. Dauhajre or Dr. Jaffe are not persuasive. Dr. Dauhajre and Dr. Jaffe did 

not explain how appellant’s job duties of delivering mail for a few hours on January 21, 2012 

caused or aggravated the diagnosed conditions. Without explaining how physiologically

appellant’s accepted employment incident caused or contributed to his diagnosed right knee 

conditions, their opinions are of limited probative value.13 Furthermore, the Board has held that 

the mere fact that appellant’s symptoms arose during a period of employment or produced 

symptoms revelatory of an underlying condition does not establish causal relationship between his 

condition and the employment factors.14

Dr. Salerno requested that OWCP approve appellant’s right knee arthroscopic surgery. She 

noted that he had been under her care since 1991 when he suffered an injury at work. Dr. Salerno

noted that appellant returned to work and was doing well for several years and then began to feel 

discomfort in the right knee. She indicated that an MRI scan of March 8, 2012 revealed a tear of 

the body and posterior horn of the lateral meniscus, small joint effusion with slight complex fluid, 

a tear of the posterior horn of the medial meniscus adjacent to the medial meniscal root, and 

probable meniscal ossicle. Dr. Salerno did not provide an opinion causally relating appellant’s

condition to his accepted employment incident of January 21, 2012. Medical evidence which does 

 

12 Id.

13 See K.K., Docket No. 17-1061 (issued July 25, 2018). 

14 See Richard B. Cissel, 32 ECAB 1910, 1917 (1981); William Nimitz, Jr., 30 ECAB 567, 570 (1979); see also 

R.C., Docket No. 17-0372 (issued May 3, 2018).
10

not offer any opinion regarding the cause of an employee’s condition is of limited probative value 

on the issue of causal relationship.15

The remaining evidence of record includes a March 8, 2012 MRI scan report of appellant’s 

right knee, and a February 6, 2012 x-ray report. The record also contains a pre January 21, 2012 

diagnostic study, i.e., a June 7, 1991 MRI scan of appellant’s right knee. The Board has held that 

diagnostic studies are of limited probative value as they do not address whether the cause of the 

diagnosed conditions.16 

Thus the Board finds that appellant failed to meet his burden of proof to establish that he 

sustained a right knee injury on January 21, 2012 causally related to the accepted employment 

incident.

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

A recurrence of disability means an inability to work after an employee has returned to 

work, caused by a spontaneous change in a medical condition which resulted from a previous 

injury or illness without an intervening injury or new exposure to the work environment that caused 

the illness.

Where an employee claims a recurrence of disability due to an accepted employmentrelated injury, he or she has the burden of proof to establish that the recurrence is causally related 

to the original injury.17 This burden includes the necessity of furnishing evidence from a qualified 

physician who concludes that the condition is causally related to the employment injury.18 The 

physician’s opinion must be based on a complete and accurate factual and medical history and 

supported by sound medical reasoning.19

ANALYSIS -- ISSUE 2

The Board finds appellant has not met his burden of proof to establish a recurrence of

disability on or after January 21, 2012 causally related to his accepted May 23, 1991 employment 

injury.

None of the physicians of record attributed appellant’s diagnosed conditions to a 

spontaneous change in medical condition which resulted from the previous injury or illness without 

 

15 B.P., Docket No. 17-0753 (issued July 10, 2018). 

16 See C.L., Docket No. 17-0354 (issued July 10, 2018); J.S., Docket No. 17-1039 (issued October 6, 2017).

17 20 C.F.R. § 10.104(b); see Federal (FECA) Procedure Manual, at Chapter 2.1500.5 and 2.1500.6 (June 2013). 

18 See S.S., 59 ECAB 315, 318-19 (2008). 

19 Id. at 319. 
11

an intervening injury or new exposure to the work environment.20 Both Dr. Dauhajre and Dr. Jaffe 

inferred that appellant’s condition was related to his federal employment delivering mail on 

January 20 and 21, 2012. These opinions were not sufficiently well rationalized to establish that 

appellant had a traumatic injury causally related his employment on January 21, 2012. However, 

neither Dr. Dauhajre nor Dr. Jaffe indicated that appellant’s right knee conditions, first diagnosed 

in January 2012, were a spontaneous recurrence of the right knee sprain he sustained on 

May 23, 1991. Dr. Dauhajre made several diagnoses with regard to appellant’s right knee, 

including internal derangement of the right knee and aggravation of appellant’s preexisting 

degenerative disease. It is appellant’s burden of proof to establish that newly diagnosed conditions 

are employment related.21 The Board notes that appellant has explained that he did not seek 

medical treatment for his right knee condition between 1991, 1992, and 2012. Therefore there was 

a 20-year gap in appellant’s medical treatment from 1992 to 2012. The medical evidence of record 

therefore does not include bridging evidence to show a spontaneous worsening of the accepted 

conditions, or that the newly diagnosed conditions occurred over time as a result of the May 23, 

1991 employment-related right knee injury.22 The Board therefore finds that appellant has not met 

his burden of proof.23

On appeal counsel notes that Dr. Jaffe predicted that appellant would develop osteoarthritis 

in the future. He also contended that Dr. Jaffe’s report of January 7, 2013 indicated that it was 

common knowledge that an ACL injury will lead to early degeneration and post traumatic arthritis. 

Speculation as to what will happen in the future is not sufficient to establish a claim. An award of 

compensation may not be based on surmise, conjecture, speculation, or the employee’s own belief 

of causal relationship.24

CONCLUSION

The Board finds that appellant has not met his burden of proof to establish that he sustained 

a right knee injury causally related to the accepted January 21, 2012 employment incident. The 

Board further finds that appellant has not established a recurrence of disability on January 21, 2012 

causally related to his accepted May 23, 1991 employment injury. 

 

20 W.H., Docket No. 17-1390 (issued April 23, 2018). 

21 See R.W., Docket No. 17-0775 (issued July 25, 2018). 

22 See M.M., Docket No. 16-1851 (issued January 19, 2018). 

23 H.T., Docket No. 17-0209 (issued February 8, 2018). 

24 L.D., Docket No. 17-1407 (issued January 19, 2018). 
12

ORDER

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

Programs dated April 10, 2017 is affirmed.

Issued: September 19, 2018

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board