United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

G.M., Appellant

and

DEPARTMENT OF THE AIR FORCE, 

LAKEHURST NAVAL BASE, 

Lakehurst, NJ, Employer

__________________________________________

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Docket No. 18-1710

Issued: June 3, 2019

Appearances: Case Submitted on the Record

Russell T. Uliase, Esq., for the appellant1

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 September 11, 2018 appellant, through counsel, filed a timely appeal from an April 10, 

2018 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the 

 

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

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.3 

ISSUES

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

hip conditions were causally related or consequential to his accepted February 23, 2015 

employment injury; and (2) whether OWCP has abused its discretion by denying appellant’s 

request for total left hip arthroplasty. 

FACTUAL HISTORY

On February 24, 2015 appellant, then a 52-year-old material handler, filed a traumatic 

injury claim (Form CA-1) alleging that on February 23, 2015 he injured his right knee when he

slipped on ice while in the performance of duty. He did not initially stop work. 

On July 6, 2015 OWCP accepted the claim for chondromalacia of the right patella; fracture 

of the posterior medial tibial plateau, right; and right knee contusion. In the acceptance letter, it

advised appellant that when his claim was first received it appeared to be a minor injury that 

resulted in minimal or no lost time from work and a limited amount of medical expenses were 

administratively approved and paid. OWCP noted that it had reopened his claim because the 

medical bills had exceeded $1,500.00. It noted that, while treating physician Dr. Jason Wong, an

osteopath Board-certified in orthopedic surgery, had indicated additional left hip diagnoses, he had 

not provided medical rationale explaining how the left hip conditions were caused or aggravated 

by the February 23, 2015 employment injury and/or how they developed as a consequence of the 

accepted conditions. OWCP informed appellant of the type of factual and medical evidence 

necessary to establish causal relationship. It afforded his 30 days to submit the necessary evidence. 

In a March 6, 2015 report, Dr. Wong reviewed a right knee magnetic resonance imaging 

(MRI) scan and provided an impression chondromalacia of the patella, possible fracture of the 

posterior medial corner of the tibial plateau, which was asymptomatic. He released appellant to 

work without restrictions. 

In a June 5, 2015 report, Dr. Wong reported that appellant had developed increased pain 

and discomfort to the left lower extremity as he had been favoring the right leg and had been told 

in the past that he had some stress fractures to the left leg. He noted that the x-rays of the left

femur and the left hip demonstrated no fractures or osseous abnormalities, but were reflective of 

mild degenerative changes to the hip. For the left hip, Dr. Wong opined that appellant had some 

arthrofibrosis and possible osteoarthritis with limited range of motion. Appellant also had pain in 

 

2 5 U.S.C. § 8101 et seq.

3 The Board notes that, following the April 10, 2018 decision, OWCP received additional evidence. However, the 

Board’s Rules of Procedure provides: “The Board’s review of a case is limited to the evidence in the case record that 

was before OWCP at the time of its final decision. Evidence not before OWCP will not be considered by the Board

for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this additional 

evidence for the first time on appeal. Id.
3

the distal thigh, which he related might be due to a stress fracture given his history. Dr. Wong 

requested authorization for a bone scan of the left knee, left hip, and left pelvis. 

In response, appellant reported that he suffered stress fractures in both legs and feet while 

in the Army in 1988. He advised that he had been favoring his right injured leg and first 

experienced symptoms in his left leg approximately four to six weeks after the February 23, 2015 

employment injury. 

An October 1, 2015 bone scan of both femurs indicated mild uptake in the left femoral 

neck, which might represent a stress-type injury. The previous computerized tomography (CT) 

scan also suggested bilateral avascular necrosis (AVN) of the hips. The radiologist recommended 

MRI scans of both hips. 

In an October 23, 2015 report, Dr. Wong noted that appellant was status post fracture of 

the tibial plateau in the posterior corner of the right knee, which was resolving with physical

therapy. He provided a history that appellant did not have any discomfort to the left hip until he 

had to start favoring his right leg due to his knee. Dr. Wong opined that appellant’s left hip pain 

may be a stress fracture due to favoring the right lower extremity. He recommended an MRI scan 

of the left hip. On November 11, 2015 appellant underwent a left hip MRI scan, which was 

positive for left femoral head superior AVN, small left hip joint effusion, and left hip mild-tomoderate osteoarthrosis. In a November 20, 2015 report, Dr. Wong indicated that the MRI scan 

showed extensive AVN of the left hip. He explained that, due to the fact appellant had to be 

nonweight bearing from the right knee injury, the increased pressure on the left side exacerbated 

the pain and discomfort in his right hip or in his left hip. Dr. Wong opined that the osteoarthritis 

was chronic, but that the AVN of the left hip may have occurred due to the injury or increased 

pressure in the leg. He noted that appellant ultimately would need a total hip arthroplasty. 

Dr. Wong concluded that the injury to the right leg contributed to the progression and exacerbation 

of the left hip pain. 

In a December 11, 2015 letter of medical necessity, Dr. Wong advised that appellant had a 

diagnosis of AVN of the left hip and the surgical procedure requested was a left total hip 

arthroplasty. He indicated that appellant was experiencing pain in his left hip with weight bearing 

and the November 5, 2015 MRI scan was significant for evidence of a superior AVN. Dr. Wong 

indicated that surgery was necessary as appellant had developed painful AVN of the left hip status 

post a fall, which he believed was exacerbated by having to apply pressure onto the left hip due to 

an injury to the right knee. Dr. Wong continued to report on appellant’s AVN of the left hip. A 

repeat left hip MRI scan was performed on March 18, 2016. In a March 25, 2016 progress report,

Dr. Wong indicated that the MRI scan showed AVN to the femoral head with a bit of collapse. He 

indicated that appellant had limited range of motion and pain with ambulation. Dr. Wong reported 

that appellant would like to proceed with the total hip arthroplasty. 

In a June 15, 2016 report, Dr. Wong noted that he initially saw appellant on February 26, 

2015 for an evaluation of his right knee following the employment injury of February 23, 2015. 

He summarized each of appellant’s examinations, reporting appellant’s assessments and 

diagnostic test results. Dr. Wong concluded that appellant had a final diagnosis of AVN with 

collapse of the femoral head and osteoarthritis of the left hip. He indicated that it was medically 

necessary to proceed with total hip arthroplasty due to the limitation in ambulation and left hip 
4

pain due to the avascular changes and the osteoarthritis. Dr. Wong opined within a reasonable 

degree of medical probability that appellant’s work injury to his right knee significantly 

contributed and/or solely contributed to the development and worsening of the left hip AVN. He 

concluded that appellant developed AVN of the left hip due to his February 23, 2015 employment 

injury. 

On August 18, 2016 OWCP requested that its district medical adviser (DMA) review 

appellant’s medical record and a statement of accepted facts (SOAF) to determine the medical 

necessity of the requested surgery and consequential injury. In an August 22, 2016 report,

Dr. Arnold Berman, the DMA, reviewed the medical records and the SOAF, and opined that the 

closed fracture of appellant’s right tibia was not competent to produce AVN and osteoarthritis of 

the left hip. He explained that the causation of AVN was typically metabolic and nontraumatic 

unless there was a specific major injury to the hip, which was not the situation in this case. The 

DMA noted that if major trauma had occurred it would have required a major facture and taken 

six to seven years for the AVN and degenerative changes to develop. He opined that it was 

unreasonable to conclude that the knee injury would cause AVN and there was no medical 

scientific basis to support such causation conclusion. The DMA noted that the x-ray and MRI scan 

findings indicated that appellant had longstanding preexisting degenerative changes of the left hip. 

He opined that the left hip replacement was required for a preexisting disease, but that it was not 

indicated for any injury or condition associated with the February 23, 2015 employment injury as 

the causation of AVN was typically associated with metabolic and other measures such as 

cortisone or major trauma. 

OWCP referred appellant for a second opinion examination with Dr. Stanley Askin, a 

Board-certified orthopedic surgeon. In an October 7, 2016 report, Dr. Askin reviewed appellant’s 

history of injury and the medical records and provided findings on examination. He noted that 

appellant’s 2013 imaging studies revealed bilateral hip AVN predating the occurrence. Dr. Askin 

disagreed with Dr. Wong that the AVN developed as a consequence of the accepted work-related 

injury and opined that, in this case, the surgery would be addressing a preexisting condition. 

OWCP found a conflict in medical opinion between Dr. Wong and Dr. Askin as to whether 

appellant’s AVN with collapse of the left femoral head and osteoarthritis of the left hip was a 

consequence of the accepted employment injury and whether the total left hip arthroplasty was 

medically necessary and causally related to appellant’s accepted conditions. It referred appellant’s 

claim to Dr. Ian B. Fries, a Board-certified orthopedic surgeon, for an impartial medical evaluation

and an opinion to resolve the conflict in medical opinion evidence. 

In a March 10, 2017 report, Dr. Fries reviewed appellant’s history, including the SOAF, 

and noted that appellant’s accepted conditions of right knee chondromalacia patella, posteromedial 

tibial plateau fracture, and contusion had all healed without subjective or objective residuals. He 

accurately described the February 23, 2015 employment injury and provided a detailed evaluation 

of appellant’s medical records. Dr. Fries also described appellant’s orthopedic examination and 

discussed diagnostic testing. He provided impressions of symptomatic AVN of the left hip, 

asymptomatic AVN of right hip, and healed right knee injury. Dr. Fries confirmed that appellant 

had clear indications for a left total hip replacement to address the symptomatic idiopathic AVN. 

He opined that the fall had not caused necrosis, noting that the CT scan of May 12, 2013 was 

reported to confirm bilateral AVN well prior to his fall. Dr. Fries explained that AVN could be 
5

seen following a major hip fracture or hip dislocation, but not due to more minor trauma. He

further opined that, any aggravation of AVN was not supported by appellant’s history, since the 

first mention of hip symptoms was more than three months after his fall. Dr. Fries concluded that 

appellant had a longstanding left hip avascular arthrosis and osteoarthritis and that the left hip 

pathology was not a consequence of the right knee injury or the injuries sustained in the fall. He 

indicated that the medical evidence supported the medical necessity for a left hip arthroplasty, but 

opined that there was no causal relationship to the accepted traumatic conditions affecting the right 

knee. 

By decision dated August 1, 2017, OWCP denied expansion of the acceptance of 

appellant’s claim to include additional diagnoses of AVN with collapse of the femoral head of the 

left hip and osteoarthritis of the left hip, finding that the evidence of record was insufficient to 

establish that stated conditions were causally related to the accepted February 23, 2015 

employment injury. It also denied his request for authorization of total left hip arthroplasty as the 

evidence of record did not support that it was medically necessary to address the effects of his 

employment injury. OWCP accorded special weight to the opinion of Dr. Fries, the impartial 

medical examiner (IME). 

On April 12, 2017 appellant underwent a left total hip arthroplasty performed by Dr. Wong. 

On August 8, 2017 appellant, through counsel, requested a hearing before a hearing 

representative with OWCP’s Branch of Hearings and Review. A hearing was held on 

January 17, 2018. No additional evidence was received.

By decision dated April 10, 2018, an OWCP hearing representative affirmed the August 1, 

2017 decision, finding that the medical evidence of record was insufficient to establish that 

appellant’s left hip AVN and subsequent surgery were causally related to or a consequence of the 

accepted February 23, 2015 employment injury. She determined that the special weight of medical 

opinion evidence rested with Dr. Fries, the IME, who determined that appellant’s left hip 

pathology was not a consequence of the accepted right knee injury and that there were no causal 

relationship to the accepted traumatic conditions affecting the right knee. The hearing 

representative concluded that, based on the medical evidence of record, OWCP’s denial of the 

requested total left hip arthroplasty was reasonable. 

LEGAL PRECEDENT -- ISSUE 1

An employee seeking benefits under FECA4 has the burden of proof to establish the 

essential elements of his or her claim, including the fact that he or she 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.5 

 

4 Supra note 2.

5 See F.H., Docket No. 18-1238 (issued January 18, 2019); Tracey P. Spillane, 54 ECAB 608 (2003).
6

These are the essential elements of each and every compensation claim, regardless of whether the 

claim is predicated upon a traumatic injury or an occupational disease.6

Where an employee claims that a condition not accepted or approved by OWCP was due 

to an employment injury, he or she bears the burden of proof to establish that the condition is 

causally related to the employment injury.7

Causal relationship is a medical issue and the medical evidence required to establish causal 

relationship is rationalized medical opinion evidence.

8

 The opinion of the physician must be based 

on a complete factual and medical background of the claimant, 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 claimant.9

When an injury arises in the course of employment, every natural consequence that flows 

from that injury likewise arises out of the employment, unless it is the result of an independent 

intervening cause attributable to the claimant’s own intentional misconduct.10 Thus, a subsequent 

injury, be it an aggravation of the original injury or a new and distinct injury, is compensable if it 

is the direct and natural result of a compensable primary injury.11 

Section 8123(a) of FECA provides that, if there is a disagreement between the physician 

making the examination for the United States and the physician of an employee, the Secretary shall 

appoint a third physician (known as a referee physician or impartial medical specialist) who shall 

make an examination.12 This is called a referee examination and OWCP will select a physician 

who is qualified in the appropriate specialty and who has no prior connection with the case.13 

When there exist opposing medical reports of virtually equal weight and rationale and the case is 

referred to an impartial medical specialist for the purpose of resolving the conflict, the opinion of 

 

6 K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); 

Delores C. Ellyett, 41 ECAB 992 (1990).

7

J.C., Docket No. 18-1722 (issued April 15, 2019); D.G., Docket No. 17-1748 (issued June 6, 2018).

8 G.N., Docket No. 18-0403 (issued September 13, 2018); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

9 K.V., Docket No. 18-0723 (issued November 9, 2018); Leslie C. Moore, 52 ECAB 132 (2000); Gary L. Fowler,

45 ECAB 365 (1994).

10 D.H., Docket No. 18-1159 (issued February 15, 2019); Mary Poller, 55 ECAB 483, 487 (2004); 1 Arthur Larson 

& Lex K. Larson, The Law of Workers’ Compensation 10-1 (2006).

11 See Y.P., Docket No. 17-0859 (issued December 4, 2018). Susanne W. Underwood (Randall L. Underwood), 53 

ECAB 139 (2001).

12 5 U.S.C. § 8123(a); A.R., Docket No. 18-0632 (issued October 19, 2018).

13 20 C.F.R. § 10.321.
7

such specialist, if sufficiently well rationalized and based upon a proper factual background, must 

be given special weight.14

ANALYSIS -- ISSUE 1

The Board finds that appellant has not met his burden of proof to establish that his left hip 

conditions were causally related to or consequential to his accepted February 23, 2015 

employment injury.

In his October 23, 2015 report appellant’s treating physician, Dr. Wong related that 

appellant did not have discomfort in his left hip until he started favoring his right leg due to his 

accepted right knee injury. In his June 15, 2016 report, he advised that appellant had a final 

diagnosis of AVN with collapse of the femoral head and osteoarthritis of the left hip. Dr. Wong 

opined that appellant’s employment injury to his right knee significantly contributed and/or solely 

contributed to the development and worsening of the left hip AVN of the left hip and that appellant 

developed AVN of the left hip due to his February 23, 2015 employment injury. Dr. Askin, 

OWCP’s second opinion physician, disagreed with Dr. Wong that appellant’s left hip conditions 

developed as a consequence of the accepted employment injury. 

OWCP properly determined that there was a conflict in medical opinion between Dr. Wong 

and Dr. Askin as to whether appellant’s AVN with collapse of the left femoral head and 

osteoarthritis of the left hip were causally related to or consequential to his accepted employment 

injury. It referred appellant, along with a SOAF, a list of specific questions, and the medical 

record, to Dr. Fries for an impartial medical evaluation and an opinion to resolve these issues.15 

The Board finds that the report of Dr. Fries is sufficient to carry the special weight of the 

medial evidence. In a March 10, 2017 report, Dr. Fries reviewed appellant’s history, including the

SOAF, and noted that appellant’s accepted conditions of right knee chondromalacia patella, 

posteromedial tibial plateau fracture, and contusion had all healed without subjective or objective 

residuals. He described appellant’s orthopedic examination and discussed diagnostic testing. 

Dr. Fries provided impressions of symptomatic AVN of the left hip, asymptomatic AVN of right 

hip, and healed right knee injury. However, he opined that the work-related fall did not cause 

AVN, noting that the May 12, 2013 CT scan was reported to confirm bilateral AVN well prior to

the fall. Dr. Fries explained that AVN could be seen following a major hip fracture or hip 

dislocation, but not due to more minor trauma. He further opined that, any aggravation of AVN

was not supported by appellant’s history, since the first mention of hip symptoms was more than 

three months after his fall. Dr. Fries concluded that appellant had a longstanding left hip avascular 

arthrosis and osteoarthritis and that the left hip pathology was not a consequence of the right knee 

injury or the injuries sustained in the fall. In situations where the case is referred to an impartial 

medical specialist for the purpose of resolving a medical conflict, the opinion of such specialist, if 

 

14 W.M., Docket No. 18-0957 (issued October 15, 2018); Darlene R. Kennedy, 57 ECAB 414 (2006). 

15 A.R., Docket No. 09-1566 (issued June 2, 2010); M.S., 58 ECAB 328 (2007); Bryan O. Crane, 56 ECAB 

713 (2005).
8

sufficiently well rationalized and based upon a proper factual background, must be given special 

weight.16

On appeal, counsel asserts that Dr. Fries’ report cannot carry the special weight of the 

evidence. He erroneously argues that Dr. Fries’ failed to provide a medical opinion as to 

osteoarthritis. As noted, Dr. Fries had indicated that the osteoarthritis was not a consequence of 

the right knee injury or the other employment-related injuries. Counsel also cited two Board 

decisions in which OWCP decisions were remanded based on the selected specialist not reviewing 

relevant medical evidence pertaining to a preexisting condition and where the IME was unable to 

review the complete medical record. In this case, he indicated that Dr. Fries reported the AVN

was preexisting based on a 2013 CT scan, which he did not have in his possession. However, the 

CT scan results were described and compared in the MRI scan report which Dr. Wong had 

submitted. The hearing representative specifically found that there was no medical evidence to 

refute the accuracy of those findings. Counsel additionally asserts that Dr. Fries failed to offer an 

opinion as to the aggravation of preexisting conditions, that his opinions were generalizations, and 

that he mischaracterized Dr. Wong’s findings as Dr. Wong had not stated that the left hip condition 

was traumatic, but that his altered gait aggravated his left hip. Dr. Fries, however, explained why 

AVN was not seen or due to minor trauma. He also opined that, an aggravation of AVN was not 

supported by appellant’s history, since the first mention of hip symptoms was more than three 

months after his fall. 

The Board finds that Dr. Fries provided a well-rationalized opinion based on a complete 

background, his review of the accepted facts, the medical record, and his examination findings. 

Dr. Fries’ opinion that the left hip avascular arthrosis and osteoarthritis and left hip pathology were

not a consequence of the right knee injury or the injuries sustained in the fall affecting the right 

knee is entitled to special weight and represents the weight of the evidence.17

Accordingly, the Board finds that appellant has not met his burden of proof to establish 

expansion of the acceptance of his claim to include additional diagnoses of AVN with collapse of 

the femoral head of the left hip and osteoarthritis of the left hip. 

LEGAL PRECEDENT -- ISSUE 2

Section 8103(a) of FECA provides for the furnishing of services, appliances, and supplies 

prescribed or recommended by a qualified physician, which OWCP considers likely to cure, give 

relief, reduce the degree or the period of disability, or aid in lessening in the amount of monthly 

compensation.18 In interpreting this section of FECA, the Board has recognized that OWCP has 

broad discretion in approving services provided under FECA to ensure that an employee recovers 

from his or her injury to the fullest extent possible in the shortest amount of time.19 OWCP has 

 

16 See W.M., Docket No. 17-0337 (issued August 8, 2017); Guiseppe Aversa, 55 ECAB 164 (2003).

17 5 U.S.C. § 8123(a); see R.S., Docket No. 10-1704 (issued May 13, 2011); S.T., Docket No. 08-1675 (issued 

May 4, 2009).

18 Id. at § 8103; B.L., Docket No. 17-1813 (issued May 23, 2018). 

19 I.T., Docket No. 17-1012 (issued July 24, 2018); W.T., Docket No. 08-0812 (issued April 3, 2009). 
9

broad administrative discretion in choosing the means to achieve this goal. The only limitation on 

OWCP’s authority is that of reasonableness.20

Abuse of discretion is generally shown through proof of manifest error, clearly 

unreasonable exercise of judgment or actions taken which are contrary to both logic and probable 

deductions from established facts. It is not enough to merely show that the evidence could be 

construed so as to produce a contrary factual conclusion.21

While OWCP is obligated to pay for treatment of employment-related conditions, appellant 

has the burden of proof to establish that the expenditure is incurred for treatment of the effects of 

an employment-related injury or condition.22 Proof of causal relationship in a case such as this 

must include supporting rationalized medical evidence.23 Therefore, in order to prove that the 

surgical procedure is warranted, appellant must submit medical evidence to show that the 

procedure was for a condition causally related to the employment injury and that the surgery was 

medically warranted. Both of these criteria must be met in order for OWCP to authorize 

payment.24

ANALYSIS -- ISSUE 2

The Board further finds that OWCP has not abused its discretion by denying appellant’s 

request for total left hip arthroplasty. 

As previously discussed, OWCP properly determined that a conflict existed in the medical 

opinion evidence as to whether his left hip conditions were causally related to the accepted 

employment injury and necessitated total hip replacement. The Board finds that OWCP properly 

accorded special weight to Dr. Fries’ medical opinion as an IME.

25

 Dr. Fries specifically found 

that, while the medical evidence supported the medical necessity for a left hip arthroplasty, there 

was no causal relationship between the diagnosed left hip conditions and the accepted conditions 

affecting the right knee. As previously noted he explained that appellant had longstanding left hip 

avascular arthrosis and osteoarthritis, which were not causally related to the minor trauma caused 

by appellant’s accepted employment injury. 

The only limitation on OWCP’s authority is approving or disapproving service under 

FECA is one of reasonableness.26 In the instant case, OWCP received a letter of medical necessity 

from Dr. Wong for a total left arthroplasty due to AVN of the left hip. It obtained an impartial 

 

20 See N.M., Docket No. 18-1584 (issued March 15, 2019); Mira R. Adams, 48 ECAB 504 (1997).

21 J.T., Docket No. 16-0731 (issued May 11, 2017); L.W., 59 ECAB 471 (2008). 

22 N.G., Docket No. 18-1340 (issued March 6, 2019); see also Debra S. King, 44 ECAB 203, 209 (1992).

23 Id.; see also Bertha L. Arnold, 38 ECAB 282 (1986).

24 See N.M., supra note 20; see also Cathy B. Millin, 51 ECAB 331, 333 (2000).

25 Supra note 14. 

26 See W.M., supra note 16; Daniel J. Perea, 42 ECAB 214, 221 (1990).
10

medical examination through Dr. Fries who found that, while the total left hip arthroplasty was 

warranted, it was not causally related to the accepted right knee injury. OWCP therefore had 

sufficient evidence upon which it made its decision to deny surgery and did not abuse its 

discretion.27

CONCLUSION

The Board finds that appellant has not met his burden of proof to establish that his left hip 

conditions were causally related to or consequential to his accepted February 23, 2015 

employment injury. The Board further finds that OWCP has not abused its discretion by denying 

his request for total left hip arthroplasty.

ORDER

IT IS HEREBY ORDERED THAT the April 10, 2018 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: June 3, 2019

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

 

27 Id.