United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.P., Appellant

and

DEPARTMENT OF THE ARMY, 81st

READINESS DIVISION, AREA 

MAINTENANCE SUPPORT ACTIVITY,

Fort Buchanan, PR, Employer

__________________________________________

)

)

)

)

)

)

)

)

)

)

Docket No. 18-1165

Issued: January 15, 2019

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 May 22, 2018 appellant filed a timely appeal from an April 10, 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 to 

consider the merits of this case.2

 

1 5 U.S.C. § 8101 et seq. 

2 The Board notes that appellant submitted additional evidence on appeal. 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.
2

ISSUE

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

condition causally related the accepted February 7, 2018 employment incident.

FACTUAL HISTORY

On February 14, 2018 appellant, then a 39-year-old military technician/mechanic, filed a 

traumatic injury claim (Form CA-1) alleging that, while repairing a truck in the performance of 

duty on February 7, 2018, he slipped and fell from a height of approximately four feet which 

resulted in a right meniscal tear. He stopped work the same day.

In support of his claim, appellant submitted a report dated February 8, 2018 from

Dr. Juan R. Suarez-Pesante, an attending Board-certified orthopedic surgeon. On examination of 

the right knee, Dr. Suarez-Pesante observed swelling, severe tenderness, and decreased range of 

motion after an unspecified traumatic injury.3 He diagnosed a right knee injury and osteoarthritis 

superimposed on a history of a partial right anterior cruciate ligament (ACL) tear.

Dr. Suarez-Pesante prescribed a knee immobilizer and crutches. 

In a report dated February 12, 2018, Dr. Magdiel Mayol-Urdaz, an attending Boardcertified orthopedic surgeon, noted a history of right knee trauma on February 7, 2018. On 

examination, he observed swelling and instability of the right knee. Dr. Mayol-Urdaz noted that,

although a December 2017 magnetic resonance imaging (MRI) scan showed a small medial tear 

of the posterior horn of the medial meniscus, appellant’s clinical presentation indicated a bucket 

handle medial meniscal tear. He aspirated approximately 40 ccs of synovial fluid from the right 

knee, “suggestive of acute trauma.”

By development letter dated March 1, 2018, OWCP advised appellant of the medical and 

factual evidence needed to establish his claim, including a detailed description of the February 7, 

2018 employment incident, and a narrative report from his physician explaining how and why that 

event would cause the claimed right knee condition. It afforded him 30 days to submit the 

necessary evidence. No response was received.

By decision dated April 10, 2018, OWCP accepted that the February 7, 2018 incident 

occurred as alleged. It denied the claim, however, as causal relationship had not been established

between the diagnosed right knee condition and the accepted February 7, 2018 employment 

incident.

LEGAL PRECEDENT

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 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 

 

3 X-rays of the right knee obtained on February 7, 2018 were negative for fracture or dislocation. 

4 Supra note 1.
3

disability or specific condition for which compensation is claimed is causally related to the 

employment injury.5 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.6

In order to determine whether an employee sustained a traumatic injury in the performance 

of duty, OWCP begins with an analysis of whether fact of injury has been established. Generally, 

fact of injury consists of two components, which must be considered in conjunction with one 

another. The first component to be established is that the employee actually experienced the 

employment incident which is alleged to have occurred.7 The second component is whether the 

employment incident caused a personal injury and generally can be established only by medical 

evidence.8 

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

relationship is rationalized medical evidence.9 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 employee.10 

Neither the mere fact that a disease or condition manifests itself during a period of employment, 

nor the belief that the disease or condition was caused or aggravated by employment factors or 

incidents is sufficient to establish causal relationship.11

ANALYSIS

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

knee condition is causally related to the accepted February 7, 2018 employment incident.

Appellant first sought treatment on February 8, 2018 from Dr. Suarez-Pesante, who 

diagnosed a right knee injury and osteoarthritis superimposed on a history of a partial right ACL 

tear. However, Dr. Suarez-Pesante did not provide an opinion as to whether the diagnosed 

condition was causally related to the accepted employment incident. The Board has held that 

medical evidence that does not offer an opinion regarding the cause of an employee’s condition is 

 

5 Alvin V. Gadd, 57 ECAB 172 (2005); Anthony P. Silva, 55 ECAB 179 (2003). 

6 See Elizabeth H. Kramm (Leonard O. Kramm), 57 ECAB 117 (2005); Ellen L. Noble, 55 ECAB 530 (2004).

7 R.E., Docket No. 17-0547 (issued November 13, 2018); David Apgar, 57 ECAB 137 (2005); Delphyne L. Glover, 

51 ECAB 146 (1999). 

8 R.E., id.

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

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

45 ECAB 365 (1994).

11 Dennis M. Mascarenas, 49 ECAB 215 (1997).
4

of no probative value on the issue of causal relationship.12 This report is, therefore, insufficient to 

establish appellant’s claim.

Appellant was also followed by Dr. Mayol-Urdaz, who noted a February 7, 2018 incident 

and diagnosed a right meniscal tear with effusion suggestive of acute trauma. Dr. Mayol-Urdaz

too did not provide an opinion as to whether the right meniscal tear was causally related to the 

accepted February 7, 2018 traumatic incident. As he did not address causal relationship, his report

is insufficient to meet appellant’s burden of proof.13

As appellant has not submitted rationalized medical evidence sufficient to establish that his 

right knee condition was causally related to the accepted employment incident, he has not met his

burden of proof.14

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 a right knee 

condition causally related to the accepted February 7, 2018 employment incident. 

 

12 See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

13 Id.

14 Id. 
5

ORDER

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

Compensation Programs is affirmed.

Issued: January 15, 2019

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