United States Department of Labor

Employees’ Compensation Appeals Board

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J.F., Appellant

and

DEPARTMENT OF JUSTICE, FEDERAL 

BUREAU OF PRISONS, Edgefield, SC, 

Employer

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Docket No. 19-0456

Issued: July 12, 2019

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On December 27, 2018 appellant, through counsel, filed a timely appeal from an 

August 27, 2018 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.

 

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

ISSUE

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

causally related to the accepted January 2, 2017 employment incident. 

FACTUAL HISTORY

On January 4, 2017 appellant, then a 26-year-old correctional officer, filed a claim for 

traumatic injury (Form CA-1) alleging that he injured his left knee on January 2, 2017 while in the 

performance of duty. He indicated that he picked up an inmate then another officer grabbed the 

inmate by the shoulders, which caused appellant to come down on his left knee. Appellant

explained that his left knee was swollen and painful, and that he needed to follow-up with the 

physician who previously operated on his knee to make sure nothing was damaged. On the reverse 

side of the Form CA-1, the employing establishment indicated that he was in the performance of 

duty when injured. It further noted that appellant stopped work on January 3, 2017. Appellant did 

not submit any medical evidence in support of his claim for FECA benefits.

By development letter dated January 10, 2017, OWCP advised appellant of the type of 

evidence needed to establish his claim for FECA benefits. It explained that it had not received any 

medical evidence, and requested that he provide a narrative report from his physician. OWCP also 

inquired about appellant’s preexisting left knee condition and the surgery he referenced on the 

Form CA-1. It specifically asked whether appellant’s condition had resolved prior to the 

January 2, 2017 incident. OWCP afforded her 30 days to submit the requested factual and medical 

evidence. No additional evidence was received.

By decision dated February 14, 2017, OWCP denied appellant’s traumatic injury claim. It 

accepted that the January 2, 2017 employment incident occurred as alleged; however, appellant 

did not submit any medical evidence containing a diagnosis in connection with his injury. OWCP 

concluded, therefore, that the requirements had not been met to establish an injury as defined under 

FECA. 

OWCP subsequently received a January 16, 2017 report from Dr. Todd Tupis, a Boardcertified orthopedist, who saw appellant for follow-up regarding his left knee. Dr. Tupis indicated 

that appellant’s history was significant for anterior cruciate ligament (ACL) reconstruction on 

May 1, 2014. He also noted that appellant had reached maximum medical improvement (MMI) 

and was released on November 3, 2014. Dr. Tupis further noted that appellant reported that on 

January 2, 2017 he was picking an inmate up and a coworker came up behind the inmate lifting 

him from his shoulders, which caused appellant to fall down causing him to strike his left knee on 

the concrete. Appellant reported seeking treatment from a local hospital and underwent x-rays and 

was issued a knee immobilizer. Findings on examination revealed small effusion of the left knee, 

a clean and dry incision, some mild quadriceps atrophy, mild tenderness at the medial joint line,

and sensation was intact. Dr. Tupis diagnosed pain in the left knee. He noted x-rays of the left 

knee revealed ACL reconstruction with no change in placement of the hardware. Dr. Tupis 

referred appellant for a magnetic resonance imaging (MRI) scan, prescribed a brace, and released 

him to work full duty.
3

On February 5, 2018 appellant requested reconsideration and resubmitted Dr. Tupis’

January 16, 2017 treatment notes.

By a decision dated February 16, 2018, OWCP denied modification of the decision dated 

February 14, 2017. It found that although Dr. Tupis correctly recounted the nature of appellant’s 

January 2, 2017 employment incident, he did not provide a diagnosis in connection with the 

incident. OWCP explained that pain and swelling were symptoms of an underlying condition, 

rather than a diagnosis in their own right.

On July 12, 2018 counsel requested reconsideration of the February 16, 2018 decision. 

Additional evidence received since OWCP’s most recent decision included January 4, 

2017 emergency room treatment records. Dr. Stephen L. Shelton, Board-certified in emergency 

medicine, examined appellant for a left knee injury that reportedly occurred at work two days prior. 

He noted a May 2014 history of multiple ligament repairs to the left knee. Appellant reported 

working as a prison guard where two days prior he was involved in an altercation with an inmate. 

Dr. Shelton noted that appellant lifted the inmate into the air causing appellant to fall and land 

directly on his left knee. He reported persistent left knee pain with mild swelling. An x-ray of the 

left knee revealed status post prior ACL repair, no fractures, no knee joint effusion, and proper 

anatomic alignment. Dr. Shelton diagnosed left knee contusion, placed appellant in a knee 

immobilizer with crutches, and discharged him.

On October 2, 2017 appellant was seen by Dr. James D. Washburn, an emergency 

medicine specialist, and subsequently seen by Dr. Jeffrey Guy, a Board-certified orthopedist. 

Dr. Washburn treated appellant in the emergency department for complaints of chronic left knee 

pain. He noted appellant’s prior history of left ACL repair. Dr. Washburn also indicated that 

appellant reported that his left knee had been bothering him since January 2017 when he fell onto 

it. He provided an assessment of chronic left knee pain and history of left ACL repair. 

Dr. Washburn discharged appellant and recommended that he follow-up with an orthopedist. 

Later that same day, Dr. Guy examined appellant. He noted that appellant had undergone 

left knee hamstring reconstruction in 2014. Appellant reported falling at work in January 2017,

and subsequently experiencing left knee swelling and instability. Findings on examination of the 

left knee revealed a well-healed prior ACL surgical incision, small effusion, no tenderness or 

swelling, normal range of motion, and intact strength, sensation, and reflexes. X-rays of the left 

knee revealed prior ACL reconstruction and mild osteophyte formation of the medial and 

patellofemoral compartments. Dr. Guy diagnosed status post left knee ACL repair in May 2014,

with recurrent left ACL tear by examination. In a separate note dated October 2, 2017, he returned 

appellant to work with restrictions. 

An October 17, 2017 left knee MRI scan revealed a complex tear of the posterior horn of 

the medial meniscus and a small tear of the lateral meniscus. 

Dr. Guy saw appellant in follow-up on October 19, 2017 for complaints of left knee 

instability, popping, and clicking. He noted that the MRI scan demonstrated a medial and lateral 

meniscus tear. Dr. Guy diagnosed complex tear of the posterior horn of the medial meniscus of 
4

the left knee and undersurface tear of the lateral meniscus. He recommended a left knee 

arthroscopic partial medial and lateral meniscectomy. On March 2, 2018 Dr. Guy returned 

appellant to light duty with a left knee brace.

A November 1, 2017 addendum to Dr. Guy’s initial October 2, 2017 treatment records 

noted that appellant reported that a reinjury occurred in September 2017 while going upstairs at 

work. Appellant denied falling, and reportedly just felt sharp pain. 

By decision dated August 27, 2018, OWCP denied modification of the decision dated 

February 16, 2018. It explained that appellant failed to provide evidence that contained a 

physician’s diagnosis of a medical condition associated with the January 2, 2017 employment 

incident.

LEGAL PRECEDENT

An employee seeking benefits under FECA3 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 of FECA,

4

that an injury was sustained in the performance of duty as alleged, and that 

any disability or medical 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 upon a traumatic injury or an occupational disease.6

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.7 

Generally, fact of injury consists of two components that must be considered in conjunction with 

one another. The first component is whether the employee actually experienced the employment 

incident that allegedly occurred.8 The second component is whether the employment incident 

caused a personal injury.9 An employee may establish that an injury occurred in the performance 

of duty as alleged, but fail to establish that the disability or specific condition for which 

compensation is being claimed is causally related to the employment incident.10

 

3

Id. 

4 S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989).

5

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

6 K.M., Docket No. 15-1660 (issued September 16, 2016).

7 D.B., Docket No. 18-1348 (issued January 4, 2019); T.H., 59 ECAB 388, 393-94 (2008).

8 D.S., Docket No. 17-1422 (issued November 9, 2017); Elaine Pendleton, 40 ECAB 1143 (1989).

9 B.M., Docket No. 17-0796 (issued July 5, 2018); John J. Carlone, 41 ECAB 354 (1989).

10 Shirley A. Temple, 48 ECAB 404, 407 (1997).
5

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.11 A physician’s opinion on whether there is a causal relationship 

between the diagnosed condition and the accepted employment incident must be based on a 

complete factual and medical background.12 Additionally, the physician’s opinion must be 

expressed in terms of a reasonable degree of medical certainty, and must be supported by medical 

rationale, explaining the nature of the relationship between the diagnosed condition and the 

specific employment incident.13

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish a left knee injury 

causally related to the accepted January 2, 2017 employment incident. 

Appellant claimed to have injured his left knee as a result of an incident with an inmate on 

January 2, 2017. OWCP accepted that the January 2, 2017 incident occurred as alleged. Appellant 

also had a history of a preexisting left knee injury, which required left knee hamstring 

reconstruction surgery in 2014. In any case where a preexisting condition involving the same part 

of the body is present and the issue of causal relationship therefore involves aggravation, 

acceleration or precipitation, the physician must provide a rationalized medical opinion that 

differentiates between the effects of the work-related injury or disease and the preexisting 

condition.14

Following the January 2, 2017 employment incident, appellant was treated in the 

emergency department on January 4, 2017. Dr. Shelton referenced appellant’s prior left knee 

surgery, as well as a January 2017 incident at work where he lifted an inmate, which caused him

to fall and land directly on his left knee. Although he diagnosed left knee contusion, he did not 

specifically address the cause of the diagnosed condition. The Board has held that medical 

evidence that does not offer any opinion regarding the cause of an employee’s condition is of no

probative value on the issue of causal relationship.15

Dr. Tupis examined appellant on January 16, 2017. He provided an assessment of left knee 

pain, and advised that appellant could return to work full duty. As OWCP correctly noted, pain is 

a symptom, not a specific medical diagnosis.16 Accordingly, Dr. Tupis’ January 16, 2017 report 

 

11 T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 238 (1996).

12 M.V., Docket No. 18-0884 (issued December 28, 2018).

13 Id.; Victor J. Woodhams, 41 ECAB 345, 352 (1989).

14 M.E., Docket No. 18-0940 (issued June 11, 2019); Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal 

Relationship, Chapter 2.805.3e (January 2013).

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

16 Findings of pain or discomfort alone do not satisfy the medical aspect of the fact of injury medical determination. 

Supra note 14 at Chapter 2.803.4a(6) (August 2012).
6

is insufficient to satisfy appellant’s burden of proof. Dr. Washburn’s October 2, 2017 assessment 

of chronic left knee pain is similarly insufficient to establish entitlement to FECA benefits.17

In his separate October 2, 2017 report, Dr. Guy noted that appellant underwent a left knee 

hamstring reconstruction in 2014 and was progressing well until a fall in January 2017. He

diagnosed status post left knee ACL repair in May 2014, with recurrent left ACL tear. After 

reviewing appellant’s recent left knee MRI scan, Dr. Guy no longer diagnosed recurrent left knee 

ACL tear, but instead diagnosed tears of the left medial and left lateral meniscus. In his 

October 19, 2017 report, he recommended arthroscopic surgery to repair the noted left knee 

meniscal tears. Both the October 2 and October 19, 2017 reports are insufficient to establish causal 

relationship because Dr. Guy did not specifically address whether appellant’s employment 

activities either caused or aggravated his current left knee condition.18 

Additionally, Dr. Guy’s October 2, 2017 and March 2, 2018 work status form reports are 

insufficient to establish causal relationship because they fail to include a diagnosis and an opinion 

on causal relationship.19

An October 17, 2017 left knee MRI scan revealed tears in the medial and lateral meniscus. 

The Board has held that diagnostic tests lack probative value as they do not provide an opinion on 

causal relationship between appellant’s employment duties and a diagnosed condition.20

As the medical evidence of record fails to establish causal relationship between appellant’s 

left knee condition and the January 2, 2017 employment incident, appellant is not entitled to FECA 

benefits.

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 established a left knee injury causally related to the 

accepted January 2, 2017 employment incident. 

 

17 Id.

18 See A.D., 58 ECAB 149 (2006).

19 Id. 

20 See J.M., Docket No. 17-1688 (issued December 13, 2018).
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ORDER

IT IS HEREBY ORDERED THAT the August 27, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: July 12, 2019

Washington, DC

Christopher J. Godfrey, 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