United States Department of Labor

Employees’ Compensation Appeals Board

___________________________________________

K.H., Appellant

and

DEPARTMENT OF DEFENSE, PENTAGON 

FORCE PROTECTION AGENCY, 

Washington, DC, Employer

___________________________________________

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Docket No. 18-0036

Issued: September 16, 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 October 5, 2017 appellant, through counsel, filed a timely appeal from an August 1, 

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.

ISSUE

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

causally related to the accepted March 25, 2014 employment incident.

 

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

FACTUAL HISTORY

On December 11, 2015 appellant, then a 44-year-old police officer, filed a traumatic injury 

claim (Form CA-1) alleging that, on March 25, 2014 when running on the track for a mandatory 

fitness improvement program, he tore the meniscus in his left knee while in the performance of 

duty. The employing establishment acknowledged that he had been injured in the performance of 

duty and that its knowledge of the facts about the injury was consistent with his account. 

OWCP received a December 3, 2015 duty status report (Form CA-17) from a physician 

assistant who noted that appellant was running during mandatory training and tore his left knee 

meniscus. 

OWCP received activity restrictions from a physician assistant, dated January 26, 2015, of 

no use of the left knee. 

In a development letter dated December 21, 2015, OWCP informed appellant of the 

deficiencies in the evidence it received and requested that he respond to an attached questionnaire. 

It afforded him 30 days to respond.

In a development letter also dated December 21, 2015, OWCP requested that the 

employing establishment respond to factual inquiries regarding appellant’s claim.

There was no response from either party for the requested for information. 

By decision dated January 22, 2016, OWCP denied appellant’s claim. It explained that the 

claim was denied on the medical component of the third basic element, fact of injury because the 

medical evidence submitted was insufficient to establish that a medical condition was diagnosed 

in connection with the accepted employment incident. OWCP concluded, therefore, that the 

requirements had not been met to establish an injury as defined by FECA.

In a January 22, 2016 response, S.B., a human resources specialist with the employing 

establishment, confirmed that the track that appellant was running on was on Federal Government 

property and that he was required to participate in the activity as part of his training. She provided 

a July 8, 2009 memorandum from S.C., the Director describing the employing establishment’s 

occupational medical and fitness program. Additionally, a copy of the law enforcement and 

security personnel physical fitness program was submitted. 

On April 4, 2016 appellant requested reconsideration and submitted additional evidence. 

In a January 14, 2016 duty status report (Form CA-17) and a January 21, 2016 attending 

physician’s report (Form CA-20), Dr. John Byrne, an internist, noted the history of appellant’s 

injury which occurred on March 25, 2014 and diagnosed a medial meniscal tear. He also noted 

that a magnetic resonance imaging (MRI) scan revealed a torn medial meniscus and diagnosed a 

tear of the medial meniscus of the knee, current. Dr. Byrne checked a box marked “yes” in 

response to whether he believed that the diagnosed condition had been caused or aggravated by an 

employment activity. He commented that appellant had “no problem before work injury.”

Dr. Byrne provided restrictions of no running, jumping, kneeling, walking, or standing for more 

than one hour. 
3

By decision dated June 29, 2016, OWCP denied modification of the prior decision. 

On August 9, 2016 appellant requested reconsideration and submitted additional evidence. 

OWCP received a copy of the December 3, 2015 report and January 14, 2016 report, by a physician 

assistant and Dr. Byrne, respectively, both of which were previously of record. 

By decision dated October 6, 2016, OWCP denied appellant’s request for reconsideration 

finding that the evidence submitted was cumulative and substantially similar to evidence or 

documentation already in the case file and previously considered. It therefore found that the 

evidence was insufficient to warrant a merit review of its prior decision. 

On May 15, 2017 appellant, through counsel, requested reconsideration and submitted new 

medical evidence in support of appellant’s claim. 

In a March 30, 2017 report, Dr. Byrne explained that appellant had been treated since 

May 2014 after he injured his knee in 2014 while participating in a training exercise for his position 

of a law enforcement officer for the employing establishment. He related that at the time of injury

appellant had pain, swelling, and locking consistent with a meniscal tear. Dr. Byrne advised that 

appellant had persistent symptoms since that employment incident and unfortunately, even though 

nonoperative conservative treatment was instituted, the results of appellant’s MRI scan showed a 

meniscal tear. He noted that there was a prolonged period of time trying to obtain approval from 

OWCP for treatment. Dr. Byrne diagnosed medial meniscus tear post knee strain and

recommended arthroscopic intervention. He opined “within a reasonable degree of medical 

certainty that his issues ... are work related, secondary to the injury as outlined.” 

By decision dated August 1, 2017, OWCP denied modification. 

LEGAL PRECEDENT

An employee seeking benefits under FECA 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,3that 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.4 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.5

To determine if an employee sustained a traumatic injury in the performance of duty, 

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

 

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

153 (1989).

4

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

ECAB 312 (1988).

5 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).
4

occurred.6 The second component is whether the employment incident caused a personal injury. 

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 injury.7

To establish causal relationship between the condition, as well as any attendant disability 

claimed and the employment event or incident, the employee must submit rationalized medical 

opinion evidence supporting such causal relationship.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

Certain healthcare providers such as physician assistants, nurse practitioners, physical 

therapists, and social workers are not considered “physician[s]” as defined under FECA.12 

Consequently, their medical findings and/or opinions will not suffice for purposes of establishing 

entitlement to FECA benefits.13

ANALYSIS

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

condition causally related to the accepted March 25, 2014 employment incident.

In support of his claim appellant submitted several medical reports from Dr. Byrne. He 

provided a January 14, 2016 duty status report (Form CA-17) and a January 21, 2016 attending 

physician’s report (Form CA-20) and noted that the injury occurred on March 25, 2014 and 

diagnosed a median meniscal tear. However, Dr. Byrne did not provide an opinion on causal 

relationship. The Board has held that medical evidence that does not offer an opinion regarding 

 

6 Elaine Pendleton, 40 ECAB 1143 (1989).

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

8

J.L., Docket No. 18-0698 (issued November 5, 2018); I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 

465 (2005).

9 L.D., Docket No. 17-1581 (issued January 23, 2018); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

10 L.D., id.; see also Leslie C. Moore, 52 ECAB 132 (2000); Gary L. Fowler, 45 ECAB 365 (1994).

11 T.H., Docket No. 18-1736 (issued March 13, 2019); Dennis M. Mascarenas, 49 ECAB 215 (1997).

12 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t).

13 K.W., 59 ECAB 271, 279 (2007); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006). A report from a physician 

assistant or certified nurse practitioner will be considered medical evidence if countersigned by a qualified physician.

Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3a(1) (January 2013).
5

the cause of an employee’s condition is of no probative value on the issue of causal relationship.14 

These reports therefore are insufficient to establish appellant’s claim. 

In his January 21, 2016 report, Dr. Byrne noted that left knee MRI scan revealed a torn 

medial meniscus. He diagnosed a tear of the medial meniscus of the knee, current. He checked a

box marked “yes” in response to whether he believed that the condition was caused or aggravated 

by an employment activity. The Board has held that when a physician’s opinion on causal 

relationship consists only of checking “yes” to a form question, without explanation or rationale, 

that opinion has little probative value and is insufficient to establish a claim.15 On the form report

Dr. Byrne explained that appellant had “no problem before work injury.” However, a medical 

opinion that indicates that a condition is causally related to an employment injury because the 

employee was asymptomatic before the injury, but symptomatic after is insufficient, without 

supporting rationale, to establish causal relationship.16

In his March 30, 2017 report, Dr. Byrne explained that appellant had been treated since 

May 2014 when his knee was injured while working as a law enforcement officer for the 

employing establishment and participating in a training exercise in 2014. The Board finds, 

however, that Dr. Byrne’s statement is conclusory in nature and fails to provide the specific date 

of injury or rationale as to how appellant injured his knees. The Board has held that a report is of 

limited probative value regarding causal relationship if it does not contain medical rationale 

explaining how a given medical condition/disability was related to employment factors.17 The 

Board finds that Dr. Byrne has not explained the relationship between appellant’s torn left knee 

meniscus and the accepted March 25, 2014 employment incident. A physician’s opinion on causal 

relationship 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 appellant’s specific employment factor(s).18 

The record contains reports from a physician assistant. Health care providers such as 

nurses, acupuncturists, physician assistants, and physical therapists are not considered physicians 

as defined under FECA. Thus, their opinions on causal relationship do not constitute rationalized 

medical opinions and have no weight or probative value.19

As appellant has not submitted rationalized medical evidence establishing a left knee 

condition causally related to the accepted March 25, 2014 employment incident, he has not met 

his burden of proof.20 

 

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

15 See M.O., Docket No. 18-1056 (issued November 6, 2018); Deborah L. Beatty, 54 ECAB 340 (2003).

16 T.M., Docket No. 08-0975 (issued February 6, 2009).

17 See Y.D., Docket No. 16-1896 (issued February 10, 2017).

18 Victor J. Woodhams, supra note 8.

19 Jane A. White, 34 ECAB 515, 518 (1983). See 5 U.S.C. § 8101(2).

20 See Linda I. Sprague, 48 ECAB 386, 389-90 (1997).
6

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 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 left knee 

condition causally related to the accepted March 25, 2014 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the August 1, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: September 16, 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