United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.B., Appellant

and

U.S. POSTAL SERVICE, COLESVILLE POST 

OFFICE, Silver Spring, MD, Employer

__________________________________________

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Docket No. 21-0150

Issued: January 10, 2022

Appearances: Case Submitted on the Record

Stephen Larkin, for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On November 11, 2020 appellant, through her representative, filed a timely appeal from 

an August 25, 2020 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.3

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.

3 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

ISSUES

The issues are: (1) whether OWCP has met its burden of proof to terminate appellant’s 

wage-loss compensation and medical benefits, effective January 15, 2020, as she no longer had 

disability or residuals causally related to her accepted January 8, 2018 employment injury; and 

(2) whether appellant has met her burden of proof to establish continuing disability or residuals on 

or after January 15, 2020 due to the accepted January 8, 2018 employment injury.

FACTUAL HISTORY

On January 8, 2018 appellant, then a 55-year-old letter carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on that date she suffered a right knee injury when she slipped and 

fell on an icy walkway while delivering a package in the performance of duty. She initially stopped 

work on January 9, 2018. 

On March 22, 2018 OWCP accepted the claim for lateral meniscus tear of the right knee, 

right knee contusion, and right knee sprain. Appellant underwent OWCP-authorized right knee 

arthroscopy with partial lateral meniscectomy, debridement of chondromalacia, and removal of 

loose body on May 4, 2018. She stopped work on that date and did not return. OWCP paid 

appellant wage-loss compensation on the supplemental rolls from May 12 through October 13,

2018 and on the periodic rolls, commencing October 14, 2018.

In a December 28, 2018 report, Dr. James York, a Board-certified orthopedic surgeon, 

noted that appellant experienced continued right knee pain following her right knee surgery. He 

examined appellant and diagnosed left knee articular cartilage damage and meniscal tear, 

aggravation of lumbar spondylosis, strain and tearing of the pelvis, aggravation of left hip 

osteoarthritis, and strain and tearing of the left thigh. Dr. York recommended physical therapy 

treatment and advised that appellant could not work for three months.

On February 4, 2019 OWCP referred appellant, a statement of accepted facts (SOAF), and 

a series of questions to Dr. Rafael Steuart, a Board-certified orthopedic surgeon, for a second 

opinion evaluation to determine the nature of her accepted conditions, the extent of disability, and 

appropriate medical treatment.

In a February 27, 2019 report, Dr. Steuart noted his review of the SOAF and appellant’s 

medical record. He examined appellant and opined that her right knee discomfort related to her 

preexisting degenerative joint disease. Dr. Steuart further opined that appellant’s work-related 

conditions had resolved and indicated that she could resume full-duty work as a letter carrier.

In an April 18, 2019 report, Dr. York opined that appellant’s employment injury 

aggravated her underlying hip arthritis and lumbar spondylosis. He found that the mechanism of 

slipping and falling “result[ed] in an injury force of 2,500 N[ewtons]” which caused trauma to the 

component parts of her knees, hips, pelvis, and lumbar spine. Dr. York noted that appellant’s 

preexisting arthritis, chondromalacia, and lumbar spondylosis were asymptomatic and that the 

employment injury significantly aggravated these conditions. He indicated that appellant had no 

thigh, pelvis, back, hip, or knee symptoms prior to the employment injury. Dr. York opined that 

appellant suffered permanent aggravation of her underlying conditions and that she was not able 

to return to work in any capacity.
3

In a June 6, 2019 supplemental report, Dr. Steuart reviewed reports from Dr. York. He 

again opined that no other medical diagnoses were causally related to the employment injury other 

than those that were previously accepted. Dr. Steuart advised that appellant could return to fullduty work as she had a normal physical examination without any objective clinical findings.

On July 11, 2019 OWCP referred appellant, an updated SOAF, and a series of questions to

Dr. Robert M. Saltzman, a Board-certified orthopedic surgeon, for an impartial medical 

examination to resolve the conflict of medical opinion evidence between Dr. York, appellant’s 

treating physician, and Dr. Steuart, OWCP’s referral physician.

In an August 12, 2019 report, Dr. Eric Dawson, an orthopedic surgeon, noted appellant’s 

history of injury and provided physical examination findings and diagnosed left knee tears, 

insertional tendinitis, adductor muscle tear, left hip tear, and lumbar nerve impingement. 

Dr. Dawson noted that there was no evidence of previous injuries and opined that the employment 

injury caused appellant’s conditions. He recommended electromyography (EMG) and nerve 

conduction velocity (NCV) studies. 

In a report, dated August 16, 2019, Dr. Saltzman reviewed the medical record and SOAF. 

He examined appellant and found that her range of motion (ROM) in the right knee was from 10 

to 100 degrees. Dr. Saltzman opined that appellant’s right knee symptoms were related to her 

underlying degenerative joint disease. He noted that she had a temporary aggravation of right knee 

degenerative joint disease with degenerative lateral meniscus tear, which was treated by 

arthroscopic partial lateral meniscectomy. Dr. Saltzman agreed with Dr. Steuart’s assessment that 

appellant’s current symptoms were related to her preexisting conditions. He indicated that her 

magnetic resonance imaging (MRI) scan findings appeared to show degenerative conditions and 

not acute abnormalities. Dr. Saltzman further noted that appellant’s x-ray findings showed 

underlying hip arthritis prior to the employment injury. He advised that appellant was unable to 

resume work as a letter carrier due to her preexisting osteoarthritis. Dr. Saltzman noted that she 

could only work in a light-duty capacity with limited walking, standing, pushing, and pulling.

On September 5, 2019 OWCP requested that Dr. Saltzman provide clarification regarding 

why appellant’s aggravation was temporary and when it resolved. It further requested that he 

provide medical rationale as to whether appellant’s accepted conditions had resolved.

In a September 12, 2019 addendum report, Dr. Saltzman noted that appellant’s MRI scan 

and physical examination findings at the time of her arthroscopic surgery did not show any acute 

changes. He indicated that her meniscus tear was “more than likely present even prior” to the 

employment injury. Dr. Saltzman advised that it was not possible to fully determine the difference 

between the work-related aggravation and the natural course of osteoarthritis. He opined that 

appellant’s aggravation of right knee degenerative joint disease was temporary as she sustained a 

knee sprain with no new findings. “Without any new specific injury,symptoms would be expected 

to resolve with time but the arthritis not only remains constant, but worsens with time.” He went 

on to say that a sprain would be expected to heal after six months and any aggravation beyond that 

time would be related to her underlying tricompartmental osteoarthritis. Dr. Saltzman noted that 

appellant’s lateral meniscus tear resolved with surgical intervention and her right knee contusion 

resolved with time. He found that appellant’s right knee sprain also resolved as she had no 

ligamentous laxity on physical examination or ligament tears on MRI scan. Dr. Saltzman opined 

that her current objective findings were expected given her age, weight, and underlying 

osteoarthritis.
4

In a September 26, 2019 report, Dr. Dawson noted that appellant had continued pain, 

spasm, stiffness, discomfort, numbness, tingling, burning, and weakness to the back, ankles, and 

knees. He provided physical examination findings and diagnosed lumbar discopathy with nerve 

impingement, intraarticular pathology to the right knee, and ankle sprain. 

On October 17, 2019 OWCP expanded the acceptance of appellant’s claim to include 

resolved temporary aggravation of tricompartmental osteoarthritis of the right knee.

On October 18, 2019 OWCP issued a notice proposing to terminate her wage-loss 

compensation and medical benefits based on Dr. Saltzman’s opinion that the January 8, 2018 

accepted conditions had ceased without residuals or disability. It afforded her 30 days to submit 

additional evidence or argument challenging the proposed termination. 

OWCP subsequently received an October 16, 2019 report from Dr. York who provided 

physical examination findings and diagnosed right chondromalacia and right knee primary 

osteoarthritis. In an accompanying duty status report (Form CA-17), Dr. York advised that 

appellant could not resume work.

In an October 25, 2019 report, Dr. Dawson provided physical examination findings. He 

noted that appellant had enthesopathy to the right knee and indicated that her employment duties 

contributed to her knee conditions. Dr. Dawson refuted Dr. Saltzman’s assessment that appellant’s 

conditions were due to degenerative changes. He opined that the employment injury stretched 

appellant’s medial components and compressed her lateral components. Dr. Dawson noted that 

her femoral condyle hammered her lateral tibial eminence and plateau with her lateral meniscus 

cartilage caught in between. He advised that appellant’s symptoms were due to this mechanism 

of injury. Dr. Dawson further indicated that Dr. Saltzman failed to adequately measure appellant’s 

ROM or describe which ligaments of the knee were tested. He noted that appellant performed fullduty work without restrictions prior to the employment injury. Dr. Dawson asserted that appellant 

had pain, swelling, and stiffness, which was not considered by Dr. Saltzman. 

By decision dated January 15, 2020, OWCP finalized the proposed termination of 

appellant’s wage-loss compensation and medical benefits, effective that date. It found that the 

medical evidence submitted was insufficient to outweigh Dr. Saltzman’s opinion, with whom the 

special weight of the medical evidence rested.

On January 22, 2020 appellant requested an oral hearing before a representative of 

OWCP’s Branch of Hearings and Review. 

In a February 5, 2020 report, Dr. York examined appellant and diagnosed right knee 

chondromalacia, right knee osteoarthritis, left knee arthritis, right knee lateral meniscus tear, and 

right knee injury. In an accompanying CA-17 report, he advised that appellant could resume 

limited-duty work with restrictions. 

A telephonic hearing was held on June 10, 2020. Appellant testified that she returned to 

work on January 16, 2020. 

In a June 22, 2020 report, Dr. Dawson noted that appellant had no significant preexisting 

arthritic condition or other major medical condition that would affect her knees prior to the 

employment injury. He reiterated that the employment injury was sufficient to cause a sprain, 

strain, or even tear to the nerves of the intraarticular structures. Dr. Dawson indicated that 
5

appellant demonstrated a loss of ROM and atrophic changes on examination. He opined that 

appellant’s conditions were not simply due to aging and were traumatic in nature. Dr. Dawson 

noted that meniscal surgery caused loss of long-term stability in her right knee. He opined that the 

employment injury caused a permanent aggravation of appellant’s osteoarthritis.

By decision dated August 25, 2020, OWCP’s hearing representative affirmed the 

January 15, 2020 termination decision. 

LEGAL PRECEDENT -- ISSUE 1

Once OWCP accepts a claim and pays compensation, it has the burden of proof to justify 

modification or termination of an employee’s benefits.4 After it has determined that, an employee 

has disability causally related to his or her federal employment, OWCP may not terminate 

compensation without establishing that the disability has ceased or that it is no longer related to 

the employment.5 Its burden of proof includes the necessity of furnishing rationalized medical 

opinion evidence based on a proper factual and medical background.6

The right to medical benefits for an accepted condition is not limited to the period of 

entitlement for disability.7 To terminate authorization for medical treatment, OWCP must 

establish that appellant no longer has residuals of an employment-related condition, which would 

require further medical treatment.8

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

examination for the United States and the physician of the employee, the Secretary shall appoint a 

third physician who shall make an examination.9 When there are opposing reports of virtually 

equal weight and rationale, the case must be referred to an impartial medical specialist, pursuant 

to section 8123(a) of FECA, to resolve the conflict in the medical evidence. 10

4 R.H., Docket No. 19-1604 (issued October 9, 2020); S.F., 59 ECAB 642 (2008); Kelly Y. Simpson, 57 ECAB 

197 (2005); Paul L. Stewart, 54 ECAB 824 (2003).

5 C.R., Docket No. 19-1132 (issued October 1, 2020); I.J., 59 ECAB 408 (2008); ElsieL. Price, 54 ECAB 

734 (2003).

6 E.K., Docket No. 18-0835 (issued September 23, 2020); G.H.,Docket No. 18-0414 (issued November 14, 2018); 

Del K. Rykert, 40 ECAB 294-96(1988).

7 M.P., Docket No. 20-0024 (issued September 1, 2020); L.W.,Docket No. 18-1372 (issued February 27, 2019);

Furman G. Peake, 41 ECAB 361, 364 (1990).

8 D.B., Docket No. 19-0663 (issued August 27, 2020); R.P.,Docket No. 18-0900 (issued February 5, 2019);

CalvinS. Mays, 39 ECAB 993 (1988).

9

5 U.S.C. § 8123(a); V.S., Docket No. 19-1792 (issued August 4, 2020); L.T.,Docket No. 18-0797 (issued 

March 14, 2019); Shirley L. Steib, 46 ECAB 309, 317(1994).

10 D.B., supra note 8; DarleneR. Kennedy, 57 ECAB 414 (2006); Gloria J. Godfrey, 52 ECAB 486 (2001).
6

ANALYSIS -- ISSUE 1

The Board finds that OWCP has not met its burden of proof to terminate appellant’s wageloss compensation and medical benefits, effective January 15, 2020.

Appellant’s attending physician, Dr. York opined that appellant was totally disabled from 

work and had ongoing residuals related to the accepted employment injury. OWCP referred 

appellant for a second opinion evaluation with Dr. Steuart who opined that appellant’s workrelated conditions had resolved and indicated that she could resume full-duty work as a letter 

carrier. In order to resolve the conflict, OWCP properly referred appellant for an impartial medical 

examination with Dr. Saltzman, pursuant to 5 U.S.C. § 8123(a).11

In a September 12, 2019 supplemental report, Dr. Saltzman noted that appellant’s 

meniscus tear was likely present prior to the employment injury. He advised that it was not 

possible to fully determine the difference between the work-related aggravation and the natural 

course of osteoarthritis. Dr. Saltzman opined that appellant’s aggravation of right knee 

degenerative joint disease was temporary, pointing out that appellant had sustained a knee sprain 

without any findings and that “Without any new specific injury, symptoms would be expected to 

resolve with time but the arthritis not only remains constant, but worsens with time.” He further 

pointed out that a sprain would be expected to resolve after six months and that any aggravation 

beyond six months would be related to her underlying tricompartmental osteoarthritis. 

Dr. Saltzman noted that appellant’s lateral meniscus tear resolved with surgical intervention and 

her right knee contusion resolved with time. He found that appellant’s right knee sprain also 

resolved as she had no ligamentous laxity on physical examination or ligament tears on MRI scan.

The Board finds that Dr. Saltzman’s opinion was conclusory in nature and did not contain 

sufficient medical reasoning to establish that appellant was no longer disabled due to her accepted 

January 8, 2018 employment injury.12 The factors that determine the probative value of medical 

evidence include the opportunity for and thoroughness of examination performed by the physician, 

the accuracy, or completeness of the physician’s knowledge of the facts and medical history, the 

care of analysis manifested, and the medical rationale expressed by the physician on the issues 

addressed to him by OWCP.13

Dr. Saltzman opined that appellant’s accepted conditions had resolved. However, he failed 

to provide a well-rationalized opinion explaining how or whether the accepted January 8, 2018 

employment injury contributed, in any way, to the preexisting, degenerative conditions that were 

diagnosed. The Board has explained that medical rationale is particularly necessary if appellant 

has a preexisting condition.14 Dr. Saltzman merely provided a conclusory statement that any 

aggravation beyond six months would be related to appellant’s underlying tricompartmental 

osteoarthritis. He provided no discussion on the opinions of Drs. York and Dawson that appellant 

11 5 U.S.C. § 8123(a).

12 See P.J., Docket No. 20-0550 (issued April26, 2021); J.W.,Docket No. 19-1014 (issued October 24, 2019);

S.B.,Docket No. 18-0700 (issued January 9, 2019); S.J.,Docket No. 17-0543 (issued August1, 2017).

13 See R.K., Docket No. 19-1980 (issued May 7, 2020); A.G.,Docket No. 19-0220 (issued August 1, 2019);

James T. Johnson, 39 ECAB 1252 (1988).

14 E.K., supra note 6.
7

suffered a permanent aggravation of her underlying osteoarthritis. Furthermore, Dr. Saltzman

advised that it was not possible to fully determine the difference between the work -related 

aggravation and the natural course of osteoarthritis. The Board has held that a medical opinion 

which is equivocal in nature is of limited probative value regarding a given medical question. 15 

Accordingly, Dr. Saltzman’s conclusory, equivocal opinion is insufficient to meet OWCP’s 

burden of proof to terminate her wage-loss compensation and medical benefits.

The Board therefore finds that Dr. Saltzman’s reports are, therefore, not entitled to special 

weight and are insufficient to meet OWCP’s burden of proof to terminate appellant’s wage-loss 

compensation and medical benefits, effective January 15, 2020.

CONCLUSION

The Board finds that OWCP has not met its burden of proof to terminate appellant’s wageloss compensation and medical benefits, effective January 15, 2020.16

ORDER

IT IS HEREBY ORDERED THAT the August 25, 2020 decision of the Office of 

Workers’ Compensation Programs is reversed.

Issued: January 10, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

15 See J.C., Docket No. 20-0973 (issued February 9, 2021); E.B., Docket No. 18-1060 (issued November 1, 2018); 

Leonard J. O’Keefe, 14 ECAB 42, 48 (1962).

16 In light of the Board’s disposition of Issue 1, Issue 2 is rendered moot.