United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

K.V., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Baltimore, MD, Employer

__________________________________________

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Docket No. 22-0698

Issued: August 22, 2022

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On April 4, 2022 appellant, through counsel, filed a timely appeal from a March 24, 2022 

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 to consider 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 knee condition 

causally related to the accepted July 26, 2021 employment incident.

FACTUAL HISTORY

On July 29, 2021 appellant, then a 59-year-old city carrier, filed a traumatic injury claim 

(Form CA-1) alleging that on July 26, 2021 he injured both kneeswhen walking up the stairs while 

in the performance of duty. He explained that he felt a tear in his left and right knees, followed by

excruciating pain. Appellant stopped work on July 26, 2021.

In an August 2, 2021 development letter, OWCP informed appellant of the deficiencies of 

his claim, requested additional factual and medical evidence, and provided a questionnaire for his 

completion. It afforded him 30 days to respond.

OWCP thereafter received an April 6, 2021 note from Dr. Rakhee Lalla, an osteopath 

Board-certified in neurology, finding that appellant had reached maximum medical improvement 

in regard to an unnamed condition. In July 27, 2021 notes, Jon Schoeffel, a physician assistant, 

reported that Dr. Theodore Manson, a Board-certified orthopedic surgeon, had performed a left 

total knee arthroplasty in March 2019.

On August 18, 2021 Dr. Manson diagnosed acute meniscal tear of the knee and found that 

appellant was totally disabled.

By decision dated September 7, 2021, OWCP accepted that the July 26, 2021 employment 

incident occurred, as alleged, but denied appellant’s claim as causal relationship was not

established between his diagnosed medical condition and his accepted July 26, 2021 employment 

incident.

On September 20, 2021 appellant, through counsel, requested a telephonic hearing before 

a representative of OWCP’s Branch of Hearings and Review.

OWCP continued to receive evidence, including a September 17, 2021 note from

Dr. Manson, which explained that appellant had fallen “at work where he sustained an injury to 

his left total knee arthroplasty.” Dr. Manson also reported that appellant was developing pain in 

his right knee, but on physical examination showed no instability and no focal issues. He also 

found greater left knee laxity in full extension. Dr. Manson recommended a right knee magnetic 

resonance imaging (MRI) scan and additional work restrictions.

On December 21, 2021 Dr. Sarah Hobart, an orthopedic surgeon, performed right knee 

arthroscopic partial medial and lateral meniscectomies due to right knee medial and lateral 

meniscal tears.

An oral hearing was held on January 7, 2022. 
3

Appellant submitted a September 17, 2021 duty status report (Form CA-17) completed by

Dr. Manson, which listed both knees as affected by the accepted July 26, 2021 employment 

incident.

In a September 28, 2021 note, Dr. Manson indicated that appellant’s right knee symptoms 

of pain, catching, locking, and crepitus with range of motion had not improved. He explained that 

appellant injured his right knee in a twisting injury at work on July 26, 2021. Dr. Manson 

recommended right knee magnetic resonance imaging (MRI) scan to rule out internal derangement 

and meniscal tear in the right knee.

On October 14, 2021 Dr. Manson completed an attending physician’s report (Form CA20), which listed a history of bilateral knee injuries and diagnosed right knee pain. He checked a 

box marked “Yes,” indicating that appellant’s condition was caused or aggravated by an 

employment activity.

On October 19, 2021 appellant underwent a right knee MRIscan, which demonstrated tears 

of the posterior horn of the medial meniscus and a small radial tear of the meniscal body.

By decision dated March 24, 2022, OWCP’s hearing representative affirmed the 

September 7, 2021 decision. He noted that appellant was alleging both right and left knee injuries 

as a result of the accepted January 26, 2021 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 that the individual is an employee of the United 

States within the meaning FECA, that the claim was timely filed within the applicable time 

limitation period of FECA,4that 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 must first be determined whether a fact of injury has been established. 

There are two components involved in establishing fact of injury. The first component to be 

established is that the employee must submit sufficient evidence to establish that he or she actually 

experienced the employment incident at the time and place, and in the manner alleged. The second 

3

Id.

4 F.H., Docket No. 18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued April26, 2019); JoeD. 

Cameron, 41 ECAB 153 (1989).

5 L.C., Docket No. 19-1301 (issued January 29, 2020); J.H., Docket No. 18-1637 (issued January 29, 2020); 

James E. Chadden, Sr., 40 ECAB 312 (1988).

6 P.A., Docket No. 18-0559 (issued January 29, 2020); K.M., Docket No. 15-1660 (issued September 16, 2016); 

DeloresC. Ellyett, 41 ECAB 992 (1990).
4

component is whether the employment incident caused a personal injury and can be established 

only by medical evidence.7

The medical evidence required to establish causal relationship between a claimed specific 

condition and an employment incident is rationalized medical opinion evidence.8 The opinion of 

the physician must be based on a complete factual and medical background of the employee, 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 employment incident identified 

by the employee.9

ANALYSIS

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

causally related to the accepted January 26, 2021 employment incident.

In his report dated August 18, 2021, Dr. Manson diagnosed acute meniscal tear of the knee. 

He did not, however, provide an opinion on the issue of causal relationship. Likewise, Dr. Hobart 

completed a surgical report on December 21, 2021 and diagnosed right knee medial and lateral 

meniscal tears without providing an opinion on the issue of causal relationship. The Board has 

held that a medical report that does not offer an opinion on causal relationship is of no probative 

value and, thus, is insufficient to establish the claim.10 Therefore, Dr. Manson’s August 18, 2021

report and Dr. Hobart’s December 21, 2021 report are insufficient to establish causal relationship.

In additional notes dated September 17 and 28, 2021, and a Form CA-20 dated October 14, 

2021, Dr. Manson diagnosed an unspecified injury to appellant’s left knee, resulting in a total left 

knee arthroplasty and right knee pain. The Board has held that pain is a symptom, not a diagnosis 

of a medical condition.11 On April 14, 2021 Dr. Lalla did not provide a diagnosis. In a Form CA17 dated September 17, 2021, Dr. Manson also did not provide an diagnosis. The Board has held 

that medical reports lacking a firm diagnosis are of no probative value.12 Thus, this evidence is 

insufficient to establish the claim.

7 T.H., Docket No. 19-0599 (issued January 28, 2020); K.L.,Docket No. 18-1029 (issued January 9, 2019); John J. 

Carlone, 41 ECAB 354 (1989).

8

S.S.,Docket No. 19-0688 (issued January 24, 2020); A.M.,Docket No. 18-1748 (issued April24, 2019); RobertG. 

Morris, 48 ECAB 238 (1996).

9 T.L., Docket No. 18-0778 (issued January 22, 2020); Y.S., Docket No. 18-0366 (issued January 22, 2020); 

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

10 T.D., Docket No. 19-1779 (issued March 9, 2021); L.B., Docket No. 18-0533 (issued August 27, 2018); D.K.,

Docket No. 17-1549 (issued July 6, 2018).

11 See E.S.,Docket No. 21-0189 (issued November 16, 2021); C.S.,Docket No. 20-1354 (issued January 29, 2021); 

D.R., Docket No. 18-1408 (issued March 1, 2019); D.A., Docket No. 18-0783 (issued November 8, 2018). L.T.,

Docket No. 20-0582 (issued November 15, 2021); E.S.; C.S., id.; J.P., Docket No. 20-0381 (issued July 28, 2020); 

R.L., Docket No. 20-0284 (issued June30, 2020).

12 Id.
5

The remaining medical evidence of record consists of diagnostic testing reports and notes 

by a physician assistant. The Board has held that diagnostic studies, standing alone, lack probative 

value and are insufficient to establish the claim.13 In addition, certain healthcare providers such 

as physician assistants are not considered “physician[s]” as defined under FECA.

14

 Their medical 

findings and/or opinions, unless cosigned by a qualified physician, will not suffice for purposes of 

establishing entitlement to FECA benefits.

15

 

As appellant has not submitted medical evidence establishing causal relationship between 

any of his diagnosed knee conditions and the accepted July 26, 2021 employment incident, the 

Board finds that he has not met his burden of proof.

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 knee condition 

causally related to the accepted January 26, 2021 employment incident.

13 See B.R., Docket No. 21-1109 (issued December 28, 2021); J.K.,Docket No. 20-0591 (issued August12, 2020); 

A.B., Docket No. 17-0301 (issued May 19, 2017).

14 Section 8101(2) provides that under FECA the term physician includes surgeons, podiatrists, dentists, clinical 

psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined 

by the applicable state law. 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t). See Federal (FECA) Procedure Manual, Part 2 

Claims, Causal Relationship, Chapter 2.805.3a(1) (January 2013); DavidP. Sawchuk, 57 ECAB 316, 320 n.11 (2006) 

(lay individuals such as physician assistants, nurses, and physical therapists are not competent to render a medical 

opinion under FECA); see also E.T., Docket No. 17-0265 (issued May 25, 2018) (physician assistants are not 

considered physicians under FECA).

15 Id.
6

ORDER

IT IS HEREBY ORDERED THAT the March 24, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: August 22, 2022

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board