United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.B., Appellant

and

U.S. POSTAL SERVICE, SAINT BERNARD 

POST OFFICE, Cincinnati, OH, Employer

__________________________________________

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Docket No. 20-1561

Issued: October 31, 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

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On August 27, 2020 appellant, through counsel, filed a timely appeal from a June 4, 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.

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 her burden of proof to establish a right knee 

condition causally related to the accepted January 11, 2019 employment incident.

FACTUAL HISTORY

On January 11, 2019 appellant, then a 55-year-old letter carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on that date she sprained her right knee when she stepped over a 

large curb with a one-foot drop and felt a pop in her knee while in the performance of duty. She

stopped work on that date.

In a January 11, 2019 emergency department note, Kristina Feder, a nurse practitioner

diagnosed right knee sprain and indicated that appellant could return to work on January 12, 2019.

In a January 17, 2019 narrative report, Dr. Brion P. Moran, a Board-certified orthopedic 

surgeon, noted that on November 21, 2018 appellant was bit by a dog and injured her right knee 

running upstairstrying to get away from the dog. Appellant noted mild discomfort thereafter. She

reported that she was again attacked by the same dog on January 5, 2019. Appellant later returned 

to work on January 11, 2019 and injured her right knee when it gave out on her while taking a step 

up on a curb. She stopped work following this incident. Dr. Moran indicated that appellant 

experienced significant pain that she did not have prior to the work incident. He diagnosed right 

knee sprain and moderate osteoarthritis, as demonstrated on x-ray. In a work status note of even 

date, Dr. Moran recommended that appellant should remain off work until further testing was 

done. In a duty status report (Form CA-17) of even date, he again diagnosed right knee sprain and 

indicated that it was caused by the claimed January 11, 2019 employment incident.

In a February 4, 2019 development letter, OWCP informed appellant of the deficiencies in 

her claim. It advised her of the additional factual and medical evidence needed and provided a 

questionnaire for her completion. OWCP afforded appellant 30 days to respond.

In response, appellant submitted a January 11, 2019 report from Dr. Paul Metzger, an 

emergency medicine specialist, who diagnosed right knee sprain. In an emergency department 

report of even date, Dr. Timothy W. Dake, Board-certified in emergency medicine, noted that 

appellant presented with right knee pain. He indicated that she previously injured her knee when 

she was chased by a dog while walking up stairs. Dr. Dake reported that appellant felt knee pain

earlier that day while taking a high step. Appellant reported that she felt a pop in her knee. 

Dr. Dake diagnosed right knee sprain. 

A February 11, 2019 magnetic resonance imaging (MRI) scan of appellant’s right knee 

revealed mild tricompartmental degenerative changes and a partial tear of the posterior root of the 

medial meniscus.

In response to OWCP’s development questionnaire, appellant indicated that she had not 

been working since her January 11, 2019 employment incident. She stated that her right knee 

made a pop after she stepped over a curb. Appellant indicated that she was never previously 

diagnosed with a right knee condition.
3

In a February 14, 2019 medical report, Dr. Moran indicated that appellant’s right knee pain 

had improved. He reviewed the February 11, 2019 MRI scan and noted that, although there was 

some questionable abnormality within the posterior horn of the medial meniscus, appellant had no 

true tear. Dr. Moran diagnosed right knee sprain and significant aggravation of right knee 

osteoarthritis. In a Form CA-17 of even date, he reiterated his diagnoses and provided work 

restrictions. In a work status note of even date, Dr. Moran advised that appellant may return to 

work on February 18, 2019 with restrictions. 

By decision dated March 8, 2019, OWCP denied appellant’s traumatic injury claim, 

finding that the evidence of record was insufficient to establish that her diagnosed conditions were 

causally related to her accepted January 11, 2019 employment incident.

In a March 6, 2019 medical report, Dr. Moran repeated his examination findings and 

diagnoses. 

In an April 17, 2019 medical report, Chandler T. Bell, a nurse practitioner, indicated that 

appellant was working again at full-duty status but continued to have some pain with extended 

periods of standing and walking. He diagnosed right knee sprain and significant aggravation of 

right knee osteoarthritis.

In a May 20, 2019 letter, Dr. Moran opined that, to a reasonable degree of medical 

certainty, appellant’s diagnosed right knee sprain and significant aggravation of right knee 

osteoarthritis were causally related to the accepted January 11, 2019 employment incident. He 

noted that it made no difference whether appellant was taking a step up or down, or that she was 

previously attacked by a dog.

On May 21, 2019 appellant requested reconsideration. 

By decision dated August 16, 2019, OWCP denied modification of its March 8, 2019 

decision. 

In a September 23, 2019 medical report, Dr. Moran again noted that appellant had a workrelated injury on January 11, 2019, when her knee popped while she was stepping over a curb at 

work. He again opined that appellant’s injury was clearly work related.

On October 7, 2019 appellant again requested reconsideration.

By decision dated November 14, 2019, OWCP denied modification of the August 16, 2019 

decision. 

On June 1, 2020 appellant, through counsel, requested reconsideration and submitted 

additional medical evidence.

In support of her request for reconsideration, appellant submitted an April 28, 2020 

narrative report by Dr. Neil Allen, a Board-certified internist and neurologist, who indicated that 

he had reviewed her medical records. He noted that on January 11, 2019 appellant stepped over a 

curb with a one-and-a-half-foot drop on the far side with her right leg. She then pivoted over a 

bent right knee as she pulled her left leg over the curb. Dr. Allen reported that as appellant did 
4

this, she felt a pop in the back of her right knee, experiencing pain and swelling. He noted her 

history of medical treatment and reported that he had reviewed the January 17, 2019 x-ray and 

February 11, 2019 MRI scan of the right knee. Dr. Allen diagnosed knee sprain/strain, 

precipitation of a medial meniscus tear, and aggravation of right knee osteoarthritis and opined 

that the conditions were work related. He explained that appellant’s osteoarthritis developed over 

time and became symptomatic on January 11, 2019 when she planted and twisted a bent right knee, 

compressing and tearing the articular cartilage within her right knee. Dr. Allen opined that the 

age-related changes in appellant’s right knee, combined with the acute trauma, such as a maximal 

axial load (downward loading) in torsion (twisting), resulted in the precipitation of appellant’s 

underlying osteoarthritis and tearing of the articular cartilage within her right knee. He also noted 

that the February 11, 2019 MRI scan demonstratedthat the accepted January 11, 2019 employment 

incident resulted in the meniscal injury as well. Dr. Allen concluded that appellant’s right knee 

osteoarthritis and meniscal conditions were directly caused and/or aggravated by the acute trauma 

sustained during the accepted January 11, 2019 employment incident.

By decision dated June 4, 2020, OWCP denied modification of the November 14, 2019 

decision. 

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 of FECA, that the claim was timely filed within the applicable time 

limitation 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 first must be determined whether fact of injury has been established. There 

are two components involved in establishing fact of injury. The first component 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 component is 

3

Supra note 2.

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).
5

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 specific employment factors 

identified by the employee.9

ANALYSIS

The Board finds that this case is not in posture for decision.

In support of her reconsideration request, appellant submitted an April 28, 2020 report by

Dr. Allen who indicated that he had reviewed appellant’s medical records. Dr. Allen accurately 

described the accepted January 11, 2019 employment incident and noted his review of a 

January 17, 2019 x-ray and a February 11, 2019 MRI scan of the right knee. He diagnosed right 

knee sprain/strain, precipitation of a medial meniscus tear, and aggravation of right knee 

osteoarthritis. Dr. Allen explained the physiologic basis for his causation opinion by noting when 

appellant planted and twisted her bent right knee, combined with the underlying age -related 

changes in the knee, it compressed and tore the articular cartilage within the knee, resulting in the 

conditions diagnosed based upon appellant’s x-ray and MRI scan. He concluded that appellant’s 

right knee injury was directly caused and/or aggravated by the accepted January 11, 2019 

employment incident.

Dr. Allen explained that the mechanism of appellant’s traumatic injury supports the 

diagnoses he had made. Although his opinion is insufficiently rationalized to establish causal 

relationship, it does raise an uncontroverted inference regarding causal relationship between the 

diagnosed condition and the accepted employment incident sufficient to require that OWCP further 

develop the medical evidence in the claim.10

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 See D.R., Docket No. 20-1104 (issued January 29, 2021); E.G., Docket No. 19-1296 (issued December 19, 2019); 

John J. Carlone, 41 ECAB 354 (1989).
6

Proceedings under FECA are not adversarial in nature and OWCP is not a disinterested 

arbiter. The claimant has the burden of proof to establish entitlement to compensation and OWCP 

shares responsibility in the development of the evidence to see that justice is done. 11

The case shall, therefore, be remanded for OWCP to refer appellant to a specialist in the 

appropriate field of medicine, along with the case record and a statement of accepted facts. Its 

referral physician shall provide a well-rationalized opinion as to whether appellant has a diagnosed

right knee condition causally related to the accepted January 11, 2019 employment incident. If the 

physician opines that a diagnosed condition is not causally related to the accepted employment 

incident, he or she must provide a rationalized explanation as to why their opinion differs from 

that articulated by Dr. Allen. After such further development of the case record as OWCP deems 

necessary, it shall issue a de novo decision.

CONCLUSION

The Board finds that this case is not in posture for decision.

ORDER

IT IS HEREBY ORDERED THAT the June 4, 2020 decision of the Office of Workers’

Compensation Programs is set aside and the case is remanded for further proceedings consistent 

with this decision of the Board.

Issued: October 31, 2022

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

11 See D.R., Id.; A.J., Docket No. 18-0905 (issued December 10, 2018); WilliamJ. Cantrell, 34 ECAB 1233, 1237 

(1983); Gertrude E. Evans, 26 ECAB 195 (1974).