United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

S.B., Appellant

and

DEPARTMENT OF THE ARMY, RED RIVER 

ARMY DEPOT, Texarkana, TX, Employer

__________________________________________

)

)

)

)

)

)

)

)

Docket No. 21-0646

Issued: July 22, 2022

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On March 22, 2021 appellant filed a timely appeal from a February 4, 2021 merit decision 

of the Office of Workers’Compensation Programs (OWCP).1 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 August 9, 2016 employment incident.

1 The Board notes that,following the February 4, 2021 decision, OWCP received additional evidence. 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

5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

This case has previously been before the Board.3 The facts and circumstances as set forth 

in the Board’s prior decision are incorporated herein by reference. The relevant facts are as 

follows.

On October 31, 2016 appellant, then a 34-year-old mechanic, filed an occupational disease 

claim (Form CA-2) alleging that he sustained a left knee condition due to factors of his federal 

employment. He explained that, as he was performing his usual daily work duties, including 

cleaning up bays, he slipped on a wet floor and injured his left knee. Appellant asserted that he 

experienced a burning sensation in his left knee that caused it to become swollen and weak. He 

noted that he first became aware of his condition and realized its relation to his federal employment 

on August 9, 2016. Appellant did not stop work. 

In support of his claim, appellant submitted an October 27, 2016 sworn narrative statement 

asserting that on August 9, 2016 he was working in the wash rack rinsing the bays and restocking 

soap when he slipped and turned on metal grating, injuring his left knee. He noted that he 

originally injured his left knee in 2010 while working in Iraq.

In an October 25, 2016 form report, Dr. Christopher R. Mann, an osteopath, diagnosed left 

knee internal derangement and left knee meniscus tear.

On November 10, 2016 appellant underwent a left knee magnetic resonance imaging 

(MRI) scan which demonstrated a linear posterior horn medial meniscal tear with superior and 

inferior articular surface extension, stage II chondromalacia throughout the knee, knee effusion, 

and bone edema and acute irritation within the medial femoral condyle.

By decision dated December 19, 2016, OWCP denied appellant’s claim. It found that the 

August 9, 2016 employment incident occurred as alleged, but denied the claim finding that the

medical evidence of record was insufficient to establish a medical diagnosis in connection with 

the accepted incident. OWCP concluded, therefore, that the requirements had not been met to 

establish an injury as defined by FECA.

OWCP continued to receive medical evidence. 

On October 25, 2016 Dr. Mann examined appellant due to left knee swelling, weakness,

and locking up. He noted that appellant reported that appellant was performing his regular duties 

on August 9, 2016 when his left knee “gave-way.” Dr. Mann indicated that appellant had been 

stepping over or around the frame of a large vehicle when appellant twisted his left knee. He 

further noted that appellant had a previous knee injury on July 18, 2010 while working in Iraq. 

Dr. Mann opined that appellant’s current condition was an aggravation of a preexisting condition, 

and that he received no treatment at the time of the original injury in 2010. He diagnosed left knee 

internal derangement and left knee meniscus tear. In a note dated December 13, 2016, Dr. Mann 

repeated his prior diagnoses.

3 Docket No. 19-1499 (issued January 27, 2020).
3

On May 8, 2017 appellant requested reconsideration of the December 19, 2016 decision. 

By decision dated June 13, 2017, OWCP denied modification of the December 19, 2016 

decision.4 

On January 23, 2018 appellant requested reconsideration of the June 13, 2017 decision. 

He submitted a December 20, 2017 report from Dr. Mann, who indicated that he was aware that 

appellant was working in the wash rack and that appellant slipped on the wet floor while walking 

around the large vehicle, which he worked on as a mechanic. Dr. Mann noted that appellant was 

getting up and down and twisting his left knee. He opined that appellant sustained a significant 

left knee injury while performing his regular job at the employing establishment on 

August 9, 2016. Dr. Mann found that appellant had sustained significant injury to the structures 

of the left knee that he did not have prior to this incident. He also noted that this was an aggravation 

of a preexisting injury that appellant first sustained at work on July 19, 2010.

By decision dated March 30, 2018, OWCP denied modification of the June 13, 2017 

decision. 

On September 20, 2018 appellant requested reconsideration of the March 30, 2018 OWCP 

decision. He provided April 30 and May 2, 2018 witness statements from coworkers who asserted 

that his July 2010 injury was to his left knee. Both noted that, when appellant returned to work, 

he drove heavy vehicles with a brace on his left knee.

In an August 22, 2018 report, Dr. Mann asserted that appellant sustained an acute injury 

on August 9, 2016. He again asserted that appellant sustained an acute traumatic “slip and twist”

at work on August 9, 2016 that resulted in left knee meniscus tear and left knee internal 

derangement. Dr. Mann noted that following the July 2010 injury appellant was allowed to drive 

with a brace on hisleft knee and that the contemporaneous medical records inaccurately referenced 

his right knee.

By decision dated December 20, 2018, OWCP modified the March 30, 2018 decision to 

find that appellant had established a diagnosed medical condition in connection with the accepted 

employment incident; however, the claim remained denied as the medical evidence of record was 

insufficient to establish causal relationship between the diagnosed left knee condition and the 

accepted August 9, 2016 employment incident.

On March 13, 2019 appellant requested reconsideration of the December 20, 2018 OWCP 

decision and submitted additional evidence. In a January 3, 2019 report, Dr. Mann repeated that 

appellant’s left knee “gave way” during a slip and twist injury at work. He opined that the 

diagnosed condition was due to the accepted employment incident.

By decision dated March 20, 2019, OWCP modified the prior decision to again find that 

appellant had not established that the employment incident occurred in the performance of duty on 

4 OWCP noted that appellant’s claim had been adjudicated as a traumatic injury rather than an occupational disease, 

as he had described a single incident instead of a condition that developed over a period of time. 
4

August 9, 2016 as alleged. Thus, it concluded that the requirements had not been met to establish 

an injury as defined by FECA.

On July 3, 2019 appellant appealed to the Board. By decision dated January 27, 2020, the 

Board found that he had established that the August 9, 2016 employment incident actually 

occurred and remanded the case for consideration of the medical evidence. The Board directed 

OWCP to issue a de novo decision addressing whether appellant has met his burden of proof to 

establish a medical condition causally related to the accepted August 9, 2016 employment 

incident.5

By decision dated May 18, 2020, OWCP denied appellant’s claim,finding that the medical 

evidence of record was insufficient to establish that the diagnosed medical condition was causally 

related to the accepted employment incident.6

On November 25, 2020 appellant requested reconsideration.

In support of this request, appellant submitted a November 2, 2020 note, wherein Dr. Mann

asserted that his prior reports were sufficient to meet appellant’s burden of proof to establish a 

traumatic left knee injury. 

By decision dated February 4, 2021, OWCP denied modification of its prior decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA7 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,8that 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.9 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.10

5

Id.

6 By decision dated July 13, 2020, OWCP revised and reissued the May 18, 2020 decision as it was mailed to an 

incorrect address.

7

Supra note 2.

8

See J.K., Docket No. 20-0527 (issued May 24, 2022); J.C., Docket No. 20-0882 (issued June23, 2021); S.B., 

Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989).

9

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

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

10 R.R., Docket No. 19-0048 (issued April25, 2019); K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., 

Docket No. 13-1402 (issued February 7, 2014); DeloresC. Ellyett, 41 ECAB 992 (1990).
5

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, OWCP must first determine whether fact of injury has been established. 11 

There are two components involved in establishing fact of injury. First, the employee must submit 

sufficient evidence to establish that he or she actually experienced the employment incident at the 

time, place, and in the manner alleged.12 Second, the employee must submit evidence, in the form 

of probative medical evidence, to establish that the employment incident caused a personal 

injury.13

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve.

14

 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 specific employment factor(s) identified by the employee.15 The weight of the 

medical evidence is determined by its reliability, its probative value, its convincing quality, the 

care of analysis manifested, and the medical rationale expressed in support of the physician’s 

opinion.16

ANALYSIS

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

condition causally related to the accepted August 9, 2016 employment incident.

In his December 20, 2017, August 22, 2018 and January 3, 2019 reports, Dr. Mann noted 

that appellant’s left knee injury occurred when appellantwas working in the wash rack and slipped 

on the wet floor and twisted his left knee while walking around a large vehicle. He diagnosed left 

knee meniscus tear and internal derangement. Although Dr. Mann generally supported causal 

relationship in his reports, he did not provide medical rationale explaining how the accepted 

August 9, 2016 employment incident caused or contributed to the diagnosed left knee conditions. 

The Board has held that a report is of limited probative value regarding causal relationship if it 

does not contain medical rationale explaining how an employment activity could have caused or 

aggravated a medical condition.17 Therefore, these reports are insufficient to establish appellant’s 

traumatic injury claim.

11 D.B., Docket No. 18-1348 (issued January 4, 2019); S.P., 59 ECAB 184 (2007).

12 D.S., Docket No. 17-1422 (issued November 9, 2017); Bonnie A. Contreras, 57 ECAB 364 (2006).

13 B.M., Docket No. 17-0796 (issued July 5, 2018); David Apgar, 57 ECAB 137 (2005); John J. Carlone, 41 ECAB 

354 (1989).

14 See J.K., supranote 8;S.A., Docket No. 18-0399 (issued October 16, 2018); see also Robert G. Morris, 48 ECAB 

238 (1996).

15 M.V., Docket No. 18-0884 (issued December 28, 2018); I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 

ECAB 345 (1989).

16 J.K., supra note 8; J.C., supra note 8; James Mack, 43 ECAB 321 (1991).

17 J.D., Docket No. 21-1422 (issued May 24, 2022); Y.D., Docket No. 16-1896 (issued February 10, 2017).
6

In an October 25, 2016 report, Dr. Mann provided a history of a previous left knee injury 

on July 18, 2010 while working in Iraq. He found that appellant’s current condition was an 

aggravation of a preexisting condition, and that he received no treatment at the time of the original 

injury in 2010. However, this report is of limited probative value as it provided an inaccurate

history of injury18 and lacked a rationalized explanation of causal relationship. The Board notes 

that the record supports appellant’s prior knee injury was to the right knee, not the left.

In notes dated October 25 and December 13, 2016, Dr. Mann diagnosed left knee internal 

derangement and meniscus tear. However, he did not offer an opinion on causal relationship. The 

Board has held that medical evidence that does not offer an opinion regarding the cause of an 

employee’s condition is of no probative value on the issue of causal relationship.19 For this reason, 

this medical evidence is insufficient to meet appellant’s burden of proof.

Appellant also submitted a November 10, 2016 MRI scan. The Board has held that 

diagnostic studies, standing alone, lack probative value on the issue of causal relationship, as they 

do not provide an opinion as to whether the employment incident caused any of the diagnosed 

conditions.20

As appellant has not submitted rationalized medical evidence establishing that his 

diagnosed left knee condition is causally related to the accepted August 9, 2016 employment 

incident, the Board finds that he has not met his burden of proof to establish his claim.

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 met his burden of proof to establish a left knee 

condition causally related to the accepted August 9, 2016 employment incident.

18 D.W., Docket No. 22-0109 (issued May 17, 2022).

19 J.D., supra note 17; S.J., Docket No. 19-0696 (issued August 23, 2019); M.C., Docket No. 18-0951 (issued 

January 7, 2019); L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued 

July 6, 2018).

20 See L.B., Docket No. 21-0353 (issued May 23, 2022); K.C., Docket No. 20-1325 (issued May 5, 2021); C.B., 

Docket No. 20-0464 (issued July 21, 2020).
7

ORDER

IT IS HEREBY ORDERED THAT the February 4, 2021 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: July 22, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board