United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

L.D., Appellant

and

U.S. POSTAL SERVICE, SOUTH TROOST 

STATION, Kansas City, MO, Employer

__________________________________________

)

)

)

)

)

)

)

)

Docket No. 21-0096

Issued: June 11, 2021

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On October 23, 2020 appellant filed a timely appeal from a July 8, 2020 merit decision of 

the Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal Employees’

Compensation Act1(FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction to 

consider the merits of this case.

ISSUE

The issue is whether appellant has met her burden of proof to establish more than 16 percent 

permanent impairment of the right lower extremity for which she previously received a schedule 

award.

FACTUAL HISTORY

On July 13, 2012 appellant, then a 46-year-old city carrier, filed a traumatic injury claim 

(Form CA-1) alleging that on that date she sustained a right ankle sprain as she fled from three 

 

1 5 U.S.C. § 8101 et seq.
2

dogs that were chasing her while in the performance of duty.2 On August 9 and 14, 2012 OWCP

accepted the claim for right ankle sprain and right posterior tibial tendon attenuation. Appellant 

underwent an OWCP-authorized right posterior tibial tendon repair with application of right 

posterior cast-splint on September 7, 2012, right flexor digitorum longus (FDL) transfer, posterior 

tibial tendon debridement, cotton osteotomy with medial cuneiform, right medializing calcaneal 

osteotomy, right gastroc release, three views interpretation with use of fluoro on January 24, 2018, 

and removal of hardware from the first metatarsal of the right foot on August 29, 2018.

On January 8, 2019 appellant filed a claim for a schedule award (Form CA-7). 

By decision dated March 11, 2015, OWCP granted appellant a schedule award for 16 

percent permanent impairment of the right lower extremity (ankle). The award ran for 46.08 weeks 

from December 2, 2014 through October 20, 2015 and was based on the impairment ratings of

Dr. Kala Danushkodi, a Board-certified physiatrist and an OWCP referral physician, and

Dr. Daniel D. Zimmerman, a Board-certified internist serving as a district medical adviser (DMA). 

Subsequently, on December 8, 2017 OWCP expanded the acceptance of appellant’s claim 

to include rupture of other tendons of the right foot and ankle.

On January 7, 2019 appellant filed a claim for an increased schedule award (Form CA-7).

OWCP, by development letter dated January 10, 2019, requested that appellant submit an 

impairment evaluation from her attending physician that addressed whether she had obtained 

maximum medical improvement (MMI) and provided a permanent impairment rating in 

accordance with the sixth edition of the American Medical Association, Guides to the Evaluation 

of Permanent Impairment (A.M.A., Guides).3

In a January 4, 2019 progress note, Dr. Bryan G. Vopat, an attending Board-certified

orthopedic surgeon, noted appellant’s medical history, which included removal of hardware over 

her first metatarsal and a calcaneal osteotomy, FDL transfer, gastroc release and medial cuneiform 

osteotomy. He noted examination findings and advised that appellant had reached maximum 

medical improvement (MMI).

On February 27, 2019 OWCP referred the record, including a statement of accepted facts

(SOAF), to Dr. Arthur S. Harris, a Board-certified orthopedic surgeon serving as an OWCP DMA, 

 

2 OWCP assigned the claim File No. xxxxxx411. Appellant also has several prior claims. Under File No. 

xxxxxx455, OWCP accepted appellant’s traumatic injury claim for contusion, medial meniscus tear, and Baker’s cyst 

of the left knee sustained on February 12, 2011 and authorized left knee arthroscopy which was performed on 

September 26, 2011. Under File No. xxxxxx664, it accepted her occupational disease claim (Form CA-2) for 

enteropathy and tibialis tendinitis of the right ankle. Under File No. xxxxxx210, OWCP accepted appellant’straumatic 

injury claim for left knee sprain sustained on November 7, 2015 and authorized left knee arthroscopy which was 

performed on November 6, 2018. It accepted her occupational disease claim under File No. xxxxxx302 for right 

rotator cuff tear and authorized right arthroscopic rotator cuff repair, superior labral anterior posterior repair, 

subacromial decompression, distal clavicle excision, and extensive glenhumeral debridement of a type 1 anterior and 

posterior labral tear which were performed on February 3, 2017.

3 A.M.A., Guides (6th ed. 2009).
3

to determine appellant’s percentage of permanent impairment pursuant to the sixth edition of the 

A.M.A., Guides and her date of MMI.

In a March 2, 2019 report, Dr. Harris reviewed the medical record, which indicated that 

appellant underwent right calcaneal osteotomy, medial cuneiform osteotomy, posterior tibial 

tendon debridement, FDL tendon transfer, and gastroc release on January 24, 2018 and right first 

metatarsal hardware removal on August 29, 2018. He utilized the diagnosis-based impairment

(DBI) rating method of the sixth edition of the A.M.A., Guides at Table16-2, page 501, and 

determined that appellant had 10 percent permanent impairment of the right lower extremity due 

to her diagnosis of posterior tibial tendon insufficiency. Dr. Harris noted that the range of motion 

(ROM) impairment rating method was not applicable.

On April 22, 2019 OWCP referred appellant, together with a SOAF, and the case file to,

Dr. Sivakoti R. Katta, a Board-certified orthopedic surgeon, for a second opinion evaluation of her

permanent impairment for schedule award purposes.

In a May 8, 2019 report, Dr. Katta noted appellant’s history of injury and medical 

treatment, and discussed examination findings. He provided: assessments of chronic right ankle 

tendinitis with associated osteoarthritis of the right ankle and foot; status post chronic sprain and 

posterior tibial tendon attenuation from appellant’s July 13, 2012 work-related injury, and surgical 

repair performed on September 7, 2012, January 24 and August 29, 2018; osteoarthritis of both 

knee joints and left ankle; probable degenerative disc disease of the lumbar vertebrae without any 

radiculopathy; and hypertension. Utilizing the DBI method at Table 16-2, page 501 of the sixth 

edition of the A.M.A., Guides, Dr. Katta determined that appellant had six percent permanent 

impairment of the right lower extremity for a diagnosis of chronic right ankle sprain with 

associated posterior tibial tendon insufficiency. He noted that he did not use the ROM method 

because appellant’s right ankle had full ROM. Dr. Katta determined that appellant reached MMI

on January 4, 2019, the date of Dr. Vopat’s examination.

On May 17, 2019 OWCP requested that Dr. Harris review Dr. Matta’s May 8, 2019 report 

and provide whether he agreed with his findings.

In a May 21, 2019 report, Dr. Harris reviewed Dr. Matta’s May 8, 2019 report and agreed 

with Dr. Matta that appellant had six percent permanent impairment of the right lower extremity 

pursuant to the A.M.A., Guides as a result of her accepted posterior tibial deficit. He determined 

that she reached MMI on May 8, 2019. 

By decision dated July 3, 2019, OWCP denied appellant’s claim for an increased schedule 

award for permanent impairment of her right lower extremity. It noted that she had previously 

been paid a schedule award for 16 percent permanent impairment of the right lower extremity.

On July18, 2019 appellant, through counsel, requested a telephonic hearing before a 

representative of OWCP’s Branch of Hearings and Review.4 The hearing was held on 

November 4, 2019.

 

4 Appellant retired on disability from the employing establishment effective September 16, 2019. 
4

By decision dated January 17, 2020, an OWCP hearing representative affirmed the July 3, 

2019 decision. She found that the weight of the medical opinion evidence established that 

appellant did not have more than the 16 percent right lower extremity permanent impairment 

previously awarded.

On May 12, 2020 appellant requested reconsideration. In support of her reconsideration

request, he submitted an April 7, 2020 report from Dr. Zimmerman, who formerly served as 

OWCP’s DMA. Dr. Zimmerman noted his review of appellant’s medical records and discussed 

examination findings. He diagnosed double or triple arthrodesis of the midfoot with moderate 

malalignment as demonstrated by a right foot and ankle x-ray performed on the date of his 

examination. Dr. Zimmerman used the DBI method and determined that, under Table 16-2, page 

508 of the sixth edition the A.M.A., Guides, appellant had 26 percent permanent impairment of 

the right lower extremity. He used grade modifiers in Table 16-6, Table 16-7, and Table 16-8 and 

the net adjustment formula based on class 3 for a class of diagnosis (CDX) of double or triple 

arthrodesis. Dr. Zimmerman determined that appellant had reached MMI as of the date of his 

impairment evaluation.

On May 26, 2020 OWCP requested that Dr. Harris review Dr. Zimmerman’s April 7, 2020 

report and determine whether he agreed with his impairment rating.

On May 29, 2020 Dr. Harris, DMA, reviewed Dr. Zimmerman’s April 7, 2020 findings 

and disagreed with his impairment rating. He noted that appellant had not undergone double or 

triple arthrodesis. Instead, appellant had undergone a reconstructive procedure for posterior tibial 

insufficiency, including medial cuneiform osteotomy with tendon transfer. Dr. Harris advised that

appellant reached MMI on April 7, 2020, the date of Dr. Zimmerman’s impairment evaluation. 

He reiterated his prior opinion that she had six percent right lower extremity permanent 

impairment. Dr. Harris also reiterated that appellant’s diagnosis did not meet the criteria to allow 

impairment to be calculated by the ROM methodology. He concluded that she had no increased 

impairment.

By decision dated July 8, 2020, OWCP denied modification of the January 17, 2020 

decision.

LEGAL PRECEDENT

The schedule award provisions of FECA5and its implementing regulations6set forth the 

number of weeks of compensation payable to employees sustaining permanent impairment from 

loss or loss of use of scheduled members or functions of the body. However, FECA does not 

specify the manner in which the percentage of loss shall be determined. For consistent results and 

to ensure equal justice under the law to all claimants, good administrative practice necessitates the 

use of a single set of tables so that there may be uniform standards applicable to all claimants.

Through its implementing regulations, OWCP adopted the A.M.A., Guides as the appropriate 

 

5 5 U.S.C. § 8107.

6 20 C.F.R. § 10.404.
5

standard for evaluating schedule losses.7 As of May 1, 2009, schedule awards are determined in 

accordance with the sixth edition of the A.M.A., Guides (2009).8 The Board has approved the use 

by OWCP of the A.M.A., Guides for the purpose of determining the percentage loss of use of a 

member of the body for schedule award purposes.9

The sixth edition of the A.M.A., Guides provides a diagnosis-based method of evaluation 

utilizing the World Health Organization’s International Classification of Functioning, Disability 

and Health (ICF).10 Under the sixth edition, the evaluator identifies the impairment CDX, which 

is then adjusted by grade modifiers based on grade modifier for functional history (GMFH), grade 

modifier for physical examination (GMPE), and grade modifier for clinical studies (GMCS).

11

 

The net adjustment formula is (GMFH-CDX) + (GMPE-CDX) + (GMCS-CDX).12

The sixth edition of the A.M.A., Guides provides a DBI method of evaluation utilizing the 

World Health Organization’s International Classification of Functioning, Disability and Health 

(ICF).13 In determining impairment for the lower extremities under the sixth edition of the A.M.A., 

Guides, an evaluator must establish the appropriate diagnosis for each part of the lower extremity 

to be rated. 

In determining impairment for the lower extremities, an evaluator must establish the 

appropriate diagnosis for each part of the lower extremity to be rated. With respect to the knee, 

the relevant portion of the leg for the present case, reference is made to Table 16-3 (Knee Regional 

Grid) beginning on page 509.14 After the CDX is determined from the Knee Regional Grid 

(including identification of a default grade value), the net adjustment formula is applied using the

GMFH, GMPE, and GMCS. The net adjustment formula is (GMFH-CDX) + (GMPE-CDX) + 

(GMCS-CDX).15 Under Chapter 2.3, evaluators are directed to provide reasons for their

 

7

Id. See also Ronald R. Kraynak, 53 ECAB 130 (2001).

8 See Federal (FECA) Procedure Manual, Part 3 -- Medical, Schedule Awards, Chapter 3.700, Exhibit 1 

(January 2010); Federal Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, 

Chapter 2.808.5(a) (March 2017).

9 P.R., Docket No. 19-0022 (issued April 9, 2018); Isidoro Rivera, 12 ECAB 348 (1961).

10 A.M.A., Guides (6th ed. 2009), page 3, section 1.3, The International Classification of Functioning, Disability 

and Health (ICF): A Contemporary Model of Disablement.

11 Id. at 493-556.

12 Id. at 521.

13 Supra note 10.

14 Id. at 509-11.

15 Id. at 515-22.
6

impairment rating choices, including choices of diagnoses from regional grids and calculations of 

modifier scores.16

OWCP’s procedures provide that, after obtaining all necessary medical evidence, the file 

should be routed to a DMA for an opinion concerning the nature and percentage of impairment in 

accordance with the A.M.A., Guides, with the DMA providing rationale for the percentage of 

impairment specified.17

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish more than 16 

percent permanent impairment of the right lower extremity for which she previously received a 

schedule award.

In support of her claim for an increased schedule award, appellant submitted an April 7, 

2020 report from Dr. Zimmerman, who used tables in the sixth edition of the A.M.A., Guides and 

opined that appellant had 26 percent permanent impairment of the right lower extremity due to her 

diagnosis of double or triple arthrodesis of the right midfoot with moderate malalignment. In 

accordance with its procedures, OWCP properly referred the medical record to Dr. Harris, a 

DMA,18 who reviewed Dr. Zimmerman’s April 7, 2020 report and concluded that Dr. Zimmerman 

erroneously based his impairment rating on a diagnosis of double or triple arthrodesis. He noted 

that appellant did not undergo double or triple arthrodesis, but instead she underwent a 

reconstructive procedure for posterior tibial insufficiency, including medial cuneiform osteotomy 

with tendon transfer.

Appellant also submitted Dr. Vopat’s January 4, 2019 progress note in which he found that 

she had reached MMI status post the removal of hardware over her first metatarsal and a calcaneal 

osteotomy, FDL transfer, gastroc release and medial cuneiform osteotomy. However, he did not 

describe a permanent impairment due to her accepted right ankle sprain.

19

 Before the A.M.A., 

Guides can be utilized a description of impairment must be obtained from the claimant’s physician. 

The evaluation made by the attending physician must include a description of the impairment

including, where applicable, the loss in degrees of active and passive motion of the affected 

member or function, the amount of any atrophy or deformity, decrease in strength or disturbance 

of sensation or other pertinent descriptions of the impairment.

20

 This description must be in 

sufficient detail so that the claims examiner and others reviewing the file will be able to clearly 

visualize the impairment with its resulting restrictions and limitations.21 The Board finds that

 

16 Id. at 23-28.

17 See supra note 8 at Chapter 2.808.6(f) (March 2017). See also P.W., Docket No. 19-1493 (issued August 12, 

2020); Frantz Ghassan, 57 ECAB 349 (2006).

18 Id.

19 See K.J., Docket No. 19-1492 (issued February 26, 2020); K.F., Docket No. 18-1517 (issued October 9, 2019).

20 See S.W., Docket No. 19-1078 (issued January 9, 2020).

21 K.F., supra note 19; A.T., Docket No. 18-0864 (issued October 9, 2018).
7

Dr. Vopat’s progress note does not describe the impairment to appellant’s right ankle in sufficient 

detail so that it can be visualized on review, and does not compute the percentage of impairment

in accordance with the A.M.A., Guides.

In a May 8, 2019 report, Dr. Matta, an OWCP referral physician, used the DBI method 

found at Table 16-2

22 and determined that appellant had six percent permanent impairment of the 

right lower extremity for a diagnosis of chronic right ankle sprain with associated posterior tibial 

tendon insufficiency.

OWCP again properly referred the medical record to Dr. Harris, a DMA,23 who reviewed

Dr. Matta’s May 21, 2019 report and agreed with Dr. Matta that appellant had six percent 

permanent impairment of the right lower extremity pursuant to the A.M.A., Guides as a result of 

her accepted posterior tibial deficit.

The Board finds that OWCP properly determined that the clinical findings and reports of

Dr. Matta and Dr. Harris constituted the weight of the medical evidence.

24

 There is no probative

medical evidence of record demonstrating greater impairment than that previously awarded.25 

Therefore, appellant has not met her burden of proof to establish an increased schedule award.

Appellant may request a schedule award or increased schedule award at any time based on 

evidence of a new exposure or medical evidence showing progression of an employment-related 

condition resulting in permanent impairment or increased impairment.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish more than 16 

percent permanent impairment of the right lower extremity for which she previously received a 

schedule award.

 

22 A.M.A., Guides 501, Table 16-2.

23 See supra note 17.

24 D.L., Docket No. 20-1016 (issued December 8, 2020); K.M., Docket No. 19-1526 (issued January 22, 2020); 

Y.S., Docket No. 19-0218 (issued May 15, 2020).

25 See D.L., id.; K.M., id.; J.M., Docket No. 18-1334 (issued March 7, 2019).
8

ORDER

IT IS HEREBY ORDERED THAT the July 8, 2020 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: June 11, 2021

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board