United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

S.B., Appellant

and

U.S. POSTAL SERVICE, SHELBY TOWNSHIP 

POST OFFICE, Shelby Township, MI, Employer

__________________________________________

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Docket No. 21-0989

Issued: May 11, 2022

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On June 16, 2021 appellant, through counsel, filed a timely appeal from a March 17, 2021 

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,following the March 17, 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

ISSUE

The issue is whether OWCP met its burden of proof to terminate appellant’s entitlement to 

wage-loss compensation and medical benefits, effective January 21, 2018 due to the accepted

condition of torn medial meniscus of the left knee, and effective February 24, 2021 due to the 

accepted condition of temporary aggravation of left knee osteoarthritis.

FACTUAL HISTORY

This case has previously been before the Board.4 The facts of the case as presented in the

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

On September 21, 2017 appellant, then a 52-year-old letter carrier, filed a notice of 

recurrence (Form CA-2a) alleging that on September 11, 2017 he sustained a recurrence of his 

August 28, 2006 left knee injury under OWCP File No. xxxxxx779.5 He stopped work on 

September 20, 2017. 

On October 5, 2017 OWCP determined that appellant had identified new work factors as 

the cause of his alleged conditions. Accordingly, it administratively converted his recurrence 

claim to a new occupational disease claim (Form CA-2) assigned OWCP File No. xxxxxx408.

By decision dated November 28, 2017, OWCP denied appellant’s occupational disease 

claim,finding that the medical evidence of record was insufficient to establish a causal relationship 

between appellant’s diagnosed left knee conditions and the accepted factors of his federal 

employment.

On April 18, 2018 appellant, through counsel, requested reconsideration. By decision 

dated September 14, 2018, OWCP denied modification of the November 28, 2017 decision. 

On March 6, 2019 appellant, through counsel, requested reconsideration and submitted 

additional medical evidence.

In a report dated February 20, 2019, Dr. Neil Allen, a Board-certified internist, reviewed 

statements from appellant detailing his work duties and medical history. He also noted review of 

an October 25, 2017 report from Dr. Steven Plomaritis, an osteopath specializing in orthopedic 

surgery, which discussed the results of x-rays and a diagnostic ultrasound. Dr. Allen opined that

Dr. Plomaritis had provided adequate history and findings to support a diagnosis of permanent 

aggravation of unilateral primary osteoarthritis of the left knee. He opined that appellant’s fulltime schedule as an aging letter carrier combined with the repetitive loading required by the 

position (climbing out of a vehicle, climbing stairs and curbs, walking, standing, and pushing and 

pulling) would result in a greater amount of degeneration than what could be restored by the body. 

Dr. Allen indicated that the result of this incomplete regeneration was destruction/disruption of 

cartilage, reduction of joint space (primary and patellofemoral), and bony destruction/deformity. 

4 Docket No. 19-1778 (issuedOctober 23, 2020)(Alec J. Koromilas, Chief Judge, dissenting). 

5 Appellant’s claim under OWCP File No. xxxxxx779was never formally adjudicated. His claims have not been 

administratively combined by OWCP. 
3

As such, he found that the repetitive wear associated with appellant’s work duties resulted in the 

permanent aggravation of appellant’s underlying arthritic condition. Dr. Allen reported that the 

aggravation was permanent because current treatments for osteoarthritis provided only temporary 

relief and not full resolution of the underlying condition. 

By decision dated June 4, 2019, OWCP denied modification of the September 14, 2018 

decision.

On August 23, 2019 appellant, through counsel, filed a timely appeal to the Board. By 

decision dated October 23, 2020,6the Board set aside OWCP’s June 4, 2019 decision and 

remanded the case for further development. The Board found that, while Dr. Allen’s February 20, 

2019 opinion was not fully rationalized and was insufficient to meet appellant’s burden of proof 

to establish causal relationship, it was sufficient, in the absence contrary evidence, to require 

further development of the record.

On November 6, 2020 OWCP prepared a statement of accepted facts (SOAF) and referred 

appellant, along with a series of questions and the case record, to Dr. Khaled J. Saleh, a Boardcertified orthopedic surgeon, for a second opinion evaluation. 

In a February 24, 2021 report, Dr. Saleh related a history of injury and medical treatment. 

He indicated that appellant’s diagnostic studies and physical examination findings correlated with 

his clinical impression of left knee medial meniscal tear, which he opined that appellant had 

sustained because of his letter carrier activities. Dr. Saleh described appellant’s daily work duties 

as a letter carrier and noted that appellant’s first left knee symptoms of gradual worsening pain 

and swelling, had occurred over a period of approximately one week and following an especially 

large volume of package deliveries on September 11, 2017. He noted that appellant’s left knee 

x-rays and diagnostic ultrasound from October 25, 2017 confirmed medial compartment bone on 

bone osteoarthritis and that a December 12, 2017 left knee magnetic resonance imaging (MRI) 

scan revealed a medial meniscal tear. Dr. Saleh related that arthroscopic surgery was 

recommended, whichappellant underwent on January 20, 2018.

7

 He noted that appellant’s current 

objective finding of mild joint line tenderness was consistent with his subjective complaint of 

intermittent left knee medial-sided pain, which typically arose from an osteoarthritis diagnosis. 

Dr. Saleh opined that appellant’s left knee medial meniscus tear and chondral lesion had resolved 

when treated surgically on January 20, 2018. He indicated that appellant’s left knee unilateral 

primary osteoarthritis arose from his 1986 left knee injury, which resulted in a complex multiligamentous reconstruction and was likely multifactorial. Dr. Saleh opined that the work injury 

temporary aggravated appellant’s preexisting left knee unilateral primary osteoarthritis and that 

the underlying osteoarthritis received appropriate conservative treatment, including physical 

therapy and therapeutic exercise along with the use of a stabilizing brace during prolonged 

ambulation. He explained that appellant’s disability period that began on September 20, 2017 did

not extend past April 20, 2018 (which represented a three-month period of recovery and physical 

therapy following the January 20, 2018 left knee surgery). Dr. Saleh concluded that appellant was 

6

See supra note 4.

7 This consisted of medial meniscectomy, medial and patellofemoral chrondroplasty and infiltration of concentrated 

marrow cells for possible stress fracture of the medial tibial plateau and the medial femoral condyle.
4

capable of returning to his position as letter carrier without restrictions, and that he had already 

done so.

By decision dated March 17, 2021, OWCP accepted appellant’s claim for torn left knee 

medial meniscus, resolved as of January 21, 2018 and temporary aggravation of preexisting left 

knee osteoarthritis, resolved as of February 24, 2021. It related that, as both conditions had 

resolved, appellant’s claim was closed upon acceptance. However, OWCP further noted that if 

appellant lost time from work due to the accepted conditions, he could claim compensation using 

a claim for compensation (Form CA-7). 

LEGAL PRECEDENT

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

modification or termination of an employee’s benefits.8 The right to medical benefits for an 

accepted condition is not limited to the period of entitlement to compensation for disability. 9 To 

terminate authorization for medical treatment, OWCP must establish that the employee no longer 

has residuals of an employment-related condition that require further medical treatment.10

OWCP’s burden of proof in terminating compensation includes the necessity of furnishing 

rationalized medical opinion evidence based on a proper factual and medical background.11

ANALYSIS

The Board finds that OWCP met its burden of proof to terminate appellant’s entitlement to 

wage-loss compensation and medical benefits, effective January 21, 2018, due to the accepted 

condition of torn medial meniscus of the left knee. 

On remand from the Board’s October 23, 2020 decision, OWCP referred appellant to

Dr. Saleh for a second opinion evaluation. In his February 24, 2021 report, Dr. Saleh described 

appellant’s daily work duties as a letter carrier and noted that appellant’s first left knee symptoms 

of gradual worsening pain and swelling, had occurred over a period of approximately one week 

and following an especially large volume of package deliveries on September 11, 2017. He noted 

that appellant’s left knee x-rays and diagnostic ultrasound from October 25, 2017 confirmed 

medial compartment bone on bone osteoarthritis and that a December 12, 2017 left knee MRI scan 

revealed a medial meniscal tear. Dr. Saleh related that arthroscopic surgery was recommended, 

which appellant underwent on January 20, 2018. He opined that appellant’s left knee medial 

meniscus tear had resolved when it was surgically treated on January 20, 2018. Dr. Saleh also 

noted that appellant’s current objective findings of mild joint line tenderness was consistent with

8

S.P., Docket No. 19-0196 (issued June 24, 2020); D.G., Docket No. 19-1259 (issued January 29, 2020); S.F., 59 

ECAB 642 (2008);Kelly Y. Simpson, 57 ECAB 197 (2005);PaulL. Stewart, 54 ECAB 824 (2003).

9

S.P., id.; J.W., Docket No. 19-1014 (issued October 24, 2019); L.W., Docket No. 18-1372 (issued 

February27, 2019).

10 Id.

11 D.G., supra note 8; M.C., Docket No. 18-1374 (issued April23, 2019); Del K. Rykert, 40 ECAB 284, 295-

96 (1988).
5

an osteoarthritis diagnosis. His conclusion is sound, rational, and logical and is supported with 

sufficient medical rationale that it is accorded the weight of the medical evidence. As the weight 

of the medical evidence establishes that the accepted left knee medial meniscus tear had resolved 

with no residuals on January 20, 2018, the Board finds that OWCP has met its burden to justify 

the termination of compensation for this medical condition. The Board will therefore affirm 

OWCP’s termination of appellant’s medical benefits effective January 21, 2018 with regard to the 

accepted condition of torn left knee medial meniscus.12 

With regard to the accepted temporary aggravation of left knee osteoarthritis, the Board 

finds that OWCP did not meet its burden of proof. Dr. Saleh opined in his February 24, 2021 

second opinion report, that the work injury had temporarily aggravated appellant’s preexisting left 

knee unilateral primary osteoarthritis which resolved on April 20, 2018, after a three-month period 

of recovery and physical therapy following the January 20, 2018 left knee surgery. In his 

February 20, 2019report, Dr. Allen opined that the repetitive wear associated with appellant’s 

work duties resulted in the permanent aggravation of appellant’s underlying arthritic condition. 

He explained that the aggravation was permanent because current treatments for osteoarthritis 

provided only temporary relief and not full resolution of the underlying condition. Dr. Allen also 

opined that his review of Dr. Plomaritis’ October 25, 2017 report, which discussed the results of 

x-rays and a diagnostic ultrasound, contained adequate history and findings to support a diagnosis 

of permanent aggravation of unilateral primary osteoarthritis of the left knee. A conflict therefore 

exists in medical opinion evidence between Dr. Allen, the treating physician, and Dr. Saleh, the 

second opinion physician. As this conflict remains unresolved, the Board finds that OWCP did 

not meet its burden to justify the termination of appellant’s entitlement to wage-loss compensation 

and medical benefits effective February 24, 2021 due to the accepted condition of temporary 

aggravation of left knee osteoarthritis. 

CONCLUSION

The Board finds that OWCP met its burden of proof to terminate appellant’s entitlement to 

wage-loss compensation and medical benefits effective January 21, 2018 for the accepted 

condition of torn left knee medial meniscus, but did not meet its burden of proof to terminate 

appellant’s entitlement to wage-loss compensation and medical benefits effective February 24, 

2021 for the accepted condition of temporary aggravation of left knee osteoarthritis. 

12 V.D., Docket No. 19-0979 (issued February 5, 2020); T.W., Docket No. 18-1573 (issued July 19, 2019); M.C., 

Docket No. 18-1199 (issued April5, 2019); see also A.C., Docket No. 16-1670 (issued April6, 2018); D.S.,Docket 

No. 13-228 (issued July 12, 2013). 
6

ORDER

IT IS HEREBY ORDERED THAT the March 17, 2021 decision of the Office of 

Workers’ Compensation Programs is affirmed in part and reversed in part.

Issued: May 11, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board