United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

S.C., Appellant

and

DEPARTMENT OF HOMELAND SECURITY,

TRANSPORTATION SECURITY 

ADMINISTRATION, FEDERAL AIR 

MARSHAL SERVICE, Atlanta, GA, Employer

__________________________________________

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Docket No. 22-1317

Issued: May 18, 2023

Appearances: Case Submitted on the Record

Appellant, pro se

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 September 15, 2022 appellant filed a timely appeal from a July 26, 2022 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 over 

the merits of this case.

ISSUE

The issue is whether appellant has met his burden of proof to establish a bilateral knee 

condition causally related to the accepted July 27, 2020 employment incident.

1

5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On August 18, 2020 appellant, then a 48-year-old federal air marshal, filed a traumatic 

injury claim (Form CA-1) alleging that on July 27, 2020 he aggravated his bilateral knee condition 

when participating in required training while in the performance of duty. He stopped work on 

July 31, 2020.

2

In support of his claim, appellant submitted a September 9, 2020 progress note from

Dr. David Brcka, a Board-certified orthopedist, who treated him for bilateral knee patellar 

chondral lesions. He reported five years of symptoms localized in the anterior aspect of the knees. 

Appellant noted being injured during a fall onto the front of his knees. X-rays of the knees 

demonstrated a lateral patellar tilt. Dr. Brcka reviewed a magnetic resonance imaging (MRI) scan

of the right knee, which revealed localized articular cartilage defect centrally. An MRI scan of the 

left knee revealed high grade chondromalacia in the lateral patella. Appellant was treated with 

intra-articular injections, which provided only temporary relief. Dr. Brcka recommended

diagnostic arthroscopic surgery.

On September 9, 2020 and August 20, 2021 Dr. Brcka prepared forms required by the 

employing establishment that noted appellant’s limitations in performing physical activities related 

to law enforcement tasks. In an employing establishment form dated July 15, 2021, he diagnosed 

bilateral knee patellar chondral injury and recommended bilateral knee surgery. Dr. Brcka treated 

appellant on January 19, 2022 for persistent pain in both knees that was aggravated by stair

climbing, kneeling and squatting. Findings on physical examination of the right knee revealed 

mild effusion, positive patellofemoral crepitance, and limited extension. Physical examination of 

the left knee revealed minimal effusion and positive patellofemoral crepitance. Dr. Brcka

diagnosed chondromalacia of the right and left patellae. He recommended diagnostic arthroscopic

surgery. In another progress note dated January 19, 2022, Dr. Brcka treated appellant for bilateral 

knee patellofemoral arthritis. He noted that appellant worked as a federal air marshal, which 

required significant agility, ability to perform quick movements, and significant lower body 

strength. Dr. Brcka opined that the diagnosed patellofemoral arthritis at its current state would not 

allow appellant to return to his job.3

In a development letter dated February 25, 2022, OWCP informed appellant of the 

deficiencies of his claim. It advised him of the type of factual and medical evidence required and

afforded him 30 days to submit the requested evidence.

In a statement dated February 28, 2022, appellant indicated that his injury continued to 

worsen over the years, and he could no longer perform his current job duties due to the progression 

2

In an employee statement of workplace injury dated August 27, 2020, appellant described a November 15, 2007 

employment incident that occurred while in an airplane simulator in which he injured both knees. He indicated that,

more recently during training exercises he, was required to kneel on cement, which exacerbated his bilateral knee 

condition. 

3 Appellant submitted a claim for compensation (Form CA-7) for disability from work for the period January 31 

through February 23, 2022. By letter dated February 28, 2022, OWCP indicated that appellant’s claim for 

compensation was premature as his claim had not yet been adjudicated.
3

of his knee conditions. He noted that because of the work-related training injury he could not 

complete many of the necessary duties of his job.

By decision dated March 30, 2022, OWCP accepted that the July 27, 2020 employment 

incident occurred as alleged. However, it denied appellant’s traumatic injury claim, finding that 

he had not submitted medical evidence containing a diagnosis in connection with the accepted 

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

establish an injury as defined under FECA.

OWCP received additional evidence. On May 4, 2022 Dr. Brcka treated appellant for 

persistent pain in both knees. He noted that previous workup was consistent with patellar c artilage 

injuries. Dr. Brcka advised that appellant sustainedan injury to his knees during a training exercise 

at work. He opined that appellant’s work injury was the major contributing cause to his bilateral 

knee injuries, persistent symptoms, and the need for knee surgery. 

On May 6, 2022 appellant requested reconsideration. 

By decision dated June 7, 2022, OWCP modified the March 30, 2022 decision to find that 

appellant had established a medical diagnosis in connection with the July 27, 2020 accepted 

employment incident. However, the claim remained denied as the medical evidence of record was 

insufficiently rationalized to establish causal relationship between the diagnosed medical condition 

and the accepted July 27, 2020 employment incident.

OWCP received additional evidence. In a progress note dated May 4, 2022, Dr. Brcka 

treated appellant for bilateral knee pain. Findings on physical examination of the knees revealed 

minimal effusion and positive patellofemoral crepitance bilaterally. Dr. Brcka diagnosed 

chondromalacia of the right and left patella and osteoarthritis of the right and left patellofemoral 

joints. In another note dated May 4, 2022, he indicated that appellant presented for recheck of his 

bilateral knee condition. Dr. Brcka noted that his symptoms were unchanged. Appellant reported 

that prior to the injury at work he had no issues with his knees. Findings on physical examination 

revealed minimal effusion and patellofemoral crepitance bilaterally. Dr. Brcka explained that 

appellant’s job as a federal air marshal required significant agility, ability to perform quick 

movements and significant lower body strength. He opined that the work injury permanently 

aggravated his knee condition and was the major contributing factor to his need for surgery.

On July 14, 2022 appellant requested reconsideration.

By decision dated July 26, 2022, OWCP denied modification of the June 7, 2022 decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA4 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 

4

Id.
4

limitation of FECA,5that 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.6 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.7

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. First, 

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. Second, the employee must 

submit sufficient evidence to establish that the employment incident caused a personal injury. 8

The medical evidence required to establish causal relationship is rationalized medical 

opinion evidence.9 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 incident identified by the employee.10

In any case where a preexisting condition involving the same part of the body is present 

and the issue of causal relationship, therefore, involves aggravation, acceleration, or precipitation, 

the physician must provide a rationalized medical opinion that differentiates between the effects 

of the work-related injury or disease and the preexisting condition.11

ANALYSIS

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

condition causally related to the accepted July 27, 2020 employment incident.

On September 9, 2020 and August 20, 2021 Dr. Brcka prepared employing establishment

forms that noted appellant’s limitations in performing physical activities. In an employing 

establishment form dated July 15, 2021, he diagnosed bilateral knee patellar chondral injury and 

5 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).

6 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).

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

Delores C. Ellyett, 41 ECAB 992 (1990).

8 T.J., Docket No. 19-0461 (issued August 11, 2020); K.L., Docket No. 18-1029 (issued January 9, 2019); John J. 

Carlone, 41 ECAB 354 (1989).

9

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).

10 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).

11 Federal (FECA) Procedure Manual, Part 2 --Claims, Causal Relationship, Chapter 2.805.3e (January 2013).

See R.D., Docket No. 18-1551 (issued March 1, 2019).
5

recommended bilateral knee surgery. Similarly, on January 19, 2022, Dr. Brcka treated appellant 

for persistent pain in both knees and diagnosed chondromalacia of the right and left patellae. In a 

progress note dated January 19, 2022, he noted that appellant worked as a federal air marshal,

which required significant agility, ability to perform quick movements, and significant lower body 

strength. Dr. Brcka opined that the diagnosed patellofemoral arthritis would not permit appellant 

to return to his job. Likewise, in a May 4, 2022 progress note, he diagnosed chondromalacia of 

the right and left patella and osteoarthritis of the right and left patellofemoral joints. However, in 

these reports, Dr. Brcka did not offer an opinion as to whether appellant’s diagnosed conditions 

were causally related to the accepted employment incident on July 27, 2020. 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.12 Accordingly, these reports 

are insufficient to establish appellant’s claim.

In a September 9, 2020 progress note, Dr. Brcka treated appellant for bilateral knee patellar 

chondral lesions after a fall onto the front of his knees. Similarly, on May 4, 2022, he treated 

appellant in follow-up for an injury to his knees sustained during a training exercise at work. 

Dr. Brcka opined that appellant’s training injury was the major contributing cause to his bilateral 

knee injury, persistent symptoms, and the need for knee surgery. Likewise, in another note dated 

May 4, 2022, he opined that the work injury permanently aggravated his knee condition and was 

the major contributing factor to requiring surgery. While Dr. Brcka opined that appellant’s 

bilateral knee conditions were work related, he failed to provide medical rationale explaining the 

basis of his opinion. The Board has held that without explaining, physiologically, how the specific 

employment incident or employment factors caused or aggravated the diagnosed condition,

opinions on causal relationship are of limited probative value. 13 Therefore, this evidence is 

insufficient to establish the claim. 

As the medical evidence of record is insufficient to establish a bilateral knee condition

causally related to the accepted July 27, 2020 employment incident, the Board finds that appellant 

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(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 bilateral knee 

condition causally related to the accepted July 27, 2020 employment incident. 

12 S.P., Docket No. 22-0711 (issued March 13, 2023); L.B., Docket No. 19-1907 (issued August14, 2020); L.B., 

Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

13 Id.
6

ORDER

IT IS HEREBY ORDERED THAT the July 26, 2022 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: May 18, 2023

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