United States Department of Labor

Employees’ Compensation Appeals Board

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A.F., Appellant

and

U.S. POSTAL SERVICE, NORTH METRO 

GEORGIA PROCESSING & DISTRIBUTION 

CENTER, Duluth, GA, Employer

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Docket No. 23-0325

Issued: July 28, 2023

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

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On January 3, 2023 appellant filed a timely appeal from a December 12, 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.2

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the December 12, 2022 decision, appellant submitted additional evidence to 

OWCP and with her appeal to the Board. 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 appellant has met her burden of proof to establish greater than 21 

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

schedule award. 

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 January 19, 2017 appellant, then a 50-year-old mail handler, filed a traumatic injury 

claim (Form CA-1) alleging that on January 16, 2017 she bruised her left knee when she struck 

her left knee on a low rail of a gate while in the performance of duty. She stopped work on 

March 3, 2017. OWCP accepted the claim for left knee contusion and left knee sprain. It paid 

appellant wage-loss compensation on the supplemental rolls, effective March 3, 2017, and on the 

periodic rolls, effective April 2, 2017. By decision dated May 9, 2017, OWCP expanded the 

acceptance of her claim to include derangement of the anterior horn of the left lateral meniscus. 

Appellant retired due to disability, effective June 25, 2018. 

In a letter dated August 26, 2021, appellant, through counsel, filed a claim for

compensation (Form CA-7) for a schedule award. 

Appellant submitted a July 8, 2021 report from Dr. Ralph D’Auria, a Board-certified 

physiatrist, who reviewed the history of the January 16, 2017 employment injury and indicated 

that her claim was accepted for left knee contusion, left knee sprain, and derangement of anterior 

horn of lateral meniscus of the left knee. Dr. D’Auria indicated that, in December 2020, she

underwent left total knee arthroplasty and x-ray examination of the left knee showed interval 

placement of the left total knee arthroplasty in good position. On examination, he noted that 

appellant walked with a mild limp, favoring the left knee. Dr. D’Auria reported left knee physical 

examination findings of tenderness on palpation to the patellar tendon, and pain on passive 

displacement of the patella. Range of motion (ROM) was limited at right flexion and left flexion. 

Dr. D’Auria noted that appellant had reached maximum medical improvement (MMI) as of that 

date. He referenced the sixth edition of the American Medical Association, Guides to the 

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

4 and utilized the diagnosis-based 

impairment (DBI) rating method to find that, under Table 16-3, (Knee Regional Grid -- Lower 

Extremity Impairments), page 511, appellant had a Class 2 impairment, which resulted in a default 

value of 25 percent, based on total knee replacement with good result. Dr. D’Auria assigned a 

grade modifier for functional history (GMFH) of 1 for antalgic limp and a grade modifier for 

physical examination (GMPE) of 1 for ROM. He indicated that a grade modifier for clinical 

3 Docket No. 19-0453 (issued July 6, 2020). By decision dated July 6, 2020, the Board reversed the November 28, 

2018 OWCP decision, finding that OWCP had not met its burden of proof to terminate appellant’s wage-loss 

compensation and entitlement to schedule award benefits pursuant to 5 U.S.C. § 8106(c)(2). 

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

studies (GMCS) was not applicable. Dr. D’Auria applied the net adjustment formula (1-2) + (1-2) 

= -2, which resulted in a final rating of 21 percent permanent impairment of the left lower 

extremity. 

On May 18, 2022 appellant filed another Form CA-7 for a schedule award. 

In a June 9, 2022 development letter, OWCP requested that appellant submit an impairment 

rating report, which applied the standards of the sixth edition of the A.M.A., Guides. It afforded 

her 30 days to submit the requested evidence. 

On November 3, 2022 OWCP forwarded Dr. D’Auria’s July 8, 2021 report, along with a 

statement of accepted facts (SOAF), to Dr. Michael M. Katz, a Board-certified orthopedic surgeon

serving as an OWCP district medical adviser (DMA), for review and opinion on the extent of any 

employment-related permanent impairment of appellant’s left lower extremity under the A.M.A., 

Guides. In a November 8, 2022 report, Dr. Katz indicated that he had reviewed the SOAF and the 

medical record, including Dr. D’Auria’s July 8, 2021 report. He agreed with Dr. D’Auria’s 

opinion that appellant had 21 percent permanent impairment of the left lower extremity. Dr. Katz 

determined that, under the DBI rating method of the A.M.A., Guides, the appropriate Class was 2, 

with a default value of 25 percent, for good result following a total knee replacement. He assigned 

a GMFH of 1 and a GMPE of 1. After applying the net adjustment formula, (1-2) + (1-2) = -2,

Dr. Katz determined that appellant had a final impairment of 21 percent permanent impairment of 

the left lower extremity. He also reported that the accepted conditions of her claim were not 

eligible for the alternative ROM rating methodology under the A.M.A., Guides.

By decision dated December 12, 2022, OWCP granted appellant a schedule award for 21 

percent permanent impairment of her left lower extremity. The schedule award ran for 60.48

weeks from May 2, 2018 through June 29, 2019 and was based on Dr. D’Auria’s July 8, 2021 and 

the DMA’s November 8, 2022 reports. 

LEGAL PRECEDENT

The schedule award provisions of FECA5 and its implementing regulations6 set 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. FECA, however, does not 

specify the manner in which the percentage of loss of a member shall be determined. For consistent 

results and to ensure equal justice under the law for all claimants, OWCP has adopted the A.M.A., 

Guides as the uniform standard applicable to all claimants and the Board has concurred in such 

5

5 U.S.C. § 8107.

6

20 C.F.R. § 10.404.
4

adoption.7 As of May 1, 2009, the sixth edition of the A.M.A., Guides, published in 2009, is used 

to calculate schedule awards.8

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. 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 509.9 After the class of diagnosis 

(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).10 Under Chapter 2.3, 

evaluators are directed to provide reasons for their impairment rating choices, including choices 

of diagnoses from regional grids and calculations of modifier scores. 11

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

should be routed through an OWCP medical adviser for an opinion concerning the nature and 

percentage of impairment in accordance with the A.M.A., Guides, with an OWCP medical adviser 

providing rationale for the percentage of impairment specified.12

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish greater than 21 

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

schedule award. 

On July 8, 2021 Dr. D’Auria provided an accurate history of injury and noted the accepted 

conditions of left knee contusion, left knee sprain, and derangement of anterior horn of lateral 

meniscus of the left knee. He indicated that appellant underwent left total knee arthroplasty and

that diagnostic testing showed interval placement of the left total knee arthroplasty in good 

position. Dr. D’Auria provided examination findings and noted that she had reached MMI as of 

that date. Utilizing the A.M.A., Guides13 and the DBI rating method, he determined that appellant 

had a Class 2 impairment under Table 16-3, (Knee Regional Grid), which resulted in a default 

value of 25 percent, based on a good result following a total knee replacement. Dr. D’Auria 

7

Id. at § 10.404 (a); see also T.T., Docket No. 18-1622 (issued May 14, 2019); Jacqueline S. Harris, 54 ECAB 

139 (2002). 

8 Federal (FECA) Procedure Manual, Part 2 --Claims, Schedule Awards and Permanent Disability Claims, Chapter 

2.808.5(a) (March 2017); see also id. at Chapter 3.700.2 and Exhibit 1 (January 2010).

9

See A.M.A., Guides (6th ed. 2009), 509-11.

10 Id. at 515-22.

11 Id. at 23-28.

12 Supra note 8 at Chapter 2.808.6(f) (March 2017). 

13 A.M.A., Guides (6th ed. 2009).
5

assigned grade modifiers and applied the net adjustment formula, in order to determine that she

had a final impairment of 21 percent permanent impairment of the left lower extremity.

On November 8, 2022 the DMA reviewed Dr. D’Auria’s July 8, 2018 impairment rating 

report and concurred with his finding that appellant had 21 percent permanent impairment of the 

left lower extremity due to her accepted left knee injury. The Board has reviewed the DMA’s 

rating, and finds that he properly applied the appropriate tables and grading schedules to the 

findings from Dr. D’Auria’s report, pursuant to the A.M.A., Guides.14 The DMA properly utilized 

the DBI rating method to find that, under Table 16-3 (Knee Regional Grid), appellant was a Class

2 impairment for good result following a total knee replacement, which resulted in a default value 

of 25 percent. He assigned a GMFH of 1 and a GMPE of 1 and applied the net adjustment formula, 

which resulted in a final impairment of 21 percent permanent impairment of the left lower 

extremity.

Accordingly, the Board finds that, as appellant has not submitted medical evidence 

establishing greater than 21 percent permanent impairment of the left lower extremity, she has not 

met her burden of proof. 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 permanent 

impairment. 

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish greater than 21 

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

schedule award. 

14 See A.S., Docket No. 22-0930 (issued January 19, 2023); see also R.S., Docket No. 21-0833 (issued 

January 25, 2022).
6

ORDER

IT IS HEREBY ORDERED THAT the December 12, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: July 28, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board