United States Department of Labor

Employees’ Compensation Appeals Board

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T.B., Appellant

and

DEPARTMENT OF HOMELAND SECURITY, 

CUSTOMS & BORDER PROTECTION, 

OFFICE OF FIELD OPERATIONS, El Paso, TX, 

Employer

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Docket No. 23-0279

Issued: August 14, 2023

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On December 21, 2022 appellant, through counsel, filed a timely appeal from a 

December 9, 2022 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 to consider the merits of this case.

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.
2

ISSUE

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

causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On July 10, 2022 appellant, then a 65-year-old customs and border protection officer, filed 

an occupational disease claim (Form CA-2) alleging that he developed chronic left knee pain due 

to factors of his federal employment, including carrying his uniform, gun, gun belt, radio, 

ammunition, and handcuffs which weighed 30 to 35 pounds, along with his body armor weighing 

another 20 pounds. He noted that he first became aware of his left knee condition on January 1, 

2022 and first realized its relation to his federal employment on July 8, 2022. Appellant did not 

stop work.

In a July 11, 2022 development letter, OWCP informed appellant of the deficiencies of his 

claim. It advised him of the type of factual and medical evidence necessary to establish his claim

and provided a questionnaire for his completion. By separate development letter of even date, 

OWCP requested that the employing establishment provide additional information regarding 

appellant’s occupational disease claim, including comments from a knowledgeable supervisor 

regarding the accuracy of appellant’s statements. It afforded both parties 30 days to respond.

On July 26, 2022 the employing establishment noted no points of disagreement with regard 

to appellant’s assertion that he developed chronic knee pain due to 20 years of carrying all the 

accumulated weight involved in his law enforcement uniform, gear, gun belt, and body armor. It 

reported that he walked on concrete, walked up and down the steep grade of a port of entry bridge

and engaged in the physical activity of inspecting vehicles. The employing establishment advised 

that appellant was required to carry his law enforcement gear on a daily basis and was required to 

wear body armor on training days or port of entry emergencies.

On July 31, 2022 appellant responded to OWCP’s development questionnaire and 

indicated that he attributed his left knee condition to carrying the weight of all his law enforcement 

uniform and gear for 20 years. He also noted that his position required extensive walkingincluding 

up the steep incline of a port of entry bridge.

In an August 5, 2022 note, Dr. Erick Gabriel Torres, an orthopedic surgeon, diagnosed 

acute tear of the medial meniscus of the left knee. In a separate note of even date, he provided 

work restrictions including limited prolonged walking, no lifting greater than 10 pounds, no body 

armor, and no gun belt.

By decision dated August 11, 2022, OWCP denied appellant’s occupational disease claim 

finding that he failed to submit a rationalized opinion from his treating physician explaining how 

his diagnosed conditions were causally related to the accepted factors of his federal employment.

OWCP subsequently received an August 5, 2022 treatment note from Dr. Torres 

recounting appellant’s history of left knee pain with insidious onset and no traumatic event. 

Dr. Torres diagnosed acute tear of the medial meniscus of the left knee. On August 18, 2022 

appellant underwent a left knee magnetic resonance imaging (MRI) scan which demonstrated a 
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prominent horizonal tear within the posterior horn of the medial meniscus and a small radial tear 

that extended to the tibial articular surface, femoral condylar cortical edema, suspected stress 

fracture, joint effusion, popliteal cyst, and chondromalacia of the patella and medial femoral 

condyle. In an August 25, 2022 note, Dr. Torres continued to provide work restrictions. 

On September 12, 2022 appellant requested reconsideration. 

In support of his request, appellant submitted a September 12, 2022 report from

Dr. Thomas E. Alost, an orthopedic surgeon, recounting his history of injury, including wearing 

heavy body gear and walking, repetitively bending, squatting, and pivoting on his left knee. 

Dr. Alost opined that as a direct result of these activities appellant had developed increased pain 

with locking in his knee. He reviewed the left knee MRI scan and diagnosed an acute complex 

tear of the medial meniscus which was directly related to the work activities. Dr. Alost 

recommended left knee arthroscopic surgery.

In September 19 and 27, 2022 notes, Dr. Alost provided work restrictions and noted 

appellant’s left knee surgery scheduled for October 3, 2022. He released appellant to return to 

full-duty work on December 5, 2022.

By decision dated December 9, 2022, OWCP denied modification of the August 11, 2022

decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA has the burden of proof to establish the 

essential elements of his or her claim, including the fact 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 period of FECA,3that 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. 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.4

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit the following: (1) a factual statement identifying 

employment factors alleged to have caused or contributed to the presence or occurrence of the 

disease or condition; (2) medical evidence establishing the presence or existence of the disease or 

condition for which compensation is claimed; and (3) medical evidence establishing that the 

diagnosed condition is causally related to the identified employment factors. 5

3 T.M., Docket No. 20-1460 (issued December 20, 2022); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 

59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989).

4 K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); 

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

5 R.G., Docket No. 19-0233 (issued July 16, 2019). See also Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. 

Fish, 46 ECAB 276, 279 (1994); Victor J. Woodhams, 41 ECAB 345 (1989).
4

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.6 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment factor(s) must be based on a 

complete factual and medical background.7 Additionally, the physician’s opinion must be 

expressed in terms of a reasonable degree of medical certainty, and must be supported by medical 

rationale explaining the nature of the relationship between the diagnosed condition and appellant’s 

specific employment factors.8

ANALYSIS

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

condition causally related to the accepted factors of his federal employment.

Appellant provided reports from Dr. Alost dated September 12 through 27, 2022. Dr. Alost 

opined that appellant’s left knee condition was caused by wearing heavy body gear and walking, 

repetitively bending, squatting, and pivoting on his left knee while performing his job duties. 

While Dr. Alost provided an affirmative opinion on causal relationship, he did not provide 

sufficient rationale to explain why he believed that appellant’s employment duties resulted in or 

contributed to his diagnosed condition. Without explaining how wearing heavy body gear and 

walking, repetitively bending, squatting, and pivoting on his left knee caused an acute complex 

tear of the left medial meniscus, Dr. Alost’s September 2022 narrative reports are of limited 

probative value. The Board has held that a report is of limited probative value regarding causal 

relationship if it does not contain medical rationale explaining how a given medical 

condition/disability was related to employment factors.9 Dr. Alost’s September 2022 reports are

therefore insufficient to meet appellant’s burden of proof.

In notes dated August 5 through 25, 2022, Dr. Torres diagnosed acute tear of the medial 

meniscus of the left knee and described appellant’s history of left knee pain with no traumatic 

event. He did not offer an opinion on causal relationship between appellant’s diagnosed condition 

and his implicated employment duties. 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.10 As such, these medical reports are also insufficient to establish the 

claim.

Appellant also submitted an August 18, 2022 left knee MRI scan. The Board has held, 

however, that diagnostic studies standing alone lack probative value on the issue of causal 

6 T.M., supra note 3; T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 238 (1996).

7 T.M., id.; M.V., Docket No. 18-0884 (issued December 28, 2018).

8

Id.; Victor J. Woodhams, supra note 5.

9

See T.M., supra note 3; A.P., Docket No. 19-0224 (issued July 11, 2019).

10 D.H., Docket No. 20-1410 (issued December 21, 2022); S.J., Docket No. 19-0696 (issued August 23, 2019); 

M.C., Docket No. 18-0951 (issued January 7, 2019); see L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., 

Docket No. 17-1549 (issued July 6, 2018); Charles H. Tomaszewski, 39 ECAB 461 (1988).
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relationship as they do not provide an opinion on causal relationship between an employment 

incident and a diagnosed condition.11

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

related to the accepted factors of federal employment, 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 left knee 

condition causally related to the accepted factors of his federal employment.

ORDER

IT IS HEREBY ORDERED THAT the December 9, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: August 14, 2023

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board

11 N.B., Docket No. 20-0794 (issued July 29, 2022); C.F., Docket No. 19-1748 (issued March 27, 2020); L.B.,id.;

D.K., id.