United States Department of Labor

Employees’ Compensation Appeals Board

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F.G., Appellant

and

DEPARTMENT OF THE ARMY, TANKAUTOMOTIVE AND ARMAMENTS 

COMMAND, ANNISTON ARMY DEPOT, 

Anniston, AL, Employer

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Docket No. 22-0268

Issued: August 16, 2022

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On December 9, 2021 appellant filed a timely appeal from an October 6, 2021 merit 

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

Employees’ Compensation Act1 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 October 6, 2021 decision, appellant submitted additional evidence to OWCP. 

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 his burden of proof to expand the acceptance of his

claim to include an exacerbation of preexisting arthritis of the right knee as causally related to the 

accepted November 16, 2020 employment injury.

FACTUAL HISTORY

On December 10, 2020 appellant, then a 63-year-old heavy mobile equipment mechanic, 

filed a traumatic injury claim (Form CA-1) alleging that on November 16, 2020 he pulled 

something in his right knee when he fell over a welding machine while in the performance of duty. 

He stopped work on November 17, 2020 and returned to work the same day.

In support of his claim, appellant submitted a November 18, 2020 report from

Dr. Gordon T. Hardy, a Board-certified orthopedic surgeon, relating that appellant was injured at 

work on November 17, 2020. Dr. Hardy’s examination of the right knee revealed pain with range 

of motion from 0 to 90 degrees, lateral knee pain, but no joint effusion, and pain over the lateral 

collateral ligament without instability. He noted that x-rays of the right knee taken that day 

revealed tricompartmental arthritis with joint space narrowing, as well as osteophyte formation, 

but no acute findings. Dr. Hardy diagnosed lateral collateral ligament sprain of the right knee and 

exacerbation of right knee arthritis. He recommended conservative treatment, administered a

cortisone injection to the right knee, and placed appellant on light-duty work with restrictions. In 

a work restriction note of even date, Dr. Hardy placed appellant on light-duty work with 

restrictions pending reevaluation in two weeks.

In the December 2, 2020, January 14, and February 18, 2021 reports, Dr. Hardy related 

appellant’s history of injury, diagnosed lateral collateral ligament sprain of the right knee and 

exacerbation of right knee arthritis, and advised appellant to continue on light-duty work using a 

right knee brace and physical therapy. In the December 2, 2020 report, he noted that appellant had 

received some benefit from the cortisone injection. Dr. Hardy’s examination of the right knee 

demonstrated lateral knee pain and pain on varus stress. He noted that x-rays of the right knee 

taken that day again revealed tricompartmental arthritis with joint space narrowing, especially in 

the medial compartment, but no acute findings. In the January 14, 2021 report, Dr. Hardy related 

that appellant continued to experience mild lateral knee pain. In a work restriction note of even 

date, he advised that appellant should remain on light-duty work with restrictions until after his 

next appointment in a month. The February 18, 2021 report noted that appellant had an improved 

range of motion from 0 to 110 degrees with pain in the extremes of flexion only and lateral-sided 

knee pain, but no instability or joint effusion.

By decision dated March 23, 2021, OWCP accepted appellant’s claim for sprain of the 

lateral collateral ligament of the right knee.

In a development letter of even date, OWCP informed appellant of the evidence needed to 

expand the acceptance of his claim to include additional conditions, specifically exacerbation of 

preexisting arthritis of the right knee, causally related to the November 16, 2020 employment 

injury. It afforded him 30 days to submit the necessary evidence.
3

In response, appellant submitted a March 18, 2021 report from Dr. Hardy relating

appellant’s history of injury and noting that appellant had improved and wanted to return to 

regular-duty work. Dr. Hardy diagnosed resolved lateral collateral ligament sprain of the right 

knee and moderate-to-severe tricompartmental arthritis of the right knee. He opined that appellant 

had returned to his baseline status and noted that the underlying knee arthritis might eventually 

require knee replacement surgery, “but this would not be a work-related procedure.” Dr. Hardy

released appellant to regular-duty work.

By decision dated October 6, 2021, OWCP denied expansion of the acceptance of the claim 

to include the additional diagnosed condition of the right knee, finding that the medical evidence 

was insufficient to establish causal relationship between the November 16, 2020 employment 

injury and an exacerbation of preexisting arthritis of the right knee.

LEGAL PRECEDENT

Where an employee claims that a condition not accepted or approved by OWCP was due 

to an employment injury, he or she bears the burden of proof to establish that the condition is 

causally related to the employment injury.3

Causal relationship is a medical question that requires medical opinion evidence to resolve 

the issue.4 The opinion of the physician must be based on a complete factual and medical 

background, must be one of reasonable certainty, and must be supported by medical rationale 

explaining the nature of the relationship between the diagnosed condition and the accepted 

employment injury.5

To establish causal relationship between the condition as well as any attendant disability 

claimed and the employment injury, an employee must submit rationalized medical evidence. 6 

The opinion of the physician must be based on a complete factual and medical background of the 

claimant, 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 the specific 

employment factors identified by the claimant.7 The weight of medical evidence is determined by 

its reliability, its probative value, its convincing quality, the care of analysis manifested, and the 

medical rationale expressed in support of the physician’s opinion.8

3 D.B., Docket No. 20-1280 (issued March2, 2021); R.R., Docket No. 19-0086 (issued February 10, 2021); K.T., 

Docket No. 19-1718 (issued April7, 2020); JajaK. Asaramo, 55 ECAB 200 (2004).

4 E.M., Docket No. 18-1599 (issued March 7, 2019); Robert G. Morris, 48 ECAB 238 (1996).

5

Id.

6 T.K., Docket No. 18-1239 (issued May 29, 2019); M.W., 57 ECAB 710 (2006); John D. Jackson, 55 ECAB 

465 (2004).

7 D.S., Docket No. 18-0353 (issued February 18, 2020); T.K.,id.; I.J., 59 ECAB 408 (2008);Victor J. Woodhams, 

41 ECAB 345 (1989).

8

See P.M., Docket No. 18-0287 (issued October 11, 2018).
4

ANALYSIS

The Board finds that appellant has not met his burden of proof to expand the acceptance of 

his claim to include an exacerbation of preexisting arthritis of the right knee as causally related to 

the accepted November 16, 2020 employment injury.

In a report dated March 18, 2021, Dr. Hardy related appellant’s history of injury and 

diagnosed resolved lateral collateral ligament sprain of the right knee and moderate -to-severe 

tricompartmental arthritis of the right knee. He further noted that appellant might require a knee 

replacement to treat the underlying arthritis but explained that such a procedure would not be

considered work related. Thus, this report is insufficient to establish causal relationship.

In reports dated November 18, 2020 through February 18, 2021, Dr. Hardy related 

appellant’s history of injury and diagnosed a lateral collateral ligament sprain of the right knee and 

exacerbation of right knee arthritis. In work restriction notes dated November 18, 2020 and 

January 14, 2021, he placed appellant on light-duty work with restrictions. In none of thosereports

or notes, however, did Dr. Hardy provide an opinion regarding causal relationship between 

appellant’s additional diagnosed condition and the accepted November 16, 2020 employment 

injury. 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. 9 

Thus, the Board finds that these reports from Dr. Hardy are of no probative value on the issue of 

causal relationship and are insufficient to meet appellant’s burden of proof.

As the medical evidence of record is insufficient to establish expansion of the acceptance 

of the claim to include an additional condition causally related to his accepted employment injury, 

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 expand the acceptance of 

his claim to include an exacerbation of preexisting arthritis of the right knee as causally related to 

the accepted November 16, 2020 employment injury.

9 L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).
5

ORDER

IT IS HEREBY ORDERED THAT the October 6, 2021 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: August 16, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board