United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
K.V., Appellant
and
TENNESSEE VALLEY AUTHORITY,
Chattanooga, TN, Employer
__________________________________________

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Appearances:
Ronald K. Bruce, Esq., for the appellant1
Office of Solicitor, for the Director

Docket No. 18-0306
Issued: August 8, 2018

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
PATRICIA H. FITZGERALD, Deputy Chief Judge
ALEC J. KOROMILAS, Alternate Judge

JURISDICTION
On November 27, 2017 appellant, through counsel, filed a timely appeal from an
October 2, 2017 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 the 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.

ISSUE
The issue is whether appellant has met his burden of proof to establish hearing loss causally
related to factors of his federal employment.
FACTUAL HISTORY
On December 17, 2014 appellant, then a 64-year-old truck driver, filed an occupational
disease claim (Form CA-2) alleging that he suffered hearing loss as a result of his federal
employment duties. He indicated that he learned that his hearing loss was employment related
when he reviewed the December 2, 2014 report of Dr. William A. Logan, a Board-certified
otolaryngologist. The employing establishment controverted the claim.
In a development letter dated December 19, 2014, OWCP requested that appellant submit
factual and medical evidence in support of his claim. To establish the factual portion of his claim,
appellant was provided a questionnaire for his completion. OWCP afforded him 30 days to submit
the necessary evidence.
In response, appellant submitted a supplemental statement labeled “CA 35B.” In this
statement, he indicated that he began work for the employing establishment on January 5, 1998 as
a truck driver and worked in this position until he retired on September 30, 2014. Appellant noted
that in this position he was exposed to loud noises on a daily basis produced by diesel powered
50 ton trucks and loud noises produced by diesel powered railroad engines. He also previously
worked for the employing establishment as a truck driver from 1982 to 1985. Appellant noted that
he wore ear plugs at work. He noted that he previously worked out of his local union office from
August 31, 1994 to January 4, 1998 where he was also exposed to loud noise. Appellant also
worked as an underground coal miner from 1985 to 1990 and from 1991 to 1993 where he was
exposed to loud noise produced by mining equipment and did not wear ear plugs. He noted that
he first noticed some hearing loss on January 1, 2012, and learned that his hearing loss was
employment related on December 2, 2014.
In a March 10, 2015 report, Whitney Maudlin, an audiologist, reviewed appellant’s claim
for the employing establishment. She noted that he was not exposed to noise levels that were
considered hazardous to the cochlea and, therefore, any hearing loss he was currently experiencing
was not work related and was not compensable per FECA. Ms. Maudlin also noted that appellant
wore state-of-the-art hearing protection devices. The employing establishment’s audiograms of
appellant, conducted on June 20 and September 22, 2014, were also submitted.
On April 7, 2015 OWCP referred appellant to Dr. Andrew S. Mickler, a Board-certified
otolaryngologist, for a second opinion examination. In answers to questions dated April 30, 2015,
Dr. Mickler diagnosed bilateral sensorineural hearing loss not due to appellant’s federal
employment. He indicated that hearing tests from prior to appellant’s federal employment were
not available, nor was a description of the noise exposure. Dr. Mickler explained that appellant’s
April 30, 2015 audiogram did not support a diagnosis of noise-induced hearing loss.

2

By decision dated June 23, 2015, OWCP denied appellant’s claim, finding that the
evidence of record was insufficient to establish that his hearing loss was causally related to “the
accepted employment event(s).”
On July 7, 2015 appellant requested an oral hearing before an OWCP hearing
representative.
By decision dated January 6, 2016, OWCP’s hearing representative determined that the
case was not in posture for a hearing as further development of the medical evidence was required.
She instructed OWCP to request that Dr. Mickler provide rationale to support his opinion that
appellant did not sustain a noise-induced hearing loss.
In a December 28, 2015 report obtained by counsel, Dr. Logan, a Board-certified
otolaryngologist, determined that using the sixth edition of the American Medical Association,
Guides to the Evaluation of Permanent Impairment,3 appellant had 5.6 percent hearing loss in the
right ear and 0 percent hearing loss in the left ear for a combined 0.9 percent binaural hearing loss.
He noted that appellant’s CA-35B form documented multiple episodes of occupational noise
exposure during this federal employment, and that it was likely that all of these occupational noise
exposures contributed to hearing loss that was observed on his audiogram.
By letter dated January 6, 2016, OWCP asked Dr. Mickler to clarify his report by providing
rationale to support his opinion that appellant did not sustain a noise-induced hearing loss as a
result of noise exposure due to his federal employment. In a February 16, 2016 report, Dr. Mickler
noted that no prior audiograms were provided for review and no levels of noise exposure were
provided by the employing establishment. He further noted that appellant’s audiogram from
April 30, 2015 did show a sensori-neural hearing loss. It was asymmetric, with the right ear worse
than the left. Dr. Mickler noted that noise-induced hearing loss produces bilateral symmetric
sensori-neural hearing loss. There is usually a typical noise notch, a dip at 4,000 hertz (Hz).
Dr. Mickler noted that neither of these indicators were found in appellant’s audiogram. He further
noted that asymmetry found could represent a retro-cochlear finding or some other diagnosis, none
of which are related to noise exposure. Dr. Mickler concluded that, from the data provided, it did
not appear that appellant’s hearing loss was related to noise exposure at his federal civilian
employment.
By decision dated February 22, 2016, OWCP denied appellant’s claim as the medical
evidence of record was insufficient to establish that his claimed hearing loss was related to the
established work-related events.
On March 9, 2016 appellant, through counsel, requested an oral hearing before an OWCP
hearing representative. By decision dated September 13, 2016, the hearing representative
determined that the case was not in posture for decision. The hearing representative noted that, as
OWCP had referred appellant to Dr. Mickler, it was obliged to provide a complete medical and
factual documentation and request clarification from OWCP as to whether noise exposure in
appellant’s federal employment caused or contributed to hearing loss.

3

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

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In a December 1, 2016 report, Dr. Mickler noted that the audiogram testing provided by
the employing establishment was for a different person, and that the audiogram of August 20, 2014
did not document the number of hours appellant was free of noise exposure prior to the audiogram.
He again noted that appellant’s hearing loss was not related to his federal employment.
Dr. Mickler noted that the levels of noise to which appellant was exposed were insufficient to
cause harm to the ear. He noted that he agreed with Dr. Mauldin’s discussion and concluded that
appellant’s hearing loss was not caused by his federal employment.
By decision dated January 25, 2017, OWCP indicated that appellant’s claim remain denied
because Dr. Mickler indicated that appellant’s hearing loss was not work related.
On February 2, 2017 appellant, through counsel, requested a telephone hearing before an
OWCP hearing representative.
During the hearing held on July 28, 2017, appellant was represented by counsel. He
testified that he worked for the employing establishment as a truck driver and was exposed to noisy
diesel powered trucks. Appellant noted that from 1982 to 1985 he did not wear ear plugs. He also
worked as a truck driver from 1998 to 2014. During this time, appellant also worked around trains
that unloaded and dumped coal, and that produced a lot of noise. He also noted that there would
be other noisy equipment running as he was doing his job, like dozers, unloaders, JLGs, and tire
cranes. Appellant described his hearing issues. Counsel contended that the greatest weight should
be given the well-rationalized medical opinion of Dr. Logan, who clearly opined that appellant’s
federal employment contributed to his hearing loss.
By decision dated October 2, 2017, OWCP’s hearing representative determined that there
was no rationalized medical evidence of record sufficient to establish hearing loss causally related
to appellant’s federal employment. He found that the weight of the medical opinion evidence
rested with the report of Dr. Mickler as his report was based on a complete and accurate factual
and medical history and a comprehensive physical examination of appellant, and Dr. Mickler
determined that appellant did not have work-related hearing loss.
LEGAL PRECEDENT
An employee seeking benefits under FECA4 has the burden of proof to establish the
essential elements 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 filed within the applicable time
limitation, that an injury was sustained while in the performance of duty as alleged, and that any
disability or specific condition for which compensation is claimed is causally related to the
employment injury.5 These are the essential elements of every compensation claim regardless of
whether the claim is predicated on a traumatic injury or occupational disease.6

4

Supra note 2.

5

Gary J. Watling, 52 ECAB 278-79 (2001); Elaine Pendleton, 40 ECAB 1143, 1145 (1989).

6

Michael E. Smith, 50 ECAB 313, 315 (1999).

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To establish that an injury was sustained in the performance of duty in an occupational
disease claim, a claimant must submit the following: (1) medical evidence establishing the
presence or existence of the disease or condition for which compensation is claimed; (2) a factual
statement identifying employment factors alleged to have caused or contributed to the presence or
occurrence of the disease or condition; and (3) medical evidence establishing that the employment
factors identified by the claimant were the proximate cause of the condition for which
compensation is claimed, or stated differently, medical evidence establishing that the diagnosed
condition is causally related to the employment factors identified by the claimant.7
Appellant has the burden of proof to establish by the weight of the reliable, probative, and
substantial evidence that his hearing loss was causally related to noise exposure in his federal
employment.8 Neither the condition becoming apparent during a period of employment, nor the
belief of the employee that the hearing loss was causally related to noise exposure in federal
employment, is sufficient to establish causal relationship.9
Causal relationship is a medical issue and the evidence generally required to establish
causal relationship is rationalized medical opinion evidence.10 Rationalized medical opinion
evidence is medical evidence which includes a physician’s reasoned opinion on whether there is
causal relationship between the claimant’s diagnosed condition and the compensable employment
factors. 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.11 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 express in support of the physician’s opinion.12
ANALYSIS
The Board finds that appellant has not established that his hearing loss was caused or
aggravated by factors of his federal employment. As appellant has not submitted rationalized
medical evidence sufficient to establish causal relationship, he has not met his burden of proof to
establish his claim.13

7

T.J., Docket No. 17-1850 (issued February 14, 2018).

8

T.C., Docket No. 17-0872 (issued October 5, 2017).

9

D.S., Docket No. 16-0903 (issued September 8, 2016); Lourdes Harris, 45 ECAB 545, 547 (1994); John W.
Butler, 39 ECAB 852 (1988).
10

Elizabeth H. Kramm, 57 ECAB 117, 123 (2005).

11

Leslie C. Moore, 52 ECAB 132, 134 (2000).

12

Id.

13

See supra note 5.

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OWCP referred appellant to Dr. Mickler for a second opinion examination and a
determination as to whether appellant had a hearing loss and whether this hearing loss was causally
related to factors of his federal employment. Dr. Mickler indicated that appellant’s audiogram did
not support a diagnosis of noise-induced hearing loss. He explained that appellant’s audiogram
from April 30, 2015 showed a sensori-neural hearing loss that was asymmetric with the right worse
than the left ear. Dr. Mickler noted that noise-induced hearing loss produced a bilateral symmetric
sensori-neural hearing loss. He also noted that there is usually a typical noise notch, a dip at 4,000
Hz. Dr. Mickler noted that neither of these were found on appellant’s audiogram. His report,
therefore, provided rationalized medical opinion and was of probative value. Thus, Dr. Mickler is
entitled to the weight of the medical evidence.
Counsel contends that the opinion of Dr. Logan was entitled to greater weight than the
opinion of Dr. Mickler. Dr. Logan’s report was based on appellant’s written statement with regard
to noise level. It was not based on any objective findings, but rather on appellant’s general
statement with regard to his work duties. More importantly, Dr. Logan did not explain how
appellant’s audiogram established work-related noise-induced hearing loss. The Board notes that
Dr. Logan opined that appellant’s occupational noise exposure likely contributed to the hearing
loss evinced on the audiogram. While the opinion of a physician supporting causal relationship
need not be one of absolute medical certainty, it must not be speculative or equivocal. The opinion
should be expressed in terms of a reasonable degree of medical certainty.14 The Board finds that
the medical report of Dr. Logan is not well rationalized and is, therefore, of limited probative
value.
It is appellant’s burden of proof to establish causal relationship between his hearing loss
and factors of his federal employment.15 As he has not submitted rationalized medical evidence
to support his allegation that his claimed hearing loss was caused by factors of his federal
employment, appellant has not met his burden of proof to establish his claim.16
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 hearing loss
causally related to factors of his federal employment.

14

S.T., Docket No. 17-1720 (issued April 23, 2018).

15

Supra note 5.

16

Id.

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ORDER
IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ Compensation
Programs dated October 2, 2017 is affirmed.
Issued: August 8, 2018
Washington, DC

Christopher J. Godfrey, Chief Judge
Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge
Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge
Employees’ Compensation Appeals Board

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
R.J., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Hazelwood, MO, Employer
_________________________________________
Appearances:
Alan J. Shapiro, Esq., for the appellant1
Office of Solicitor, for the Director

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Docket No. 22-0112
Issued: March 22, 2022

Case Submitted on the Record

ORDER DISMISSING APPEAL
Before:
ALEC J. KOROMILAS, Chief Judge
PATRICIA H. FITZGERALD, Alternate Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

On November 1, 2021, appellant through counsel, filed a timely appeal from a
September 7, 2021, merit decision of the Office of Workers’ Compensation Programs (OWCP).
The Clerk of the Appellate Boards assigned Docket No. 22-0112.
In a letter dated March 7, 2022, counsel requested that the appeal be dismissed.
The Board has duly considered the matter and concludes that counsel ’s request f or the
dismissal of the appeal should be granted. Accordingly,

1

In all cases in which a representative has been authorized in a matter before the Board, no cla im f or a f ee f or
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 b y t he B oard .
Id. An attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeano r,
subject to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment o f
fees to a representative, prior to approval by the Board, may be reported to appropriate authorities for investigation.

IT IS HEREBY ORDERED THAT the request for the dismissal of the appeal is
granted. The appeal docketed as No. 22-0112 is dismissed.
Issued: March 22, 2022
Washington, DC

Alec J. Koromilas, Chief Judge
Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge
Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge
Employees’ Compensation Appeals Board

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United States Department of Labor
Employees’ Compensation Appeals Board
___________________________________________
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and
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DEPARTMENT OF TRANSPORTATION,
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FEDERAL AVIATION AUTHORITY,
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NATIONAL HEADQUARTERS,
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Washington, DC, Employer
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___________________________________________ )
F.T., Appellant

Docket No. 15-1109
Issued: June 17, 2016

Case Submitted on the Record

Appearances:
C. Jude Iweange, Esq., for the appellant

Office of Solicitor, for the Director

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
COLLEEN DUFFY KIKO, Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION
On April 20, 2015 appellant filed a timely appeal of a November 4, 2014 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
ISSUE
The issue is whether OWCP met its burden of proof to terminate appellant’s wage-loss
compensation and medical benefits effective February 27, 2014.
1
2

5 U.S.C. § 8101 et seq.

Appellant requested oral argument. However, in a December 21, 2015 decision, the Board exercised its
discretion and denied appellant’s request for oral argument as her arguments could be adequately addressed in a
decision based on a review of the case record. Order Denying Request For Oral Argument. Docket No. 15-1109
(issued December 21, 2015).

FACTUAL HISTORY
On September 19, 2012 appellant then a 58-year-old systems accountant, filed a
traumatic injury claim (Form CA-1) alleging that on September 13, 2012 while in the
performance of duty she slipped and fell on a bathroom floor and injured her back, hip, neck,
shoulder, knees, legs, hands, and right ankle. She stopped work on September 13, 2012.
On November 5, 2012 OWCP accepted her claim for neck sprain, right hip and thigh
sprains, right knee and leg sprains, and lumbar sprain. Appellant was placed on the periodic rolls
and received appropriate compensation for injury-related disability.
In a March 13, 2013 report, Dr. Assaf T. Gordon, a treating Board-certified physiatrist
physician specializing in pain medicine, noted appellant’s history of injury and treatment. He
determined that appellant’s lumbar magnetic resonance imaging (MRI) scan revealed expected
age-related changes. Dr. Gordon diagnosed right knee sprain, sprain and strain other unspecified
sites, hip, thigh, and neck sprain and strain, and back strain, lumbar.
In an August 26, 2013 report, Dr. Jorge A. Mondino, an orthopedic surgeon and treating
physician, noted that appellant continued to have symptoms of the cervical and lumbar spine
sprains. He advised that appellant was undergoing therapy and having a great deal of pain in the
cervical spine and shoulders. Dr. Mondino also related that appellant was diagnosed with
fibromyalgia. He recommended that appellant stay off work and continue care with the pain
clinic.
In a November 19, 2013 report, Dr. Ai Huong Phu, Board-certified in physical medicine
and rehabilitation, advised that appellant was being seen for chronic pain to include facet
arthropathy, degeneration of lumbar intervertebral disc, lumbosacral radiculitis, and unspecified
myalgia. He advised that appellant was able to return to work four hours a day, no more than
three days a week with limitations on physical activities to avoid aggravating her pain. Dr. Phu
ruled out lumbosacral radiculitis based on electromyogram/nerve conduction studies of the lower
extremities. Dr. Phu indicated that her ability to return to full-duty work was to be determined
based upon her progress with treatment.
On November 8, 2013 OWCP referred appellant for a second opinion, along with a
statement of accepted facts, a set of questions, and the medical record to Dr. Mohammad
Zamani, a Board-certified orthopedic surgeon, determine whether appellant continued to have
residuals of, or any disability stemming from appellant’s accepted work injury.
Dr. Zamani, in his November 22, 2013 report, described appellant’s history of injury and
treatment and provided results on examination. He noted the neck and upper extremities
revealed no obvious deformity or pain on palpation in the cervical spine area with no
paravertebral muscle spasm or tightness. Dr. Zamani also advised that he found no click or
popping on range of motion. There was full active range of motion of the neck on flexion and
rotation. Extension of the neck was 20 degrees and appellant reported pain on extreme motion of
the neck. Range of motion of both shoulders, both elbows, both wrists, and both hands and
fingers were without deficit. Grip power was grade 5. Dr. Zamani found normal circulation and
sensation and reflexes with no measurable or visible atrophy. There was normal trunk alignment

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and no thoracic tenderness. Although appellant reported pain from palpation of the lumbar area,
Dr. Zamani found no spasm or tightness. Appellant was able to walk a normal gait and walk on
tiptoe and heel. She had full range of motion of hips, knees, feet, and ankle. Appellant had
forward flexion of the back to 70 degrees, lateral tilt to 20 degrees, 20 degrees extension, 10
degrees rotation, and 45 degrees with pain on extreme flexion and extension. He advised that
appellant had been previously diagnosed with fibromyalgia and complained of pain all over her
body. Dr. Zamani reviewed the statement of accepted facts and the accepted conditions of neck
sprain, right hip and thigh sprains, right knee and leg sprains, and lumbar sprain. He determined
that the conditions were temporary aggravations. Dr. Zamani found that “total disability ceased
one week after the incident due to the fact that there was nothing seriously wrong, there was no
serious trauma, and it was a minor soft tissue trauma.” Regarding physical restrictions, he
advised that they would be attributable to preexisting conditions of fibromyalgia and neck
arthritis. Dr. Zamani advised that appellant was capable of returning to work with no
restrictions. He noted, however, that due to an arthritic condition she would be precluded from
heavy activity and heavy lifting over 30 or 40 pounds. Dr. Zamani explained that appellant’s
date-of-injury position was sedentary and would be able to perform it with no restrictions. He
completed the work capacity evaluation on December 24, 2003, advising no restrictions.
On January 24, 2014 OWCP issued a notice of proposed termination of wage -loss and
medical compensation benefits based on the report of Dr. Zamani, which established that
residuals of the work injury had ceased.
OWCP finalized the termination on February 27, 2014. It found that the weight of
medical evidence rested with Dr. Zamani and supported that appellant no longer had residuals of
the accepted work-related conditions.3
On March 4, 2014 appellant requested a hearing, which was held on August 12, 2014.
During the hearing, she explained that her examination with Dr. Zamani lasted only 10 minutes.
Appellant also believed he had not reviewed her medical records because she was in severe pain,
remained under medical care, and was still taking medication.
In a February 21, 2014 report, Dr. G. Hudson Drakes, an interventional pain medicine
specialist, noted appellant’s history of injury and treatment. He indicated that appellant’s injury
had contributed to her neck pain and also impacted her ability to function in the workplace.
Dr. Drakes also explained that he was concerned with Dr. Zamani’s report, as it appeared that he
had conducted a cursory examination. He recommended a functional capacity evaluation. He
found it difficult to dignify the rest of his conclusions with a response knowing it was necessary
to fully before rendering an opinion. Dr. Drakes recommended an independent medical
examination. OWCP received additional medical evidence, which included physical therapy
reports and copies of previously submitted reports.
By decision dated November 4, 2014, an OWCP hearing representative affirmed the
termination of benefits, but found that the medical evidence submitted after the termination was
sufficient to require further development. The hearing representative explained that a conflict of
3

In a February 27, 2014 decision, OWCP also denied authorization for epidurography injection, foramen epidural
injection, and fluroguide for spine injection.

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opinion existed between Dr. Zamani and Dr. Drakes necessitating an impartial medical
examination with regard to any ongoing disability and need for medical care.
LEGAL PRECEDENT
Once OWCP accepts a claim and pays compensation, it bears the burden to justify
modification or termination of benefits.4 Having determined that an employee has a disability
causally related to his or her federal employment, OWCP may not terminate compensation
without establishing either that the disability has ceased or that it is no longer related to the
employment.5
ANALYSIS
In the instant case, OWCP accepted that appellant sustained sprain of the neck, right hip
and thigh sprains, right knee and leg sprains, and lumbar sprain.
In the November 19, 2013 report, Dr. Phu advised that appellant was being seen for
chronic pain to include facet arthropathy, degeneration of lumbar intervertebral disc, lumbosacral
radiculitis, and unspecified myalgia. He also advised that appellant was able to return to work
four hours a day, no more than three days a week with limitations on physical activities to avoid
aggravating her pain. Regarding her ability to return to full-duty work, Dr. Phu advised that was
to be determined based upon her progress with treatment.
OWCP referred appellant for a second opinion examination with Dr. Zamani, with regard
to any residuals of, or any disability from work resulting from appellant’s work injury.
In the November 22, 2013 report, Dr. Zamani found that there were no obvious
deformities of the neck and upper extremities, although he found pain on palpation in the
cervical spine area with no paravertebral muscle spasm or tightness. He opined that “total
disability ceased one week after the incident due to the fact that there was nothing seriously
wrong, there was no serious trauma and it was a minor soft tissue trauma.” Dr. Zamani
explained that physical restrictions would be attributable to the preexisting conditions of
fibromyalgia and neck arthritis. He indicated that appellant was capable of performing all
activity as usual prior to her fall without any restrictions. Dr. Zamani noted that she had an
arthritic condition that precluded heavy activity and heavy lifting over 30 or 40 pounds. He
explained that the job was sedentary and she was able to do it without restrictions. Dr. Zamani
opined that appellant had no residuals of the work injury as the current symptoms were related to
her pre-existing conditions fibromyalgia and neck arthritis. He completed the work capacity
evaluation on December 24, 2013, advising no restrictions. The Board finds that Dr. Zamani’s
opinion is well rationalized and represents the weight of the medical evidence regarding
appellant’s accepted conditions and ability to work. The Board also finds that at the time of the
termination there were no current reports from a treating physician to contradict Dr. Zamani’s
findings. In this regard, Dr. Phu supported appellant’s return to work on a part-time basis in his
4

Curtis Hall, 45 ECAB 316 (1994).

5

Jason C. Armstrong, 40 ECAB 907 (1989).

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November 19, 2013 report. However, he did not provide any medical rationale to explain why
appellant’s continuing condition and disability were due to the accepted condition.6
Dr. Gordon provided diagnoses of right knee sprain, sprain and strain of other specified
cites, hip and thigh, neck sprain and strain, and lumbar strain. However, he neither related these
conditions to appellant’s September 13, 2012 employment injury, nor did he address the issue of
disability. The Board notes that medical evidence that does not offer any opinion regarding the
cause of an employee’s condition is of limited probative value on the issue of causal
relationship.7 As Dr. Gordon did not address causal relationship, the Board finds that his report
is of limited probative value.
Similarly, although Dr. Mondino reported that appellant continued to experience
symptoms about the cervical and lumbar spine areas, diagnosed fibromyalgia, and noted
continuing treatment for the cervical spine and shoulders, he too did not address causal
relationship. As such, his report is also of limited probative value.8 Additionally, as OWCP did
not accept fibromyalgia as resulting from the September 13, 2012 employment injury, it is
appellant’s burden of proof to establish causal relationship.9 This he has not done. No other
medical evidence contemporaneous with the termination of benefits provides medical rationale
in support of an ongoing, employment-related condition. Because appellant no longer had
residuals or disability related to her accepted employment condition at the time of the
termination, OWCP properly terminated entitlement to wage-loss compensation and medical
benefits effective November 17, 2013. Accordingly, its decision to terminate appellant’s
compensation and medical benefits shall be affirmed.
Counsel for appellant asserts that OWCP erred when it found that appellant was no
longer entitled to medical and wage-loss compensation and in denying further medical treatment.
However, as the Board has found these arguments are not supported by the evidence of record.
The Board also notes that regarding the issue of whether appellant established continuing
employment-related residuals or disability after the termination, an OWCP hearing
representative found a conflict in the medical evidence and remanded that aspect of the claim for
further medical development. Consequently, this issue is not presently before the Board as it is
in an interlocutory posture at this time.10
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.
6

See George Randolph Taylor, 6 ECAB 986, 988 (1954) (where the Board found that a medical opinion not
fortified by medical rationale is of little probative value).
7

See, e.g., R.E., Docket No. 10-679 (issued November 16, 2010); K.W., 59 ECAB 271 (2007).
8

Id.

9

See Jaja K. Asaramo, 55 ECAB 200 (2004).

10

See 20 C.F.R. § 501.2(c)(2) (there will be no appeal with respect to any interlocutory matter decided (or not
decided) by OWCP during the pendency of a case).

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CONCLUSION
The Board finds that OWCP met its burden of proof to terminate appellant’s wage-loss
compensation and medical benefits effective February 27, 2014, as she had no residuals of her
work-related injury.
ORDER
IT IS HEREBY ORDERED THAT the November 4, 2014 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: June 17, 2016
Washington, DC

Christopher J. Godfrey, Chief Judge
Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge
Employees’ Compensation Appeals Board

6


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
A.A., Appellant
and
DEPARTMENT OF JUSTICE, U.S. DISTRICT
COURT, Philadelphia, PA, Employer
__________________________________________

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Appearances:
Aaron B. Aumiller, Esq., for the appellant
Office of Solicitor, for the Director

Docket No. 09-1998
Issued: July 7, 2010

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Chief Judge
MICHAEL E. GROOM, Alternate Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On August 3, 2009 appellant filed a timely appeal from a February 6, 2009 decision of
the Office of Workers’ Compensation Programs denying her claim for a left knee condition.
Pursuant to 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 sustained an aggravation of a preexisting left knee
condition as a result of her accepted July 4, 2003 employment injury.
FACTUAL HISTORY
This case was previously before the Board.1 By order dated August 18, 2006, the Board
set aside a March 9, 2006 Office decision and remanded the case for further development of the
medical evidence. The Board instructed the Office to refer appellant to an impartial medical
1

See Docket No. 06-1011 (issued August 18, 2006).

specialist to resolve a conflict in medical opinion as found by an Office hearing representative in
a November 14, 2005 decision.
On July 8, 2003 appellant, then a 50-year-old deputy clerk, filed a traumatic injury claim
alleging that on July 4, 2003 she injured her head, neck and right shoulder, leg and eye when a
wood and steel frame fell onto her as she attended the opening of the National Constitution
Center. She was off work for three days and then returned to part-time work. On September 4,
2003 appellant returned to full duty. The Office accepted her claim for cervical and right
shoulder strains and contusions of the face, scalp and neck.
In a July 26, 2004 report, Dr. Paul A. Marchetto, an attending orthopedic surgeon,
provided findings on physical examination. Appellant had left knee instability that had worsened
since her July 4, 2003 employment injury when she was struck by some staging.2 Dr. Marchetto
recommended arthroscopic surgery consisting of acromioclavicular (ACL) reconstruction using
an Achilles allograft.
In an October 11, 2004 report, Dr. Steven J. Valentino, a Board-certified orthopedic
surgeon and an Office referral physician, reviewed the medical history and provided findings on
physical examination. He found that the July 4, 2003 employment injury did not cause or
aggravate appellant’s left knee condition.
By decision dated October 29, 2004, the Office denied appellant’s claim for left knee
surgery on the grounds that the medical evidence did not establish that her left knee condition
was causally related to her July 4, 2003 employment injury.
On November 22, 2004 appellant requested an oral hearing before an Office hearing
representative that was held on August 17, 2005.
Following the hearing, appellant submitted a December 16, 2004 report from
Dr. Joseph V. Vernace, an orthopedic surgeon, who reviewed the medical history and provided
findings on physical examination. Dr. Vernace stated that medical reports from Dr. Marchetto,
before and after the July 4, 2003 employment injury, showed that appellant sustained further
injury to her preexisting left knee condition on July 4, 2003. He opined that appellant required
ACL revision surgery as a result of the July 4, 2003 employment injury.
By decision dated November 14, 2005, an Office hearing representative found a conflict
in medical opinion between Dr. Valentino and Dr. Vernace. The hearing representative
instructed the Office to obtain medical reports from Dr. Marchetto regarding his treatment of
appellant’s left knee condition before and after the July 4, 2003 employment injury. These
reports were referenced in Dr. Vernace’s report but were not of record. The hearing
representative instructed the Office to refer appellant to an impartial medical specialist after it
obtained Dr. Marchetto’s reports.

2

On September 26, 2001 appellant was a pedestrian when she was struck by a car bumper and dragged during a
nonwork-related accident. She injured her left knee and underwent surgery on October 31, 2001. She was off work
for six months.

2

By decision dated March 9, 2006, the Office denied appellant’s claim for a left knee
condition. It noted that records from Dr. Marchetto had not been submitted and she could not be
referred to an impartial medical specialist until the medical history record was complete.
Following the Board’s August 18, 2006 remand, the Office referred appellant, together
with the entire case file, a statement of accepted facts and a list of questions, to Dr. Zohar Stark,
a Board-certified orthopedic surgeon and the impartial medical specialist selected to resolve the
conflict in medical opinion.
In a June 7, 2007 report, Dr. Stark reviewed the medical history and provided findings on
physical examination. Appellant sustained severe injuries to her left knee in the 2001 nonworkrelated motor vehicle accident. She underwent reconstructive surgery of her knee ligaments.
Dr. Stark noted that she did not wear a brace on June 7, 2007 or use any ambulating aids. On
physical examination, appellant was able to walk with a reciprocating heel/toe gait but stated that
she could not walk on her toes and would not attempt this maneuver. She could heel walk but
complained of left knee pain. There was no sensory or motor deficit to her lower extremities.
There was no effusion in her left knee or reduced quadriceps muscle strength or mass. There
was tenderness on palpation over the patella borders the tibial tubercle area. Range of motion of
the left knee was 0 to 120 degrees of flexion. Drawer and Lachman tests were negative and there
were no signs of varus/valgus instabilities. In reviewing the medical history, Dr. Stark noted a
discrepancy in that Dr. Valentino found no left knee instability but Dr. Vernace did find
instability. He found no left knee instability during his examination of appellant. Dr. Stark
stated that her accepted July 4, 2003 injuries to her neck, shoulders and face had resolved. He
opined that appellant did not sustain any injury to her left knee on July 4, 2003 which altered the
preexisting condition of the knee. The suggested left knee arthroscopic surgery with ACL
reconstruction was not related to the July 4, 2003 employment injury. The need for surgery and
her left knee limitations were residuals of her preexisting left knee condition.
In a July 1, 2008 decision, the Office denied appellant’s claim for aggravation of her
preexisting left knee condition and related surgery on the grounds that Dr. Stark’s report
established that her left knee condition was not aggravated by the July 4, 2003 employment
injury.
On July 8, 2008 appellant requested a telephonic hearing that was held on
November 14, 2008.
On August 6, 2008 Dr. Vernace reiterated his opinion that appellant reinjured her left
knee during the July 4, 2003 incident. Appellant sustained a significant left knee injury in 2001
but was apparently functioning well until the July 4, 2003 incident greatly exacerbated her left
knee condition. Dr. Vernace noted that appellant used a cane because of pain and left knee
instability.
On November 7, 2008 Dr. Marchetto stated that appellant had regained significant left
knee stability following the 2001 motor vehicle accident and was functioning without a knee
brace. Appellant had decreased left knee stability following the July 4, 2003 employment injury.
On November 7, 2008 she presented with severe left knee pain. Dr. Marchetto opined that

3

appellant sustained a new left knee injury on July 4, 2002 that accelerated the degradation of her
left knee condition. He found that she needed a total left knee replacement.
On November 21, 2008 Dr. James J. Purtill, a Board-certified orthopedic surgeon and an
associate of Dr. Marchetto, noted appellant’s long history of severe left knee pain. He provided
findings on physical examination and diagnosed severe left knee degenerative joint disease.
Dr. Purtill discussed prospective left knee replacement surgery with appellant.
By decision dated February 6, 2009, an Office hearing representative affirmed the July 1,
2008 decision.3
LEGAL PRECEDENT
To determine whether a federal employee has sustained a traumatic injury in the
performance of duty, it first must be determined whether the fact of injury has been established.
There are two components involved in establishing the fact of injury. First, the employee must
submit sufficient evidence to establish that he or she actually experienced the employment
incident at the time, place and in the manner alleged.4 Second, the employee must submit
medical evidence to establish that the employment incident caused a personal injury.5 An
employee may establish that the employment incident occurred as alleged but fail to show that
his or her disability or condition relates to the employment incident.
To establish a causal relationship between an employee’s condition and any disability
claimed and the employment event or incident, he or she must submit rationalized medical
opinion evidence based on a complete factual and medical background supporting such a causal
relationship. Rationalized medical opinion evidence is medical evidence which includes a
physician’s opinion on the issue of whether there is a causal relationship between the employee’s
diagnosed condition and the compensable employment factors. 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 the specific employment factors identified
by the claimant.6

3

Subsequent to the February 6, 2009 Office decision, additional evidence was associated with the file. The
Board’s jurisdiction is limited to the evidence that was before the Office at the time it issued its final decision. See
20 C.F.R. § 501.2(c). The Board may not consider this evidence for the first time on appeal.
4

Bonnie A. Contreras, 57 ECAB 364, 367 (2006); Edward C. Lawrence, 19 ECAB 442, 445 (1968).

5

T.H., 59 ECAB ___ (Docket No. 07-2300, issued March 7, 2008); John J. Carlone, 41 ECAB 354, 35657 (1989).
6

I.J., 59 ECAB ___ (Docket No. 07-2362, issued March 11, 2008); Victor J. Woodhams, 41 ECAB 345,
352 (1989).

4

Section 8123(a) of the Act provides that “if there is disagreement between the physician
making the examination for the United States and the physician of the employee, the Secretary
[of Labor] shall appoint a third physician who shall make an examination.”7 Where a case is
referred to an impartial medical specialist for the purpose of resolving a conflict, the opinion of
such specialist, if sufficiently well rationalized and based on a proper factual and medical
background, must be given special weight.8
ANALYSIS
The Office found a conflict in medical opinion between Dr. Vernace and Dr. Valentino as
to whether the July 4, 2003 employment injury aggravated appellant’s preexisting left knee
condition. It properly referred her to Dr. Stark for an impartial medical evaluation.
Dr. Stark reviewed the medical history and provided findings on physical examination.
He noted that appellant sustained severe injuries to her left knee in a 2001 nonwork-related
motor vehicle accident and underwent reconstructive surgery. Appellant did not wear a brace to
her examination on June 7, 2007 or use any ambulating aids. On physical examination, she was
able to walk with a reciprocating heel/toe gait but would not attempt to walk on her toes.
Appellant could heel walk but complained of left knee pain. Dr. Stark found evidence of sensory
or motor deficit to her lower extremities. There was no effusion in her left knee and or reduced
quadriceps muscle strength or mass. Range of motion of the left knee was 0 to 120 degrees of
flexion. Drawer and Lachman tests were negative and there were no signs of varus/valgus
instabilities. Appellant had no left knee instability. In reviewing the medical history, Dr. Stark
noted a discrepancy in that Dr. Valentino found no left knee instability but Dr. Vernace did find
instability. He found that appellant’s accepted July 4, 2003 injuries to her neck, shoulders and
face had resolved. Dr. Stark opined that appellant did not sustain any injury to her left knee on
July 4, 2003 which altered the preexisting condition of the knee. The suggested left knee
arthroscopic surgery with ACL reconstruction was not related to the July 4, 2003 employment
injury. The need for surgery and her left knee limitations were residuals of her preexisting left
knee condition. The report of Dr. Stark is based upon a complete and accurate factual and
medical background and detailed findings on physical examination. Dr. Stark is Board-certified
in orthopedic surgery, an appropriate field for evaluating appellant’s left knee condition. The
Board finds that his thorough and well-rationalized report established that appellant’s preexisting
left knee condition was not aggravated by the July 4, 2003 employment injury. Accordingly, the
Office met its burden of proof in denying appellant’s claim for a left knee condition based on the
medical opinion of Dr. Stark that the left knee condition and proposed surgery in 2007 were not
causally related to the July 4, 2003 employment injury.
On August 6 and November 7, 2008 Dr. Vernace and Dr. Marchetto reiterated their
opinion that appellant reinjured her left knee during the July 4, 2003 incident. Appellant
sustained a significant left knee injury in 2001 but was apparently functioning well until the
July 4, 2003 incident greatly exacerbated her left knee condition. An additional report from a
7

5 U.S.C. § 8123(a); see also Raymond A. Fondots, 53 ECAB 637 (2002); Rita Lusignan (Henry Lusignan), 45
ECAB 207 (1993).
8

See Roger Dingess, 47 ECAB 123 (1995); Glenn C. Chasteen, 42 ECAB 493 (1991).

5

claimant’s physician, which essentially repeats earlier findings and conclusions, is generally
insufficient to overcome the weight accorded to an impartial medical specialist’s report where
appellant’s physician had been on one side of the conflict in the medical opinion that the
impartial medical examiner resolved.9 Dr. Vernace and Dr. Marchetto were on one side of the
conflict which Dr. Stark’s opinion was found to resolve. In their 2008 reports, they merely
reiterated their opinions that appellant’s preexisting left knee condition was aggravated by the
July 4, 2003 employment injury. These reports are not sufficient to overcome the weight of
Dr. Stark’s medical opinion. The Board finds that the 2008 reports of Dr. Vernace and
Dr. Marchetto are not sufficient to establish that appellant’s left knee condition was aggravated
by her July 4, 2003 employment injury.
On November 21, 2008 Dr. Purtill noted appellant’s long history of severe left knee
pain. He provided findings on physical examination and diagnosed severe left knee degenerative
joint disease. Dr. Purtill discussed prospective left knee replacement surgery with appellant. He
is an associate of Dr. Marchetto who, as noted, was on one side of the conflict in medical opinion
resolved by Dr. Stark. Additionally, Dr. Purtill did not address the issue of the causal
relationship of appellant’s July 4, 2003 employment injury to her left knee condition. His report
is not sufficient to establish that appellant’s left knee condition was aggravated by her July 4,
2003 employment injury.
On appeal appellant contends that the December 16, 2004 report of Dr. Vernace
established that her preexisting left knee condition was causally related to her July 4, 2003
employment injury. As noted, however, there was a conflict in medical opinion between
Dr. Vernace and Dr. Valentino, requiring resolution of the conflict by an impartial medical
specialist. She contends that Dr. Stark’s report is deficient because he stated that she sustained
injuries only to her neck, shoulders and face.10 Appellant contends that he was not aware that
her knees were struck by a table during the July 4, 2003 employment incident. Dr. Stark noted
that the history obtained from appellant included the fact that her knees were struck by a table in
the July 4, 2003 employment incident. Appellant asserts that an injury to her knees is an
accepted condition because the Office hearing representative accepted as factual that she
established through her testimony an injury to her legs when the table where she was sitting on
July 4, 2003 struck her knees. As noted, there are two components involved in establishing the
fact of injury. First, the employee must establish that he or she actually experienced the
employment incident at the time, place and in the manner alleged. The hearing representative
found that appellant’s testimony established the incident as alleged. However, the second
component consists of medical evidence sufficient to establish that the employment incident
caused a personal injury. The hearing representative did not find that the medical evidence
established an injury to her legs. Rather, the hearing representative found a conflict in medical
opinion as to whether the July 4, 2003 employment incident aggravated appellant’s preexisting
left knee condition.

9

See Roger G. Payne, 55 ECAB 535 (2004).

10

As noted, the Office accepted her claim for cervical and right shoulder strains and contusions of the face, scalp
and neck.

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Appellant contends that Dr. Stark did not provide rationale supporting his opinion that
her preexisting left knee condition was not aggravated by the July 4, 2003 employment injury.
Dr. Stark reviewed a description of her symptoms, including her complaint of left knee pain and
locking but no numbness, tingling or weakness of the lower extremities, the fact that she had
severe injuries to her left knee in the 2001 motor vehicle accident and underwent surgical
reconstruction of her knee ligaments and the fact that she wore a left knee brace at the time of the
July 4, 2003 employment injury but did not have a knee brace or ambulating aids at her June 7,
2007 examination with Dr. Stark. He noted the fact that appellant was off work for just one
week following the July 4, 2003 employment injury, worked part time for four months and then
returned to full duty (whereas she was off work six months for her 2001 left knee injury).11 On
physical examination, he listed her ability to perform a reciprocating heel/toe gait, her refusal to
attempt toe walking and her complaint of left knee pain, a negative sitting root test, straight leg
raising of 80 degrees bilaterally, no sensory or motor deficit of the lower extremities, normal
deep tendon reflexes of the lower extremities and no left knee instability, effusion or reduced
quadriceps muscle strength or mass. Left knee findings were normal except for tenderness on
palpation over the patella borders and tibial tubercle area. Dr. Stark addressed information from
his review of the medical records, including the fact that a September 18, 2003 note released
appellant to full duty with no mention of left knee problems. He concluded that the July 4, 2003
employment injury did not aggravate her left knee injury. The Board found that the physician
based his opinion on his physical examination of appellant, the history and symptoms she
provided and a review of the medical records.
Appellant contends that Dr. Stark did not conduct an unbiased examination because he
also performs second opinion examinations for the Office. The mere fact that he performs such
examinations does not establish bias in his examination of appellant. Appellant provided no
evidence of bias on the part of Dr. Stark.
CONCLUSION
The Board finds that appellant failed to establish that her preexisting left knee condition
was aggravated by her July 4, 2003 employment injury.

11

The September 6, 2006 statement of accepted facts noted that appellant was off work for six months following
the 2001 motor vehicle accident, recuperating from surgery and undergoing physical therapy.

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ORDER
IT IS HEREBY ORDERED THAT the decision of the Office of Workers’
Compensation Programs dated February 6, 2009 is affirmed.
Issued: July 7, 2010
Washington, DC

Alec J. Koromilas, Chief Judge
Employees’ Compensation Appeals Board

Michael E. Groom, Alternate Judge
Employees’ Compensation Appeals Board

James A. Haynes, Alternate Judge
Employees’ Compensation Appeals Board

8


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
L.D., Appellant
and
U.S. POSTAL SERVICE, Cumming, GA,
Employer
__________________________________________

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Appearances:
Appellant, pro se
Office of Solicitor, for the Director

Docket No. 07-1293
Issued: September 25, 2007

Case Submitted on the Record

DECISION AND ORDER
Before:
DAVID S. GERSON, Judge
MICHAEL E. GROOM, Alternate Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On April 13, 2007 appellant filed a timely appeal of the February 20, 2007 nonmerit
decision of the Office of Workers’ Compensation Programs which denied reconsideration and a
December 12, 2006 merit decision which denied her traumatic injury claim. Pursuant to
20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over the merits of this case.
ISSUES
The issues are: (1) whether the Office properly denied appellant’s reconsideration
request; and (2) whether appellant sustained a traumatic injury while in the performance of duty
on October 16, 2006.
FACTUAL HISTORY
On October 26, 2006 appellant, then a 35-year-old rural carrier, filed a traumatic injury
claim alleging that on October 16, 2006 she injured her left shoulder while picking up and lifting
a tray of mail to put in the motor vehicle. Two return to work notes dated October 24 and 25,
2006 from Dr. Folsom Proctor, an orthopedic surgeon, were received by the Office. In an

October 30, 2006 note, appellant’s supervisor stated that on October 18, 2005 appellant informed
the supervisor that her shoulder hurt.
On November 1, 2006 the Office requested additional factual and medical information
from appellant. Appellant did not respond. The Office received a November 13, 2006
evaluation report from a physical therapist.
On December 12, 2006 the Office denied appellant’s claim on the grounds that the
medical evidence was insufficient to support her claim as the only report was from a physical
therapist not a physician.
On February 5, 2007 appellant requested reconsideration. The Office received additional
information on December 26, 2006. A December 15, 2006 magnetic resonance imaging (MRI)
scan report of the cervical spine revealed degenerative changes at C5-6 and C6-7 and an MRI
scan report of the same date of the left shoulder was unremarkable.
On February 20, 2007 the Office received a packet of medical reports which had initially
been submitted to the employing establishment’s injury compensation office. The Office
received reports from Dr. Proctor dated November 9, 2006 to January 8, 2007. In the
November 9, 2006 report, Dr. Proctor stated that appellant had left shoulder and neck pain due to
lifting mail trays. In the December 19, 2006 report, Dr. Proctor found tenderness over the
trapezius and mild amount of degenerative stenosis at the C5 level. On January 8, 2007
Dr. Proctor opined that appellant could return to work full duty without restrictions. Visit reports
from a nurse practitioner dated October 18 and 24, 2006 were also received.
On February 20, 2007 the Office issued a nonmerit decision denying appellant’s
reconsideration request. The Office stated that the only medical evidence received in support of
the request for reconsideration were MRI scan reports and a report from Dr. Proctor dated
January 8, 2007. The Office concluded that these reports were not new and relevant evidence.
LEGAL PRECEDENT -- ISSUE 1
Under section 8128(a) of the Federal Employees’ Compensation Act, the Office has the
discretion to reopen a case for review on the merits.1 Section 10.606(b)(2) of Title 20 of the
Code of Federal Regulations provides that the application for reconsideration, including all
supporting documents, must set forth arguments and contain evidence which: (i) shows that the
Office erroneously applied or interpreted a specific point of law; (ii) advances a relevant legal
argument not previously considered by the Office; or (iii) constitutes relevant and pertinent new
evidence not previously considered by the Office.2 Section 10.608(b) provides that, when an
application for reconsideration does not meet at least one of the three requirements enumerated

1

5 U.S.C. § 8128(a).

2

20 C.F.R. § 10.606(b)(2).

2

under section 10.606(b)(2), the Office will deny the application for reconsideration without
reopening the case for a review on the merits.3
The Act provides that the Office shall determine findings of fact in making an award for
or against payment of compensation after considering the claim presented by the employee and
after completing such investigation as the Office considers necessary with respect to the claim.
Since the Board’s jurisdiction of a case is limited to reviewing that evidence which was before
the Office at the time of its final decision, it is necessary that the Office review all evidence
submitted by a claimant and received by the Office prior to issuance of its final decision. As the
Board’s decisions are final as to the subject matter appealed, it is critical that the Office address
all evidence relevant to that subject matter which was properly submitted to the Office prior to
the time of issuance of its final decision.4 The Board has held that this principal applies with
equal force when evidence is received by the Office the same day a final decision is issued.5 As
the Board’s decisions are final as to the subject matter appealed, it is critical that the Office
review all newly received evidence relevant to that subject matter prior to the time of issuance of
its final decision.6
ANALYSIS -- ISSUE 1
Appellant requested reconsideration of the Office’s denial of her claim on
February 5, 2007. She submitted medical evidence in support of this request, which was
received by the Office on February 20, 2007, the same day the Office issued a nonmerit decision
denying appellant’s request for reconsideration. The Board finds that medical evidence related
to appellant’s claim was received but not reviewed by the Office prior to its rejection of
appellant’s request for reconsideration. Therefore, in accordance with Board precedent,7 the case
must be remanded for a proper review of the evidence and an appropriate final decision on
appellant’s request for reconsideration.8
CONCLUSION
The Board finds that this case is not in posture for a decision. The Board finds that the
Office failed to review all of the relevant evidence in this case related to appellant’s request for
reconsideration. The Board therefore remands the case for a review of the evidence and issuance
of an appropriate final decision.

3

20 C.F.R. § 10.608(b).

4

William A. Couch, 45 ECAB 548 (1990).

5

Linda Johnson, 45 ECAB 439 (1994).

6

William A. Couch, supra note 4.

7

Linda Johnson, supra note 5.

8

As the case is remanded for further review by the Office the Board will not review the merits at this time.

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ORDER
IT IS HEREBY ORDERED THAT the decision of the Office of Workers’
Compensation Programs dated February 20, 2007 is set aside and remanded for further action
consistent with this decision.
Issued: September 25, 2007
Washington, DC

David S. Gerson, Judge
Employees’ Compensation Appeals Board

Michael E. Groom, Alternate Judge
Employees’ Compensation Appeals Board

James A. Haynes, Alternate Judge
Employees’ Compensation Appeals Board

4


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
L.K., Appellant
and
DEPARTMENT OF HOMELAND SECURITY,
TRANSPORTATION SECURITY
ADMINISTRATION, Las Vegas, NV, Employer
__________________________________________

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Appearances:
Alan J. Shapiro, Esq., for the appellant
Office of Solicitor, for the Director

Docket No. 15-0675
Issued: October 1, 2015

Case Submitted on the Record

DECISION AND ORDER
Before:
PATRICIA H. FITZGERALD, Deputy Chief Judge
COLLEEN DUFFY KIKO, Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On February 9, 2015 appellant, through counsel, filed a timely appeal from a January 2,
2015 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.
ISSUES
The issues are: (1) whether OWCP met its burden of proof to terminate appellant’s
compensation benefits effective March 21, 2014; and (2) whether appellant met her burden of
proof to establish that she sustained a tear of the of the left knee or aggravation of degenerative
joint disease causally related to the accepted injury.

1

5 U.S.C. § 8101 et seq.

FACTUAL HISTORY
On April 30, 2012 appellant, then a 49-year-old transportation security officer, filed a
traumatic injury claim alleging that on that date she twisted her left knee while walking to a
briefing. OWCP accepted the claim for left knee sprain and paid benefits. The employing
establishment offered appellant a light-duty position on May 21, 2012 and she returned to work.
The exact date that appellant returned to work is unclear from the record.
A June 1, 2012 magnetic resonance imaging (MRI) scan of appellant’s left knee was
interpreted by Dr. Alison Nguyen, a diagnostic radiologist, as revealing medial meniscal
posterior horn/posterior root ligament junction deep radial tear, moderate osteoarthrosis of the
medial knee compartment, and patellofemoral chondral injury.
In a June 20, 2012 report, Dr. Eugene P. Libby, a Board-certified orthopedic surgeon,
noted that this was appellant’s initial office visit. He reported that she somehow misstepped and
suffered a twisting injury to her left knee on April 30, 2012. Appellant noted immediate pain
along the medial side of her left knee and was unable to bear full weight and suffered from sharp
stabbing pain along the medial side of her left knee causing her to limp. Dr. Libby noted that her
history was complicated by the fact that she had recently started treatment for left knee pain
approximately one month or so before her April 30, 2012 injury and had received two viscos
supplementation injections. Appellant indicated that her pain was different than the pain she
experienced before the April 30, 2012 injury because the pain was sharper and located along the
medial joint line of the left knee. The left knee also felt like it wanted to catch, which it never
did before.
Dr. Libby provided examination findings and noted the June 1, 2012 MRI scan showed
tear of the medial meniscus, moderate osteoarthrosis medial compartment, and patellofemoral
chondral injury left knee. An impression of symptomatic traumatic medial meniscus tear left
knee and decompensation preexisting degenerative joint disease left knee was provided.
Dr. Libby indicated that with this episode there was a change in the left knee pain type,
frequency, and intensity which went along with new meniscal injury on top of appellant’s
preexisting arthritic left knee pain. He opined that this was a classic mechanism of injury which
can result in new onset meniscus injury/tear in a knee with preexisting degenerative joint disease.
Dr. Libby explained that, with the intrinsic forces generated within the knee, what had the
outward appearance of being a trivial injury was in reality significant and severe enough to result
in meniscus tear with resultant pain. He concluded that the tear of medial cartilage or meniscus
of knee occurred as a direct result of the April 30, 2012 left knee injury.
In a November 30, 2012 report, Dr. Bernard C. Ong, a Board-certified orthopedic
surgeon, noted the history of injury and stated that the most probable diagnosis was medial
meniscus tear with preexisting arthritis. He also noted that there were other possibilities in the
differential diagnosis. Dr. Ong requested a left knee arthroscopic surgery to treat left knee
meniscus tear and arthritis.
In a March 15, 2013 report, Dr. Ong noted that appellant reinjured her knee at work on
March 9, 2013. He diagnosed left knee medial meniscus tear and arthritis and opined that she
aggravated her left knee after twisting it.

2

In an April 22, 2013 report, Dr. Ong noted that appellant reported her left knee pain
worsened since the reinjury of the left knee. He diagnosed left knee medial meniscus tear and
arthritis. Dr. Ong stated that appellant aggravated her left knee after twisting it during a reinjury
at work.
In a July 16, 2013 report, Dr. Libby opined that appellant’s traumatic left knee sprain had
resolved. He noted that she continued to have symptomatic traumatic medial meniscus tear of
the left knee, for which he requested permission for her to undergo arthroscopic debridement
surgery.
Appellant was thereafter referred for a second opinion examination. In an October 28,
2013 report, Dr. Aubrey A. Swartz, a Board-certified orthopedic surgeon serving as an OWCP
second opinion physician, reviewed the statement of accepted facts, her medical history and
reported physical examination findings. He indicated that appellant had a long history of
osteoarthritis in the left knee, which was advanced in the medial compartment, and also had
degenerative changes in the patellofemoral compartment that were associated with her genu
varus deformities of both knees, which were congenital. Dr. Swartz reported that she was
received viscos supplementation and injections a few weeks before the reported injury. A review
of the records indicated that appellant had chronic painful osteoarthritis, which required
treatment before her April 30, 2012 claim. He indicated that there was no specific evidence that
a new medial meniscus tear resulted from the April 30, 2012 injury as a prior MRI scan was not
available to compare pre-incident the status of the medial meniscus. Dr. Swartz noted that
appellant had severe pain with bone-on-bone arthritis prior to her claim and continued with such
pain. He found no evidence either way as to whether the undersurface tear of the medial
meniscus related to appellant’s claim or was simply part of an advanced degenerative process
occurring in the left knee. Dr. Swartz found that appellant required a total joint replacement of
the left knee, but stated that it was not related to the April 30, 2012 claim. He explained that she
was having substantial problems before and after the twisting injury and it was unlikely that an
undersurface tear could make any difference with respect to the painful advanced arthritic
condition appellant was experiencing. Dr. Swartz reported her restrictions were attributable to
her preexisting condition.
In a December 4, 2013 letter to appellant and Dr. Libby, OWCP provided a copy of
Dr. Swartz’ second opinion report and requested that Dr. Libby submit a report with objective
findings and rationale which explained how the incident on April 30, 2012 aggravated her
underlying degenerative condition and/or caused the medial meniscus tear.
In an August 14, 2013 report, Dr. Libby opined that the left knee traumatic sprain had
resolved. In medical reports dated December 2 and 17, 2013, he continued to diagnose a left
knee medial meniscal tear and degenerative joint disease left knee. In his December 17, 2013
report, Dr. Libby noted that appellant reported to him that she had felt no pain or problems with
left knee before the April 30, 2012 incident. After reviewing Dr. Swartz’ report, he reported that
it appeared she was receiving Supartz injections into her left knee before her claimed work
injury. Dr. Libby opined that appellant would benefit from a left knee replacement arthroplasty,
but it would be best handled under her private health insurance. He discharged her from care and
requested that her care be transferred to a pain management subspecialist for her future pain
medication needs. No opinion on causation was provided.

3

In a January 21, 2014 report, Dr. Robert W. Patti, a Board-certified orthopedic surgeon,
noted the history of injury and provided an impression of internal derangement of the left knee,
likely torn medial and/or lateral meniscus; and marked quadriceps and hamstring weakness. He
reported that he did not review any MRI scan reports. Dr. Patti also provided work restrictions.
No opinion on causation was provided. In a January 21, 2014 Form CA-20, Dr. Patti reported
that appellant twisted her knee at work and diagnosed internal derangement which he opined
with a checkmark “yes” was caused or aggravated by employment activity. In a January 28,
2014 report, he provided a clinical impression of advancing degenerative arthritis of the knee and
advancing medial meniscal tearing pathology, and some ongoing weakness bilaterally. Dr. Patti
opined that appellant’s left knee has on sequential MRI scans a worsening medial meniscal
condition from a work-related injury. He also opined that her left knee condition was work
related and total knee replacements of both knees were needed.
In a February 14, 2014 letter, OWCP advised appellant that it proposed to terminate her
benefits on the grounds that she ceased to have residuals of her accepted work-related medical
condition and no medical had been submitted to establish that the April 30, 2012 work incident
caused or aggravated a meniscal tear or arthritis of the left knee. The termination was based on
the opinion of Dr. Swartz, the second opinion referral physician. Appellant was provided 30
days to respond.
In response to the notice of proposed termination, OWCP received copies of previously
submitted reports along with new evidence, which included January 28, 2014 work restrictions
from Dr. Patti. In a February 27, 2014 report, Dr. Patti indicated that appellant has bilateral
advanced degenerative arthritis of her knees, a nonindustrial condition. With that background,
appellant had a noted twist of her knee as mechanism with acute onset of pain in her knee that
has not gone away. The twisting was a trauma with the weakness of the tissues from the
degenerative changes. Appellant has a torn medial meniscus likely attributable to that twisting
injury a year and a half ago and she has loose bodies which could also be from the traumatic
source. Dr. Patti stated that appellant needed a total knee replacement. He indicated that the
current reason she still has significant disability was historically related to the medial tearing.
Dr. Patti stated that he did not know whether the acute onset of appellant’s prominent discomfort
medially and deep was from the knee being twisted and progressing or tearing the medial
meniscus. He also indicted that he reviewed records from Dr. Swartz.
In a March 10, 2014 report, Dr. Ong indicated that appellant had a left knee medial
meniscus tear and severe arthritis. He stated that he had not treated her for nine months and felt
questions regarding her left knee and treatment were best answered by her most current treating
physicians, Dr. Libby and/or Dr. Patti.
By decision dated March 21, 2014, OWCP terminated appellant’s benefits effective that
day. Weight of the medical evidence was accorded to Dr. Swartz’ opinion.
On April 2, 2014 OWCP received appellant’s March 31, 2014 request for a telephonic
hearing before the Branch of Hearings and Review, which was held October 17, 2014. Appellant
explained that she had some minor treatment to her knee prior to the April 2012 injury and an
injury on March 9, 2013, but she did not have any specific injuries to her knee prior to the

4

April 2012 work event. Counsel argued that the claim should be expanded to include the
diagnosed meniscal injury.
OWCP received a June 1, 2012 left knee MRI scan report and a duplicate copy of
Dr. Libby’s June 20, 2012 report.
In a June 7, 2012 report, Dr. Robert P. Kaplan, a family practitioner, noted that appellant
was walking and her left knee twisted on April 30, 2012. He reported on her physical
examination of May 2, 2012 and the results of MRI scan and x-ray testing. Dr. Kaplan
diagnosed torn meniscus of left knee and opined that the injury to appellant’s left knee was
related to her April 30, 2012 incident at work.
By decision dated January 2, 2015, an OWCP hearing representative affirmed OWCP’s
March 21, 2014 decision. She found that OWCP had met its burden of proof to establish that the
accepted condition of left knee strain had resolved, and that appellant had not met her burden of
proof to establish that any additional conditions were causally related to the accepted incident.
LEGAL PRECEDENT -- ISSUE 1
Once OWCP accepts a claim, it has the burden of justifying termination or modification
of compensation. After it has been determined that, an employee has disability causally related
to his or her employment, OWCP may not terminate compensation without establishing that the
disability had ceased or that it was no longer related to the employment.2 OWCP’s burden of
proof includes the necessity of furnishing rationalized medical opinion evidence based on a
proper factual and medical background.3 Furthermore, the right to medical benefits for an
accepted condition is not limited to the period of entitlement for disability. To terminate
authorization for medical treatment, OWCP must establish that a claimant no longer has
residuals of an employment-related condition that requires further medical treatment.4
ANALYSIS -- ISSUE 1
OWCP accepted that appellant sustained a left knee sprain on April 30, 2012 when she
twisted her knee. The issue is whether it properly terminated her benefits effective March 21,
2014 as she no longer had residuals of the April 30, 2012 injury.
The Board finds that OWCP met its burden of proof to terminate appellant’s benefits for
the accepted left knee sprain condition. In his July 16 and August 14, 2013 reports, Dr. Libby,
appellant’s treating physician, opined that the traumatic left knee sprain had resolved. There is
no medical evidence of record to dispute that the traumatic left knee sprain had, in fact, resolved.
Dr. Swartz, OWCP’s second opinion physician, stated in his October 28, 2013 report that
appellant had a long-standing preexisting arthritic condition of the left knee, as well as
congenital deformity. He concluded that, while appellant now required total knee replacement,
2

Jason C. Armstrong, 40 ECAB 907 (1989).

3

See Del K. Rykert, 40 ECAB 284, 295-96 (1988).

4

Mary A. Lowe, 52 ECAB 223 (2001); Wiley Richey, 49 ECAB 166 (1997).

5

her current condition was not related to the accepted work injury. The other physicians of record
discussed her current diagnoses, but did not find residuals of the accepted condition.
Thus, OWCP properly terminated appellant’s benefits for the accepted left knee sprain
condition as there was no evidence of residuals of the accepted condition.
LEGAL PRECEDENT -- ISSUE 2
For conditions not accepted by OWCP as being employment related, it is the employee’s
burden to provide rationalized medical evidence sufficient to establish causal relationship. It is
not OWCP’s burden to disprove such relationship.5
To establish a causal relationship between the condition as well as any attendant
disability claimed and the employment injury, an employee must submit rationalized medical
evidence based on a complete medical and factual background, supporting such a causal
relationship.6 Causal relationship is a medical issue and the medical evidence required to
establish a causal relationship is rationalized medical evidence.7
ANALYSIS -- ISSUE 2
Appellant had a history of left knee medial meniscus tear and degenerative arthritis in her
left knee, OWCP developed the issue of whether the April 30, 2012 twisting injury permanently
or temporary aggravated her degenerative condition and/or caused the medial meniscus tear.
OWCP determined that the weight of the medical evidence rested with Dr. Swartz, a Boardcertified orthopedic surgeon serving as the second opinion physician.
Based on a clinical examination, review of the medical record, and statement of accepted
facts, Dr. Swartz opined that the medical record did not show a new medial meniscus tear
resulting from the April 30, 2012 twisting injury. He explained that there were no MRI scan
findings to compare the status of the medial meniscus before the incident to the recent MRI scan.
Appellant had consistent, chronic painful osteoarthritis which required three visits in April 2012
in which she received viscos supplementation injections in her left knee antedating her April 30,
2012 claim. Dr. Swartz further explained that appellant had a long history of osteoarthritis in the
left knee and the June 1, 2012 MRI scan noted a progression of tear involving the posterior horn
medial meniscus which would not indicate previous tear. He stated that she was having
substantial problems immediately before the April 30, 2012 incident and was having substantial
problems since the incident. Dr. Swartz indicated that she required a total joint replacement of
the left knee, but it was not related to the April 30, 2012 claim. He attributed appellant’s
meniscus tear and degenerative condition to other conditions not accepted by OWCP.

5

G.A., Docket No. 09-2153 (issued June 10, 2010); Jaja K. Asaramo, 55 ECAB 200 (2004); Alice J. Tysinger, 51
ECAB 638 (2000).
6

See Manuel Gill, 52 ECAB 282 (2001).

7

Paul Foster, 56 ECAB 208 (2004); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

6

The Board finds that OWCP properly accorded the weight of the evidence to the medical
opinion of Dr. Swartz. Dr. Swartz’ report contains an extensive review of the medical record,
discusses appellant’s prior history of arthritis in the left knee and her treatment with injections to
the knee shortly before this incident and supports his opinion with reasoning.8
The reports from appellant’s physicians are insufficient to cause a conflict of medical
opinion with that of Dr. Swartz regarding causal relationship.
In his initial report of June 20, 2012, Dr. Libby opined that the tear of medial cartilage or
meniscus of knee occurred as a direct result of the April 30, 2012 left knee injury. He stated that
with this episode there was a change in the left knee pain type, frequency, and intensity which
went along with a new meniscal injury on top of appellant’s preexisting arthritic achy left knee
pain. Dr. Libby indicated that twisting was a classic mechanism of injury which could result in
new onset meniscus injury/tear in a knee with preexisting degenerative joint disease, as the
intrinsic forces generated within the knee were significant and severe enough to result in
meniscus tear with resultant pain. However, the conclusory findings do not explain how the
meniscus tear could be separated from appellant’s serious preexisting knee condition. Although
Dr. Libby discusses generally the possibility that it could occur, there are no diagnostic studies to
confirm that the meniscus tear was not also preexisting. Following a review of Dr. Swartz’
report, Dr. Libby continued to attribute appellant’s traumatic medial meniscus tear of the left
knee and decompensation of the degenerative joint disease left knee to the mechanism of the
twisting injury on April 30, 2012. He acknowledged that she had received injections into her left
knee before the alleged injury and had reported the pain and problems with the left knee prior to
the April 30, 2012 incident. Dr. Libby based his belief that the meniscus tear was work related
on appellant’s description of the pain as being “different.” His reports contain no significant
record review and his opinion is not based on comparative diagnostic tests. Dr. Libby’s opinion
relies almost entirely on appellant’s perception that her pain changed after her April 30, 2012
occurrence. He offered better medical support for his conclusory opinion that she suffered a torn
meniscus as a result of that occurrence.9 Thus, Dr. Libby’s reports are of diminished probative
value and are insufficient to create a conflict in medical opinion.
In his November 30, 2012 report, Dr. Ong noted the history of injury and stated that the
most probable diagnosis was medial meniscus tear with preexisting arthritis. The Board has held
that medical opinions that are speculative or equivocal in character are of diminished probative
value.10 In March 15 and April 22, 2013 reports, Dr. Ong noted that appellant reinjured her knee
at work on March 9, 2013 and her left knee pain worsened. While he opined that she aggravated
her left knee after twisting it during a reinjury at work, he based the reinjury on a March 9, 2013
occurrence and not the April 30, 2012 occurrence. Thus, these reports do not discuss the
April 30, 2012 occurrence and are of limited probative value.
8

See James Mack, 43 ECAB 321 (1991).

9

Medical evidence that states a conclusion, but does not offer any rationalized medical explanation regarding the
cause of an employee’s condition is of limited probative value on the issue of causal relationship. See J.F., Docket
No. 09-1061 (issued November 17, 2009); A.D., 58 ECAB 149 (2006).
10

D.D., 57 ECAB 734, 738 (2006); Kathy A. Kelley, 55 ECAB 206 (2004).

7

In a January 21, 2014 report, Dr. Patti noted the history of injury and provided an
impression of internal derangement of the left knee, likely torn medial and/or lateral meniscus
and marked quadriceps, and hamstring weakness. However, he offered no opinion on causation.
The Board has held that medical evidence that does not offer any opinion regarding the cause of
an employee’s condition is of limited probative value on the issue of causal relationship.11 In
January 21 and 28, 2014 reports, Dr. Patti related that appellant had twisted her knee at work and
the diagnosed conditions of internal derangement and advancing degenerative arthritis of the
knee and advancing medial meniscal tear pathology and ongoing bilateral weakness were caused
or aggravated by employment injury. While he explained in his January 28, 2013 report that the
sequential MRI scans of her left knee showed a worsening medial meniscal condition from a
work-related injury, he offered no medical support for his opinion.12 In his February 27, 2014
report, Dr. Patti explained that the twisting was a trauma with the weakness of the tissues from
the degenerative arthritis of her knees. He opined, however, that he did not know whether the
acute onset of appellant’s prominent discomfort medially and deep was from the knee being
twisted and progressing or from the tearing of the medial meniscus.
In his June 7, 2012 report, Dr. Kaplan noted the history of injury, diagnostic testing, and
examination findings. He diagnosed torn meniscus of the left knee and opined that the injury to
appellant’s left knee was related to the April 30, 2012 occurrence. The Board finds, however,
that Dr. Kaplan did not provide sufficient medical rationale explaining how her twisting
occurrence of April 30, 2012 caused a new condition.13
On appeal appellant alleges that OWCP’s decision is contrary to fact and law. However,
there is no medical evidence that she has any residuals of her accepted left knee sprain.
Furthermore, appellant’s physicians lack the probative value necessary and those reports do not
establish that the April 30, 2012 occurrence caused appellant’s current left knee condition or
aggravated a preexisting condition.14 As appellant failed to provide such probative medical
opinion in this case, the Board finds that she did not meet her burden of proof to establish her
claim.
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 OWCP met its burden of proof to terminate appellant’s benefits
effective March 21, 2014 as she no longer had any residuals causally related to her accepted left
11

C.B., Docket No. 09-2027 (issued May 12, 2010).

12

Medical evidence that states a conclusion but does not offer any rationalized medical explanation regarding the
cause of an employee’s condition is of limited probative value on the issue of causal relationship. See J.F., Docket
supra note 9; A.D., 58 ECAB 149 (2006).
13

See J.F., supra note 9; A.D., supra note 9.

14

W.W., Docket No. 09-1619 (issued June 2, 2010).

8

knee sprain. The Board further finds that she did not meet her burden of proof to establish that
the April 30, 2012 twisting injury permanently or temporary aggravated her degenerative
condition and/or caused the medial meniscus tear.
ORDER
IT IS HEREBY ORDERED THAT the January 2, 2015 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: October 1, 2015
Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge
Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

James A. Haynes, Alternate Judge
Employees’ Compensation Appeals Board

9