FECA Manual regarding emotional conditions:
Part 2 at 2-0805-7
Precedent for emotional conditions: Lillian Cutler 28 ECAB 125 (1976)
09-0439 December 29, 2009
09-0764P December 18, 2009
08-2557 August 11, 2009
To establish that a claimant sustained an emotional condition causally related to factors of employment, the claimant MUST submit: 1) factual evidence identifying and supporting employment factors or incidents alleged to have caused, contributed or adversely affected the condition by his/her employment, 2) rationalized medical evidence establishing that the claimant has an emotional condition or psychiatric disorder, 3) rationalized medical opinion evidence establishing that the emotional condition is causally related to the identified compensable employment factors; and 4) sufficient evidence to establish that s/he actually experienced the employment incident at the time, place, and in the manner alleged.
Rationalized medical evidence is evidence which relates a work incident or factors of employment to a claimant's condition, with stated reasons of a physician. The opinion must be one reasonable medical certainty and must be supported by medical rationale explaining the nature of the relationship of the diagnosed condition and the specific employment factors or employment injury. When the matter asserted is a compensable factor of employment and the evidence of record establishes the truth of the matter asserted, the Office must base its decision on the analysis of the medical evidence. Nurses or licensed social workers do not constitute competent medical evidence for the purpose of the Act.
An administrative or personnel matter Will Be considered to be an employment factor where the evidence discloses error or abuse on the part of the employing establishment.
The Board has held that emotional reactions to situations in which an employee is trying to meet his or her position requirements are compensable. Where a claimed disability results from an employee's emotional reaction to his/her regular or specially assigned duties, altered job duties or to an imposed employment requirement, the disability comes within the coverage of the Act.
Administrative and personnel matters, although generally related to the employee's employment, are administrative functions of the employer rather than the regular or specially assigned work duties of the employee and are NOT covered under the Act.
The Board has held that frustration with the policies and procedures of the employing establishment are administrative matters and are NOT compensable factors of employment.
Disability is NOT covered where it results from an employee's fear of a reduction-in-force, frustration from not being permitted to work in a particular environment or to hold a particular position, or to secure a promotion. Disabling conditions resulting from an employee's feeling of job insecurity or the desire for a different job do not constitute a personal injury sustained while in the performance of duty within the meaning of the Act.
The Board has held that actions of the employing establishment which the employee characterizes as harassment or retaliation may constitute factors of employment giving rise to coverage under the Act. Mere perceptions of harassment and retaliation are not compensable under the Act. A claimant must establish a factual basis for the claim by supporting the allegations of harassment with probative and reliable evidence.
For harassment to give rise to compensable disability, there must be some evidence that harassment or discrimination did in fact occur. With regard to emotional claims arising under the Act, the term discrimination or harassment as applied by the Board is not the equivalent of that as defined or implemented by other agencies, such as the EEOC. Under the Act, the term "harassment" is synonymous, as generally defined, with a persistent disturbance, torment or persecution, i.e., mistreatment by co-employees or workers.
As a rule, allegations alone by a claimant are insufficient to establish a factual basis for an emotional condition claim. The claimant must substantiate allegations with probative and reliable evidence which establishes that the acts alleged or implicated by the employee did, in fact, occur.
Where an emotional condition is the only work-related condition known to be present, referrals should be made to clinical psychologists as long as the file contains no indication that medication for a psychological condition is being used. This action should be taken even if the attending physician is a psychiatrist, but not where psychogenic overlay is felt to be present, as these cases presuppose a connection between the psychological condition and its physical manifestation which can best be addressed by a psychiatrist.