Stress Claims

(This article first appeared in the July/August 2019 issue of the American Postal Worker magazine) 

If you are feeling stressed, you are not alone. It is estimated that 8 in 10 Americans feel stress in their daily lives. Numerous studies indicate job stress is the greatest source of stress for adults in the U.S.

Stress is associated with increased rates of heart attacks, hypertension and other physical conditions. It can trigger insomnia, anxiety, depression, panic attacks and other debilitating mental disorders that can lead to lost time from work, and cause sufferers to face unfair scrutiny due to the baseless stigma attached to mental and emotional illness. When work factors cause or aggravate a preexisting mental or emotional condition, postal employees have the right to receive benefits under the Federal Employees Compensation Act (FECA).

Establishing a stress claim can be a bit more difficult than the typical injury and disease claims filed with the Office of Workers Compensation Programs (OWCP). Knowing how to meet the requirements and understanding what qualifies as compensable work factors help achieve claim approval. All claims, including stress, must meet five basic elements to achieve claim approval. Claims must be timely filed by a civilian employee. There must be a fact of injury which consists of two components – a workplace event, and a resulting medical diagnosis. The claimant must be in performance of duty within their scope of employment, and a causal relationship between the injury and the workplace must be established by a physician, generally a physiatrist or clinical psychologist for stress claims. The doctor’s medical narrative should contain medical reasoning explaining how the work environment or physicality used in performing duties caused or worsened an existing condition. Simply stating work caused the condition lacks medical reasoning, and will likely cause claim denial.

Stress claims can be particularly difficult because not all work factors are considered “compensable.” The Employees Compensation Appeals Board (ECAB) has held that directing employees is an administrative function and within the realm of managerial authority. For an action to be compensable the claimant must prove the employing agency erred or abused their discretionary authority beyond the employee’s perception (see Marlon Vera, 54 ECAB 834 (2003)).

The Cutler concept holds that compensation law does not apply to every illness that is somehow related to employment. It does, however, provide that disabilities arising from an emotional reaction, including fear and anxiety stemming from a perceived inability to carryout assigned duties or imposed job requirements, fall within FECA coverage. On the other hand, disabilities that originate from frustration or disagreement over not being permitted to work in a particular location or position are not covered. These circumstances are considered self-generated except where error is proven (Lillian Cutler, 28 ECAB 125 (1976)). The ECAB also concluded that a detail assignment to another city satisfied the Cutler criteria rendering the emotional disability covered (Brenda Getz, 39 ECAB 245 (1987)).

Harassment, teasing and being called derogatory names are also compensable factors of employment provided the reasons behind the behavior is not imported into work from the employee’s personal life (Abe E. Scott, 45 ECAB 164 (1993)). The ECAB follows the “friction and strain doctrine” which considers individual characteristics and interaction between employees making some claims compensable when conflict arises over non-work issues (Larson, The Law of Workmen’s Compensation, §11.16[a]).

Proving error or abuse requires evidence. Statements from the claimant, coworkers and other witnesses, as well as investigative memorandums, contract provisions with an explanation of the error, or other rulings finding error or abuse can all prove beneficial.

Once the offense is established to be in performance of duty, medical documentation will be evaluated to whether the causality for the claimed disability has been established. To learn more, click here to access PM Chapter 2 Claims, Sections 801 – 805; more specifically 804.12 and 804.17.