The Federal Employees’ Compensation Act (FECA) covers mental health. The psychological or emotional condition must result from work duties and activity and must be diagnosed by a medical professional. To receive compensation, the employee must file a claim and submit the necessary proof.
Mental Health Coverage Under FECA
Mental health is covered under FECA. A mental health injury can result from a single traumatic incident or multiple events that contribute to the condition.
For a single incident, the employee should file for traumatic injury a CA-1 Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation.
For an occupational disease, where the mental condition results from multiple episodes, the employee should file CA-2 Notice of Occupational Disease and Claim for Compensation.
FECA mental health claims are administered by the U.S. Department of Labor Office of Workers’ Compensation Programs (OWCP). Apply at the Employees’ Compensation Operations & Management Portal.
Is an accompanying physical injury required?
No. You do not have to have a physical injury to make a claim for a mental health condition under FECA.
Types of Mental Health Conditions Covered
Types of mental health conditions that may be covered under FECA include:
- Post-Traumatic Stress Disorder (PTSD)
- Anxiety
- Depression
- Opioid use disorder
- Panic attacks
- Nervousness
- Mental distress
What if the job is known to be stressful?
In some state workers’ compensation systems, a person can’t file workers’ compensation for ordinary mental stress of the job. For example, first responders, such as police, fire, and EMTs, are known to face emotionally challenging situations. Some state workers’ compensation programs deny these critical workers the relief they need when trauma is part of the job.
FECA allows these claims. Even if the mental health condition results from typical working conditions, a civilian employee may still bring a claim.
Filing a Mental Health Claim Under FECA
Someone filing a FECA claim for a mental health condition must submit the following proof:
- Diagnosis of an emotional or psychiatric disorder
- Medical evidence establishing the emotional condition
- An employment factor that caused or contributed
- Evidence establishing the condition is causally related to employment
S.K., Docket No. 18-1648 (issued March 14, 2019). You may need a detailed history of work exposure, previous emotional conditions, and the treatment that you have received. Proof may include the results of a physician’s exam.
In addition to evidentiary proof, a claim must be in a set time period.
Challenges in Proving Mental Health Claim
Some of the evidence for a FECA mental health claim will be provided by medical professionals.
You need an affirmative diagnosis of an emotional, mental, or psychological condition. You need a professional opinion that the condition is the result of work duties.
Even this may not be enough. You need corroborating evidence of the working factor. In addition to your own statement, you may rely on witnesses, work records, incident reports, complaints, and other information to show what happened.
Another challenge in proving a FECA claim for mental health is that the employee has the burden of proof. Although the FECA process is supposed to be non-adversarial, it can still be difficult when evidence is in the hands of supervisors and coworkers may fear retaliation. You can have an attorney represent you to build the proof in your case.
What mental health is not covered under FECA?
FECA does not pay compensation for mental health conditions that result from:
- Perceived job insecurity
- Possible reduction in force
- Not being given certain work environments or exceptions
- Doing the work in general
- Dissatisfaction with work assignments or tasks
- Not getting a promotion or certain position
- Unfounded perceptions of employment or harassment
- Disagreeing with a supervisor without error or abuse by the supervisor
Generally, administrative and personnel matters do not fall under FECA. They are related to employment, but they are not work duties. Harassment on the job can be an employment factor, but the employee must provide corroborative evidence.
Appealing Denied Mental Health Claims
If any of the elements of a claim are not met, the case is initially denied. Read the denial documents carefully, as they should contain a reason for the denial. For your appeal to succeed, you must address the reason given.
There are multiple ways to appeal, so it’s important to choose the best route for you.
You may appeal to a hearing before an office representative. The review may be by oral argument or written review of the record. Usually, the review is limited to the contested decision, but the hearing representative has some discretion.
You may request reconsideration by the district office. You have one year to file from the date of the denial, and the request must contain new evidence or arguments. There is no specific form, but you must identify the decision and the issue for which you are requesting review.
In addition, you may take your case to the Employees’ Compensation Appeals Board (ECAB). The appeal reviews only the evidence available at the time of the initial decision. The request must be filed within 180 days of the original decision.
Resources for Federal Employees with Mental Health Claims
A federal employee whose mental health condition prevents them from working may receive 66 2/3 of their pay. If the person can work with reduced wages, they may receive 66 2/3 of the difference in earnings. There is an additional amount if the person has a dependent. In addition, the person may receive mental health care.
The law states that the U.S. government must furnish services and supplies recommended by a physician to cure, give relief, reduce the period of disability, or lessen monthly compensation. If mental health care, therapies, or medication will help, you may receive these treatments as part of your FECA mental health claim.
Contact an Experienced FECA Claims Lawyer Today
Have you suffered a mental health condition as a federal employee? Is your mental condition work-related? You can have help from an experienced FECA claims lawyer today. Contact attorney Daren Sarphie of Sarphie Law. Learn about your case and whether FECA covers mental health for a specific situation. See how an attorney can help. Contact us now.