OWCP Work Related Psychiatric Conditions Tutorial Podcast

A psychiatric condition is accepted under FECA only if a qualified mental health professional diagnoses an emotional condition and provides a rationalized opinion that it was directly caused or substantially aggravated by specific, substantiated incidents or conditions of federal employment — not by general job stress or properly conducted personnel actions.

If you are pursuing such a claim, almost all successful claimants use an attorney or experienced representative who specializes in federal workers’ compensation, because the medical and factual causation burdens are extremely high.

. Medical Causation Requirements for Establishing a Psychological DSM-5 Diagnosis for a Federal Employee Work-Related Injury 

Under FECA, a psychological condition (e.g., PTSD, major depressive disorder, or anxiety disorder per DSM-5 criteria) qualifies as a compensable "injury" if it arises out of and in the course of employment (5 U.S.C. § 8101(5); FECA PM Part 2, Chapter 2-0200). Emotional/psychiatric claims are scrutinized closely due to their subjective nature, and OWCP applies the Lillian Cutler criteria from ECAB precedent (28 ECAB 125 (1976)) to establish eligibility. 

Click on the transcript for more information to source for scheduled awards. 

The podcaster is Dr. Stephen Taylor, OWCP legal consultant for Oberheiden Law Firm.  Dr. Taylor’s contact information is:

https://fedcompconsultants@protonmail.com If you need a medical provider or assistance with an OWCP /  DOL claim in Tampa, Jacksonville, Pensacola Florida, Mississippi or Daphne Alabama    you can make an appointment to see Dr. Taylor, or Dr. Sullivan   at the clinic at  FWC Medical Centers. To make a consultation with Dr. Taylor  call the clinic at 813-215-4356 or go  to our website at https://fwcmedicalcenters.net/     or     https://fedcompconsultants.com/

Transcript

Welcome to Federal Workers Compensation Coffee Break Podcast. I’m Dr. Stephen Taylor a Federal Workers Compensation Consultant and a medical provider in Tampa, Jacksonville & Pensacola Florida and Daphne Alabama, who has been helping government employees with work-related injuries, disability, FERS Disability, VA disability and other types of Federal program filings for 31 years. I have assisted hospitals, clinics and doctors for over 25 years with being successful with OWCP. I have also worked with injured Federal Workers all over the country with properly filing their Federal Workers Compensation Claims and/or disability claims for about three decades. I  decided  to create a tutorial podcast to assist with the type of topics that have needed the most assistance over the years, related to injured federal workers and/or contractors as a resource for people who are looking for assistance with DOL-OWCP federal workers . The name of this tutorial podcast is  Federal Workers Compensation Coffee break Podcast. It is based on the lunch and learn short learning format.  Here at this podcast we discuss all sorts of topics related to federal workers compensation, Department of Labor, OWCP, FECA ACT, FERS, longshore-maritime, DOD contractors, VA benefits over a cup of coffee. 

Today we are going to continue to cover I have decided to complete the last episode of this 4th to 5th season of the podcast with assisting you in developing OWCP federal work injury psychological injury cases. 

I have brewed up something important today to assist psychologist, psychiatrist and psychological injured  federal workers in understanding how to file psychological federal OWCP injury case.  Ket's get our coffee going and get to it. 

Note that while DSM-5 is the current standard for psychiatric diagnoses (updating prior DSM-IV references in older materials), FECA claims require a rationalized medical opinion linking the diagnosis to employment factors. All claims must meet the five basic elements of compensability under 20 C.F.R. § 10.115, including performance of duty and causal relationship. 

Under the Federal Employees’ Compensation Act (FECA), psychiatric or emotional conditions are compensable, but the eligibility standard is significantly stricter than for physical injuries. OWCP accepts psychological claims only when the employee meets a well-established legal test supported by case law from the Employees’ Compensation Appeals Board (ECAB).

 Core Legal Standard for Acceptance of a Psychiatric Injury under FECA

To establish a work-related emotional or psychiatric condition, the employee must prove:

1. A diagnosed emotional or psychiatric condition (e.g., PTSD, major depression, generalized anxiety disorder, adjustment disorder, etc.) from a psychiatrist or clinical psychologist.

2. The condition was caused, precipitated, aggravated, or accelerated by specific “factors of federal employment.”

3. Those factors of employment must be substantiated by objective and factual evidence (statements, emails, reports, performance reviews, investigative reports, etc.).

 Key Principle: “Lillian Cutler” Rule (Cutler v. Department of Labor, ECAB 1967 – still the controlling standard)

OWCP and ECAB distinguish between three categories of stress claims:

-- Example types of psychological  Claim  - Compensable -- Explanation --

 Emotional reaction to normal work duties, workload, or routine personnel actions (e.g., assignments, deadlines, performance appraisals, reassignments, denial of leave) -- No -- General job stress or dissatisfaction is not compensable. --

-- Emotional reaction to administrative or personnel actions (e.g., discipline, investigations, transfers) -- Only if the employee proves the agency committed error or abuse in carrying out the action -- Employee has the burden to prove the agency acted wrongfully or abusively. Mere disagreement is not enough. --

-- Emotional injury caused by a specific traumatic incident or series of incidents (physical or non-physical) that are compensable “factors of employment” -- Yes -- Examples: sexual or racial harassment, threats of violence, assault, discrimination, retaliation for filing EEO or whistleblower complaints, witnessing a traumatic event, etc. --

 Most Common Compensable “Factors of Employment” for Psychiatric Claims

- Sexual harassment or hostile work environment (if substantiated

- Discrimination or retaliation (if agency found to have violated EEO laws or Whistleblower Protection Act)

- Physical assault or credible threat of violence

- Being subjected to verbal abuse, bullying, or mobbing that rises to the level of abuse (not mere rude behavior)

- Error or abusive action in a personnel matter (e.g., wrongful discipline, improper investigation)

- Traumatic exposure (e.g., law enforcement, first responders, or postal workers witnessing shootings, accidents, or deaths)

 What Is Almost Never Accepted

- “I have a difficult boss”

- Heavy workload or long hours by themselves

- Fear of future RIF (reduction in force) or reorganization

- Disagreement with ratings or awards

- Feeling “micromanaged” or “undervalued”

 Evidence Required for Acceptance

1. Medical diagnosis and rationalized medical report from a psychiatrist or Ph.D. psychologist that:

   - Gives a firm DSM-5 diagnosis

   - Explains causation or aggravation in detail

   - Rules out or accounts for non-work-related stressors (divorce, financial problems, pre-existing conditions, etc.)

2. Factual corroboration (not just the employee’s allegations) of the work factors claimed:

   - Witness statements

   - Emails, texts, memos

   - OIG, EEO, or OSC investigative reports

   - Grievance or disciplinary records

 Special Rules for PTSD

PTSD claims (especially common among law enforcement, air traffic controllers, and postal employees after shootings) are more frequently accepted because they are tied to a discrete traumatic event, but the event itself must still be a compensable factor of federal employment.

 Summary of Eligibility Standard in One Sentence

A psychiatric condition is accepted under FECA only if a qualified mental health professional diagnoses an emotional condition and provides a rationalized opinion that it was directly caused or substantially aggravated by specific, substantiated incidents or conditions of federal employment — not by general job stress or properly conducted personnel actions.

If you are pursuing such a claim, almost all successful claimants use an attorney or experienced representative who specializes in federal workers’ compensation, because the medical and factual causation burdens are extremely high.

1. Medical Causation Requirements for Establishing a Psychological DSM-5 Diagnosis for a Federal Employee Work-Related Injury 

Under FECA, a psychological condition (e.g., PTSD, major depressive disorder, or anxiety disorder per DSM-5 criteria) qualifies as a compensable "injury" if it arises out of and in the course of employment (5 U.S.C. § 8101(5); FECA PM Part 2, Chapter 2-0200). Emotional/psychiatric claims are scrutinized closely due to their subjective nature, and OWCP applies the Lillian Cutler criteria from ECAB precedent (28 ECAB 125 (1976)) to establish eligibility. These require: 

A valid DSM-5 diagnosis: Medical evidence must confirm an emotional or stress-related psychiatric disorder meeting DSM-5 diagnostic criteria (e.g., via clinical interview, standardized testing like MMPI-2, or symptom checklists). The diagnosis must be rendered by a qualified physician, such as a licensed psychiatrist or clinical psychologist (meeting FECA's definition under 5 U.S.C. § 8101(2) and 20 C.F.R. § 10.5(j)—doctoral degree, independent practice licensure, and relevant supervised experience). General statements like "stress" are insufficient; a specific DSM-5 disorder (e.g., F43.10 Acute Stress Disorder) is required. 

Factual evidence of compensable employment factors: The claimant must identify and substantiate specific work-related incidents or factors (e.g., a traumatic event, harassment, or excessive workload) with probative evidence beyond mere allegations (e.g., witness statements, personnel records, or agency reports). Personal perceptions alone do not suffice; OWCP verifies if the factors are "compensable" (i.e., not due to non-work issues like marital problems). For a single-event traumatic injury, file Form CA-1; for gradual onset over multiple shifts, use Form CA-2 (per FECA Bulletin No. 23-02).

Rationalized medical opinion on aggravation and resulting disability: A qualified psychiatrist/psychologist must opine (to reasonable medical certainty) that the event aggravated the pre-existing condition, causing new or worsened disabling symptoms (e.g., "The [event] on [date] exacerbated baseline GAD [F41.1 DSM-5], increasing panic attacks from occasional to daily, resulting in full inability to perform supervisory duties"). Include: 

Pre- vs. post-event comparison (e.g., GAF score drop from 70 to 50). 

Causal rationale (e.g., how the trauma triggered dormant symptoms via DSM-5 mechanisms like conditioned fear response). 

Disability extent (total/partial) with specific impacts (e.g., concentration deficits preventing 8-hour shifts). 

Evidence must show the aggravation is "material" (not de minimis) and employment-related, distinguishing from non-work factors. OWCP may refer for DMA review or second opinion if unclear (FECA PM Part 3, Chapter 3-0500). 

For partial disability, pay 66⅔% of pay loss (75% with dependents); full if total (5 U.S.C. §§ 8105-8106). Example: ECAB Docket No. 16-0175 upheld acceptance where a threat aggravated pre-existing emotional issues, causing disability. If temporary, monitor via periodic reports (Form CA-20) until resolution (FECA PM Part 2, Chapter 2-1400). 

3. Medical Causation Requirements and Eligibility for Aggravation of a Pre-Existing Psychological Condition Aggravated/Accelerated Over Two or More Shifts (CA-2 Injury) Due to Work-Related Events 

For gradual aggravation over multiple shifts (occupational disease via Form CA-2), the pre-existing psychological condition must be materially worsened by cumulative work factors (e.g., ongoing harassment, high-stress deadlines) occurring over >1 workday/shift, producing or accelerating the disabling condition (5 U.S.C. § 8101(5); 20 C.F.R. § 10.5(ee); FECA PM Part 2, Chapter 2-0800). Eligibility requires the five basic elements (20 C.F.R. § 10.115), with the "date of injury" as awareness of causal link (up to 3-year filing limit). Per FECA Bulletin No. 23-02, use CA-2 unless a single-shift event dominates; no COP for gradual claims. 

Specific requirements: 

Pre-existing condition documentation: As in Q2, establish non-disabling baseline via historical records. 

Factual evidence of cumulative work factors: Identify and verify ongoing events over the date range (e.g., emails, logs, witness affidavits showing progressive exposure). Factors must be "compensable" (e.g., not routine personnel actions unless arbitrary/abusive; Lillian Cutler applies to verify). OWCP issues a Statement of Accepted Facts (SOAF) post-development. 

Rationalized medical opinion on aggravation/acceleration: Physician must opine that work factors over the period aggravated/accelerated the condition, causing disability (FECA PM Part 2, Chapter 2-0300; Bulletin No. 23-05 for analogous disease claims). Key elements: 

Diagnosis update (e.g., progression from adjustment disorder [F43.23 DSM-5] to major depression [F32.9] due to cumulative stress). 

Temporal/causal link (e.g., "Shifts from [date range] exposed claimant to unrelenting demands, accelerating symptom severity via chronic HPA axis dysregulation, per DSM-5 trauma criteria"). 

Objective support (e.g., serial GAF scores, therapy notes showing escalation). 

Disability quantification (partial/full, with work impacts like avoidance behaviors). 

Opinion must be unequivocal, based on full history (including non-work factors), and explain why work was the "proximate cause" (not just contributory). DMA/second opinion resolves conflicts (FECA PM Part 3, Chapter 3-0200). 

Eligibility extends to temporary aggravation (benefits during worsened period) or permanent if residuals persist (e.g., chronic PTSD). Per FECA PM Part 2, Chapter 2-0805, develop via CA-35 (Evidence for Occupational Disease) for detailed medical/factual proof. ECAB Docket No. 17-2021 accepted overwork/deadline aggravation of depressive neurosis as gradual. Monitor via Form EN-1032 for ongoing entitlement. 

4. Utilization of OWCP-5a for a Psychological Condition and Proper Procedure for Completing It for Work Restrictions or Off-Work Restrictions 

Psychological injured federal workers that have restrictions, partial disability or temporary total disability require a psychological OWCP return to work status form to be utilized. 

OWCP-5a—Work Capacity Evaluation for Psychiatric/Psychological Conditions. 

Utilization: Form OWCP-5a is a specialized tool under FECA PM Part 3, Chapter 3-0600, used by treating physicians, second opinion examiners, or referees to assess and document work capacity/restrictions for accepted psychological conditions (e.g., post-traumatic stress disorder). It supports disability determinations, return-to-work (RTW) planning, and partial/total benefits by quantifying mental/functional limitations (e.g., stress tolerance, interpersonal capacity). Unlike general OWCP-5 (physical), OWCP-5a focuses on psychiatric impairments, informing nurse interventions, vocational rehab, or schedule awards (if whole-person impairment per AMA Guides, 6th Ed.). It's submitted with reports like CA-20 and used in periodic entitlement reviews (FECA PM Part 2, Chapter 2-1300) or conflicts (5 U.S.C. § 8123). Example: In ECAB Docket No. 23-0270, it supported full RTW despite symptoms. 

Proper Procedure for Completion (Work/Off-Work Restrictions): 

Follow FECA PM Part 3, Chapters 3-0500/3-0600 for impartiality and rationale. The form has sections for patient info, diagnosis, history, exam findings, and opinions; complete in narrative if needed. Steps: 

Gather Background: Review SOAF, full medical records (e.g., DSM-5 notes, prior OWCP-5a), and CE questions (e.g., "Can claimant tolerate 40-hour weeks?"). Include pre-injury baseline and work demands (e.g., via Dictionary of Occupational Titles). 

Section 1: Patient/Claimant Info: Enter OWCP file number, date of birth, injury date, accepted conditions (e.g., F32.9 Major Depressive Disorder), and exam date. 

Section 2: Diagnosis and History: State DSM-5 diagnosis, symptom onset/aggravation, treatment (e.g., CBT, SSRIs), and causal rationale (e.g., "Work trauma per SOAF precipitated symptoms; pre-existing anxiety aggravated by 20%"). Note objective findings (e.g., mental status exam, PHQ-9 score >20 indicating severe depression). 

Section 3: Work Capacity Opinion: Address RTW feasibility: 

Current Capacity: Rate as full-time/usual position, part-time, light duty, or total off-work (with duration, e.g., "Off-work 4 weeks due to acute suicidal ideation"). 

Restrictions: Specify psychiatric limits (e.g., "No high-stress deadlines; avoid coworker interactions >2 hours/day; no decision-making under pressure; reduced hours to 20/week"). Rationalize per DSM-5 impacts (e.g., "Concentration deficits [Criterion F] preclude multitasking"). 

Prognosis: Timeline for improvement (e.g., "Full RTW in 3 months with therapy") and further needs (e.g., accommodations under light duty). 

Section 4: Signature/Rationale: Physician signs, explaining opinions with medical certainty (e.g., "Based on DSM-5 criteria and exam, restrictions are necessary to prevent exacerbation"). Attach narrative if complex. 

Submit to OWCP within 30 days; Claims Examiner or District Medical Advisor reviews for weight (high if rationalized/specialist-based). For off-work, justify medical necessity (5 U.S.C. § 8103); update every 2-4 weeks via 5a form with narrative listing necessary interventions (FECA PM Part 3, Chapter 3-0201). If disputed, referee exam uses a blank OWCP-5a as part of his denial.

. Remember, this isn’t medical or legal advice—I’m not your doc or lawyer—but I try to be your roadmap to fight for fair comp results. 

Ok… I think that is enough for today…I need to warm up this coffee and get going. So,  I want to thank you for listening and want to remind you to share this podcast with other federal workers, if  you have benefitted  from this information please leave a 5 star review on the platform you found this podcast, so others will also find this information online. Also, if you need an approved  medical provider for your DOL -OWCP Or Longshore case in Florida you can still  find me in Tampa, Jacksonville  and Pensacola and now in Daphne Alabama. To make a consultation with me to discuss your case or if you know someone if Florida who is recently injured you can call the clinic at 813-215-4356 or 813-877-6900 or go  to our website at https://fedcompconsultants.com/   & https://mrtherapycenter.com/  Also if you are in  another state and you want me to assist you with claim questions or assistance for your  doctor you can email me at fedcompconsultants@protonmail.com 

As usual I want to thank all of you who put on that uniform, that badge, deliver that mail, take care of our veterans and make this government run… a big thank you. I do this for free just for you…We could not do this  without all of the work all of you out there do…so this is my big  thank you. And remember if you  have an injured federal claim and you need assistance….I am  here to help!.

See you next time. Everyone have a blessed holidays, pray for our nation to heal and we will see you after the new year with a new season of Federal Workers Comp Coffee Break podcast. 

Off to get my coffee!