This is not just another article about filling out Form CA-1 immediately or about selecting your own doctor. Reviewing recent decisions of the Employees' Compensation Appeals Board, a number of topics were discussed that were thoroughly interesting and which might be applicable to an injured letter carrier's situation.

Abuse of Discretion

Claims Examiners for the Department of Labor do make mistakes. When a decision is so illogical as to make no sense, it can be challenged as an abuse of discretion. The standard for this idea is found in many ECAB decisions.

An abuse of discretion is generally shown through proof of manifest error, clearly unreasonable exercise of judgment, or actions taken which are contrary to both logic and probable deductions from known facts. Wilson L. Clow, Jr., 44 ECAB ___ (Docket No. 92-118, issued October 26, 1992); Patsy R. Tatum, 44 ECAB ___ (Docket No. 91-1422, issued February 19, 1993), et al.

Contribution

When death from a non work-related condition is hastened by a work activity, coverage under the FECA may be possible. Medical proof of contribution after the fact would be quite complicated due to the deceased state of the claimant. Such a claim would be advanced by the beneficiary.

To hasten disability or death is to cause it as far as the right to compensation is concerned. It is not necessary to prove a significant contribution to a condition for the purposes of establishing causal relationship. Rudy C. Sixta, Jr. 44 ECAB

(Docket No. 92-1457, issued June 2, 1993).

Human Instincts Doctrine

The Human Instincts Doctrine, closely related to the previous discussion of Contribution, is a vital concept requiring that the employer behave responsibly when an employee becomes too ill or injured while working to make effective decisions. The neglect of the employer to properly respond to such a situation, even when the underlying illness is not work related, can lead to a successful claim of compensation. Proof would be required that the neglect produced an actual contribution to the employee's final condition.

Under the "human instincts" doctrine, cited with approval by the Board in Mildred Drisdel, 32 ECAB 82 (1980) and 33 ECAB 409 (1982), an employer has the duty to make reasonable efforts to procure medical aid or other means of relief to an employee who becomes ill or injured on the job, and who as a result is helpless to provide for his own care. Any failure, on the part the employer, to satisfy this duty may be sufficient to establish a causal connection between an employee's condition and the employment if it is shown that such failure contributed to the condition for which compensation is claimed. Marianne Eick (George E. Eick), 40 ECAB ___(1989) [89-0457 issued July 7].

Positional Risk Doctrine

Letter carriers often arrive at the scene of a crime or other traumatic situation. Even if not the direct victim, a stress or other injury to the letter carrier is often deemed compensable by OWCP. The Postal Service often controverts such claims, arguing that the letter carrier was not the injured party.

Applying the positional risk doctrine, the Board found that appellant's coming upon the body of a suicide victim, while delivering mail, did occur at a time when appellant was engaged in his employer's business, at a place where he could reasonably be expected to be, and while he was fulfilling the duties of his employment. The requirement that appellant deliver the mail placed him at the mailbox where he discovered the suicide victim. Although appellant's injury may have been caused by a neutral force, since his employment placed him in the place of injury, his injury is covered under the FECA. Larry J. Thomas, 44 ECAB ___ (Docket No. 92-564, issued December 14, 1992).

Suicide

Suicide claims are very difficult for OWCP to adjudicate, based on the self-infliction of the injury, the deceased state of the claimant, and the need to establish how the cause of the behavior can be proven to have arisen out of the employment. The ECAB could extend coverage to victims of suicide under certain rules, as discussed below.

In determining whether an employee's suicide is causally related to factors of his employment, the Office has adopted the "chain of causation" test. In explaining that all suicide claims are not precluded by section 8102(a)(2) of the Act, the Office's Procedure Manual provides that compensation can be paid if the job-related injury (or disease) and its consequences directly resulted in the employee's domination by a disturbance of the mind and loss of normal judgment which, in an unbroken chain, resulted in suicide. Further Larson, in his treatise on worker's compensation, notes that suicide, under the majority rule, is compensable if the injury produces mental derangement and the mental derangement produces suicide. Carolyn King Palermo (Dwayne Palermo), 42 ECAB ___ (Docket No. 89-1811, issued February 27, 1991).

Idiopathic Falls

Idiopathic falls are a confusing subject in compensation claims. Three ideas can explain most such claims: A fall to the work surface causing injury precipitated by an underlying condition such as epilepsy or syncopy will not normally be awarded coverage, and will be deemed an idiopathic fall. An idiopathic fall which produces an injury because the employee struck an instrumentality of work while falling, such as a table, railing, machine, lamp, or other object not directly on the work surface, will be covered due to the intervention of the work instrument. Finally, a fall of unknown cause should be covered because its idiopathic nature is unproven. Confused? The ECAB decisions which follow explain the differences.

Appellant, a customs inspector, experienced an episode of syncope during which he fell. His fall was found to be idiopathic in nature and related to a pre-existing medical condition. The Office properly found that appellant's injury did not arise in the course of his employment. Donald F. McGettigan, 43 ECAB___ [Docket No, 91-1448, issued February 26, 1992].

An injury resulting from an idiopathic fall, where a personal, nonoccupational pathology causes an employee to collapse and to suffer injury upon striking the immediate supporting surface and there is no intervention or contribution by any hazard or special condition of employment, is not within coverage of the FECA. However, the fact that the cause of a particular fall cannot be ascertained, or that the reason it occurred cannot be explained, does not establish that it was due to an idiopathic condition. This follows from the general rule that an injury occurring on the industrial premises during working hours is compensable unless the injury is established to be within an exception to such general rule. If the record does not establish that the particular fall was due to an idiopathic condition, it must be considered as merely an unexplained fall, one which is distinguishable from a fall in which it is definitely proved that a physical condition preexisted and caused the fall. Dora J. Ward, 43 ECAB ___ (192) [Docket No. 91-1545, issued May 21].

Although a fall is idiopathic, an injury resulting from the fall is compensable if some job circumstance or working condition intervenes in contributing to the incident or injury, such as if an employee, instead of falling directly onto the floor, strikes a part of his or her body against a wall, a piece of equipment, furniture, machinery or some similar object. A claimant has the burden of establishing that he or she struck an object connect with the employment during the course of an idiopathic fall. Lowell D. Meisinger, 43 ECAB (1992) [Docket No. 92-0102, issued July 29].

Appellant, an automobile mechanic, sustained an idiopathic fall at work due to a seizure. The Office accepted that he struck his head on a trailer as he fell to the ground and awarded benefits for a laceration of the right ear, concussion, hematoma, and chest contusion. Appellant alleged that, after the fall, his condition deteriorated and attributed tremors, intermittent numbness and dizziness to the employment injury... Lowell D. Meisinger, 43 ECAB (1992) [Docket No. 92-0102, issued July 29].

Due Process

Frustrated injured workers frequently express the desire to sue OWCP when in receipt of an adverse decision, not understanding the concept of exclusiveness of remedy. The ECAB decision which follows affirms the self-contained appeals process within the FECA.

Appellant alleged that the actions of the Office in adjudicating his claim violated his right to procedural due process. The Ninth Circuit Court of Appeals held that because adequate post-deprivation remedies for any deprivation were available and offered, appellant received all the process he was due. A violation of procedural rights requires only a procedural correction, not the reinstatement of a substantive right to which appellant may not be entitled on the merits. Paul K. Raditch, 43 ECAB (1992) [Docket No. 91-1593, issued April 30].