The specific source of these incidents remains under investigation and the prognosis for the symptoms and/or diseases that result is unclear, yet OWCP must address these events. Image: AlexLMX/Shutterstock.com
By: FEDweek StaffFollowing is a policy statement from the Labor Department on how the Federal Employees Compensation Act will handle claims related to “anomalous health incidents,” more commonly known as “Havana Syndrome”—a catchall term for conditions whose origin is uncertain but whose frequency has increased in recent years.
Background: The FECA covers injury in the performance of duty; injury includes a disease proximately caused by federal employment. The U.S. Department of Labor’s (DOL) Office of Workers’ Compensation Programs (OWCP) Division of Federal Employees’, Longshore and Harbor Workers’ Compensation (DFELHWC) provides to an employee injured while in the performance of duty, the services, appliances, and supplies prescribed or recommended by a qualified physician, which OWCP considers “likely to cure, give relief, reduce the degree or the period of disability, or aid in lessening the amount of the monthly compensation.” See 5 U.S.C. § 8103. The FECA pays compensation for disability or death of an employee resulting from injury in the performance of duty.
In recent years, and predominantly overseas, some Federal employees have reported a series of sudden sensory events such as sounds, pressure, or heat concurrently or immediately preceding the sudden onset of symptoms such as headaches, pain, nausea, or disequilibrium (unsteadiness or vertigo). Symptoms were first reported by personnel stationed in Cuba and have since been collectively referred to as Havana Syndrome.
The specific source of these incidents remains under investigation and the prognosis for the symptoms and/or diseases that result is unclear. Notwithstanding, it remains the responsibility of OWCP to provide Federal employees with medical care and compensation for disability or death resulting from these AHIs.
FECA Bulletin 22-03 provided instructions for how anomalous health incident (AHI) claims were to be handled when initially received. The Bulletin advised that if there were additional diagnosed conditions at the time of receipt, beyond traumatic brain injuries (e.g., gastrointestinal conditions, cancer, etc.), that these conditions would require a well-rationalized opinion from a physician addressing causal relationship, and that the claims examiner could consider a referral to a District Medical Advisor (DMA) if needed to determine if the AHI was competent to cause the additional diagnoses indicated.
Medical research however is limited concerning which conditions are connected to traumatic brain injuries resulting from anomalous health incidents. For that reason, claims for additional conditions beyond traumatic brain injuries will now require a review by a DMA. This pertains to both new and already accepted claims for AHIs.
Purpose: To provide targeted instructions to claims staff on the development of consequential conditions in AHI claims.
Action: Additional and consequential conditions in AHI claims will be fully developed, to include a review by a DMA.
In both new and already accepted claims, the claims examiner should review the medical evidence submitted and undertake any development that is necessary. The claims examiner should request medical evidence from the treating physician that addresses all of the medical conditions that they have diagnosed in connection with the AHI, including the results of any diagnostic testing.
New claims however should not be delayed in accepting the case for a traumatic brain injury as appropriate in accordance with Bulletin 22-03, and then developing for the additional conditions.
After appropriate development has been undertaken, the claims examiner should refer the case to a DMA for review and to provide an opinion as to whether the AHI was capable of producing the additional or consequential condition(s). The DMA should be presented with the correct factual framework for the medical opinion requested. A Statement of Accepted Facts (SOAF) should be used for conveying this information.
1. If the DMA advises that the condition(s) are related to the AHI, the additional or consequential condition(s) should be accepted.
2. If the DMA advises that the condition(s) are not related, or requests additional information, the claims examiner should provide the attending physician with the DMA report and afford an additional thirty (30) days to provide evidence to support a causal relationship between the claimed condition(s) and the AHI.
5 Steps to Protect Your Federal Job During the Shutdown
Over 30K TSP Accounts Have Crossed the Million Mark in 2025
The Best Ages for Federal Employees to Retire
Best States to Retire for Federal Retirees: 2025
Primer: Early out, buyout, reduction in force (RIF)
See also,
OPM Guidance Addresses Pay Issues arising During, After Shutdown
