Printing - FECA-PT2 - National Association of Letter Carriers

the body originally injured is termed an intervening injury if compensation is claimed subsequent to
the second injury. In this case the CE must determine whether the disability is due to the second
injury alone, or whether the effects of the first injury still contribute to the disability. Unless the
second injury breaks the chain of causation between the original injury and the disability claimed,
the disability will be considered related to the original incident.
When an intervening injury has occurred and a subsequent period of disability has been claimed,
the CE should obtain the following information from the claimant to resolve the issue of causal
relationship:
(1) A statement giving full details of the second incident and copies of all medical reports
pertaining to treatment of this injury; and
(2) A medical report containing a reasoned opinion concerning the relationship between
the disability currently claimed and both the original injury and the intervening injury.
2-0805-7 Psychological Factors Affecting Medical Condition
7. Psychological Factors Affecting Medical Condition. Unlike psychological conditions which may result
from employment factors or from the effects of a specific injury, psychological factors affecting the
medical condition express themselves physically in conjunction with an injury or illness. The symptoms
have no physical basis, nor are they produced voluntarily. If pain is the only symptom, the term used to
designate the condition is "psychogenic pain disorder." If physical functioning is lost or altered, the term
"conversion disorder" applies.
In either case, the symptom or pain is quite real to the individual involved although there is no
demonstrable physical disorder. (Malingering, on the other hand, is the voluntary presentation of false or
exaggerated symptoms in pursuit of an obvious goal, such as avoiding work or obtaining financial
compensation.)
Indications that psychological factors may be present include apparent lack of recovery within the usual
medical time frame and exaggerated symptoms in comparison with the objective findings. To be
compensable, such factors must be related to the employment injury rather than to some other aspect of
the claimant's life.
The issue of psychological factors should be developed only if the attending physician indicates that such a
component is present and that it is related to the employment injury. Where such a prima facie case is
established, the CE should refer the claimant to a Board-certified psychiatrist for evaluation and opinion
concerning causal relationship.
2-0805-8 High-Risk Employment
8. High-Risk Employment. Certain kinds of employment routinely present situations which may lead
to infection by contact with animals, human blood, bodily secretions, and other substances. Conditions
such as HIV infection and hepatitis B more commonly represent a work hazard in health care facilities,
correctional institutions, and drug treatment centers, among others, than in Federal workplaces as a
whole. Likewise, claims for brucellosis, anthrax, and similar diseases will most often arise among
veterinarians and others who regularly work with livestock.
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