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EEOC Finds @StateDept Liable Under the Rehabilitation Act in US Embassy Kabul Medical Clearance Denial

Posted: 12:21 am ET

 

This is a case where an FSO previously diagnosed with rheumatoid arthritis was granted a Class 2 medical clearance for an assignment at the US Embassy in Kabul, Afghanistan.  While at post, the FSO developed pericarditis and was hospitalized in Kabul in 2013; she was subsequently medevaced to Texas. The FSO was later told by State/MED that she retained her Class 2 Medical Clearance, but it was not Kabul-approved.  In August 2013, the FSO filed an EEO complaint alleging that the State Department discriminated against her on the basis of disability. The State Department’s decision  notes that in denying her clearance, its medical officers failed to conduct a sufficient individualized assessment of the risk posed by Complainant’s medical condition and its impact on her ability to return safely to Kabul.  It held “that there was no evidence that the medical officers and Medical Review Panel took into account the duration of the risk, the nature and severity of the potential harm, and the likelihood that the harm will occur or the imminence of the potential harm, as required by the law.”  It also concluded that MED“improperly denied Complainant a Class 2 medical clearance (Kabul-approved).”  The FSO on appeal asserted that she was not provided with full relief, including reasonable attorney’s fees and costs. In response to that appeal, the State Department noted that its final decision was, get this — “erroneously issued.”

Summary of Case via EEOC:

In September 2011, Complainant was assigned to work as an Administrative Officer at the Agency’s Embassy in Kabul, Afghanistan.  Complainant had been diagnosed with ongoing rheumatoid arthritis since 1999. In conjunction with her assignment to Kabul, Complainant was reviewed by the State Department’s Office of Medical Services (State/MED) for a medical clearance.  Complainant was granted a Class 2 (Kabul-approved) medical clearance 2 and she started her duties in Kabul.  While on leave from Kabul in the United States in June 2012, Complainant saw a doctor and was prescribed a new medication for her arthritis called Leflunomide. At the time, Complainant did not report that she was taking this new medication to Agency medical officials.

In April 2013, Complainant developed pericarditis which led to her hospitalization in Kabul.  At that time, her physicians at the hospital advised her to stop taking Leflunomide and she did so.  Upon her release from the hospital, Embassy medical officials made the decision to send Complainant back to the United States for an evaluation by her own physicians. On May 7, 2013, Complainant departed Kabul for El Paso, Texas.

Upon her return to El Paso, Complainant was examined by her own physician (“Complainant’s Physician”) for clearance to return to Kabul.  She provided documentation to the Agency’s Office of Medical Services indicating that her physician had no concerns with her return to Kabul. On May 31, 2013, Complainant was initially informed by the Agency’s physician (“Agency Physician”) that her medical clearance for Kabul would be renewed.

However, on June 3, 2013, the Agency Physician informed her that she retained her Class 2 Medical Clearance, but was not Kabul-approved.  Complainant was told that the reason for the denial of her clearance to return to Kabul was her use of Leflunomide, a drug banned by the Department of Defense for use by personnel assigned to Afghanistan.3  As Complainant had stopped using the medication since her April 2013 hospitalization, she appealed the denial of her medical clearance for Kabul.  Her appeal was denied by the Agency’s Medical Review Panel on the grounds that her cessation of Leflunomide was too recent. The Panel indicated that Complainant needed to show a period of at least 12 month of “clinical stability” before she could return to Kabul.  The Panel defined clinical stability as “the absence of systemic clinical manifestations of pericarditis and rheumatogic problems.”  There was some speculation that, because Leflunomide reduces resistance to infection, Complainant’s pericarditis may have resulted from its use.  Complainant then requested an Administrative Waiver to allow her to return to her position in Kabul.  That waiver was also denied on June 19, 2013.  Since May 2013, Complainant has been working from the Agency’s El Paso, Texas, Intelligence Center.

On August 22, 2013, Complainant filed an EEO complaint alleging that the Agency discriminated against her on the basis of disability (rheumatoid arthritis) when her “Return to Post Authorization” was not reinstated and she was prevented from returning to work at the U.S. Embassy in Kabul.

At the conclusion of the investigation, Complainant requested a hearing before an EEOC Administrative Judge (AJ).  However, on March 10, 2014, the Agency issued a final decision pursuant to 29 C.F.R. § 1614.110(b). In its decision, the Agency conceded the Complainant was an individual with a disability as defined by the Rehabilitation Act.  The Agency further determined that Complainant was an otherwise qualified individual with a disability, as she had been performing in the position in question in Kabul for the preceding two years, and had the requisite knowledge, experience, skill, and education to perform the position.

The Agency’s decision then noted that Complainant was denied a Class 2 Medical Clearance (Kabul-approved) because of the perceived risk of harm she posed to herself due to her recent use of the drug Leflunomide. As a result of this determination, Complainant was prevented from returning to her previously-approved assignment in Kabul.  The Agency’s decision went on to conclude that, in denying her clearance, its medical officers failed to conduct a sufficient individualized assessment of the risk posed by Complainant’s medical condition and its impact on her ability to return safely to Kabul.  Specifically, Agency held that there was no evidence that the medical officers and Medical Review Panel took into account the duration of the risk, the nature and severity of the potential harm, and the likelihood that the harm will occur or the imminence of the potential harm, as required by the law.  The Agency decision noted that medical opinions that supported Complainant ability to safely return to Kabul were improperly given little weight during the medical clearance determination.  Accordingly, the Agency’s final decision concluded that it improperly denied Complainant a Class 2 medical clearance (Kabul-approved).

Based on its finding that Agency medical staff had failed to provide Complainant with an individualized assessment, the Agency ordered the Office of Medical Services to go forward and actually conduct the required individualized assessment of Complainant’s medical condition and her ability to return to the Administrative Officer position at the Agency’s Embassy in Kabul without posing a significant risk of substantial harm to herself or others.

This appeal followed.  On appeal, Complainant did not challenge the findings by the Agency, but asserted that she was not provided with full relief, including reasonable attorney’s fees and costs.

In response to the appeal, the Agency noted that its final decision was erroneously issued in light of Complainant’s previous request for a hearing.  As such, the Agency argued that the final decision should be voided.  In response, Complainant argued that the final decision should not be considered void and the matter should not be remanded for a hearing.

EEOC ANALYSIS AND FINDINGS: Violation of Rehabilitation Act

As an initial matter, we find that Complainant’s statement on appeal constitutes a withdrawal of her earlier hearing request.  As such, we deny the Agency’s request to void its final decision.

In that decision, the Agency found that its medical staff failed to conduct a proper individualized assessment as required by the Rehabilitation Act when Complainant was prevented from returning to work at the U.S. Embassy in Kabul.  Complainant does not challenge the Agency’s findings in its final decision.  As such, we affirm the Agency’s specific findings.  However, the Agency did not expressly state that its actions constituted discrimination in violation of the Rehabilitation Act.

As evidenced by the Agency’s final decision, there is no dispute that Complainant is an individual with a disability who was otherwise qualified for the position in she had previously held in Kabul. In other words, she met the skill, experience, education and other job requirements to perform the duties of the position in Kabul, apart from the Agency’s decision to retract her medical clearance for work in Kabul.

The Agency noted in its findings in its own decision that Complainant’s Physician provided medical documentation that Complainant was no longer taking Leflunomide, the drug of concern, had not had flare-ups of her medical condition, and had embarked on a healthier lifestyle. However, the Agency conceded that Complainant’s supporting medical documentation was improperly “given little if any weight.”  The Agency also admitted in it decision that the denial of the Class 2 Medical Clearance was due to the “perceived risk of harm she posed to herself or others” and not on an actual risk.  Based on the record including the medical evidence provided by Complainant’s Physician, we find that Complainant has shown that she was qualified for the position in question in Kabul and was only prevented from doing so based on the Agency’s perception that she posed a safety risk.  This moves the burden of proof squarely to the Agency to prove that there is a significant risk of substantial harm. Massingill v. Dep’t. of Veterans Affairs, EEOC Appeal No. 01964890 (July 14, 2000).  See also, Branham v. Snow, 392 F.3d 896 (7th Cir. 2005) (“employer’s burden to show that an employee posed a direct threat to workplace safety that could not be eliminated by reasonable accommodation”); Hutton v. Elf Atochem N. America, 273 F.3d 884, 893 (9th Cir. 2001) (direct threat affirmative defense).

Here, as already noted, the Agency’s own decision concluded that Complainant was denied a Class 2 Medical Clearance because of perceived risk of harm she posed to herself or others.  Our regulations permit the Agency to deny job assignments on the basis of disability where such an assignment would pose a direct threat. See 29 C.F.R. § 1630.2(r). A “direct threat” is defined as a “significant risk of substantial harm” that cannot be eliminated or reduced by reasonable accommodation. Interpretive Guidance of Title 1 of the Americans with Disabilities Act, Appendix to 29 C.F.R. Part 1630, § 1630.2(r); Echazabal v. Chevron U.S.A., Inc. 536 U.S. 73 (2002); 29 C.F.R. § 1630.2(r).

The issue in finding direct threat is “not…whether a risk exists, but whether it is significant.” Bragdon v. Abbott, 524 U.S. at 649. A direct threat must be based on an individualized assessment of the individual that takes into account: (1) the duration of the risk, (2) the nature and severity of the potential harm, (3) the likelihood that the potential harm will occur, and (4) the imminence of the potential harm. Interpretive Guidance on Title I of the Americans With Disabilities Act, Appendix to 29 C.F.R. § 1630.2(r). The individual assessment must be based on a reasonable medical judgment that relies on the most current medical knowledge and/or on the best available objective evidence. Id. A determination of significant risk cannot be based merely on an employer’s subjective evaluation, or, except in cases of a most apparent nature, merely on medical reports.

The Agency held in its final decision that it “failed to conduct a sufficiently individualized assessment of the risk posed by Complainant’s medical condition, and its impact on her ability to return safely to Kabul.  There is no evidence that the following factors were taken into account: 1) the duration of the risk; 2) the nature and severity of the potential harm; 3) the likelihood that the potential harm will occur; and 4) the imminence of the potential harm.”  Based on the record and the Agency’s own findings in its decision, we determine that the Agency has not met its burden of establishing that Complainant’s return to Kabul would have posed a direct threat.  Accordingly, the Agency’s defense to denying Complainant the Class 2 Medical Clearance was not established, and the Agency is liable under the Rehabilitation Act.

As a result of this violation of the Rehabilitation Act, Complainant is entitled to make-whole relief, which the Agency did not provide her in its final decision.  First, the Agency should offer Complainant the assignment in Kabul if she chooses to return. See Nathan v. Department of Justice, EEOC Appeal No. 0720070014 (July 19, 2013) (awarding the complainant the position for which he applied following a determination that the agency violated the Rehabilitation Act when it medically disqualified him without an individualized assessment). In addition, Complainant correctly argues that she should be awarded reasonable attorney’s fees and legal costs for processing her EEO complaint, as well as the opportunity to support her claim for compensatory damages. Also, we find that the Agency provide training to relevant management highlighting the Agency’s obligations with respect to the Rehabilitation Act.

The EEOC concludes the case with a modification of the State Department’s  final decision and remanded the matter to the agency with the following order signed by Carlton M. Hadden on October 25, 2016.  The EEOC case file notes that compliance with the Commission’s corrective action is mandatory.

The Agency is ordered to take the following remedial action:

1. Within 60 calendar days from the date this decision is issued, the Agency shall offer Complainant an assignment in Kabul substantially similar to the one she lost. If Complainant rejects the offer of the assignment, the Agency shall use the date of rejection for purposes of back pay calculations as noted below.  If Complainant accepts the assignment, the Agency shall use the date Complainant assumes the assignment for purposes of back pay.

2. The issue of compensatory damages is REMANDED to the Agency. On remand, the Agency shall conduct a supplemental investigation on compensatory damages, including providing the Complainant an opportunity to submit evidence of pecuniary and non-pecuniary damages. For guidance on what evidence is necessary to prove pecuniary and non-pecuniary damages, the parties are directed to EEOC Enforcement Guidance: Compensatory and Punitive Damages Available Under § 102 of the Civil Rights Act of 1991 (July 14, 1992) (available at eeoc.gov.) The Agency shall complete the investigation and issue a final decision appealable to the EEOC determining the appropriate amount of damages within 150 calendar days after this decision is issued.

3. The Agency shall determine if Complainant is entitled to an award of back pay as a result of the denial of her return to her assignment in Kabul.  The Agency shall determine the appropriate amount of back pay, with interest, and other benefits due Complainant, pursuant to 29 C.F.R. § 1614.501, no later than sixty (60) calendar days after the date this decision is issued.  The Complainant shall cooperate in the Agency’s efforts to compute the amount of back pay and benefits due, and shall provide all relevant information requested by the Agency.  We note that the Agency should consider if there would have been a difference in locality pay and benefits to Complainant including but not limited to promotions or other incentives for an assignment in Kabul, Afghanistan.

If there is a dispute regarding the exact amount of back pay and/or benefits, the Agency shall issue a check to the Complainant for the undisputed amount within sixty (60) calendar days of the date the Agency determines the amount it believes to be due.  The Complainant may petition for enforcement or clarification of the amount in dispute.  The petition for clarification or enforcement must be filed with the Compliance Officer, at the address referenced in the statement entitled “Implementation of the Commission’s Decision.”

4. Within sixty (60) days from the date this decision is issued, the Agency is ordered to provide at least eight (8) hours of training to the responsible officials covering their responsibilities under the Rehabilitation Act. The training shall cover the Agency’s obligations regarding the provision of reasonable accommodation, as well as its obligation to conduct an individualized assessment pursuant to the direct threat defense.

5. If Complainant has been represented by an attorney (as defined by 29 C.F.R. § 1614.501(e)(1)(iii)), she is entitled to an award of reasonable attorney’s fees and costs incurred in the processing of the complaint, including this appeal.  29 C.F.R. § 1614.501(e).  The award of attorney’s fees shall be paid by the Agency.  The attorney shall submit a verified statement of fees to the Agency — not to the Equal Employment Opportunity Commission, Office of Federal Operations — within sixty (60) calendar days of this decision is issued.  The Agency shall then process the claim for attorney’s fees in accordance with 29 C.F.R. § 1614.501.

The State Department was also ordered to post this order within 30 days of the date of the decision for a duration of 60 consecutive days.

The Agency is ordered to post at its Washington D.C. facility copies of the attached notice.  Copies of the notice, after being signed by the Agency’s duly authorized representative, shall be posted both in hard copy and electronic format by the Agency within 30 calendar days of the date this decision is issued, and shall remain posted for 60 consecutive days, in conspicuous places, including all places where notices to employees are customarily posted.  The Agency shall take reasonable steps to ensure that said notices are not altered, defaced, or covered by any other material.  The original signed notice is to be submitted to the Compliance Officer at the address cited in the paragraph entitled “Implementation of the Commission’s Decision,” within 10 calendar days of the expiration of the posting period.

 

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Peace Corps OIG: 53% of Rapes Perpetrated on Volunteers Not Reported, See Why

Posted: 2:18 am ET

 

The Inspector General for the Peace Corps released its final evaluation report of the Peace Corps’ Sexual Assault Risk Reduction and Response Program.  The report notes that there were 513 sexual assaults entered into the Peace Corps’ Consolidated Incident Reporting System between September 3, 2013 and September 29, 2015.

In 2014, Volunteers reported 251 sexual assaults and there were 241 sexual assaults in 2015. The assaults in 2015 included 52 rapes, 35 aggravated sexual assaults, and 154 non-aggravated sexual assaults.

The main findings are:

  • The Peace Corps largely complied with the requirements in the Kate Puzey Act.
  • Compared to our SARRR evaluation in 2013, the Peace Corps markedly improved how it supported Volunteers who had reported a sexual assault. However we found individual cases where the Peace Corps did not meet its standard to respond effectively and compassionately to victims of sexual assault, including a few instances of victim blaming and improperly sharing confidential details with staff.
  • Some applicants were either not aware of the crime and risks previous Volunteers had faced in their country of service or they did not understand the information that was provided to them.
  • The SARRR program did not fully utilize some staff with SARRR expertise. The SARRR program would also benefit from a risk reduction strategy that tailors training to the country of service, addresses the risks of sexual harassment, and identifies factors that make sites unsafe.
  • Finally, the SARRR training’s design and delivery may have detracted from Volunteer comprehension and learning.

The Kate Puzey Peace Corps Volunteer Protection Act of 2011 (the Kate Puzey Act) required the Peace Corps to undertake a number of reforms, including providing sexual assault risk reduction and response (SARRR) training for Volunteers, developing a comprehensive SARRR policy, and training overseas staff on that policy. The Act directed the Peace Corps OIG to evaluate the effectiveness and implementation of the training and policy, and to review a statistically significant number of sexual assault cases.

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Stats on Rapes and Sexual Assaults

Peace Corps Volunteers and trainees reported 251 sexual assaults in 2014 and 241 sexual assaults in 2015. The assaults in 2015 included 52 rapes, 35 aggravated sexual assaults, and 154 non-aggravated sexual assaults.  Female Volunteers reported the majority of these sexual assaults (228 cases). Male Volunteers reported 13 sexual assaults including 1 rape, 6 aggravated sexual assaults, and 6 non-aggravated sexual assaults.

Starting in 2014, the Peace Corps began surveying Volunteers at the close of their service regarding crimes they had experienced and not reported to the agency. Survey results indicated that the proportion of Peace Corps victims who did not report one or more rapes or aggravated sexual assaults was similar to the proportion of Peace Corps victims who did not report other crimes: roughly 50 percent of crimes against Volunteers were not reported. This Peace Corps analysis indicated that 53 percent of rapes and 49 percent of aggravated sexual assaults were not reported. It also showed that 85 percent of surveyed respondents who experienced at least one non-aggravated sexual assault had not reported one or more of them to the Peace Corps.

Available Help and Agency Reporting

The evaluation found that the agency had provided contact information for: the Peace Corps Inspector General, a 24-hour sexual assault hotline for Volunteers, the Peace Corps Office of Victim Advocacy, and the Sexual Assault Response Liaison in the Volunteer’s country of service as required by the Act.
[…]
The Kate Puzey Act required the Peace Corps to create a system “for restricted and unrestricted reporting of sexual assault.” Volunteers may file either a “restricted” or a “standard” report, depending on which response services they would like the agency to provide. According to MS 243 Procedures, the restricted reporting option “allows Volunteers to request certain specific services without dissemination of personally identifying information about the Volunteer or the details of the sexual assault beyond those who are directly providing the services, and without automatically triggering an official investigative process.” The agency treats all reports as restricted until the Volunteer decides to choose a standard report, and a Volunteer may elect to convert his or her restricted report to standard at any time.

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Some Volunteers had not learned important information in the sexual assault risk reduction and response sessions, including the difference between restricted and standard reporting, the services available to a victim of a sexual assault, how to report a sexual assault incident, and the identity and role of Sexual Assault Response Liaisons at post. The training was insufficiently tailored to the country of service (as required by the Act), was not responsive to the needs of diverse Volunteers, and did not address the problem of sexual harassment. In addition, some staff delivered the training inconsistently due to poor training skills. Furthermore, the Peace Corps’ approach to assessing the Volunteer training was incomplete and did not provide a useful measure of training effectiveness.
[…]
[T]he agency often accommodated Volunteers’ requests to change sites for safety and security reasons, in some cases Volunteers were separated from the Peace Corps rather than relocated to another site. Volunteers we interviewed felt disenfranchised from the discussions regarding their safety and continued service.[…]We found that staff and Volunteers had a mistaken belief that they were limited to six or fewer counseling sessions after a sexual assault. As a result, some Peace Corps Medical Officers provided incorrect information about the availability of counseling. We concluded that some Volunteer sexual assault survivors could have been deterred from reporting their need for counseling.

Non-Reporting Analysis

The analysis summarized the primary reasons Volunteers had not reported their sexual assaults, which included: embarrassment, self-blame, not perceiving the sexual assault as a crime or serious event, and believing that there was nothing the Peace Corps could do about the assault. For non-aggravated sexual assaults—which were both the most frequently reported type of assault, as well as the most under reported—surveyed Volunteers had not reported them for three main reasons: they did not think the incidents were serious or threatening; they perceived the incident as commonplace in the environment where they served; and they did not believe there was anything the Peace Corps could do to address it.

Other reasons that surveyed Volunteers said they had not reported their sexual assaults included concerns about how Peace Corps staff might respond, such as blaming the victim for their assault, failing to respect the victim’s privacy and confidentiality, or simply not responding to the victim in a timely and supportive manner. Volunteers also indicated in their survey responses that they had not reported a sexual assault because they anticipated adverse consequences, such as being required to change their site, sent home, or punished for having violated a Peace Corps policy. These concerns were significantly more pronounced for rape victims and aggravated sexual assault victims than for non-aggravated sexual assault victims.

Among surveyed Volunteers who had not reported their assaults to the Peace Corps because they were concerned about how staff would respond to them or the potential adverse consequences of reporting, a relatively high percentage had served at a small number of posts. Two of the 54 posts in the survey constituted almost 25 percent of the Volunteers who did not report their assaults because of these concerns. Nine posts represented nearly 50 percent of the Volunteers who had not reported an assault for similar reasons.

 

The PC/OIG review includes interviews with 127 staff, 72 Volunteers, visits to 6 countries, and review of 138 sexual assault cases.  The report also includes 36 recommendations for the Peace Corps.

The report is a crucial reference as the State Department task force works on FAM guidance for sexual assault in the Foreign Service. NSVRC also notes that supporting survivors means assisting them with financial burdens as well as physical & emotional ones. Read here: 

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Related posts:

 

 

From Someone Who Has Unfortunately Been There: Sexual Assault Trauma Triage in the Foreign Service

Posted: 1:51 am ET

 

In response to our post — First Person: I am a ✂️ FSO who was ✂️ raped in ✂️… Continuing on has been ✂️ incredibly difficult…, we received the following from a Foreign Service member who does not want to be identified but sent a note that says “here are some suggestions for sexual assault trauma triage in the FS, from someone who has unfortunately been there.”  

1. Reach out to someone outside of DOS for support, like friends and family back home whose discretion you trust. There is so much shame involved in sexual assault, but you do not have to go through this alone.

2. Find a therapist (PhD preferable). Sexual assault survivors report the most improvement with Cognitive Processing Therapy (CPT) and EMDR (you’ll likely have to do this domestically). If you can’t find a CPT sexual assault specialist, try going to your closest VA hospital’s website and look for one there. Reach out to her and ask for a private practice referral for sexual assault in a military-like service. Since you’re overseas, you may be able to find a private CPT specialist who does Skype/telephone. Be prepared to pay out-of-pocket, and it won’t be cheap. And speaking of costs: CPT for sexual assault may be the most psychologically taxing thing you’ve ever done, but it is worth it. I promise.

3. Consider a medical curtailment to get yourself out of the situation immediately. The only department that I trust at DOS is MED. Fill out a MED update form, and note the questions on what should be the second page (related to PTSD). Check whichever boxes are relevant to you. You can also write down there what happened to you—something as simple as “Sexual assault at Post” will suffice. They will have a psychiatrist reach out to you—and you can request a female psychiatrist. If they don’t immediately contact you, start calling twice a day until you get what you need. Depending on your symptoms, you may qualify for a Limited Class 2, but if you need to be back in the U.S. for intensive counseling (and there is no shame in doing so, your well-being is the priority), they can work with you on getting you a Class 4 so that therapy can happen domestically.

4. FSO Friend who wrote in: I know that curtailment can seem like he wins. But this is emergency triage, and you may need to retreat to a place of safety (far away from him) until you have healed enough to decide your next steps. This is a “put on your oxygen mask before attempting to help others” level-situation. Please don’t be ashamed of curtailment if that is what you need to do for you. You are the priority right now. Please don’t tough it out and expose yourself to further harm–including the psychological trauma of being around him regularly. And please don’t suffer in silence. Out of all of the organizations at DOS that claim that they can help, I believe that MED actually can help you. Please use MED if it’s appropriate for you.

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This is one person’s suggestions based on her experience and perspective and we’re passing this along for consideration. Since the sender did not provide a return email, we have not been able to ask follow-up questions. We have to respect that this is all that she is able to share at this time. She reached out to this blog out of concern for the FSO who was raped.  We will leave this up to you to consider which of her suggestions may be worth exploring depending on what feels appropriate in your case.

Read more about Cognitive Processing Therapy (CPT) (PDF).

Read here on the Eye Movement Desensitization and Reprocessing (EMDR).

Curtailment is the shortening an employee’s tour of duty from his or her assignment.  It may include the employee’s immediate departure from a bureau or post, or from assignments in the U.S.  3 FAM 2440 says that curtailment is an assignment action, not a disciplinary one. Folks, of course, know that in real life that’s not always true.

Please note that 3 FAM 2444 allows an employee assigned within the United States to request voluntary curtailment of his or her tour of duty for any reason “by submitting the request and an explanatory memorandum to the assignments panel via his or her counseling and assignments officer. The bureau of assignment must state its support for or opposition to the employee’s request.”  What happens if one is a sexual assault victim in a domestic assignment or while on extended TDY or on training and have to go through this to get curtailed from an assignment where the perpetrator is also located? Imagine this happening to an untenured employee. What  does one write in the explanatory memo — I was raped, and I need to curtail my assignment because my attacker is right next door? How many folks will get to see that memo? Something for the new State Department task force to think about.

We should add that another FS member’s medical clearance was downgraded to a Domestic only (Class 5)  after reporting to MED.  12 FAM 210 notes that Class 5 is issued to all who have a medical condition which is incapacitating or for which specialized medical care is best obtained in the United States.  Employees or eligible family members with a Class 5 medical clearance may not be assigned outside the United States.  So right there, that’s really scary stuff for Foreign Service folks.

On November 22, the State Department directed a task force to create a new Foreign Service Manual section for sexual assault (see U/S For Management Directs Task Force to Create New Sexual Assault FAM Guidance).

 

Sexual Assault Related posts:

 

 

First Person: I did everything right. I filed a report the next business day … #FSassault

Posted: 12:55 am  ET

 

I did everything right. I filed a report the next business day with RSO. The accused was removed from post shortly thereafter. 

My victimization didn’t really begin until I sought assistance 6 months later from MED when I arrived at my next post. MED sent me on a MEDEVAC to DC from my post to a facility that didn’t treat trauma and required I take a $60 taxi each way daily from Oakwood Falls Church where most of my colleagues from my unaccompanied post were staying due to long term training. 

MED refused to discharge me for weeks despite requests for relocation and a new treatment plan. I finally found my own providers online when the State Department didn’t provide a list of referrals prior to my discharge. 

Then, the MEDEVAC team advised me of their recommendation for a Class 5 medical clearance (domestic only) without ever speaking to my psychiatrist and without providing a reason. 

I filed appeals of my medical clearance without success all the way to the Director General. 

MED refused to assist with my PTSD claim for worker’s compensation despite the reported incident occurring at the U.S. Embassy in a warzone where we can’t leave the compound. 

My out of pocket medical expenses (therapist/ psychiatrist/medicine) would not be covered once my MEDEVAC ended. My housing was paid for at my post and my children were enrolled in the international school. We didn’t receive our HHE for 6 months after having someone else pack out our goods. 

Without access to the State Department system, it was nearly impossible to secure an onward assignment. I didn’t have contact information for my 360s and no access to my employee profile. I went house shopping in DC with a realtor and was advised there was no suitable housing for a family of my size at an amount I could afford. Washington, DC has bedroom occupancy regulations which made it difficult to accommodate. 

The State Department sent me to the brink of financial ruin. I took a huge pay cut, lost my paid housing, my kids lost their prestigious school, and my spouse lost job opportunities available at post all because I was a victim and sought assistance from MED.

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The account above is an unsolicited email from a Foreign Service employee who did not want us to use her name but wanted to share her story. She said she previously served in Israel, Iraq, Colombia, Venezuela, Georgia, and Afghanistan, all with a Class 1 medical clearance, meaning “worldwide available” for Foreign Service assignments. She told us she was also last promoted in 2015. 

According to her, Diplomatic Security asked if she wanted to go to the medical unit but she declined. Regarding the perpetrator, she said, “I have no verification that he is overseas with his family, but he is listed on the GAL [global address list] and so is his wife.”  She added, “He had also destroyed government property ✂️ and was highly intoxicated in the middle of the night when he was subdued by security. It apparently had no effect on his security clearance or medical clearance as he had the ability to serve overseas at his next post with his family.” 

She said that she chose to stay at her post in the warzone until the end of her tour so she would not lose her onward assignment. She arrived at her onward post in Europe and was  subsequently medically evacuated (MEDEVAC) after she contacted MED.

She told this blog, “I was never hospitalized. I was never a threat to myself or others. It is hard to believe that this is my life. The biggest issue I have is that I was never provided a reason as to why my clearance was denied other than a generic “best care is available in the U.S.” 

The post she was evacuated from is a European post with high level of medical care including English speaking therapists and psychiatrists. Post has a resident regional medical officer (RMO) and a resident regional medical officer/psychiatrist (RMO/P).

The FS employee told us she is on leave without pay and believed that her OWCP claim (Office of Workers’ Compensation Programs) for PTSD was one of the factors in the downgrading of her medical clearance.

She shared with us an OCWP letter in which “Under Accepted Event(s) That Are Factors of Employment” is this:

“– That while assigned to the US embassy in ✂️ from 2014-2015. you were sexually harassed and assaulted by a colleague who was under the influence of alcohol after checking on him at his room.” 

We hope to have a follow-up post on the MED – OCA – OCWP mess.

 

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US Mission Russia Issues Alert on Confirmed Anthrax Cases in Siberia

Posted:1:23 am ET

Last week, the US Embassy in Moscow issued a message alerting U.S. citizens of confirmed anthrax cases in the Yamalo-Nenets Autonomous District:

U.S. citizens residing in or traveling to the Yamalo-Nenets Autonomous District should be aware of reported cases of anthrax affecting humans and animals in the region.

As of August 3, local media sources report 20 confirmed cases of anthrax in humans, resulting in the death of one child.  In total, more than 70 people have been hospitalized.  Between 1,500 and 2,300 animals have died or been killed in conjunction with efforts to combat spread of the disease.  According to the U.S. Centers for Disease Control and Prevention, anthrax is spread by ingesting spores in the air, food, and drink, and is not transmitted by direct human-to-human contact.

Local media outlets report that the governor has declared a quarantine in the district, and the area immediately surrounding the site of the outbreak has been evacuated.  Authorities have also banned the export of animals, furs, antlers, or meat, as well as mushrooms and berries, from the affected area.  At this time, there have been no reports of the disease in neighboring regions.

U.S. citizens are encouraged to avoid travel to affected areas.  U.S. citizens in or transiting through the Yamalo-Nenets Autonomous District should exercise caution, comply with local authorities’ instructions on quarantined areas, and follow local media for the latest information.  Any U.S. citizens who believe they may have been exposed to infected animals or animal products should seek medical attention.

The Yamalo-Nenets Autonomous District is under the consular district of USCG Yekaterinburg.

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Ron Capps: Seriously Not All Right, Five Wars in Ten Years (Excerpt)

Posted: 5:23 pm PT

 

Ron Capps is a U.S. Army veteran and a former Foreign Service officer. He served in the military from 1986 until the early 1990’s. In 1994, he moved to the Army Reserved and joined the Foreign Service. His FS assignments took him to Cameroon, the Central African Republic, Kosovo, and Rwanda. Between 1996-2002, he also deployed as an intelligence officer in Uganda and Zaire for the U.S. Army.  According to his online bio, after the September 11 attacks, he served with XVIII Airborne Corps and the Defense intelligence Agency in Afghanistan as a soldier. Later, he was also deployed to Darfur and Chad as a soldier, and Iraq and Darfur (again) as a Foreign Service officer. “Throughout his career of service, Capps was often working in close proximity to murder, rape, and genocide. He suffered from regular and intense nightmares; he was diagnosed by an Army psychiatrist with PTSD and depression, and prescribed Prozac. In 2006, he nearly committed suicide. He was medically evacuated from service by the Regional Medical Officer of the State Department.”

He retired from government work and pursued a Master of Arts in Writing from Johns Hopkins University in 2009. In 2012, he founded the Veterans Writing Project, a non-profit organization that hosts free writing workshops and seminars for veterans and service members, as well as their adult family members.  VWP is a 501(c)(3) non-profit. You can support the group with a tax-deductible donation or through the Amazon Smile program.

Ron Capps is the author of the book, Seriously Not All Right: Five Wars in Ten Years, which details his own experiences with PTSD.  To mark June as PTSD Awareness Month, we’re sharing an excerpt from Mr. Capps’ book with you (courtesy of Amazon Kindle).

Via Amazon/Kindle

Click on image to read an excerpt or buy the book  Book cover via Amazon Kindle

 

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@StateDept FAQ: Zika Virus Infections – Updated May 27, 2016

Posted: 11:48 pm ET

The State Department issued a Zika Travel Alert: Updated Guidance and New Information for Employees and Family Members (PDF) back in February 2016.  There is additional info here on Zika Medical Evacuations and on the Zika page.  Below is the latest FAQ on zika virus infections updated last week by state.gov. Click the lower righthand arrow to maximize the viewing box.

 

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Foggy Bottom Finally Delivers Guidance for Domestic or Overseas Obstetrical Medevac– What’s New?

Posted: 12:15 am ET

Remember the January 2016 Burn Bag: Expectant Parents Still Waiting For Foggy Bottom to Deliver 2015 Pregnancy Cable? It’s May, and the Pregnancy Guide (PDF) finally came out!

“The U.S. Department of State Bureau of Human Resources’ Pregnancy Guide provides information to assist Foreign Service employees and family members with pregnancy-related questions and issues. The guide includes information on payment for medical expenses, types of leave, obtaining a diplomatic passport and visa for the child, allowances and per diem, and other topics related to an obstetrical medevac.”

The guide above is available directly from state.gov here.

According to the pregnancy guide above, its key source of information is 3 FAH-3 (Maternity, Surrogacy, and Adoption Handbook) and 16 FAM 300 (Medical Travel).  “Information was selected to address the specific issues related to a birth parent serving overseas on overseas or domestic obstetrical medieval.”  Also 16 FAM 315.2 for Delivery Outside the United States.

3 FAH-3  (Maternity, Surrogacy, and Adoption Handbook) reportedly has some superseding text issued by the Department in a Department Notice in June 2015 and this subchapter according to the online regs will be revised to reflect the new guidance  — FAH says refer to Department Notice 2015_06_099 for more information.

16 FAM 300 (Medical Travel) — as far as we could tell from the online regs — has not been updated since July 11, 2012.

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So okay, help us out here —  if there was a Department Notice back in June 2015 for 3 FAM-3, and 16 FAM 315.2  has not been updated since July 2012, where was the holdup with this new guidance? Or for that matter, can anyone tell what is new here?

 

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What about your own embassy staff and employees? Are you urging pregnant women to come home? #Zika

Posted: 2:14 am EDT

 

During the February 5 Daily Press Briefing, State Department spox John Kirby talked about the zika virus. And he was asked this:

QUESTION: What about your own embassy staff and employees? Are you urging pregnant women to come home?

MR KIRBY: At this time, I’m not aware of any warning to pregnant U.S. Government employees overseas in terms of coming home. These are obviously decisions that they have to make. But we are, however, just like we would for American citizens, certainly making sure that we’re providing our posts and our employees all the information that they need and that they have – that is available so that they can make these informed decisions. But I’m – I’m not aware of any order or requirement here at the State Department to order them back home.

But there’s a lot going on. And I can tell you Secretary Kerry is very focused on this. We were – he was talking about this just yesterday morning in a – I’m sorry, just this morning in a staff meeting, in a morning staff meeting. So it’s very much on his mind, and we’re going to continue to work with the interagency to do as much as we can. And obviously, it’s an evolving situation. As information becomes available or needs to change, we’ll change that.

We understand that an ALDAC that was sent out on January 21st, that says ALL pregnant USG employees or family members covered under the Department of State Medical Program are authorized voluntary medical evacuation from posts affected by Zika.

 

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