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

Posted: 12:55 am  ET
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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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State Department on PTSD Workers’ Comp Claims: How Well Is This Working?

— Domani Spero
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We received a note recently from a reader who is deeply concerned about his/her State Department friend diagnosed with PTSD from an assignment in a war-torncountry. The condition is allegedly aggravated by the lack of understanding on the part of the officer’s superiors who “pressured” the employee to return to another “very stressful/high pressure work duties.”

“My friend was not shot, raped, tortured or maimed by explosive devices. No single, well-defined, event happened. That said, s/he/it now lives a life far more constrained by physiological barriers due to time spent in dangerous climes.”

That got us looking at what resources are available to State Department employees suffering from PTSD.  We found the following information on state.gov.

Employees working in high threat environments such as Afghanistan, Iraq, Pakistan, Libya and Yemen may develop symptoms of Post Traumatic Stress Disorder (PTSD) as a result of their performance of duty.

PTSD may be basis for a workers’ compensation claim under the Federal Employees’ Compensation Act (FECA). The FECA is administered by the U.S. Department of Labor, Office of Workers’ Compensation Programs (OWCP). If an OWCP claim is accepted, benefits may include payment of medical expenses and disability compensation for wage loss.

When an employee develops any mental health symptoms, including symptoms of PTSD, he/she is encouraged to make a confidential appointment with a counselor in the Office of Medical Services (MED)’s Employee Consultation Services (ECS) office. If the initial evaluation indicates symptoms suggestive of PTSD, ECS will refer the employee to MED’s Deployment Stress Management Program (DSMP) for further evaluation. A psychiatrist designated by DSMP will document the initial symptoms for the OWCP claim form (CA-2) and CA-20 (Attending Physician’s Statement). If the employee requires assistance in completing the OWCP claims package, HR’s Office of Casualty Assistance (OCA) will help the employee gather the required documentation, complete the necessary paperwork, and submit the claims package.

OWCP has advised the Department that PTSD claims will be handled expeditiously. PTSD claims from Department employees have been successfully adjudicated by OWCP in the past. The Office of Employee Relations (HR/ER) will remain the point of contact with OWCP. HR/ER will provide consultation, advice and guidance on the OWCP process and on issues regarding the employee’s use of leave (annual, sick, and use of FMLA), disability accommodation options, and benefits. HR/ER will manage the employee’s claim after OWCP receives it and continue in its liaison role with OWCP to meet the employee’s needs.

Some PTSD patients may require treatment by a specialist outside of the Department of State. For such cases, MED/DSMP may refer the employee to an outside provider. MED will cover the initial cost of treatment until OWCP accepts the claim, submitted by the employee through HR, and OWCP will reimburse MED once the claim is accepted. If OWCP does not accept the case as work-related, the employee should submit the medical bills to his/her insurance carrier to reimburse MED for the initial treatment costs. Subsequent treatment costs will be the responsibility of the employee’s health insurance provider.

Throughout this process, the Office of Casualty Assistance (OCA) will assist the employee and his/her family as they adjust to the employee’s medical condition and explore various options affecting their career with the Department. OCA’s role is to assist the employee with paperwork and coordinate with other Department offices as appropriate.

Workers’ Comp Resources: (* = Intranet Website)

DoL Workers’ Compensation Program Website
OWCP Forms: CA-2 CA-2a CA-20 (pdf)
DoL’s Publication CA-801

DoS Office of Casualty Assistance (OCA)* Tel: 202-736-4302
DoS Office of Employee Relations (HR/ER)*

Email: HRWorkersCompensation@state.gov

 

Frankly, the Office of Casualty Assistance (OCA) has not been terribly impressive. So we’d like to know how responsive is OCA at State when it comes to offering assistance to employees with PTSD who had to deal with worker’s comp?

And how well is DOL’s Workers’ Comp program working if you have PTSD?

We must add that while PTSD is typically associated with assignments to high threat environments such as Afghanistan, Iraq, Pakistan, Libya and Yemen, Foreign Service employees and family members are assigned to over 280 posts around the world.  Some of these assignment are to war-torn countries in Africa that are not priority staffing posts like AIP or are in critical crime posts such as some cities in Mexico, the DRC, and several posts in the Western Hemisphere (looking at Honduras, Guate and El Salvador). Studies show that crime events are also associated with high rates of PTSD.   The focus on PTSD and employees in high threat environments in the state.gov information above excludes a long list of critical crime posts and appears to discount, by omission, crime-related PTSD and post-traumatic experience in posts not located in Afghanistan, Iraq, Pakistan, Libya and Yemen.

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State Dept’s Bureau of Neglected Disease – Dengue+Encephalitis, What Help Is There?

— By Domani Spero

She joined the Foreign Service over 20 years ago.  Among her overseas postings were New Delhi, Damascus, Alexandria, Northern Iraq, and Beirut.  In 2009, she opened the new Consulate’s PD shop in Hyderabad.  In 2010, she contracted dengue fever. And encephalitis. She was medevaced to Singapore and spent 10 days at a hospital there.  That was not her only hospital confinement.

In the November 2013 issue of Foreign Service Journal, FSO Juliet Wurr writes:

“Over the next year, first in Hyderabad and then in Washington, D.C., I discovered and then struggled to cope with the repercussions of my illness. My doctor concluded that my now-unreliable memory, constant drowsiness and cognitive impairment were all the result of my encephalitis. I knew that my Foreign Service career had come to an end.”

The CDS describes Dengue (pronounced den’ gee) as a disease caused by any one of four closely related dengue viruses (DENV 1, DENV 2, DENV 3, or DENV 4). The viruses are transmitted to humans by the bite of an infected mosquito. The CDS says that with more than one-third of the world’s population living in areas at risk for transmission, dengue infection is a leading cause of illness and death in the tropics and subtropics. There are reportedly as many as 100 million people infected yearly.   In September this year, the NYT reported about India’s dengue problem.  In October, the Raw Story called it New Delhi’s “mysterious dengue fever epidemic.

Click on image to see an interactive Dengue map of the word.

Click on image to see an interactive Dengue map of the word.

Dengue is an endemic illness in India, the second-most populous country in the world.  Anecdotal reports suggest that the U.S. Embassy in Delhi has about half a dozen dengue cases among mission members this year alone. We’ve requested information on current mission-wide dengue cases and medevaced cases but have not heard anything back.

A separate report in the Indian Critical Care Medicine notes that “Encephalopathy is a very common neurological complication of dengue fever. Dengue encephalopathy is usually secondary to multisystem derangement like shock, hepatitis, coagulopathy, and concurrent bacterial infection.”  Encephalitis is the irritation and swelling of the brain that can be mild and short and results in full recovery. Or it can be severe with permanent impairment or death as a possibility.  For more on encephalitis, see the National Institute of Health.

In an email to this blog, Ms. Wurr writes:

“I think there is a huge gap in what State can do statutorily and what morally they should do.  If employees and the public realized this I think they would be outraged.  I want to do all I can to publicize because there are simple changes they can do that don’t depend on legislation.  I am retiring six years earlier than expected.  State refuses to advocate for me with Department of Labor Workers Comp.  I am receiving no compensation for my $500+ medical bills each month or for wages lost.”

Ms. Wurr said that she had been to the Office of Medical Services and the Bureau of Human Resources, who “were kind and welcoming, but eventually they admitted they had nothing to offer me.” She had also been to the Office of Casualty Assistance twice, and told this blog, “They said there was nothing they could do.”

She had filed a claim at the Labor Department’s Office of Workers’ Compensation Programs last year. It was denied. She had refiled that claim, it was denied for the second time. The reason for the denials, “I could not convince Labor that my illness was caused by being in India as an employee of the Department of State.”

She’s up for a third filing, and has now hired a lawyer.

If this story sounds familiar, it’s because it happened before.

Remember Frank Pressley who was wounded in the East Africa bombing and had filed for permanent disability? The  Office of Workers’ Compensation Programs and the State Department’s Office of Casualty Assistance (OCA) both made the news:

Compensation claims examiners questioned the precise percentage of Pressley’s handicap. Two non-government doctors administered tests and said the arm was 78 percent disabled, permanently. The Office of Workers’ Compensation Programs said it was only 40 percent disabled.

Hoping to minimize runarounds, he contacted Kendall B. Montgomery, director of the State Department’s Office of Casualty Assistance, which was established in 1999 in response to the embassy bombings.

“I get no assistance, no options, no real help,” he e-mailed last summer. “I’m afraid that nothing is going to happen unless I get a lawyer. That would be very sad for me. I trust the system, my country.”

“Frank, I understand — and share — your frustration,” Montgomery told him in a December e-mail. The federal workers’ compensation program “is just not meeting its obligations to you and many others. The system is broken, but there is no will to fix it.”

After The Washington Post inquired about the status of Pressley’s disability compensation, government officials including the State Department’s Office of Casualty Assistance suddenly got their Minute Maid:

The State Department’s Kendall Montgomery vowed she would push for “speedy approval” of medical treatments for injured employees mired in the federal compensation system.

“We’re putting a very high priority on it,” she told The Post while a public affairs official monitored her words. “We’re once again trying to start a new round of discussion between ourselves and the Department of Labor. . . . We do hope they’re fruitful discussions.” 

Soon after, the Department of Labor stopped disputing Mr. Pressley’s claim to a 78 percent disability in his left arm and paid up.

But whatever “fruitful discussions” the State Department conducted with the Department of Labor back in 2002, the result is clear.  We sent email inquiries to the Office of Casualty Assistance (OCA) and the Family Liaison Office (FLO) asking what type of assistance their offices provide to cases like Ms. Wurr’s in ensuring that sick/injured employees mired in the federal compensation system are not stuck there. We also wanted to know more information about the State Department and specifically OCA’s role in advocating for cases before DOL’s Office of Workers’ Compensation Programs.

Today, we received a one-sentence response to our email and a non-response to our questions from Kirk A. Leach, the director of the State Department’s Office of Casualty Assistance.

“The Department is fully supportive of Ms. Wurr’s case and is actively engaged in advocating her position with the Department of Labor’s Office of Worker’s Compensation.”

That’s the same office, who according to Ms. Wurr, gave this response: “They said there was nothing they could do.” After learning of  OCA’s response to our inquiry, Ms. Wurr was surprised.  If they are working on her behalf, she said, “they kept it secret from me.” LOL!

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