Postal Worker Suicide and Death Benefits
In K.P. and U.S. Postal Service, No. 23-0936 (ECAB 05/12/25), the widow of a postal worker claimed death benefits under FECA, alleging her husband’s suicide was caused by intractable pain from his work-related bilateral carpal tunnel syndrome. The worker, age 48, had stopped working after surgery and had a history of high-dose opioid use, later reduced. The week of his death, he was in severe pain and seeking new treatment.
OWCP denied the claim, citing a medical report that identified multiple contributing factors—opioid dependence, alcohol intoxication, family and psychiatric history, and past trauma—rather than a direct, unbroken causal chain from the work injury to the suicide.
ECAB found the record incomplete. While evidence showed chronic pain and opioid dependence were possible suicide risk factors, the physician also noted it was “difficult to conclude” the suicide directly resulted from the work injury. ECAB remanded the case, instructing OWCP to obtain a supplemental medical opinion addressing whether the work-related condition or opioid treatment/withdrawal contributed to depression or anxiety that led to suicide.
Rule of Law: FECA recognizes suicide as compensable if a work injury and its consequences cause a mental or physical state that produces a compulsion to commit suicide, disabling the employee from exercising sound judgment, with an unbroken causal chain from injury to death. Both factual and rationalized medical evidence are required.
Takeaway: While claimants bear the burden of proof, OWCP has a duty to assist in developing the evidence to ensure justice in these non-adversarial proceedings.
Commentary
This case highlights several recurring themes in FECA death benefit claims involving suicide:
1. The “Unbroken Chain” Standard is Stringent – OWCP often denies claims where alternative contributing factors exist, especially in cases involving substance use, mental health history, or non-work stressors. The presence of multiple possible causes makes it
harder to prove that the work injury was the primary driver of the suicide.
2. Chronic Pain and Opioid Use Complicate Causation – The link between chronic pain from an accepted injury, long-term opioid therapy, and mental health deterioration is well-recognized in medical literature. Yet, in FECA claims, it must be tied together by a clear, rationalized medical opinion. Withdrawal or medication changes can exacerbate depression or anxiety, potentially tipping the scale toward suicide—but the physician must explicitly connect these dots.
3. ECAB’s Emphasis on OWCP’s Development Duty – Although FECA places the burden on the claimant, ECAB consistently reminds OWCP of its shared responsibility to fully develop the medical record, especially in cases with serious consequences like death benefits. The remand here reflects that principle.
4. Practical Implication for Practitioners – Attorneys and claimants should ensure that medical evidence explicitly addresses:
– How the accepted injury and its pain impacted mental health.
– Whether medication use, withdrawal, or treatment changes contributed to impaired judgment.
– How alternative causes weigh against, or interact with, the work injury in leading to suicide.
Without such direct causal reasoning, OWCP will likely continue to deny, and ECAB may remand rather than reverse.
