PTSD in railroad drivers under the Federal employers' liability act.

Railroad and subway drivers can experience psychological trauma when trains strike or nearly miss other trains, motor vehicles, or persons or become instruments of death. Derailments, collisions, and suicides on the tracks can induce feelings of helplessness, horror, guilt, and anxiety in the drivers. Although some drivers experience acute stress disorder (ASD) or post-traumatic stress disorder (PTSD), their conditions are not always acknowledged within the occupational setting. The world literature suggests that PTSD has been an increasing focus of concern, giving rise to detailed intervention protocols. In the United States, the Federal Employers' Liability Act (FELA) governs the adjudication of work-related injuries among railroad employees. In practice, it is difficult for railroad drivers with PTSD to receive benefits if there was no "direct impact" linked to the employer's negligence. In this article, the authors review the literature on PTSD among railroad drivers, discuss relevant case law, and explain how the FELA militates against some employees with PTSD.