Entitlement to Reimbursement for Alcoholism Treatment

B-198804: Dec 31, 1980

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Shirley Jones
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The Department of Housing and Urban Development asked whether it could reimburse an employee for rehabilitation and treatment expenses incurred after she was erroneously assured by Department officials that her Federal Employees Health Benefits Plan would cover the expenses. The employee had been experiencing difficulty in the performance of her duties due to alcoholism. The Department finally recommended that the employee check herself into a private hospital, and officials of the Department advised her that her group health insurance carrier would cover the cost of the treatment. After checking into the hospital, the employee was notified that her insurance would not cover the bill. The employee believed that the Department should be held responsible for the cost of the treatment since its personnel had assured her that the costs would be covered by her insurance. She contended that the Department was responsible for the acts of its agents and was liable for the expenses incurred by the employee in reliance on their erroneous advice. However, the rule is well established that the United States can be neither bound nor estopped by the unauthorized acts of its agents. In addition, the Federal Personnel Manual Supplement states that there is no provision in the applicable laws for payment of Federal employee rehabilitation costs; the employee is responsible for the costs of treating his or her drinking or drug problem as with any other health condition. It further states that the employee may receive some financial help, as with other illnesses, from his or her Federal Employees Health Benefits Plan. In this case, the record clearly established that the Government officals involved represented only that the employee's insurance would cover the expenses of rehabilitation. There was no evidence that the employee was advised, or that the Government officials stated, that the Federal Government would cover the costs of the employee's treatment. Therefore, GAO was aware of no authority permitting the Government to cover the cost of the employee's treatment and rehabilitation expenses, and the Department was not authorized to reimburse the employee for the claimed expenses.