Applying FELA

The Court’s precedent applying FELA provides the answer. To qualify as compensable pain and suffering, a person’s emotional distress must be the direct consequence of an injury or condition. See Gottshall, 512 U. S., at 544 (“[T]hese terms traditionally have been used to describe sensations stemming directly from a physical injury or condition” (internal quotation marks omitted)). Damages for emotional harms that are less direct may be recovered only pursuant to a stand-alone tort action for negligent infliction of emotional distress. Ibid. (defining negligently inflicted emotional distress as “mental or emotional harm (such as fright or anxiety) that is caused by the negligence of another and that is not directly brought about by a physical injury”).

The common law accords with this rule. The weight of authority defines pain and suffering as emotional distress that is the direct consequence of an injury. See Minneman, Future Disease or Condition, or Anxiety Relating Thereto, as Element of Recovery, 50 A. L. R. 4th 13, 25 (1986) (“[T]he fear that an existing injury will lead to the future onset of an as yet unrealized disease or condition is an element of recovery only where such distress . . . is the natural consequence of, or reasonably expected to flow from, the injury”); see also Restatement (Second) of Torts §456(a) (1963–1964) (hereinafter Restatement) (tortfeasor liable for “fright, shock, or other emotional disturbance resulting from the bodily harm or from the conduct which causes it”).