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Psychological Conditions in a Workers’ Compensation Claim

10/5/2013 | Category: Workers Compensation-Psychological Conditions
This past summer, the Supreme Court of Ohio addressed the compensability of psychological conditions in a workers’ compensation claim, holding that psychological conditions, such as Post-Traumatic Stress Disorder (PTSD), must arise out of a compensable physical injury to qualify for workers’ compensation coverage.

The Supreme Court of Ohio’s decision in Armstrong concerned injuries sustained by a dump truck driver (Mr. Armstrong), who was involved in a motor vehicle accident.  Another vehicle impacted Mr. Armstrong’s dump truck from the rear at a high rate of speed.  Mr. Armstrong witnessed the other vehicle come to rest under his dump truck, instantly killing the other driver.  Thereafter, Mr. Armstrong filed a workers’ compensation claim that was allowed for neck and back injuries.  The claim was also allowed for PTSD on the basis that the psychological condition was caused by Mr. Armstrong witnessing a distressing event.  The Employer appealed the allowance of PTSD on the basis that Mr. Armstrong’s psychological condition was not caused by the physical injuries allowed in the claim.

Experts for both the Employer and Mr. Armstrong agreed that Mr. Armstrong’s PTSD was related to his motor vehicle accident.  The Employer, however, maintained that a psychological condition must result from an actual physical injury to qualify for workers’ compensation coverage.  The Employer argued that a psychological condition arising from witnessing an event, even if the event caused physical injury to the injured worker, does not create a right to workers’ compensation coverage.  The compensable physical injury itself must lead to the psychological condition.  In this case, the Employer argued that Mr. Armstrong’s physical injuries did not cause his PTSD; rather, his PTSD resulted from witnessing the accident and witnessing the severity of the other driver’s injuries.

The trial court agreed with the Employer, deciding that Mr. Armstrong’s PTSD was not compensable because it did not arise from his physical injuries.  Mr. Armstrong appealed the trial court’s decision to the Second District Court of Appeals.  The Second District upheld the trial court’s determination that compensable mental or psychological injuries must arise from a compensable physical injury.

The matter was then heard by the Supreme Court of Ohio.  The Employer argued that the Ohio Revised Code requires a direct and proximate causal relationship between a physical injury and the mental or psychological condition to qualify for coverage.  Mr. Armstrong argued that PTSD was compensable because it arose out of the same incident causing compensable physical injuries to his neck and back.  The Supreme Court of Ohio rejected Mr. Armstrong’s argument and stated "the plain language of R.C. 4123.01(C) and (C)(1) requires that to constitute a compensable injury for purposes of workers' compensation, a psychiatric condition must be causally related to the claimant's compensable physical injury.  Accordingly, the statute must be applied as written."  The Supreme Court held that the psychological condition was not compensable if it arose only from involvement in the accident.

The Armstrong decision, although clearly favorable to Ohio employers defending against psychological conditions being added to workers’ compensation claims, is not without opposition.  The Seventh District Court of Appeals recently issued a decision wherein PTSD was found to be a compensable psychological injury under a “duel-causation” theory.  The Seventh District’s decision in Jones concerned an employee who suffered a wrist fracture while being taken hostage.  A workers’ compensation claim was filed and subsequently allowed for the wrist fracture.  Ms. Jones endeavored to have the diagnosis of PTSD recognized in her workers’ compensation claim on the basis that her PTSD was caused by both her wrist injury and the experience of being held hostage.  The Employer objected on the basis that her PTSD did not arise from her wrist injury alone.  Evidence strongly supported the fact that Ms. Jones’ PTSD would not have occurred but for the hostage taking incident.  Nevertheless, the Seventh District held that the Claimant “is not required to demonstrate that she would suffer from PTSD if her wrist had been fractured absent being held hostage, nor is she required to demonstrate that being held hostage did not play a role in the development of her PTSD.”  The Seventh District acknowledged that the Claimant must show a causal connection between her physical injury and psychological trauma; however, the Seventh District opined that a compensable physical injury would be considered a “contributing factor” to support the allowance of a psychological condition.  A compensable physical injury does not have to be the sole cause of the psychological condition.

The Ohio Supreme Court’s decision in Armstrong is presently controlling; however, the competing theory outlined by the Seventh District in Jones will provide opposing counsel with a contrary argument.  Employers should always consider obtaining an independent psychological evaluation of a claimant to explore whether or not an alleged psychological condition is the direct and proximate result of a compensable physical injury.  A comprehensive psychological evaluation will also aid in establishing the root causes of an alleged psychological condition.

Please feel free to contact Chad Fine or any of the workers’ compensation attorneys at RBS with questions or concerns regarding psychological conditions in a workers’ compensation claim.

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