In 2013, the Minnesota legislature amended the Workers’ Compensation Act to allow claims for post traumatic stress disorder (PTSD) as an occupational disease. Since that time, the Minnesota Workers’ Compensation Court of Appeals and the Minnesota Court of Appeals have frequently needed to address questions on PTSD and its compensability as a work injury.
Last year, the Minnesota Supreme Court addressed the issue of an Employee who had been diagnosed with PTSD but no longer met the diagnostic criteria for the disorder. Chrz v. Mower County, 986 N.W.2d 481 (Minn. 2023). Under established court precedent, mental injuries other than PTSD are not compensable in the absence of a physical injury. In Chrz, the Employee’s diagnosis had been changed from PTSD to “other specified trauma and stress related disorder.” In affirming that the Employee was not entitled to ongoing workers’ compensation benefits, the Supreme Court noted that the Employee no longer met the “occupational disease” element of Minn. Stat. 176.66, and therefore, could no longer establish a claim for benefits.
Under Chrz, any Employee whose workers’ compensation claim was based upon PTSD (with no associated physical injury) would no longer be entitled to benefits as soon as he no longer met all of the diagnostic criteria. That diagnostic criteria is outlined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, the DSM, as required by Minn. Stat. Sec. 176.011, subd. 15(d). At the time of the medical evaluations performed relative to the Chrz case, that was the DSM-5. As of March 2022, the most recent version is the DSM-5-TR (text revision), which does include a significant change to the diagnostic features of PTSD:
“The diagnosis of PTSD requires that the duration of the symptoms in Criteria B, C, D, and E be more than 1 month (Criterion F). For a current diagnosis of PTSD, Criteria B, C, D, and E must all be met for more than 1 month, for at least the past month. For a lifetime diagnosis of PTSD, there must be a period of time lasting more than 1 month during which Criteria B, C, D, and E have all been met for the same 1-month period of time.”
(DSM-5-TR, at 307-08, emphasis added).
These categories pertain to the presence of intrusion symptoms (Criterion B), persistent avoidance of stimuli (Criterion C), negative alterations in cognitions and mood (Criterion D), and marked alterations in arousal and reactivity (Criterion E). Criterion F requires that Criteria B-E have been met for at least one month. Prior to the language of the DSM-5-TR, if any of Criteria B-E were no longer met, the Employee would no longer meet the diagnostic criteria for PTSD.
The Minnesota Workers’ Compensation Court of Appeals first addressed the language of the DSM-5-TR in Peterson v. City of Minneapolis, the decision for which was provided on June 28, 2024. In Peterson, the Employee was a former Minneapolis police officer who had been exposed to traumatic events during his employment with the city from 1999 to 2021. After an evaluation in May 2022 by his psychologist, it was noted that the Employee had benefitted from the mental health treatment he had received and that he was no longer experiencing as severe and as frequent of symptoms. Therefore, he met some, but not all, of the diagnostic criteria for PTSD.
At hearing, the Employee’s psychologist noted that the Employee did in fact meet the diagnostic criteria under the DSM-5-TR. Per the Employee’s psychologist, under the new language of the DSM-5-TR, when Criteria B-E have been met for the same 1-month period of time, those criteria are considered met for life.
In accepting the conclusions of the Employee’s psychologist that the Employee continued to meet the diagnostic criteria for PTSD, the Court of Appeals noted that the new language of the DSM-5-TR addressed the “legal conundrum” presented in the Chrz decision: that an Employee with PTSD could improve to the point that he would no longer be entitled to workers’ compensation benefits but still be experiencing signification limitations.
Another issue in Peterson was the Employee’s diagnosis of other specified trauma disorder (OSTD). The Compensation Judge had determined that the OSTD was a consequential injury from the PTSD and was, therefore, compensable. The Employer appealed, arguing that this was a mental/mental injury, which would not be compensable under the Minnesota Workers’ Compensation Act.
In affirming the decision of the Compensation Judge, the Court of Appeals focused, not on the mental/mental aspect, on the fact that consequential injuries to compensable injuries were typically also compensable: the general rule is that “every natural consequence that flows from the injury” is compensable. Gerhardt v. Welch (1964). In concluding that the Employee’s OSTD diagnosis was in fact compensable, the Court of Appeals stated, “once an employee has established a compensable PTSD injury, any mental health condition substantially caused by, aggravated by, or accelerated by, the PTSD diagnosis, is also compensable as a consequential injury.”
This aspect of the Peterson decision seems to be a significant departure from the typical analysis of mental/mental injuries. Both aspects of the Peterson decision significantly expand the compensability of PTSD claims, through the duration of PTSD itself and the compensability of consequential claims. The Peterson decision is a reminder that the landscape of workers’ compensation law is constantly changing, especially as it relates to claims involving post-traumatic stress disorder. Anyone working in the realm of workers’ compensation needs to stay up to date not only on the statute, rules, and caselaw, but also on the pertinent medical literature as well.
The attorneys at Brown & Carlson are well versed in the intricacies of claims involving PTSD. We are always happy to discuss any specific claims and to answer questions on how to handle these claims.
