In Rowe v. City of Minneapolis, No. A24-1465 (Minn. 2026), the Minnesota Supreme Court contemplated ways in which an employer can rebut the statutory presumption that an employee’s PTSD diagnosis is an occupational disease “due to the nature of employment” under Minnesota Statutes section 176.011, subdivision 15(e).
The Employee, with no demonstrated history of PTSD, was hired by the City of Minneapolis in 1997. While working with the City of Minneapolis, the Employee experienced several significant traumatic events during his 25-year career as a police officer. In October 2021, the Employee started receiving mental health treatment and he was subsequently diagnosed with PTSD and was advised to stop working as a police officer.
At this request of his attorney, Dr. Kasey Aleknavicius, a licensed psychologist, performed a psychological evaluation of the Employee in early 2022, and she relied on the DSM-5 to diagnose the Employee with PTSD and major depressive disorder.
Dr. Kenneth Young, a licensed psychologist, completed a psychological examination on behalf of the City of Minneapolis, and he completed his report in November 2022. Dr. Young concluded the Employee did not meet the diagnostic criteria for PTSD using the DSM-5.
Dr. Aleknavicius re-evaluated the Employee in February 2023 and issued an updated report. In her report, she found the Employee did not satisfy all the criteria required for a PTSD diagnoses; however, despite the absence of the necessary criteria, Dr. Aleknavicius assessed the Employee with PTSD using the DSM-5-TR.
At hearing, both Dr. Aleknavicius and Dr. Young testified in support of their respective opinions. The compensation judge determined the Employee met the statutory presumption for work-related PTSD; however the judge further found that the City had established substantial factors rebutting the presumption. The compensation judge found Dr. Young’s opinions to be more persuasive than those of Dr. Aleknavicius, specifically noting that Dr. Young’s use of an outdated DSM-5 instead of the DSM-5-TR was a “red herring and irrelevant.” The judge found that Dr. Young had testified that the diagnostic criteria in the DSM-5 and DSM-5-TR were identical, and that the diagnostic tool Dr. Aleknavicius used to support her opinions was unchanged after the publication of the DSM-5-TR.
On appeal, the WCCA concluded that Dr. Young’s failure to use the DSM-5-TR contravened the statute governing the PTSD presumption and that his entire opinion should not have been considered by the compensation judge. As a result, the WCCA set aside the compensation judge’s finding that the City had rebutted the statutory presumption and made its own finding that the City had failed to rebut the presumption.
The Supreme Court reversed the WCCA’s decision.
The Supreme Court acknowledged that the Dr. Young relied on an outdated version of the DSM, as the DSM-5-TR was unambiguously the most recently published version of the DSM. However, the Supreme Court concluded that the WCCA erred in concluding that an independent psychological examination is the only proof that could allow for a rebuttal of the statutory PTSD presumption. The Supreme Court specifically noted that an employer could rebut the statutory presumption by showing that the employee did not receive a PTSD diagnosis or by demonstrating that the Employee’s PTSD diagnosis was invalid or not credible. The Supreme Court specified that a competing diagnosis or “other evidence” could be utilized could rebut the presumption, and the Supreme Court noted that this “other evidence” could include an expert opinion attacking the expert opinion diagnosing the PTSD, which would not require an evaluation of the employee at all. Ultimately, the Supreme Court confirmed that an independent psychological examination is not required for an employer to rebut the statutory PTSD presumption.
Though the Supreme Court acknowledged that an independent psychological examination that utilizes an outdated DSM will generally have less probative value than an examination that utilizes the most recent DSM, a compensation judge is not barred from consider expert opinions based on an outdated edition of the DSM.
The Supreme Court highlighted that Dr. Young’s opinions served to undermine the validity and credibility of Dr. Aleknavicius’s opinions, and the Supreme Court ultimately set aside the WCCA’s decision to set aside the compensation judge’s finding because of Dr. Young’s reliance on an outdated DSM.
The Rowe decision helps provide clarity in defending the statutory PTSD presumption.
The Supreme Court has identified that the statutory PTSD presumption can be rebutted by utilizing an independent psychological examination to provide a competing diagnosis to the PTSD claimed through the presumption; however, for such an opinion to be persuasive, the examiner should utilize the most recent version of the DSM in rendering the competing diagnosis. As an alternative, as demonstrated in Rowe, other evidence can also be used to attack the expert opinion diagnosing the PTSD, by, for example, undermining the methodology of or pointing out errors in the PTSD diagnosing expert’s opinions. Of note, the Supreme Court specifically noted that a rebuttal expert is not required in every statutory PTSD presumption case, as the statutory PTSD presumption can also be attacked by an employer that provides evidence that the employee fabricated treatment records that supported the PTSD diagnosis.
Ultimately, when attempting to rebut the statutory PTSD presumption, ensure that the independent psychological examiner utilizes the most recent version of the DSM if the examiner offers a diagnosis to compete with the claimed PTSD. Additionally, specifically request that the independent psychological examiner comment on the methodology used by the PTSD diagnosing expert and that the independent psychological examiner identify any errors made by the PTSD diagnosing expert in their report.