Some Minnesota workers’ compensation practitioners would say that it appears claims of consequential mental health injuries are on the rise. Cynics will say this is done to increase the value of a workers’ compensation claim. More trusting people will say it is due to increased access to mental health treatment and recognition of mental health conditions. Regardless of which view one falls into, it is important to be able to defend against these types of claims.
The traditional rule in Minnesota workers’ compensation is that every natural consequence that flows from an injury is compensable. Gerhardt v. Welch, 267 Minn. 206, 209 (1964). “Every natural consequence” would seem to cast a significantly wide net. It does not mean, however, that any injury that may not have happened but for the work injury would be compensable. A heart attack after testifying at a workers’ compensation hearing on a compensable shoulder injury is not compensable. See Hendrickson v. George Madsen Constr. Co., 31 W.C.D. 608 (1979). Injuries sustained from a motor vehicle accident while on the way to an independent medical examination are not compensable. See Robinson v. Honeywell, (W.C.C.A. 1991).
The rule that every natural consequence is compensable is balanced by an understanding that, the more remote a claimed consequence is from a work injury, the less likely it is that the claim consequence is compensable. Schaaf by Schaaf v. Biffs, (WCCA 2005, No. WC05-110). In Schaaf, the Employee sustained an injury to the left knee, which left him in a wheelchair. It was argued that this led to weight gain, depression, and increased level of smoking, which aggravated his cardiac condition, leading to his death. The WCCA denied the Employee’s wife’s claim for dependency benefits. The WCCA has also denied a claim that alcoholism was a consequential injury where “there was an intervening nonmedical factor, unemployment, separating the personal injury from the claimed compensable consequence.” Melartin v. Mavo Sys., Inc., 65 W.C.D. 405 (W.C.C.A. 2005).
This is an important concept to remember in the context of consequential mental health claims. Consequential mental health claims as the direct result of compensable, physical injuries are compensable. See Hartman v. Cold Spring Granite Co., 18 W.C.D. 206 (1954). The key issue to keep in mind here is that the consequential mental health claim must be the direct result of the work injury.
It is not difficult to imagine claims where an Employee claims depression from boredom due to unemployment or stress and anxiety from financial restraints from the two-thirds compensation rate. Even assuming the Employee was diagnosed by a provider with depression, stress, anxiety, or some other mental health condition, this would not be sufficient for a compensable mental health claim. In Cartagena Quijada v. Heikes Farm, Inc., the WCCA denied a claim for consequential depression where the Employee alleged that the work injury caused unemployment, which led to financial and family problems.
In the context of a workers’ compensation claim, this means that it is necessary to carefully review the Employee’s claim of a consequential mental health injury. It means carefully reviewing medical records to determine what the Employee has reported as contributing to mental health systems. It means carefully crafting deposition questions to understand the heart of the Employee’s claim.
When defending a workers’ compensation claim that involves a consequential mental health claim, it can be easy to be more focused on the primary, physical injury rather than the mental health claim. Unless the Employee is alleging a particularly severe mental health condition, an Employer and Insurer may elect to save the expense of working up a defense to the mental health claim. Independent psychological examinations are not frequently sought.
This could make it difficult to defend against the claim in the context of a mediation or, particularly, when negotiating with an intervening mental health provider. This is why it is important to have carefully reviewed the origins of the Employee’s mental health symptoms. Evidence that the Employee’s mental health condition originates from indirect consequences of the work injury provides a defense against the compensability of the mental health condition without needing further workup.
The Minnesota Workers’ Compensation Court of Appeals recently had to address the issue of consequential mental health claims in the context of compensable PTSD. In Peterson v. City of Minneapolis, the court found that the Employee had a compensable, consequential mental health injury as the result of a compensable PTSD diagnosis. This case seemingly had two opposing components of Minnesota workers’ compensation law to contend with: that PTSD as the result of one’s work is a compensable work injury and that consequences of compensable work injuries are typically compensable versus the understanding that mental stimuli producing mental injuries are not compensable (i.e., mental/mental claims).
In Peterson, the WCCA concluded that the Employee’s other specified trauma disorder (OSTD) was directly related to the underlying work-related PTSD diagnosis and therefore compensable, stating “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.”
Peterson has been appealed to the Minnesota Supreme Court, and their decision is expected to be issued in the near future. That decision may provide more guidance on how to address mental/mental claims going forward.
At Brown and Carlson, our attorneys are experienced with defending workers’ compensation claims that involve consequential mental health injuries, including carefully examining medical records, asking the right questions during a deposition or cross examination, and bringing the right arguments into settlement conversations, either with the Employee themselves or with a medical provider.
If you have questions on any Minnesota claim, reach out to Eric Behr or any of the attorneys at Brown and Carlson.
