Wednesday, June 26, 2013

Psychiatric Allowances in an Ohio Workers' Compensation Claim Must Result from the Physical Injury, Not the Mechanism of Injury

All too often, Ohio workers’ compensation claims are additionally allowed for psychological conditions that have not necessarily resulted from the allowed physical injury in the claim, but rather from the circumstances of the accident itself, or from the socioeconomic fallout from a work injury.  Ohio Revised Code §4123.01(C)(1) provides Industrial Commission hearing officers with the gift of plain, unambiguous language.  It states that psychiatric conditions are excluded from the general definition of injury “except where the claimant’s psychiatric conditions have arisen from an injury or occupational disease sustained by that claimant.” Yet, psychological allowances continue to be added to claims, even when the genesis of the conditions are contrary to the statute’s plain language.

The statute doesn’t state that a compensable psychiatric condition can arise from the financial hardship that often follows a work related disability, nor from a particularly heinous mechanism of injury.  The General Assembly did carve out one exception to the premise that a psychiatric injury can grow from something other than the allowed physical injury, which is if the mental condition arises from “sexual conduct in which the claimant was forced by threat of physical harm to engage or participate.”  R.C. 4123.01(C)(1)  The fact that the one exception for sexual assault is so carefully carved out in the statute should necessarily mean that all other potential causes for a mental condition are not to be considered, besides when a psychiatric condition arises from a physical injury sustained by the claimant.

On June 4, 2013, the Ohio Supreme Court offered clarification to the Industrial Commission on this issue, despite the seemingly clear statute.  In Armstrong v. John R. Jurgensen Co., Slip Opinion No. 2013-Ohio-2237, the court ruled that the claimant’s post traumatic stress disorder was caused by the involvement in the work related motor vehicle accident that caused his physical injury, but was not caused by the physical injury itself.  Therefore, the psychiatric disorder was not compensable in the claim. 

In this case, the claimant, Armstrong, was a dump truck driver who had his truck stopped at a yield sign on a highway access ramp when he noticed a vehicle approaching behind him at an accelerated speed.  The vehicle struck the dump truck from behind.  Before being taken to the hospital, he saw the other driver slumped behind the wheel, and suspected that the other driver was dead.  His suspicion was later confirmed.  Armstrong’s claim was allowed for various back sprains, and he later asked to add post traumatic stress disorder to his claim.  Armstrong’s psychologist opined that the PTSD was caused by both the physical injuries and the horror of the motor vehicle accident itself.  The employer’s expert insisted that Armstrong would have developed PTSD even if he hadn’t sustained the physical injuries during the accident. 

The Industrial Commission granted the request to add the PTSD to the claim.  The employer appealed into court and won at trial level, the Second District Court of Appeals, and now at the Supreme Court.  Unambiguously, just as in the statute, the Supreme Court held that, “for a mental condition to be compensable under the Ohio workers’ compensation system, a compensable physical injury sustained by the claimant must cause the mental condition.”  It is simply not good enough that a mental condition arises contemporaneously with a physical injury as a result of the same accident.  The psychiatric condition must be connected to the physical injury itself.

This decision is potentially a game changer when it comes to psychiatric conditions in Ohio claims.  Take a claim where a claimant suffers a torn rotator cuff in the course and scope of their employment.  If they work in a job requiring use of their arm, they are likely to be out of work or on light duty for an extended period of time.  If they begin to show clinical signs of depression, is the condition due to the torn rotator cuff or does it arise as a consequence of the various impacts on the claimant’s life?  The degree of separation between the actual physical injury and the development of the psychological condition may now be too much to support a compensable psych condition.

No doubt this issue will be challenged and the courts will be asked to further refine the Armstrong holding.  For the time, however, employers may have just received a new tool in the defense of flow through psychological conditions.