Rowe v. City of Minneapolis Police Department, et. al, No. WC24-6550 (WCCA, August 16, 2024)
The Employee appeals a finding and order that the Employee did not sustain a compensable PTSD injury.
The Employee began working as a police officer for Minneapolis in 1997. The Employee underwent a pre-employment psychological examination finding he had above average intelligence, social judgement, and did not have any significant personality or emotional problems. There was no comments on the Employee’s alcohol use.
The Employee testified his alcohol use began with occasionally becoming intoxicated in high school and college, then continued social drinking in his twenties with friends at happy hours and weddings. Beginning in 2003 the Employee would occasionally binge drink and it was recommended he quit drinking. From 2003 to 2013 there were periods the Employee did not drink for months due to training or other reasons.
The Employee experienced several traumatic events during the 25 years as a police officer. Over his career the Employee responded to five mass shooting, was involved in six officer involved shootings, hundreds of homicide calls, and six incidents involving deceased children. Specifically a close colleague to the employee was killed while pursuing a suspect in 2007 after which time he began to drink hard liquor alone, began withdrawing from friends and family and became easily angry.
In 2012 the Employee reported to an active shooter call and encountered multiple deceased people and was under threat of being wounded or killed for over 90 minutes; he felt overwhelmed by this.
In November 2013 at a medical visit the Employee’s alcohol consumption was described as occasional; he was eating well and working out four to five times per week.
In 2015 the Employee was promoted to sergeant. He assisted during a protest following the shooting death of a man killed by police officers. He was at the precinct when shots were fired into the crowd of protesters causing a mass casualty scene.
By 2015 the Employee was expressing anger, withdrawing from family, drinking alone, and using Benadryl to sleep. He found going to work overwhelming and was reluctant to respond to calls for service. His drinking increased and he found it therapeutic to avoid feelings of anger and internal turmoil.
In 2019 the Employee joined internal affairs to avoid street policing duties. During this time the Employee reviewed officer involved shootings, use of force incidents, misconduct, and critical incidents. During this time he had to watch hundreds of videos of body camera footage.
In October 2021 the Employee sought treatment for counseling. He reported being a police officer for years. It was noted he had presenting symptoms of sleep disturbance, depression, anxiety, anger/irritability, hyperarousal, lack of motivation, and intrusive negative thoughts/memories. The initial assessment ruled out PTSD but was later revised to include PTSD. He was recommended to stop working as a police officer. The Employee continued with therapy once per month through the time of hearing.
The Employee was seen for a preventative health visit in February 2022. The Employee’s alcohol use was again discussed.
The Employee was evaluated in March 2022 as part of a retirement disability evaluation. He was given multiple tests including Life Events Checklist for DSM-5 (LEC-5) Extended Version, Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) (past month version), Minnesota Multiphasic Personality Inventory-3 (MMPI-3), PHQ-9 and Generalized Anxiety Disorder 7-item Scale (GAD‑7). Using the DSM-5 the doctor found he met the criteria for PTSD, among other diagnoses, all of which were the result of his work as a police officer. It was concluded the severity of his PTSD symptoms precluded him from working as a police officer.
The Employee hired counsel April 4, 2022. The self-insured employer denied primary liability challenging whether the statutory presumption applied and asserted he had pre-existing mental health conditions unrelated to employment.
A peer reviewed report was completed June 30, 2022 and Dr. Erdos completed the CAPS-5 PTSD screening agreed the Employee was properly diagnosed with PTSD, major depressive disorder, and alcohol use disorder and were a direct result of his work as a police officer. The Employee then filed a claim petition.
An IPE was completed by Dr. Young who used the CAPS-5 (past month version) and MMPI-3. Using this exam the IPE found no clear and consistent evidence the Employee met, or had ever met, the criteria for PTSD. He did find he had AUD but was not a result of his work.
The Employee followed up with his provider at the request of his attorney and again has the CAPS-5 (past month version). He again was diagnosed with PTSD and AUD.
In October 2023 the claim went to hearing on whether or not the Employee was entitled to the statutory presumption that the PTSD was work related, whether he had a lifetime diagnosis of PTSD, whether the Employer and Insurer had submitted substantial factors to rebut the presumption, whether the major depressive disorder and AUD were a consequence of the OTSD, and whether he is entitled to miscellaneous benefits.
The Employee’s wife testified that prior to becoming a police officer he was outgoing and enjoyable and that in 2013 he began to withdraw, become angry, and drink more often. She testified he continued to have nightmares and sleep difficulties.
Each expert doctor testified explaining their opinions. The Employee’s doctor testified she used the DSM-5 revised text to evaluate the Employee in February 2023 and while the prior test criteria is identical that the text revision provides clarity in how to identify and evaluate PTSD.
The Employer’s expert doctor said his mental health was not caused by his alcohol use alone but that his PTSD symptoms pre-dated his problematic alcohol use and did not occur only when drinking. He doctor said the DSM-5-TR found a distinction that once a person meets PTSD diagnostic criteria the diagnosis continues until all symptoms are in remission.
The Employer’s doctor testified the Employee had severe AUD and did not ever find the Employee to have symptoms supporting PTSD. He indicated there is not a difference from a clinical standpoint in the DSM-5 and DSM-5-TR; just a text revision. Dr. Young found there was difficulty in differentiating between PTSD and AUD in the presence of pre-existing history of alcohol abuse.
In the findings and order the judge found the Employee was entitled to the presumption of PTSD. Then, relying on Dr. Young’s opinion, found the self-insured employer provided substantial factors rebutting the presumption that the Employee never met the diagnosis of PTSD under DSM-5. Due to this finding, no consequential mental health condition was discussed.
The Employee appealed. The Employee asserted the judge erred in that Dr. Young did not use the DSM-5-TR, the most recent published edition of the DSM and further asserted the Dr. Young report misstated his alcohol use.
Under Minn. Stat. 176.011 PTSD must be diagnosed by a licensed psychiatrist or psychologist using the most recent edition of the DSM. The court found while the DSM-5 and DSM-5-TR had the same criteria, the diagnosis is dependent on more than the criteria and the new edition includes narrative text and clarity in identifying and evaluating the criteria factors. To side with the argument that the two editions are the same, the court would be deciding that certain sections of the TR version were not relevant and that was not their role.
The Employee established the presumption and this was not rebutted so the Findings and Order is vacated. Based on this, several issues were not decided by the judge including consequential injuries and entitlement to benefits so these issues are remanded for determination.