The employee argued the compensation judge erred as a matter of law by finding the employee did not sustain PTSD. Affirmed.
In 2006, Bruce M. Holzschuh, the employee, was assigned to work as the coordinator of veteran student services. The duties of this position involved meeting with veteran students to provide them with guidance and counseling related to their school activities, benefits, and funding. The employee testified that much of his job involved listening to military veteran students discuss the psychological effects they were experiencing from traumatic situations they had encountered during their combat service. The employee frequently heard them recount the graphic details of injuries they had sustained during military service, or of the injuries or deaths of fellow soldiers, adversaries, and noncombatants.
In 2014, the employee was diagnosed with a moderate major depressive disorder. He has not returned to work again since May 17, 2016.
On May 19, 2016, the employee told his family physician that he had been feeling more depressed, stressed, and overwhelmed. He attributed the increased symptoms of stress to his work with the veteran students. He then began treating with a licensed medical and family therapist, who diagnosed the employee with PTSD caused by repeated exposure to the details of the traumatic events related by the military veterans he had counseled during his work for the employer. The employee also treated for his psychological condition during this period with a certified nurse practitioner. The employee has not received further psychological treatment since August 2016.
The employee filed a claim petition seeking workers’ compensation benefits as a result of an alleged PTSD condition stemming from his work for the employer. He obtained a psychological evaluation from Dr. David Lund, Psy.D., which opined that the employee met the criteria for a diagnosis of PTSD in the DSM-5.
The self-insured employer had the employee evaluated by psychologist Dr. Paul Arbisi, Ph.D., for an independent psychological examination. Dr. Arbisi opined that the employee did not meet the diagnostic criteria of PTSD as set out in DSM-5. He disagreed with Dr. Lund over whether, under the facts unique to this case, hearing second-hand the details of traumatic incidents experienced by others constituted a sufficient “exposure” to traumatic events to meet the DSM-5 criteria.
In a follow-up report, Dr. Lund repeated his views and disagreed with Dr. Arbisi.
At hearing, Judge Behounek found that the employee had failed to prove that he had a PTSD condition. The employee appealed.
The employee sought benefits based on a claim of PTSD, which is defined in Minn. Stat. § 176.011, subd. 15(d), and relies on the definition in the DSM-5.
The DSM-5 is set out in code 309.81. A diagnosis of PTSD requires that specific diagnostic criteria be met, which are set out in sections labeled A through H. The first of these, Criterion A, requires:
Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
- Experiencing repeated or extreme exposure to aversive details of the traumatic event(s).
Diagnostic and Statistical Manual of Mental Disorders, 271, code 309.81 (Am. Psychiatric Ass’n 5th ed., 2013).
There was no claim that the employee met subparts 1-3 of Criterion A of code 309.81. The issue before the compensation judge was whether the employee’s work activities met subpart 4 of that criterion. The employee’s and the employer and insurer’s medical experts offered contrary opinions. The compensation judge concluded that the work-related stories of aversive details relating to traumatic events in this case did not meet the requirements of Criterion A of code 309.81 of the DSM-5.
Under the substantial evidence standard, the compensation judge’s findings and order were affirmed.
Takeaway: Repeatedly hearing traumatic stories did not constitute repeated or extreme exposure to aversive details.