Employer and Insurer appealed a determination that the Employee suffered a permanent aggravation of her underlying preexisting mental health conditions. The Employee was involved in two work-related collisions in 2019. One accident resulted in the death of the driver of the other vehicle. She was declared dead at the scene. The Employee also witnessed the reaction of the husband of the driver. Upon returning to work, she then suffered a second accident about 30 days later. The Employee reported feeling helpless and having through she might have killed another person. The Employee suffered some physical injuries as a result of this accident, describing ongoing knee, shoulder, back, and hip/leg pain.
In the years leading up to her work injuries, she had minimal mental health care. She had treated for chronic ADHD, insomnia, anger, anxiety, worries, and irritability, which she had been prescribed medication. Following the collisions, she underwent a psychological exam, describing increased depression, anxiety, and irritability since the two collisions. The Employee was subsequently seen for a neuro-psychiatric exam on behalf of the Employer and Insurer. It was opined that the Employee suffered from adjustment disorder with anxiety and depression, but that her pre-existing mental condition had not been aggravated by the collision, but did have a temporarily aggravation of PTSD. It was opined the Employee sustained only temporary physical injuries that resolved within a month.
The Employee continued to treat for her mental health, and continued to be held off work for her PTSD by her treating provider. Dr. Hansen, her treatment provider, opined that the Employee’s preexisting difficulties with major depressive disorder and ADHD had been exacerbated by the trauma she experienced, and that she developed PTSD because of both accidents. The Employee was also examined by Dr. Keller for a psychological evaluation, where she was again diagnosed with chronic PTSD as a result of both collisions, and that her other mental health conditions were exacerbated and aggravated by the collisions. The Employee subsequently underwent a second neuro-psychiatric exam on behalf of the Employer and Insurer, where it was again opined that the collisions did not cause or aggravate her preexisting mental health conditions, but that she did develop PTSD as a result of the collisions. As such, the Employer and Insurer admitted liability for PTSD and agreed to pay the bills for that condition.
Following the hearing, the compensation judge found that the Employee did not sustain any permanent aggravation of her physical injuries, but that the Employee did sustain a permanent aggravation of her preexisting depression, anxiety, and ADHD and a result of both collisions. Wage loss and medical benefits were awarded.
On appeal, the Employer and Insurer argued that the judge improperly awarded a mental/mental claim with the finding of the aggravation of her preexisting mental health conditions, and that the expert opinions of the Employee lacked foundation. On appeal, the WCCA found sufficient foundation existed as both doctors were treating doctors of the Employee, and foundation was established both by the medical records and by the care personally provided. The WCCA also found that the Employee’s injuries did not arise from solely mental stimuli, but that evidence supports that the Employee did, in fact, suffer physical injuries from the collisions. Lastly, the WCCA noted that the compensation judge was presented with well-founded opinions, and the choices of medical opinions is typically undisturbed on appeal. The WCCA affirmed.
Takeaway: Physical stimulus, not physical injury, is required for compensability of mental injuries. Further, the choice of medical opinions is left to the compensation judge, and usually undisturbed on appeal.