The employee worked as a deputy sheriff for Carlton County beginning in August of 2001. On August 20, 2019, the employee was evaluated by Dr. Keller, licensed psychologist, who diagnosed the employee with PTSD in a report dated September 12, 2019.
The County denied primary liability for the PTSD claim, “pending the results of an IME.” The County then had the employee examined by Dr. Arbisi on July 20, 2020. Dr. Arbisi issued a report dated September 8, 2020 and opined that the employee does not meet criteria for PTSD at the time of the exam or for the 30 days before the exam, but acknowledged that it is possible for someone to meet criteria during a different 30-day period because “PTSD can be cured.”
The compensation judge found the IME report from Dr. Keller more persuasive and denied the claim for PTSD. The employee appealed that denial and the WCCA reversed, holding that the employee qualified for a presumption of PTSD due to his employment as a police officer with no prior diagnosis of PTSD and Dr. Arbisi’s opinion failed to rebut that presumption because he didn’t address whether the employee had PTSD in September of 2019, when the diagnosis was given by Dr. Keller.
The County appealed to the Supreme Court and the Supreme Court affirmed the WCCA decision. In its analysis, the Supreme Court stated: “The PTSD presumption in [Minn. Stat. 176.011] subdivision 15(e), though, requires that the employee be diagnosed with PTSD. That is all.” The Supreme Court notes that there is no requirement that the diagnosis of PTSD be more credible or persuasive than any competing diagnosis. In other words, as long as an employee is employed in a qualifying position (i.e. a first responder such as a police officer), gets a diagnosis from a licensed psychologist or psychiatrist, and has no prior diagnosis of PTSD, as soon as he/she gets a diagnosis, the PTSD claim is compensable under the presumption statute.
The Supreme Court clarifies that an employer/insurer still has a chance to rebut a presumption with a competing opinion or evidence that the diagnosis was not valid or credible. However, the Supreme Court confirms that to rebut an opinion on PTSD, at least in a presumption case, the competing opinion must address the presence of PTSD at the time of disablement or at the same time that the PTSD diagnosis was given.
Takeaway; First, always make sure that your IME doctor is addressing whether the employee had a PTSD diagnosis during the timeframe that was examined by the diagnosing provider – opining that the employee didn’t have PTSD at a different time will do no good. Second, this case creates practical roadblocks for challenging a PTSD diagnosis initially since we often cannot get an IME fast enough to deny a claim before an NOPLD has to be filed. Our attorneys are happy to discuss options for how to best dispute or handle PTSD claims in light of this Supreme Court decision.