The Minnesota Supreme Court reversed the WCCA’s January 2019 decision and in doing so, provided clarification that a compensation judge need not “conduct an independent assessment to verify that a diagnosis of a psychologist or psychiatrist confirms to the PTSD criteria set forth in the DSM before accepting the expert’s diagnosis.”
This case involved a deputy sheriff who claimed entitlement to workers’ compensation benefits based on PTSD arising out of his work as a deputy sheriff over 10 years. The employee obtained an opinion from a licensed psychologist that he did have a diagnosis of PTSD. The employer and insurer obtained an opinion from licensed psychologist Dr. Arbisi, that the employee did not have a diagnosis of PTSD. Based on the opinion of Dr. Arbisi, the employer and insurer denied the employees claim. At hearing, the compensation judge adopted the opinion of Dr. Arbisi and denied the employee’s claim for workers’ compensation benefits related to PTSD.
The employee appealed to the WCCA. The WCCA reversed the compensation judge’s denial and stated that a compensation judge must make an independent assessment of whether an expert medical opinion is consistent with the DSM-5 criteria before the judge can properly rely on such an expert medical opinion. The WCCA opined that Dr. Arbisi’s report did not conform to the DSM-5 criteria and thus should not have been adopted by the compensation judge.
The employer and insurer appealed to the Supreme Court. The Supreme Court reinstated the compensation judge’s opinion and specifically clarified that Minn. Stat. 176.011 subdivisions 15(a), (d), and 16 do not require a compensation judge to independently read and apply the DSM-5 criteria before adopting an expert medical opinion as the WCCA suggested. The Court states that Minn. Stat. 176.011 subdivision 15(d) “does nothing more than require that a diagnosis of PTSD in a workers’ compensation case be done by a licensed psychiatrist or psychologist based on the latest version of the DSM.” The Supreme Court concluded that Dr. Arbisi’s opinion was based on adequate foundation and based on the DSM-5 criteria for PTSD thus the WCCA erred by reversing the compensation judge’s reliance on Dr. Arbisi’s report.
It is important to keep in mind that there is now a rebuttable presumption that PTSD diagnosed for certain first responders or emergency personnel is work related so long as the employee was diagnosed after beginning their employment and had not been diagnosed with PTSD before beginning their employment. This presumption had not yet been enacted at the time of this specific case, so there was no analysis of whether the employer and insurer adequately rebutted the presumption that the employee’s diagnosed (but disputed) PTSD was work related.