Lucas Peterson v. City of Minneapolis and Fairview Health Servs., No. WC23-6596 (June 28, 2024)
The Employee was hired by the Employer in 1999 as a community service officer. He was seen by a licensed psychologist for a pre-employment mental health examination, and he did not appear to have any significant personality or emotional difficulty. In 2000, a similar examination of the Employee was conducted before he entered the police academy, and he was again found to have no significant personality or emotional problems, and upon graduation, became a police officer.
Over the next 21 years, the Employee experienced several significant traumatic events as a police officer, including experiencing 10-15 officer-involved shootings, 3-5 of which resulted in him shooting at another person. He responded to 30-50 homicide calls, of which 5-6 involved the deaths of children. During his 18 years as a member of the SWAT team, the Employee worked as part of several units, including the Gang Strike Force, the Community Response Team, the Undercover Narcotics Unit focused on violent drug-related crimes. He was drinking heavily and acting distant.
In March 2021, the Employee learned that the Minnesota Bureau of Criminal Apprehension (BCA) had reopened an investigation of his actions during a May 10, 2013, incident. A local newspaper article implied that he had murdered the suspect. The Employee felt that this investigation reopened an old wound that had been resolved eight years earlier. The Employee began therapy, twice per week, with Nick Weidner of Life Development Resources. Dr. Peter Dahlstrom of M Health Fairview – Vadnais Heights Clinic diagnosed the Employee with anxiety related to multiple work-related stressors. Mr. Weidner diagnosed the Employee with PTSD and generalized anxiety disorder.
On April 28, 2021, the Employee hired an attorney to pursue workers’ compensation benefits. They requested a meeting with Dr. John Cronin, a licensed psychologist at Primary Behavioral Health Clinics. Dr. Cronin deemed the Employee unfit for police work and he stopped working as a police officer as of May 26, 2021. Dr. Cronin opined that the Employee had diagnoses of PTSD as defined by the DSM-5, generalized anxiety disorder, and major depressive disorder, all of which were caused by his employment as a police officer for the Employer. Dr. Cronin did note the Employee was capable of other work. After receiving Dr. Cronin’s report, the Employer filed a notice of primary liability determination denying liability, asserting that the Employee did not have PTSD under the DSM-5.
Dr. Jessica Thackaberry, a board-certified psychiatrist, did a record review, and opined that the Employee was appropriately diagnosed with PTSD under the DSM-5 and that he also suffered from symptoms of generalized anxiety disorder “within the diagnosis” of PTSD. She further stated that due to the many work-related traumatic events, his PTSD was “fairly complex” and would require the Employee to be off of work for more than one year. At the request of the Employer, Dr. Kenneth Young, a licensed psychologist, examined the Employee, and opined that regardless of any cause, the Employee had no mental health disorder, PTSD or otherwise. Then, Dr. Kacey Aleknavicius, a licensed psychologist, examined the Employee at the request of his attorney. She opined that the Employee had previously met the DSM-5 criteria for a diagnosis of PTSD, and had since received mental health treatment and medication which relieved some of his symptoms. As of the time of her examination, Dr. Aleknavicius found that the Employee no longer met all criteria for a PTSD diagnosis under the DSM-5 and that his diagnosis was other specified trauma disorder (OSTD).
Employee’s claim petition came on for hearing before a compensation judge on March 23 and April 27, 2023. The compensation judge issued his findings and order on June 28, 2023. Relying upon the opinions of Dr. Cronin and Dr. Aleknavicius, he found that the Employee suffered a compensable PTSD work injury, that he was entitled to the presumption of compensability, that the Employer did not rebut the presumption, and that the Employee continued to meet the diagnosis of PTSD under the DSM-5-TR. Consequently, the compensation judge awarded temporary total disability (TTD) and temporary partial disability (TPD) benefits, a rehabilitation consultation, and various medical benefits. The compensation judge also found the Employer put forth a frivolous denial of the Employee’s claim until the receipt of Dr. Young’s report, and thereby awarded a 30 percent penalty to the Employee on TTD benefits payable through the date of that report. The compensation judge found that the opinions of Dr. Aleknavicius were more persuasive than those of Dr. Young and that the Employee sustained a consequential mental health injury, specifically OSTD, as a result of his PTSD condition.
The Employer appealed to WCCA. With regard to Employer’s contention that compensation judge erred as a matter of law in adopting Dr. Aleknavicius’ opinion because she considered the medical records and opinions of Dr. Dahlstrom, a medical doctor, and Mr. Weidner, a therapist, neither of whom are licensed psychiatrists nor psychologists, the court found that the compensation judge’s consideration of this other evidence in determining the persuasiveness of the opinions of Dr. Cronin and Dr. Aleknavicius was not an error of law.
With regard to Employer’s argument concerning the new language in the DSM-5-TR, the court held that they leave the interpretation of the DSM to the medical experts. Here, Dr. Aleknavicius offered an interpretation of the meaning of the additional text in the DSM-5-TR. Dr. Young disagreed with this interpretation but offered no other interpretation. The compensation judge resolved that dispute by finding Dr. Aleknavicius’ opinion more persuasive. Doing so was not legal error and was supported by substantial evidence. WCCA found that evidence supports the compensation judge’s finding that the Employee had met the criteria for a PTSD diagnosis based on Dr. Aleknavicius’ opinion that Criteria B-E are met for this Employee’s lifetime, and that Criteria A and F were therefore also met for his lifetime.
Turning their attention to the consequential mental injury, WCCA noted that as to the issue of compensability of a mental health condition that developed as a consequence of PTSD, that issue had not been decided by the WCCA or by the Minnesota Supreme Court, so they looked past Minnesota Supreme Court precedent. The Employer argued that other than injuries involving PTSD conditions, mental/mental injuries were not compensable, whether direct or consequential, per Lockwood. However, WCCA noted that since compensability of consequential injuries had long been recognized, once an employee had established a compensable PTSD injury, any mental health condition substantially caused by, aggravated by, or accelerated by, the PTSD diagnosis, was also compensable as a consequential injury.
And lastly, with regard to the penalties claim, the court found that the Employee established all necessary elements for application of the presumption that his PTSD diagnosis was work related. He was a first responder recognized by the statute, he had a diagnosis of PTSD from a licensed psychologist, and he had no prior diagnosis of PTSD. The Employer stated that the Employee’s alleged pre-existing mental health conditions were being further investigated, but the Employer had presented no evidence of any investigation undertaken, after it received Dr. Cronin’s report or after it issued its primary denial of liability, of the Employee’s alleged pre-existing mental health issues. WCCA found that the Employer did not have evidence to rebut the presumption of causation until Dr. Young’s report was obtained in March 2022. Consequently, it found that the compensation judge did not err in finding the initial denial to be frivolous and did not abuse his discretion in awarding a 30 percent penalty on the TTD benefits awarded to the Employee from the onset of the claim until the issuance of that report. Therefore, the penalty award was affirmed.