When workers suffer from mental disorders or psychiatric injuries as a result of a job-related issue or incident, they may be entitled to workers’ compensation benefits. These benefits may include coverage of medical bills for therapy and medication. It could also cover a portion of lost wages if the condition leaves you unable to work. However, these claims are often treated with a high dose of skepticism by employers, insurers, doctors and even courts.
Seasoned Massachusetts work injury lawyers understand how crucial it is to have extensive knowledge of statutory and case law as well as how to assert our clients’ rights vigorously throughout the claims process.
Determining whether mental disorders or psychiatric injuries are work-related can be a tedious process and requires extensive documentation and medical assessment. Mental disorders and psychiatric injuries can be the result of job-related:
In each of these scenarios, the condition may be compensable under Massachusetts workers’ compensation laws.
State Compensation Insurance Fund v. Workers’ Compensation Appeal Board and Guzman
Although the standards and case law precedents vary from state-to-state, a recent case out of California deals with a work-related psychiatric injury that stemmed from a work accident. The case was weighed by the California Court of Appeals for the Sixth Appellate District.
Claimant was a laborer employed for about six months when he was injured at work. Typically, his jobs included compacting, digging and moving materials around the construction site. In the course of his work, he used a machine known as a compactor. On the day in question, he was working on the compactor on a flat surface. About a half hour before the accident, he was using the machinery on a hillside, where pipe was being laid. Claimant was packing the dirt that covered the pipe. Previously, he’d only worked with the machine on flat surfaces. This particular slope was at about a 45-degree angle, about 7 feet high. He was halfway up the slope when the compactor struck a rock, rose into the air and caused plaintiff to fall backward, the machine subsequently following on top of him.
As a result of this incident, plaintiff suffered back injuries that required two surgeries. Additionally, he suffered psychiatric injuries, for which he sought treatment. He later testified he’d never suffered any injuries on the compactor before, never feared working with it and had never previously lost control of the machine like that.
The state board of workers’ compensation awarded him benefits for both his back injury and psychological injury stemming from the accident. The board ruled – based largely on claimant’s testimony – that the psychiatric injury was the result of a sudden and extraordinary employment condition. Further, the board ruled that despite employer’s testimony contending such an incident was a typical hazard of claimant’s occupation, there was no evidence to support this and that employer’s argument concerning foreseeability of the incident was flawed because it presented no evidence the machine was prone to this kind of recoil upon encountering rocks.
The board denied the employer’s motion for reconsideration. Employer sought a review by the appellate court.
Before the appeals court, the employer argued employee failed to meet his burden in proving this type of event was uncommon, citing the fact that construction sites are bound to have rough spots, lose/ uneven materials, gravel and rocks, and that the risk of a heavy machine losing balance as a result of encountering these hazards is not outside the scope of the ordinary. Claimant contended his testimony – with 12 prior years of experience using this machine – should be evidence this was not a common hazard.
In California, there are certain conditions for an employee’s psychiatric injury to be deemed compensable through workers’ compensation, and one of those conditions is that the condition or incident was “extraordinary and sudden.” The burden of proof is on the worker. Previous rulings had held that while a rack of falling lumber in a store aisle is extraordinary, a fall from a ladder is not, nor is falling on rain-slicked concrete.
The appellate court ruled in favor of the employer, finding claimant’s argument that such hazards are uncommon, unusual or unexpected to be unpersuasive. The court ruled the worker’s compensation board erred in awarding psychiatric benefits for this worker’s injuries.
This is not to say that workers in Massachusetts shouldn’t pursue them, but they should understand they may encounter certain challenges – which is why working with an experienced workers’ compensation lawyer in Boston is crucial.
Favorable Workers’ Compensation Outcomes Possible With Good Lawyer
Other recent cases in Massachusetts have resulted in more favorable outcomes for claimants seeking compensation for psychiatric injuries. For instance, the case of Conners v. Liberty Mutual Insurance Company ended in a positive resolution for an employee who sought compensation for depression he suffered, which he claimed was a direct result of his work-related right shoulder injury.
According to court records, plaintiff was injured in May 1999 and again in July 2001. In 2007, he suffered another work injury, this time to his right shoulder. The workers’ compensation insurer accepted that the shoulder injury was work-related and paid benefits. However in 2011, plaintiff sought to join his claim for a psychiatric injury that resulted from his accepted shoulder injury. Specifically, he asserted his depression stemmed from the injury because he had limited relief from the surgeries, constant pain and limited use of his right arm and shoulder.
Finding the predominant cause of his psychiatric condition post-injury was his prior psychiatric condition, the claim was denied. However, the Department of Industrial Accidents reversed this portion of the decision. The board found that the administrative law judge considering his claim initially failed to use the correct standard. Specifically, the judge used MGL c. 152 section 1(7A) which applies only to “pure” mental injuries, and not those that stem from a work-related physical injury. Instead, the judge should have used the “major cause standard,” as outlined in the 2007 “Cornetta Case,” and pertains specifically to Major Depressive Disorder and Anxiety Disorder. The court found plaintiff had met his burden and his depression should be covered by the workers’ compensation insurer.
There was also the 2017 case involving a patient who was injured in 2005 in a slip-and-fall while descending stairs at her employer’s place of business. She suffered several fractures to her foot, but then also subsequently suffered from depression. After several unsuccessful surgeries, she feels constant pain, can’t leave the house for days at a time (especially during the cold) and severe sadness and anger. As a result, the administrative law judge found her permanently and totally disabled – not just because of her orthopedic condition, but also because of the major depression that was causally related to that injury.
The insurer appealed, but the industrial board affirmed – and ordered the insurer to pay the claimant’s legal fees.
If you have suffered from depression, anxiety, PTSD or some other psychiatric condition as a result of your work injury in Massachusetts, we may be able to help you obtain additional benefits.
If you or someone you love has been injured a Boston work accident, call for a free and confidential appointment at 1-888-367-2900.
State Compensation Insurance Fund v. Workers’ Compensation Appeals Board, Feb. 23, 2018, California Court of Appeal, Sixth Appellate District
More Blog Entries:
Medical Benefits in Boston Workers’ Compensation Claims, Feb. 15, 2018, Boston Workers’ Compensation Attorney Blog