Commission awards open medical for life in a PTSD Claim
By J. Bradley Young, Harris Dowell Fisher & Young L.C
October 14, 2022 - At the end of September, the Missouri Labor and Industrial Relations Commission entered an award in the Robert Dahman v. City of Clinton case, where the Commission ordered medical to be left open for life due to the claimant’s PTSD.
The facts in this claim were not in dispute. Claimant worked as a police officer in the small town of Clinton, MO (population 9,000). An officer was shot and killed and claimant arrived at the scene shortly thereafter. The shooter had shot through the decedent’s protective gear, and claimant feared for his life due to the fact that claimant was wearing the same type of protective gear that the decedent was wearing at the time he was shot. Claimant had to leave the police department, sought and received medical care, and was awarded open medical for life.
WHY IS THIS CASE IMPORTANT
Normally, in most “mental-mental” PTSD cases (meaning that the claimant was not physically injured, only emotionally injured), the employer has the “extraordinary and unusual” defense under Section 287.120.8:
“[m]ental injury resulting from work-related stress does not arise out of and in the course of the employment, unless it is demonstrated that the stress is work related and was extraordinary and unusual.”
This means that even if there is an absolute relationship between the employment and the mental stress, the claim will only be compensable if the event that caused the stress was “extraordinary and unusual”.
One might think that seeing a fellow police officer killed in the line of duty may not be that “extraordinary and unusual”. In some cities, this is unfortunately and tragically a regular occurrence. However, in the small town of Clinton, MO, this was the very first time a police officer was shot and killed in the line of duty. As such, the Commission found, seeing this event rose to the “extraordinary and unusual” standard.
Any time that you are dealing with a mental-mental stress claim, the first question that must be answered is whether the event that caused the emotional stress or trauma was unusual and extraordinary.
In the case of Mantia v. MO Dept. of Transportation (2017), the Missouri Supreme Court found the claim to be non-compensable even though the claimant saw a dead body while investigating a vehicle crash. Because the claimant’s job was to investigate fatal vehicle crashes, the MO Supreme Court found that for a person in the claimant’s job position, seeing a dead body was not “extraordinary and unusual”.
The second step in the analysis should be to determine the nature of the event itself. The Missouri Workers Compensation Act states that mental stress that relates to certain employment actions is not compensable. Specifically, §287.120.9 outlines the defense, stating:
“A mental injury is not considered to arise out of and in the course of the employment if it resulted from any:
any similar action taken in good faith by the employer.”
So, if the claimant’s mental stress arises out of any of the actions outlined above, the claim will not be compensable even if there is a clear medical link between the event and the mental stress.
The third step of the process should be to determine if the claimant has any pre-existing psychological issues that could be causing or contributing to the claimant’s current symptoms. If pre-existing psychological issues or conditions are present, you have an argument for apportioning the disability between the pre-existing conditions and the work-related event.
If you want to discuss this decision in more detail, or if you currently have any similar claims you would like to discuss in light of the attached decision, please feel free to call or email Brad Young, email@example.com, (636) 532-0300.