In Part 1 of this post, we explored the three types of work related mental injury claims addressed by the Pennsylvania Workers’ Compensation Act. In Part 2, we discussed how courts are increasingly easing the burden of proving abnormal working conditions. Now, we will discuss practical steps you can take to ensure you are not faced with a workers’ compensation claim for a mental condition completely unrelated to the workplace.
There are, of course, many reasons why people experience unhappiness or depression or feelings of insecurity or imbalance completely unrelated to their work environment:
Family Situations
- a parent and a child do not talk to each other;
- a spouse has left a marriage;
- a wife is physically incapable of having a child;
- a spouse is abusive, physically or emotionally;
- a spouse is drug dependent or alcohol dependent;
- a spouse has had an extramarital affair;
- a parent suffers from Alzheimer’s or Dementia requiring the son or daughter to institutionalize him or her;
- an adult experiences for the first time memories of abuse inflicted years earlier by a parent or other family member;
- a parent’s child is killed or physically harmed;
- a parent’s child suffers from a dysfunctional condition such as Attention Deficit Disorder or Schizophrenia or becomes drug dependent or has encounters with law enforcement
Self-Induced Depression
- the individual experiences anger/frustration over his or her lack of achievement, e.g. failing to land a job promotion or having never attended college;
- the individual is inherently self-driven due to family expectations or unrealistic self-expectations;
- an individual experiences frustration/anger over his or her confrontation with middle age;
- the individual experiences delusions of grandeur causing profound employee dissatisfaction with job;
Other Causes
- seemingly unrelated non-work related psychiatric conditions such as “histrionic personality syndrome” resulting indirectly in the filing of a workers’ compensation claim;
- a false claim filed for purposes of secondary gain or monetary reward
What many lawyers fail to consider and investigate, are the circumstances surrounding, and leading up to, the occurrence of the mental injury at issue. The lawyer who explores and analyzes those circumstances has a distinct advantage over the lawyer who does nothing more than respond to the basic allegations of the claim.
Employers, adjusters and nurse case managers can greatly assist their lawyers by conducting a thorough investigation after notice of a “stress claim.” Some investigation best practices are as follows:
- Conduct a thorough interview of the employee, ask questions about history of mental health treatment or diagnoses and ask about any other potential contributing factors.
- Review employee’s attendance record for a history/pattern of absences that may be related to a stress or mental health reasons.
- Obtain a HIPAA and mental health release allowing the release of mental health information by the employee’s treating doctors and then obtain such records; also look for increased blood pressure, sleep disorders and cardiovascular disease, which may be related to non work stressors.
- Speak to supervisors and co-workers to determine if the employee has mentioned any stress related issues in the past.
- Investigate the working condition the employee alleges is abnormal or that led to the mental injury claim. Is it truly abnormal? Did the employee’s job recently change? Were there any reports of problems, issues or concerns prior to receiving notice of the claim? Have similar incidents occurred with other employees and is there any training provided to employees regarding such situations, etc?
Once the facts have been investigated, it is the responsibility of the attorney to present the facts to the workers’ compensation judge from the proper perspective. Proper development of the facts, including the events leading up to the claim, ultimately allows defense counsel to provide the workers’ compensation judge with the full flavor of the dispute.
If you have questions regarding an alleged work-related stress or mental injury claim, please contact Paul Clouser or Denise Elliott in the Lancaster office.