Typically, a drug test cannot be certified as positive until a Medical Review Officer (“MRO”) verifies the result.  For drivers subject to the Federal Motor Carrier Safety Act, Department of Transportation Regulations state that an MRO must verify as positive a confirmed test result for drugs, unless the employee presents a legitimate medical explanation for the presence of the drug in his/her system.  The employee bears the burden of establishing the legitimate medical reason for the positive test.

With the passage of state laws legalizing the use of medical marijuana, including here in Pennsylvania, many have questioned whether the use of medical marijuana, pursuant to state law, constitutes a legitimate medical reason for a positive drug test. In an updated “Medical Marijuana Notice” issued this fall, the Department of Transportation answered the question.  The DOT said “No.”

The DOT’s Notice makes it clear that marijuana, in all forms, remains illegal under federal law and the DOT expects that MROs will treat marijuana, whether used recreationally or medicinally, as illegal.  Accordingly, the Notice provides that “Medical Review Officers will not verify a drug test as negative based upon information that a physician recommended that the employee use ‘medical marijuana’ . . . It remains unacceptable for any safety‐sensitive employee subject to drug testing under the Department of Transportation’s drug testing regulations to use marijuana.”

The implications of medical marijuana use for CDL drivers is now clear.

But, what about drug tests for employees not regulated by the DOT?

The reality is that most MROs follow DOT testing guidelines for all drug tests in an effort to ensure consistency.  Accordingly, even when a non-DOT regulated employee tells the MRO that he/she is certified to use medicinal marijuana, the MRO will nonetheless certify the test as positive.  The MRO may include an external note to the employer that the employee claimed medicinal use.  However, the MRO will not seek to confirm the employee’s claim or to otherwise determine if the employee is a certified user.

The take-away is this . . . drug testing facilities will not help employers decide how to handle medical marijuana use.  A positive drug test will be a positive drug test, regardless of whether the employee is certified to use medical marijuana.  Accordingly, at the end of the day, outside of the CDL context the burden remains on the employer to decide, in accordance with its policies, how, if at all, the employee’s medicinal use impacts employment status.

Should you have any questions about your company’s drug testing procedures or your drug testing policies as the Pennsylvania Medical Marijuana Act nears full implementation, do not hesitate to contact us.

Since the passage of the Medical Marijuana Act (“MMA”), we have received many questions from employers regarding the MMA’s impact on employment law; one of the most frequent questions being – what do I do if an employee tells me he/she is using medical marijuana? While the answer to this question will partly depend on state regulations that have yet to be issued, for now there are a few things that employers should know and do when confronted with an employee who is using medicinal marijuana:

  1. Recognize that only “certified users” are legally permitted to use medicinal marijuana in Pennsylvania. Only individuals who are “certified” under the MMA are authorized to use medical marijuana in Pennsylvania. Because the regulatory framework to implement the certification process has not been implemented, there presently is no mechanism for individuals in Pennsylvania to become “certified.” Until the regulatory framework is in place and certifications are being issued, any employee who reports that he is using medical marijuana is likely violating the law. Until a certification is issued, the employee is not entitled to the protections contained in the MMA, such as the anti-discrimination provision at §2103(b)(1), which we discussed here.
  1. Understand that the MMA does not require employers to accommodate the use of medical marijuana while the employee is at work. The MMA specifically provides “nothing in this Act shall require an employer to make an accommodation for the use of medical marijuana on the property or premises of any place of employment.” §2103(b)(2). For this reason, it appears employers may implement and/or continue to enforce policies that prevent marijuana use at work or on the employer’s premises, regardless of whether the use is certified under the MMA.
  1. Analyze the employee’s situation in accordance with the ADA. Under current interpretations of the law, it appears that the ADA does not prohibit an employer from discharging an employee who tests positive for marijuana, even if the use was prescribed by a doctor. However, the employee who voluntarily discloses medical marijuana use, because the employee has a disability, may be entitled to protection under the ADA. Accordingly, an employer should engage in an interactive process with the employee to determine whether accommodations are warranted. While we strongly recommend that employers seek guidance from counsel in these situations, the following general steps should be followed in all situations:
  • Ask the employee, in writing, to obtain a letter or report from his/her health care provider identifying the condition for which the medicinal marijuana has been prescribed and how, if at all, the employee’s use of medicinal marijuana will impact or impair the employee’s ability to perform his/her job. Providing a copy of the employee’s job description to the health care provider is a best practice.
  • To the extent the employee’s ability to perform his/her job is impacted by the use of medicinal marijuana, assess whether the employee can perform the essential functions of the job with or without reasonable accommodation. Remember, this is a fact-specific inquiry that should be conducted on a case-by-case basis. For example, if you would normally provide medical leave to an employee temporarily prohibited from performing his job due to the use of prescription drugs, you may be required to do the same for an employee with a prescription for medicinal marijuana.
  • To the extent an employee’s ability to perform his/her job is not impacted by the use of medicinal marijuana, remind the employee that reporting to work “under the influence” and the use of marijuana at work or on the employer’s premises are strictly prohibited.
  • Continue communicating with your employee to fulfill your obligations to interact under the ADA.

Naturally, if you have specific questions about the MMA and its impact on your workplace, please don’t hesitate to call any member of our Labor and Employment Law Practice Group for further guidance. As the Pennsylvania Department of Health begins to implement temporary regulations, we will keep you apprised of further developments.

Pennsylvania’s Medical Marijuana Act (MMA) was signed into law on April 17, 2016 and officially took effect last week. One of the questions we’ve been asked since the passage of the Act is: how will employer provided insurance (both health and workers’ compensation) be affected by the legalization of medical marijuana in Pennsylvania? The simple answer is that there should be no immediate effect on either employer provided health insurance or the administration of workers’ compensation insurance.

Pursuant to Section 2102 of the MMA, insurers and health plans, whether paid for by Commonwealth funds or private funds, are not required to provide coverage for medical marijuana. The inclusion of Section 2102 in the MMA is consistent with a nationwide consensus that medicinal cannabis need not be covered under health insurance. That marijuana remains a Schedule I controlled substance, is illegal under federal law and is not an FDA approved medical treatment lend support to those employers and insurance companies objecting to coverage. Section 2102 recognizes these concerns and objections and gives clear guidance to insurers and health plans in Pennsylvania regarding their requirements – or rather the lack thereof – to provide health insurance coverage for medicinal marijuana.

With regard to workers’ compensation coverage, insurance carriers and self-insured employers may have similar objections to paying for medicinal cannabis prescribed for a work-related condition covered by the MMA (i.e. neuropathies or severe chronic pain). Section 2102 is broadly written and, thus, likely also supports the argument that medical marijuana need not be covered under workers’ compensation insurance.

While the MMA does not require employers and carriers to provide coverage for medicinal cannabis, we recognize that some employers may consider doing so. In the context of chronic pain for example, medicinal cannabis is seen as an alternative to opiate therapy, which can be costly, ineffective and, in some cases, deadly. If the treating physician of an injured worker suffering from chronic pain should suggest medical marijuana as an alternative to opiates, there is nothing in the Act prohibiting workers’ compensation insurance from covering such treatment. Before providing coverage, however, employers and carriers should ensure that there is compliance with all other aspects of the MMA. For example, the prescribing doctor must be a registered “Practitioner” as that term is defined by the Act, the requirements of “Continuing Care” must be met and the injured worker must be suffering from one of the “Serious Conditions” enumerated in the Act. Employers and carriers should further consider the impact of federal law on providing such coverage and should consult with counsel to address specific questions.

As with any new law, there are many unanswered questions. The Department of Health is required to publish temporary regulations by October 17th and full regulations must be published by the fall of 2017. These regulations should provide guidance on the implementation of the Act and interpretation of specific provisions. Note – medical providers may not begin prescribing medicinal marijuana until the regulatory framework is in place. Accordingly, until the regulations are published, we cannot know the full impact that the law will have on the workplace.

The McNees Labor and Employment Group will be closely monitoring developments to the law and, specifically, the implementation of the temporary and permanent MMA regulations. We will continue to keep you advised as things develop. In the meantime, should you have specific questions about the law, your policies and plans or your employees, please do not hesitate to contact any member of the McNees L&E Group.

As if it knew we would be discussing this topic at the 26th Annual McNees Labor and Employment Seminar on June 3rd, in Hershey, PA, the Commonwealth Court of Pennsylvania recently issued a decision addressing whether an injury occurring in an employer’s parking lot was sustained in the course and scope of employment for purposes of workers’ compensation coverage.

In Quality Bicycle Products, Inc. v. WCAB, the employer challenged the claim related to an injury sustained by an employee while the employee was running to his car. The claimant was leaving work after receiving a panicked message from his wife that his daughter was missing from school. While running through the parking lot to his car, he heard a pop in his knee, felt excruciating pain and fell to the pavement. The employer denied benefits for the knee injury, arguing that the claimant was not in the course and scope of his employment at the time he was injured.

An injury occurs within the course and scope of employment, and is considered work related, if: “(1) the claimant was furthering the interest of the employer’s business at the time of the injury; or (2) if the injury was caused by a condition of the employer’s premises or the operation of employer’s business thereon.”  The employer argued that claimant could not meet either prong of this test. The Court agreed.

In analyzing the case, the Court first noted that “an injury suffered while traveling to and from work [which claimant was in this case] is not considered to have occurred in the course and scope of employment.” This is because the employee is not furthering the business or affairs of his employer while merely commuting. When an employee is not furthering the business of the employer, the employee must satisfy the three part premises test to demonstrate a work related injury: (1) the injury occurred on the employer’s premises; (2) the employee’s presence thereon was required by the nature of his employment; and (3) the injury was caused by the condition of the premises or by the operation of employer’s business thereon. In Quality Bicycle, the parties agreed that the first two prongs were satisfied, but the employer argued that the third was not. The Court agreed, explaining that the parking lot neither caused nor contributed to claimant’s injury. Rather his injury was caused by his own act of running. The Court distinguished this case from others where the injury was found to be work related – an employee who suffered a seizure in his car and was injured when he wrecked into a concrete abutment on employer’s property; an employee who was thrown off the hood of a moving car when the driver turned suddenly to avoid a closed exit gate. In both those cases, it was the employer’s premises (the concrete abutment, the closed gate) that caused or contributed to the accident. Conversely in Quality Bicycle, claimant’s knee popped as a result of his running, not because of a bump, hole or rock on the pavement.

The lesson from this case is that employers should thoroughly investigate questionable claims and analyze such claims down to the most minor detail. If an injury occurs on the premises, don’t automatically assume that it is work related. In Quality Bicycle, claimant’s admissions that his knee simply popped, he felt pain and then fell to the pavement were key to the employer’s denial and ultimate success. Accordingly, we strongly recommend that an employer’s injury report include space for the employee to state, in his/her own words, what happened and what caused the injury.

To learn more about what injuries are and are not work related, join us on June 3, 2016 for our 26th Annual Labor and Employment Seminar.

On April 17, 2016, Pennsylvania Governor Tom Wolf signed the Medical Marijuana Act (MMA), which legalizes medicinal marijuana in Pennsylvania. The MMA, which takes effect on May 17, 2016, includes various provisions related to employment, and we have received many questions regarding what employers must, can and cannot do as a result of the new law. The simple answer is that, for the time being, we do not believe that employers are required to take immediate action. No immediate changes to your drug and alcohol policies or how you deal with drugs in the workplace are necessary for now, but stay tuned.

The MMA requires the Department of Health (“Department”) to promulgate full regulations within 18 months, and the Department is also required to begin publishing temporary regulations no later than six months from the Act’s effective date. Accordingly, we expect further guidance before the end of 2016 and anticipate frequent changes to the rules and regulations surrounding the MMA and its interpretation thereafter.

So, what do you need to know about the law now?

  • The MMA contains an employment anti-discrimination provision that states as follows:

No employer may discharge, threaten, refuse to hire or otherwise discriminate or retaliate against any employee regarding an employee’s compensation, terms, conditions, location or privileges solely on the basis of such employee’s status as an individual who is certified to use medical marijuana. MMA §2103(b)(1).

This anti-discrimination provision seems clear; however, it does raise some unanswered questions.  Although more than 20 other states have legalized medicinal marijuana, for purposes of the MMA, an “individual who is certified to use medical marijuana” seemingly refers only to individuals certified under Pennsylvania law. It is unclear whether an employee who is certified in another state would be entitled to the protection of §2103(b)(1).  Also, keep in mind that it will take some time for Pennsylvania to implement the regulatory framework to begin the certification process, set up dispensaries and begin actually distributing marijuana.

  • Employers are not required to accommodate the use of medical marijuana at work and employers retain the ability to discipline employees for using marijuana at work. Along these lines, the MMA provides:

Nothing in this Act shall require an employer to make an accommodation for the use of medical marijuana on the property or premises of any place of employment. This Act shall in no way limit an employer’s ability to discipline an employee for being under the influence of medical marijuana in the workplace or for working while under the influence of medical marijuana when the employee’s conduct falls below the standard of care normally accepted for that position. MMA §2103(b)(2).

While employers retain the right to discipline users of medical marijuana if they are “under the influence” at work, we do not yet know what is meant by “under the influence.” It remains to be seen which definition of “under the influence” will apply to potential employee discipline.

  • The MMA prohibits certified users from performing certain safety-sensitive jobs while “under the influence” of medicinal marijuana, including: (1) operating or being in physical control of chemicals which require a permit issued by the federal government, state government, federal agency or state agency; (2) operating or being in control of high-voltage electricity or any other public utility; (3) performing any employment duties at heights or in confined spaces, including, but not limited to, mining; (4) performing tasks that the employer deems life-threatening to either the employee or any employees of the employer; and (5) performing any duty that could result in a public health or safety risk. MMA §510.
  • The MMA does not require employers to “commit an act that would put the employer or any person acting on its behalf in violation of federal law.” MMA §2103(b)(3). For example, an employer would not be required to accommodate medicinal marijuana use if such accommodation violates federal DOT regulations.
  • The MMA does not, currently, supersede an employer’s rights under the ADA. For example, under current interpretations of the law, employers are not prohibited by the ADA from discharging an employee who tests positive for marijuana, even if the use is pursuant to a valid prescription. This could change, however, as the MMA evolves and as we further understand how “under the influence” will be defined in Pennsylvania. Further, the EEOC may change its position on the protected nature of medical marijuana as more states allow its use.

As with any new law, we have much left to learn. The McNees Labor and Employment Group will be closely monitoring the implementation of the temporary and permanent MMA regulations. We will keep you advised as things develop and are hopeful that the temporary regulations will address some of our unanswered questions, including: (1) what is meant by “under the influence;” and (2) whether the anti-discrimination provisions apply to those certified to use medical marijuana in other states. In the meantime, should you have specific questions about the law, your policies or your employees, please do not hesitate to contact any member of the McNees L&E Group.

In 2010, the Pennsylvania Legislature enacted the Construction Workplace Misclassification Act (CWMA), which, in part, attempted to clarify who is and is not an independent contractor (in the construction industry) for the purposes of workers’ compensation coverage.

Section 3(a) of the CWMA provides: “For purposes of workers’ compensation . . . an individual who performs services in the construction industry for remuneration is an independent contractor only if: (1) the individual has a written contract to perform such services; (2) the individual is free from control or direction over performance of such services both under the contract of service and in fact; and (3) as to such services, the individual is customarily engaged in an independently established trade, occupation, profession or business.” 43 P.S. §933.3(a).

To the extent an individual does not meet such definition, the individual will be deemed an employee and the general contractor/employer will be responsible for maintaining and providing workers’ compensation coverage for such individual.  Recently, in Staron v. Workers’ Compensation Appeal Board (Farrier), the Commonwealth Court clarified the first prong of the definition – the “written contract” requirement.

In Staron, the claimant responded to an advertisement by Lee’s Metal Roof Coatings and Painting (“Lee’s”) for a painter.  Claimant was allegedly a self-employed subcontractor with 20 years experience in painting and roof work.  Claimant began working for Lee’s, using his own tools and equipment and taking very minimal direction from Lee’s.  Approximately two months into the relationship, claimant fell off a roof and was injured.  Lee’s presented claimant with a written independent contractor agreement upon his release from the hospital, which claimant freely signed.  Claimant nonetheless sought workers’ compensation benefits from Lee’s, which were granted by the Workers’ Compensation Judge and affirmed by the Workers’ Compensation Appeal Board on the basis that claimant was an employee of Lee’s and not an independent contractor.  On appeal, the Commonwealth Court found that claimant was not an independent contractor, as defined by the CWMA, because there was no written contract between Lee’s and the claimant at the time claimant was injured.  It did not matter to the Court that claimant voluntarily signed the agreement after his injury.  According to the Court, the written independent contractor agreement contemplated by the CWMA must be in place prior to any injury being sustained in order to satisfy the “written contract” requirement of the Act.

Note, the Court did not say that the contract must be signed before any work is commenced in order to render the contractor an independent contractor.  The Court simply said that the agreement must be signed prior to the contractor sustaining an injury.  Nonetheless, the best practice would be for businesses employing independent contractors and sub-contractors, particularly in the construction trades, to ensure that Independent/Subcontractor Agreements are executed prior to the commencement of any work being performed.  Remember though that the existence of a written agreement will not necessarily carry the day in a dispute over the classification of an injured worker.  The written agreement is only one part of the test.  Accordingly, businesses in the construction trade should be mindful of the other CWMA requirements for independent contractor classification and should periodically review all independent contractor and subcontractor relationships to ensure compliance with the CWMA.

In 2003, the Pennsylvania General Assembly amended Section 601 of the Workers’ Compensation Act to expand the definition of the word “employee” to include employees who, while in the course and scope of their employment, provide aid to a person in order to (1) prevent the commission of a crime, (2) apprehend someone suspected of having committed a crime or (3) render emergency care, first aid or rescue at the scene of an emergency.  77 P.S. §1031(a)(10).  This amendment is commonly referred to as the Good Samaritan amendment and has historically been limited in its application – applying to volunteer emergency personnel only.  Recently, however, the Commonwealth Court rejected this limitation and effectively expanded the Good Samaritan amendment to apply to any employee who provides “Good Samaritan” type aid while in the course and scope of his or her employment.

In Pipeline Systems, Inc. v. WCAB (Pound), the Claimant was injured when he responded to a call for help – “man down. Jack fell.”  Claimant was assisting with the installation of pipelines and manholes at a borough sanitation plant.  Near the pipeline installation was a concrete pit.  On the day of the incident, Claimant and others responded to the call for help and found a borough employee lying at the bottom of the pit.  Claimant and others descended a ladder into the pit in an effort to help the man, but unfortunately discovered that the man had died in the fall.  While climbing out of the pit, Claimant lost consciousness and fell 20 feet, injuring his left leg, knee, foot, ribs, back and lung.  He sought workers’ compensation benefits, but the employer denied that he was entitled to benefits, arguing that Claimant went outside the course and scope of his employment when he decided to be a Good Samaritan.  Employer relied on the Supreme Court’s decision in Kmart Corp. v. WCAB (Fitzsimmons).   In Kmart Corp., the Supreme Court held that a Kmart employee was not in the course and scope of her employment when she was injured while rendering aid to a fellow employee, who was in the Kmart food court on her lunch break and was being attacked by her estranged boyfriend.  In litigation, the employer also argued that the Good Samaritan amendment to the Act did not apply to Claimant, as Claimant was not volunteer emergency personnel.

The Commonwealth Court, in Pipeline Systems, rejected the employer’s arguments, citing the Good Samaritan amendment, which was adopted three years after the Supreme Court decided the Kmart case.  The Court found that the amendment was not limited to volunteer emergency personnel and could apply to any employee who renders aid to another while in the course and scope of his/her employment.  In this case, the Court found that Claimant was within the course and scope of his employment when he was injured, because he was “in the midst of his work” when he responded to the call for help, climbed into the pit, and fell.

In light of this ruling, employers will be unable to deny benefits for injuries sustained by Good Samaritan employees (as defined in Section 601), unless they can show that the employee was outside the course and scope of employment when the Good Samaritan aid was provided.  Under most circumstances, this will be a difficult burden for the employer to meet.  Accordingly, it is our recommendation that employers consider adopting Good Samaritan policies.  Employees should be told to refrain from putting themselves or others at risk and instead follow protocols for contacting emergency personnel and reporting the emergency to the appropriate person within the company.  Having such a policy in place may not preclude an employee from receiving benefits if he or she violates the policy, provides aid and is injured but it could dissuade employees from intervening in dangerous situations that they are not trained to deal with, thereby helping to reduce the possibility of an injury being suffered.  Additionally, under the right set of facts, the employee could be disciplined for violating a positive work rule, which may preclude him or her from receiving workers’ compensation wage loss benefits.

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.

In Part 1 of this blog post, we explored the three legal classifications of potentially work related mental injury claims addressed under the Pennsylvania Workers’ Compensation Act: physical/mental, mental/physical, and mental/mental. In this part, we will take a closer look at the rapidly developing area of mental/mental cases. We will also provide practical advice on how you can protect your company from mental stress claims in Part 3 of this post.

As you will recall from Part 1, to succeed in establishing a Workers’ Compensation claim for a mental/mental injury (mental stimulus/mental injury), the employee must demonstrate that the injury resulted from an abnormal working condition. Historically, this has been a difficult burden for employees to meet. Consider, for example, the convenience store hold-up cases, where a convenience store clerk is held-up at gun point, is not physically touched or harmed, but suffers from anxiety, panic attacks and PTSD thereafter. In such cases, the employee cannot meet his/her burden of proving an abnormal working condition because, hold-ups are common in the industry, clerks are told as such, and clerks are trained regarding what to expect and how to handle a hold-up.

Recently, however, the courts have begun to ease the burden of proving abnormal working conditions.

In Payes v. WCAB (2013), the Pennsylvania Supreme Court notably eased the burden of proof in mental/mental cases, by holding that mental injury cases are highly fact-sensitive and that the Workers’ Compensation Judge (“WCJ”), as fact finder, must be given broad latitude in determining whether or not “abnormal working conditions” exist, given the specific facts of each individual case. In Payes, a State Trooper sustained PTSD after striking and killing a pedestrian who ran in front of his patrol car while he was traveling to the barracks. The WCJ awarded benefits, but the Appeal Board ruled in favor of the employer, finding that there was no abnormal working condition.  The Commonwealth Court affirmed, holding that a police officer can be expected to witness horrible tragedy and that “it is not beyond the realm of possibility for an officer to have to take someone’s life.” Further, the Court found it was normal for a police officer to administer first aid, including CPR, to a crash victim and that not all first aid attempts are successful.

The Supreme Court reversed, finding that the trooper was entitled to an award of benefits caused by “a singular extraordinary event occurring during [the claimant’s] work shift.” An abnormal working condition was found to exist, even though state troopers are routinely exposed to vehicle accidents, mayhem, bodily injury, death, murder and violent acts, in the normal course of their duties.  In this case, the death was found to be a “suicide by cop” situation, in which the responding officer was also placed in the zone of danger due to oncoming traffic, while attempting to revive the decedent, prior to the arrival of emergency personnel. The Supreme Court held that a State Trooper is not normally exposed to a mentally disturbed individual running in front of his vehicle, thus requiring the Trooper to perform CPR on such individual on a busy interstate highway. The lesson from Payes is that deference will be given to the fact finder, the WCJ, in these cases, to decide whether or not an abnormal working condition exists.

Recently, the Commonwealth Court followed the Supreme Court’s lead in Payes, by vacating and remanding a mental/mental case to the WCJ, for further consideration as to whether an armed robbery of the general manager of a check cashing business involved an “abnormal working condition.” The manager and her husband were abducted at gunpoint while opening the store. The husband was handcuffed and forced into the backseat of the gunman’s car, while the Claimant was led into the office at gunpoint, shoved to the ground and hog-tied. A panic button she had been given by her employer was inoperable, although she was eventually able to free herself and call 911. Following the assault, Claimant had regular nightmares, panic attacks, bouts of crying, and difficulty getting dressed or bathed.  She was diagnosed with PTSD as a direct result of the armed robbery. Noting that Claimant had been trained on how to respond in the event of a robbery and that a robbery was foreseeable and more than just a remote possibility, the WCJ nevertheless found no abnormal working condition. On remand, however, the Court held that the Judge is obligated to consider the facts surrounding this specific robbery, in deciding whether abnormal working conditions were present. Murphy v. WCAB (Pa. Cmwlth. Ct. 2015).

The trend toward compensability of stress claims is likely to continue in Pennsylvania, based on these developments.  Accordingly, employers would be wise to consider taking steps to reduce potential exposure to such claims.  A thorough investigation of the circumstances surrounding the filing of a claim for workers’ compensation benefits is perhaps the most important initial step to take.  Why?  Because there are so many causes for psychological or psychiatric conditions. We will explore this more in Part 3, tomorrow!

Mental injury claims, often stemming from workplace stressors, are on the rise and can create major headaches for employers. Understanding the relationship between stress in the workplace and resulting mental and physical disorders, such as psychiatric disorders or cardiovascular disease, isn’t easy.  Often there are more questions than answers. Can stress lead to anxiety attacks or depression? Can job induced stress cause your blood pressure to rise? Could it cause a heart attack or cardiac condition? How do we separate work-related from non-work related causes?

A recent estimate from the National Institutes of Health projected that the cost to the American economy of stress related health claims is close to $150 billion per year.  The cost is reflected in decreased productivity, absenteeism and massive increases in medical treatment costs.  Accordingly, it is not uncommon for corporations to spend millions of dollars each year on “stress management” programs.  As claims of stress-related mental illness and cardiovascular injury continue to rise, it becomes increasingly important for companies to be able to distinguish cases of compensable work-related stress from other non-compensable situations.  To do so, the employer must have a good working knowledge of some of the medical concepts associated with stress, and the legal framework within which these concepts will be applied.  To assist employers in this regard, Part 1 of this blog post will provide an overview of the general concepts and part 2 will explore some of the more recent Pennsylvania cases.

Employers familiar with mental injury claims will recall that Pennsylvania law distinguishes between three (3) types of mental injury cases – – physical/mental (a physical stimulus causing mental injury), mental/physical (a mental or emotional experience causing physical consequences), and pure mental/mental cases (mental or emotional stimulus causing purely emotional sequelae).

The above distinctions are important because differing burdens of proof apply depending on the proper categorization of the case.  In physical/mental and mental/physical cases, the Claimant need only establish, by a preponderance of the evidence, that his or her injuries arose in the course and scope of employment.  A higher burden of proof, however, attaches to mental/mental injuries and to prevail in these cases, the Claimant must demonstrate the presence of “abnormal working conditions.”

The best example of a “physical/mental” case involves an amputation or orthopedic injury of sufficient severity to necessitate later psychological counseling or psychiatric treatment for a condition such as depression or PTSD.  The mirror image of the physical/mental case is the so-called “mental/physical” case, which involves a work-related mental stimulus, triggering physical injury or illness.  Sometimes a heart attack or cardiac condition can qualify as a compensable event under this standard. A determination of causal connectedness to work often depends on medical evidence and opinion.  Although employees often file claims for depression and anxiety caused by general workplace stress, these claims usually are not compensable, because these are mental/mental claims and the abnormal work condition requirement is difficult to meet. Although difficult to prove, mental/mental cases, where an alleged abnormal working condition creates a mental stressor that in turn produces a mental or emotional disability, are the most hotly litigated.  These are highly fact specific cases with significant emotional investment by the Claimant. The heightened burden of proof (i.e. presence of an abnormal working condition) is typically found to have been met only where a mental disability is directly caused by a violation of law, such as sex, age, race or disability discrimination, or by some workplace event that is totally unexpected and abnormal with respect to Claimant’s specific employment (i.e. a police officer who witnesses a shooting has not necessarily been exposed to an abnormal working condition, absent additional facts).

The Pennsylvania Supreme Court held benefits were proper in a mental/mental case involving a coal miner with a pre-existing post-traumatic stress disorder.  The pre-existing condition, of which the employer was aware, had been caused by unwelcome homosexual propositions from his commanding officer, while initially serving in the U.S. Army in Vietnam.  The worker successfully argued that his underlying condition was materially aggravated by a series of three incidents over eight (8) days, during which his boss made comments in the presence of other workers, implying that he wanted to have sex with Claimant.  The employer offered testimony to establish that the comments were no different from the regular crude banter that often takes place between coal miners, and therefore did not constitute abnormal working conditions.  The Pennsylvania Supreme Court disagreed, noting that there had been sufficient evidence of a “course of conduct on the part of a supervisory employee, clearly calculated to cause severe emotional distress.”  Accordingly, the claimant met his burden of showing that he suffered from a mental injury, which involved more than a mere subjective reaction to normal working conditions.  RAG & (Cyprus) Emerald Resources v. WCAB (PA Supreme Court 2007).

With the foregoing legal framework in mind, in Part 2 of this blog post, we will explore more recent developments in the mental/mental line of cases and provide some practical insights as to how you can protect your company from work-related stress claims.