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Mental injury difficult to prove for workers' compensation claim

While workers' compensation insurance carriers and employers require sufficient evidence to pay benefits to an injured worker, some evidence is not so easy to provide.  When an employee breaks an arm or leg from a fall or suffers another physical injury, the ailment is relatively apparent.  But mental conditions attributed to employment are more difficult to prove.  There is no objective test like an X-ray that can prove in Minnesota courts or other states that a worker has suffered a mental injury.

One recent case that unfolded in another state is a prime example of how the two types of injuries can be treated differently in workers' compensation claims. The case involved a clothing store manager who reported an armed robbery at his store which led police to arrest the two men involved. At the time of the robbery, the two men arrested had warned the manger not to report the crime. After the arrest, the brother of one of the men charged with the crime visited the store and shot the manager 12 times and threatened the man's family. The manager still chose to testify at the trial which ended with the men being sent to prison.

As a result of the robbery and shooting, the manager filed a claim for substance dependency related to post-traumatic stress disorder he had suffered since the incident. While the employer's workers' compensation coverage paid the man's medical expenses and temporary benefits as he recovered from his physical wounds, the carrier refused to pay for expenses related to the psychological injuries. The court where the workers' compensation claim ultimately ended up didn't agree, awarding the man benefits for inpatient rehabilitation for substance abuse, future medical expenses and extended his temporary disability payments.

While psychological and emotional conditions will continue to rely on the testimony of medical professionals to provide sufficient evidence for the award of benefits, cases like the store manager's are a step in the right direction.

Many employees hesitate to report psychological conditions because of the stigma associated with them, even fearing that bringing attention to the condition could cost them their job. But as courts start to legitimize the effects of conditions such as depression, PTSD and other mental disabilities, employers and workers' compensation carriers may be more open to accepting the subjective evidence required to prove the need for benefits.

Source: Omaha.com, "Nebraska Supreme Court: Workers' comp includes PTSD, drug treatment after store shooting," Chris Machian, April 12, 2014

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