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Workers’ compensation, PTSD, and emergency responders

Workers’ compensation systems provide those who are injured during the course of employment with financial benefits in the event of an accidental personal injury or occupational disease. Maryland’s workers’ compensation laws went into effect over a century ago. Over the years, case law has expanded the definitions of these terms — the courts found an accidental personal injury to include those injuries that arise out of and in the course of employment and occupational diseases as ailments or illnesses connected to exposure to a hazard during their employment.

These definitions continue to evolve.

In the 1990s, the courts heard a wave of cases from workers who sought compensation for stress-related mental injuries like post-traumatic stress disorder (PTSD). This was not the first time the courts heard these types of claims. Examples are present that reach back to the 1920s. Even then, when information was scarce and research on the impact of mental illness relatively new, the courts recognized the need for compensation. During the surge in the nineties, the courts provided guidance on how to navigate these claims. This guidance continues to evolve to this day.

How do courts review requests for workers’ comp due to stress injuries like PTSD?

During the wave of cases in the nineties, the courts categorized mental health claims into one of three types: physical-mental, mental-physical, or mental-mental. Physical-mental claims arose when a physical injury caused a mental condition. This occurred when an injury at work led to a mental disorder that made it difficult or impossible to continue work.

Mental-physical claims involved stress causing a physical injury, such as seeing something shocking at work that resulted in a heart attack. Mental-mental claims involved seeing something shocking that led to mental or psychological injury. Although the courts have stated that “psychic trauma” can lead to damage much the same as physical trauma, this mental-mental category was and continues to be the most controversial because there is no physical element. This makes it difficult to establish the connection between the mental stimulus and the mental injury.

Do courts review these cases as an accidental injury or occupation disease?

It depends on the details. Two cases provide guidance, one on how these cases can qualify as an accidental injury and the second on the distinctions that could mean the case is more likely to find success for workers’ comp coverage as an occupational disease.

The first, Belcher v. T. Rowe Price, involves a three-ton beam that fell from a construction site and crashed into an office space. The beam landed five feet away from a secretary who was sitting at her desk completing her day’s work. The secretary suffered panic attacks because of this incident and filed a claim for PTSD. In the workers’ comp claim she argued the mental stimulus, the shock of the beam crashing through the office, led to the development of a mental injury, PTSD. The courts agreed that the beam crashing through the office was an “unexpected and unforeseen event that occur[ed] suddenly or violently” and qualified for compensation as an accidental personal injury.

The other main case that provides guidance for these types of claims is Means v. Baltimore County. Doreen Kay Means was employed by Baltimore County as a paramedic. During her time on-the-job she responded to a number of gory, shocking accident scenes, including a catastrophic car accident that killed five teenagers and a motorcycle accident where the driver was not wearing a helmet and suffered serious, fatal head injuries. Shortly after witnessing these scenes, the paramedic began suffering from PTSD. She claimed the mental stimulus of seeing these shocking accidents led to the mental injury of PTSD. This is different from the previous case because Means can also establish that the nature of her job as a paramedic led to exposure to hazards that could result in mental disease. As such, the court agreed that if Means could establish the experience on-the-job led to PTSD, her case could qualify for compensation as an occupational disease.

What should emergency responders who suffer from PTSD learn from this analysis?

The law is meant to protect those who suffer an injury while on-the-job, including mental injuries like PTSD. But these cases are complex. It is important to gather the evidence needed to establish that your claim meets all the requirements set out by statute and previous case law, including the use of medical opinions causally relating the occurrence at work to the PTSD diagnosis. Due to the complexity of these cases an injured employee should seek legal counsel from experienced Workers’ Compensation attorneys.

  • AMERICAN ASSOCIATION for JUSTICE
  • AABA
  • MARYLAND ASSOCIATION FOR JUSTICE
  • BAR ASSOCIATION OF BALTIMORE CITY | 1880
  • MSBA | MARYLAND STATE BAR ASSOCIATION
  • MARYLAND CRIMINAL DEFENSE ATTORNEYS ASSOCIATION