Minnesota Supreme Court Affirms Denial of PTSD Claim
Court’s Decision Reaffirms Compensation Judges’ Role in Interpreting and Choosing Between Conflicting Medical Opinions
On July 17, 2019, the Minnesota Supreme Court issued its first major decision interpreting a 2013 amendment to Minnesota’s Workers’ Compensation law allowing employees to assert “mental injury” claims if they suffer PTSD. In Smith v. Carver County, the Court ruled that the statute does not require a compensation judge to conduct an independent assessment to verify that a medical expert’s diagnosis conforms to the DSM-5 PTSD criteria before accepting the expert’s diagnosis and conclusions. In doing so, the Court reversed the Workers’ Compensation Court of Appeals (WCCA) and reinstated the decision of the trial court denying the employee’s PTSD claim.
Smith worked as a deputy sheriff with the Carver County Sheriff’s Office for nearly 10 years. He resigned in 2016 and was later diagnosed with PTSD due to events he witnessed while working as a deputy. After his diagnosis, Smith filed a workers’ compensation claim petition seeking worker’s compensation benefits for his PTSD. While Minnesota law generally does not allow mental injury claims, since enacted in 2013 Minn. Stat. § 176.011, subd. 15(d) allows PTSD claims provided the diagnosis of PTSD conforms to the most recently published edition of the Diagnostic and Statistical Manual of Mental Disorders. Currently, that is the DSM-5.
Smith’s employer, Carver County, denied the claim and requested an independent psychological evaluation. Dr. Arbisi performed the independent examination and determined that while Smith had mixed anxiety and depressed mood, he did not have PTSD. At the workers’ compensation hearing a compensation judge viewed all of the medical evidence from the claimant’s treating licensed psychologist and Dr. Arbisi. The judge found the independent examination conducted by Dr. Arbisi more persuasive and denied Smith’s PTSD claim and related claims for workers’ compensation benefits.
Smith appealed to the WCCA. The WCCA reversed, concluding the PTSD statute required the compensation judge to go beyond weighing and choosing between competing expert medical opinions. The WCCA ruled that compensation judges must make an independent determination that every expert opinion diagnosing PTSD conforms with the criteria set forth in DSM-5.
The Minnesota Supreme Court overturned the WCCA’s ruling and found the statute does not oblige a compensation judge to independently verify a medical expert’s opinion conforms with the diagnostic criteria for PTSD set forth in the DSM V. The Court maintained that the compensation judge’s role is to determine the credibility and persuasiveness of expert opinions. The judge’s choice between experts will be upheld if the expert selected had adequate foundation for his opinion. In this case, Dr. Arbisi’s opinion included facts and data upon which the judge relied in forming his opinion, explained the basis for his opinion, and did not assume facts unsupported by the evidence.
COMMENT: The Minnesota Supreme Court essentially found the WCCA created a judicial amendment to the statute which the Legislature did not intend and which the plain language of the statute did not require. The Court’s decision in Smith maintains the traditional role of compensation judges in determining the credibility, foundational support and other factors impacting the reliability of expert opinions. Additionally, the Court’s interpretation of the “plain and straightforward” language of the statute simply means the statute “does nothing more than require that a diagnosis of PTSD in a workers’ compensation case be done by a licensed psychiatrist or psychologist based on the latest version of the DSM.”
It’s also important to keep in mind that the result in this case may have been quite different if Smith was injured on or after January 1, 2019. In 2018 the Minnesota Legislature amended the PTSD statute to create a rebuttable presumption of work-related PTSD for certain first responders and other emergency personnel. If these employees were not diagnosed with PTSD before their employment and were diagnosed with that condition after they began their employment, the presumption is that their employment caused the PTSD. This presumption may be rebutted by undefined “substantial factors brought by the employer or insurer”. This likely would not have changed the result in this case because the judge found Smith did not have PTSD. However, the rebuttable presumption may have made it easier for the compensation judge to adopt the treating doctor’s opinion that Smith had PTSD.