Mental and Emotional Injuries
Louisiana workers compensation covers some mental and emotional injuries, but these injuries need to be connected to a serious accident or traumatic event that happened at work.
Such a covered mental injury could be a mental injury that was caused by mental stress, if the mental injury was the result of a sudden, unexpected, and extraordinary stress related to the employment. Or the mental injury could be a mental injury caused by physical injury.
Either way, the mental injury or illness must be diagnosed by a licensed psychiatrist or psychologist. A licensed social worker or counselor is not sufficient to trigger benefits. In fact, the diagnosis of the licensed psychiatrist or psychologist must meet the criteria as established in the most current issue of the Diagnostic and Statistical Manual of Mental Disorders presented by the American Psychiatric Association.
So essentially, there are two types of "mental and emotional stress" claims: (1) mental or emotional injury caused solely by mental stress, and (2) mental or emotional injury caused by a physical injury or trauma.
Each of these are governed by different rules under Louisiana workers compensation:
- Mental injury caused by mental stress. Mental injury or illness resulting from work related stress shall not be compensable, unless the mental injury was the result of a sudden, unexpected, and extraordinary stress related to the employment and is demonstrated by clear and convincing evidence.
- Mental injury caused by physical injury. A mental injury caused by a physical injury to the employee's body shall not be compensable, unless it is demonstrated by clear and convincing evidence.
Clear and Convincing Evidence
All these requirements must be met by a standard of "clear and convincing evidence," which is a medium high bar which is often not easily met. Basically, "clear and convincing” means that the evidence is highly and substantially more likely to be true than untrue; or in other words that something is "highly probable." For comparison, clear and convincing evidence is a medium level of burden of proof which is a more difficult standard to meet than the preponderance of the evidence standard (which is more likely than not), but a less difficult standard to meet than proving evidence beyond a reasonable doubt (which is the burden of proof used in criminal cases).
Nonetheless, the Louisiana Supreme Court has clearly held that mental stress and trauma cases are compensable (which means that yes there is a claim to be paid), even without physical injuries or objective symptoms, so long as the cause was stress arising out of employment related issues.
But generally, the Louisiana courts have handled these types of claims fairly conservatively, perhaps because of the vague nature of these claims. Often the courts find that if the mental disorder, even if work-related, is not caused by physical injury or sudden and extraordinary stress, then it is likely not compensable. But each of the two types of mental and emotional injuries are governed by different rules under Louisiana workers compensation.
Mental Injuries Caused by Mental Stress
A mental injury caused by mental stress is compensable (which means that yes there is a claim to be paid), if the following elements are established by clear and convincing evidence:
- That mental injury originated in a sudden, unexpected and extraordinary stress;
- That the stress was related to employment;
- That the mental injury is diagnosed by a licensed psychiatrist or psychologist; and
- That the diagnosis is as per criteria set out in the current DSM (Diagnosis and Statistical Manual).
Most mental injuries from mental stress cases deal with conflicts between employees and either a supervisor, co-worker or a customer. These types of incidents are usually found to meet the requirement that the injury arises from an employment related incident.
Examples of Mental Injuries Caused by Mental Stress
One example of a case that the courts found to be compensable involved an employee who was a witness to the suicide of a co-worker. However, if no licensed psychiatrist or psychologist had diagnosed the employee as suffering from a mental disease or defect related to a readily identifiable, unusual and dramatic work-related incident, then this suicide example would not have been compensable.
Most mental/mental injury cases in which benefits are denied are cases in which the claimant cannot show a specific extraordinary event that resulted in an injury. However, in one case example, an argument with a supervisor that did not involve any "yelling" was found to be a sufficiently extraordinary event when an "abnormally susceptible" worker was involved. But in another case example, where the evidence revealed that the event occurred over several days, the mental injury was found not to have happened suddenly, and thus the employee could not recover benefits.
Additionally, the mere showing that a mental injury is related to general conditions of employment or to incidents occurring over an extended period of time, is typically not enough to justify compensation. Such was the case in one workers compensation example, where a claim for mental stress claim was brought on the basis of sexual harassment. The court denied that claim because it ruled that the mental injury must be precipitated by an accident, an unexpected and unforeseen event that occurs suddenly or violently.
In another case, a workers compensation claimant demonstrated by clear and convincing evidence that his depression was caused by "sudden, unexpected, and extraordinary stress" related to his employment as president of an insurance company handling claims in the aftermath of Hurricane Andrew. This employee was working 15 to 18 hours per day, reviewing each claim himself, and he constantly handled calls from irate insureds, some of whom threatened to kill him. The medical evidence showed that the claimant was in good health prior to the hurricane, and the treating psychiatrist concluded that the employee was suffering from major depression and that the work stress he encountered after the hurricane played a major role in precipitating his mental condition. For these reasons, this workers compensation claimant was able to recover full workers compensation benefits.
In another case, an employee was found to suffer a compensable accident and injury entitling her to receive worker's compensation benefits, when her co-workers placed an artificial frog in a shell canister they knew the employee would open and inspect. The injured employee had an extreme phobia of frogs and, after the incident, was hospitalized, treated and unable to return to work. Because of these facts, this workers compensation claimant was able to recover full workers compensation benefits.
But on the other hand, in another case, a general foreman on a high rise construction project failed to make his claim that his panic disorder was a result of job related stress, where there was no sudden stressful event after a regular meeting of all foremen, and the stress he experienced was not unexpected or extraordinary for a high rise job. While the employee was able to show that his stress was a result of his employment and that he was disabled, the workers compensation court denied his claim because it found that his stress was not unexpected for a foreman, and not extraordinary for that line of work.
So clearly, it is not easy to recover for a mental injury caused by work-related mental stress. But it certainly can be done, especially with an experienced attorney. Success in these types of cases is determined case by case by the particular facts of each case, and an employee really does need an experienced Louisiana workers compensation attorney to properly assemble the evidence and present such relevant and important facts in a clear and convincing manner to the judge.
Mental Injuries Caused By Physical Injury
In order for mental illness resulting from physical injury to be compensable, an injured or sick employee must be able to prove the following:
- That the employee is suffering from a mental or emotional condition or injury;
- That the employee has suffered an actual physical injury; and
- That the employee's physical injury has caused the employee's mental or emotional condition or injury.
Above all, the injured or sick employee needs a mental health professional to relate the employee's mental condition to the employee's work-related physical injury. It there is no mental health professional of the opinion that the employee's physical injury has caused the employee's mental condition, the the employee will not be able to recover benefits related to his or her mental condition.
That being said, it is important to recognize that while a physical injury must be clearly established, there is no requirement that the physical injury be one which itself rises to the level of a compensable injury of a physical nature. This means that an employee could suffer a physical injury that does not need medical treatment or cause the employee to miss work, but could still recover workers compensation benefits if that same physical injury caused a mental or emotional condition which caused the employee to require mental health treatment or to be unable to work.
Also, if the employee suffers an actual physical injury here, it does not matter how small the injury is, so long as the injury is documented. For example, in one Louisiana workers compensation case, the courts granted workers compensation benefits after a finger sprain aggravated an employee's pre-existing depression.
Unfortunately, once again, all these requirements must be met by a standard of "clear and convincing evidence." Clear and convincing evidence is a medium bar which is often not easily met. Basically, "clear and convincing” means that the evidence is highly and substantially more likely to be true than untrue; or in other words that something is "highly probable."
Finally, instances of these types of mental illnesses resulting from physical injury are much more common than one might guess. Most common is the scenario where an employee injures his or her back at work, but then this back injury causes the employee to suffer depression, due to a chemical/biological change caused by chronic pain from the employee's back injury. Of course, recovering workers compensation benefits for these types of mental and emotional conditions can be quite difficult for someone who is not well versed and well expended in Louisiana workers compensation law. For these reasons, any employee suffering from mental or emotional illnesses that is connected somehow to the worker's employment really does need an experience Louisiana workers compensation attorney to handle his or her claim.