Determining the compensability of so-called "mental-mental" cases—those instances in which a mental (as distinguished from a physical) impact or stimulus results in a mental injury or occupational disease—is among the most challenging issues within the workers' compensation arena. On the one hand, the American workplace is not—and never has been—free from stresses and strains; there is a compelling argument that those with thin skins should not recover disability benefits where other veterans of the work force "tough it out" for years without complaint. On the other hand, there are clearly some instances in which the nature of the employment stress is either so extraordinary or so burdensome that the resulting injuries are every bit as real as the familiar cuts, bruises, and broken bones that occur within the working environment. And whatever happened to the notion that the employer takes the employee as it finds him or her—thin skin and all? What standards are to be applied in determining compensability where the complaint is often based upon subjective reactions and not discrete, objective incidents?
In a recent North Carolina case [Hassell v. Onslo County Bd. of Educ., 2008 N.C. LEXIS 498 (June 12, 2008)], the state's supreme court was called upon to review a decision of the state's Industrial Commission that denied a public school teacher's claim that her generalized anxiety disorder (GAD) was brought about by her unruly classrooms and that it constituted an occupational disease as defined by the state's Workers' Compensation Act. In a divided opinion, the state high court affirmed a decision by a similarly divided panel of the state's Court of Appeals, and held that there was competent evidence to support the Commission's findings that the teacher had not sustained an occupational disease. The high court disavowed a factual finding by the Commission that the teacher's GAD had been caused by her inability to control the classes and affirmed the denial of benefits in spite of the contention by the teacher that the Commission's assignment of "blame" was an inappropriate introduction of employee fault into the world of workers' compensation where it did not belong.
This commentary by Thomas A. Robinson analyzes the case, discusses relevant issues related to mental-mental injury claims and their relationship to occupational disease, and observes that a surprisingly large number of states refuse to allow disability awards for any sort of mental-mental case. The author discusses the majority rule—that at least under some circumstances, employees who show that their mental injuries are sufficiently tied to the workplace can recover, either under an injury theory or an occupational disease theory. Noting that in Hassell, the Industrial Commission gave little weight to the uncontradicted testimony of the teacher's medical expert that tended to establish a causal relationship between her GAD and the workplace, the author observes that the Commission and the state's appellate courts came dangerously close to disqualifying the teacher's occupational disease claim on an inappropriate basis of employee fault.
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