Illinois Workers’ Compensation Commission confirms claimed psychological injuries occurring as a result of everyday stress in the workplace remain non-compensable.
On a happier note, Illinois employers should review and understand two important Commission rulings which provide clarity with regard to the compensability of mental-mental injuries, a topic which has garnered a lot of discussion over the years and where there has long been ambiguity. We remain happy to report the Illinois Commission hasn’t gone to the legal standard on our “Left Coast” of allowing everyone who can demonstrate they are more stressed out from work than normal life can get weekly workers’ compensation benefits.
For our readers who are unaware, what Illinois calls a “mental-mental” injury occurs when normal and expected workplace stress causes psychological “injuries,” dysfunction or mental disorders. We see several such cases every year and with each claim even the most veteran adjusters have identical questions on whether it is acceptable to deny. Obviously the circumstances of each case are different and we cannot give a universal rule but in our experience it is rare that we find sufficient evidence to accept a mental-mental injury as compensable in this state. Over the years there have been conflicting decisions on the topic, however we applaud the Commission for the recently issued decisions in Cook v. Pactiv and Peters v. Albertson/Jewel Food Stores where in a well-reasoned and rational fashion, the Commission ruled against compensability for different mental-mental injuries. In doing so they provided significant clarity on the handling of such matters for attorneys on both sides, risk managers and claims adjusters alike.
In Cook, the Illinois Commission held the mental-mental theory of compensation for psychological injuries does not include mental injuries caused by stressful situations characteristic of the normal workplace. The claimant in Cook was a machine operator who alleged trouble sleeping, hypertension, depression and anxiety as a result of a change in his shifts and job duties. The case was initially found compensable by the arbitrator who noted claimant’s hypertension was physical, rendering what the Arbitrator felt was a compensable physical-mental claim.
On review, the Commission found error in the arbitrator’s rationale and reversed the decision as the physical-mental theory was improperly applied to the facts. To be clear, the physical-mental theory of compensability is applicable only where a sudden, unforeseen physical injury directly leads to an adverse mental condition. Thus the claim fell under the mental-mental theory and was not compensable because the claimant did not meet the requisite burden for establishing a compensable mental-mental claim. The Commission clearly identified the three aspects of a claimant’s burden as
- A mental disorder must arise in a situation where stress is greater than the day to day emotional strain experienced by all employees,
- The condition exists in reality, from an objective standpoint, and
- The employment conditions were obviously a contributing factor to the mental disorder.
Similarly, in Peters the Commission affirmed an arbitration decision finding mental disorders not resulting from trauma must arise in a situation of greater dimension than day to day emotional strain and tension which all employees must experience. The claimant in Peters was a grocery store employee who was asked to apologize at a meeting and was prevented from leaving the room for five to ten minutes. It was ruled this situation did not expose the claimant to an identifiable condition of employment that was common and necessary to all or a great many occupations.
Please remember psychological injuries arising from sudden and unforeseen traumatic events at the Illinois work site are compensable. We tell all of our clients and readers if someone dies or is seriously injured in your workplace, you have to deal with the serious injury or death but also remember every worker who saw, experienced or knew of the accident is also potentially a claimant. Be sure to provide counseling and sensitive assistance if other ostensibly “non-injured” workers start to show signs of strain or mental problems. They may be suffering expected sequalae of the tragedy and may be entitled to benefits; a wise risk manager shouldn’t ignore their psychological needs in the workplace.
This article was drafted by law students and KC&A paralegals Michael F. Sullivan and Kevin J. Carey. We recommend all claims adjusters and underwriters use these decisions and Mike and Kevin’s analysis as guideposts for the future handling of mental-mental claims. Please respond with questions or concerns or post them on our blog.
