Case Title: Armstrong v. John R. Jurgensen Co.

Citation: 2013-Ohio-2237

Docket Number: 2012-0244

State: ohio

Court: Ohio Supreme Court

Date: 2013-06-04T00:00:00Z

Document:
[Until this opinion appears in the Ohio Official Reports advance sheets, it may be cited as 
Armstrong v. John R. Jurgensen Co., Slip Opinion No. 2013-Ohio-2237.] 
 
 
 
NOTICE 
This slip opinion is subject to formal revision before it is published in 
an advance sheet of the Ohio Official Reports.  Readers are requested 
to promptly notify the Reporter of Decisions, Supreme Court of Ohio, 
65 South Front Street, Columbus, Ohio 43215, of any typographical or 
other formal errors in the opinion, in order that corrections may be 
made before the opinion is published. 
 
SLIP OPINION NO. 2013-OHIO-2237 
ARMSTRONG, APPELLANT, v. JOHN R. JURGENSEN COMPANY ET AL., 
APPELLEES. 
[Until this opinion appears in the Ohio Official Reports advance sheets, it 
may be cited as Armstrong v. John R. Jurgensen Co., 
Slip Opinion No. 2013-Ohio-2237.] 
Workers’ compensation—R.C. 4123.01(C)(1)—PTSD—No compensable physical 
injury—Judgment denying benefits affirmed. 
(No. 2012-0244—Submitted January 23, 2013—Decided June 4, 2013.) 
APPEAL from the Court of Appeals for Clark County, 
No. 2011-CA-6, 2011-Ohio-6708. 
____________________ 
 
FRENCH, J. 
{¶ 1} In this appeal, we consider whether, for a mental condition to be 
compensable under the Ohio workers’ compensation system, a compensable 
physical injury sustained by the claimant must cause the mental condition.  We 
hold that it must. 
 
 
SUPREME COURT OF OHIO 
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Facts and Procedural History 
{¶ 2} On August 27, 2009, appellant, Shaun Armstrong, was involved in 
a motor-vehicle accident while operating a one-ton dump truck within the course 
of his employment by appellee, John R. Jurgensen Company.  While stopped at a 
yield sign on an access ramp to I-70 east, Armstrong observed a vehicle 
approaching from behind with increasing speed.  Armstrong braced for a 
collision, afraid he was going to be seriously injured.  The approaching vehicle 
struck the dump truck from behind, pushed it forward, and came to rest “basically 
underneath” the dump truck. 
{¶ 3} After the collision, Armstrong was in shock and did not know the 
extent of his injuries.  Looking in his mirror, Armstrong saw the other driver with 
his head down and observed fluid leaking from the vehicles.  Armstrong exited 
the dump truck, afraid the vehicles would catch fire, and called 9-1-1.  Armstrong 
then noticed that the other driver was not moving and that blood was coming from 
his nose; he suspected the driver was dead.  After being transported to the 
emergency room, Armstrong was treated for physical injuries and released.  He 
was distressed to learn, while in the emergency room, that the other driver had, in 
fact, died. 
{¶ 4} Armstrong filed a workers’ compensation claim for his physical 
injuries, and his claim was allowed for cervical strain, thoracic strain, and lumbar 
strain.  He subsequently requested an additional allowance for posttraumatic-
stress disorder (“PTSD”).  A Bureau of Workers’ Compensation (“BWC”) staff 
hearing officer allowed Armstrong’s additional claim, finding his PTSD 
compensable because it was causally related to his industrial injury and his 
previously recognized conditions.  Jurgensen appealed to the Industrial 
Commission of Ohio, which refused the administrative appeal. 
{¶ 5} After the Industrial Commission refused Jurgensen’s administrative 
appeal, Jurgensen appealed to the Clark County Court of Common Pleas pursuant 
January Term, 2013 
 
3
to R.C. 4123.512.  The parties stipulated that Armstrong suffers from PTSD, and 
the trial court conducted a bench trial to determine Armstrong’s right to workers’ 
compensation benefits for that condition. 
{¶ 6} Both Armstrong and Jurgensen presented expert testimony 
regarding the cause of Armstrong’s PTSD.  Armstrong presented the videotaped 
deposition testimony of Jennifer J. Stoeckel, Ph.D., who evaluated Armstrong and 
diagnosed his PTSD.  Dr. Stoeckel testified that Armstrong developed PTSD as a 
result of the accident and that his physical injuries contributed to and were causal 
factors in his development of PTSD.  Jurgensen, on the other hand, presented the 
testimony of William L. Howard, Ph.D., who agreed with Dr. Stoeckel that 
Armstrong suffered from PTSD as a result of the accident, but opined that 
Armstrong’s physical injuries did not cause his PTSD.  Dr. Howard testified that 
the PTSD was caused by witnessing the accident and “the mental observation of 
the severity of the injury, the fatality, [and] the fact that it could have been life-
threatening to him at some point.”   Dr. Howard believed that Armstrong would 
have developed PTSD even without his physical injuries. 
{¶ 7} The trial court held that Armstrong’s PTSD was not compensable 
because it did not arise from his physical injuries.  The Second District Court of 
Appeals affirmed, holding that the applicable statutory definition of “injury” 
includes psychiatric conditions only when they arise from a compensable physical 
injury.  The court of appeals further determined that competent, credible evidence 
supported the trial court’s factual finding that Armstrong’s PTSD did not arise 
from his physical injuries.  Armstrong v. John R. Jurgensen Co., 2d Dist. No. 
2011-CA-6, 2011-Ohio-6708, ¶ 39. 
Question Presented 
{¶ 8} The question before us is whether R.C. 4123.01(C)(1) limits 
workers’ compensation coverage for psychiatric conditions to those conditions 
caused by the claimant’s compensable physical injury. 
SUPREME COURT OF OHIO 
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Analysis 
{¶ 9} 
The Ohio Constitution, Article II, Section 35 vests in the General 
Assembly the right to establish a workers’ compensation system for the purpose 
of providing workers and their dependents compensation for death, injuries, and 
occupational disease occasioned in the course of employment.  Article II, Section 
35 “gives the General Assembly the sole authority to determine [workers’ 
compensation] coverage and to define which occupational injuries will be 
covered.”  McCrone v. Bank One Corp., 107 Ohio St.3d 272, 2005-Ohio-6505, 
839 N.E.2d 1, ¶ 34, citing Rambaldo v. Accurate Die Casting, 65 Ohio St.3d 281, 
288, 603 N.E.2d 975 (1992). 
{¶ 10} Aside from certain statutory exceptions, R.C. 4123.54(A) 
provides that every employee who is injured or contracts an occupational disease 
is entitled to receive compensation for loss sustained on account of the injury or 
occupational disease.  R.C. 4123.01(C) defines “injury” for purposes of workers’ 
compensation: “ ‘Injury’ includes any injury, whether caused by external 
accidental means or accidental in character and result, received in the course of, 
and arising out of, the injured employee's employment.”  Psychiatric conditions 
are excluded from the general definition of “injury,” “except where the claimant's 
psychiatric conditions have arisen from an injury or occupational disease 
sustained by that claimant.”  R.C. 4123.01(C)(1). 
{¶ 11} This case presents an issue of statutory construction, centering on 
whether Armstrong’s PTSD qualifies as an “injury” under R.C. 4123.01(C)(1).  
Specifically, we must determine what nexus is required between a psychiatric 
condition and a compensable physical injury for the psychiatric condition to 
qualify as a compensable injury.  Jurgensen maintains that R.C. 4123.01(C)(1) 
requires a direct and proximate causal relationship between the physical injury 
and the mental condition, but Armstrong maintains that Ohio courts have always 
allowed compensation for mental conditions that arise contemporaneously with 
January Term, 2013 
 
5
physical injury, regardless of a causal relationship between the two.  The Ohio 
Association for Justice (“OAJ”), as amicus curiae, has filed a brief in support of 
Armstrong’s position. 
{¶ 12} A court’s paramount concern in construing a statute is legislative 
intent.  State ex rel. Dispatch Printing Co. v. Johnson, 106 Ohio St.3d 160, 2005-
Ohio-4384, 833 N.E.2d 274, ¶ 21, citing State ex rel. Steele v. Morrissey, 103 
Ohio St.3d 355, 2004-Ohio-4960, 815 N.E.2d 1107, ¶ 21.  To discern legislative 
intent, we first consider the statutory language, reading the words and phrases in 
context, according to rules of grammar and common usage.  R.C. 1.42; State ex 
rel. Choices for South-Western City Schools v. Anthony, 108 Ohio St.3d 1, 2005-
Ohio-5362, 840 N.E.2d 582, ¶ 40.  The court may not delete or insert words, but 
must give effect to the words the General Assembly has chosen.  Bailey v. 
Republic Engineered Steels, Inc., 91 Ohio St.3d 38, 39-40, 741 N.E.2d 121 
(2001).  When a statute is unambiguous, a court must apply it as written.  Id. at 
40. 
{¶ 13} R.C. 4123.95 prescribes that the provisions of R.C. Chapter 4123 
“shall be liberally construed in favor of employees.”  R.C. 4123.95 does not, 
however, license alteration of unambiguous statutory language.  Kilgore v. 
Chrysler Corp., 92 Ohio St.3d 184, 189, 749 N.E.2d 267 (2001) (Moyer, C.J., 
dissenting) (“R.C. 4123.95 does not authorize this court to effectively rewrite the 
statutory system in favor of claimants and their lawyers to assure them favorable 
results”); Gleich v. J.C. Penney Co., Inc., 10th Dist. No. 85AP-276, 1985 WL 
10104, *2 (Aug. 8, 1985).  The language of R.C. 4123.01(C) is unambiguous, and 
we must apply it as written.  We will not rewrite the statute under the guise of 
liberal construction. 
{¶ 14} Pursuant to the plain language of R.C. 4123.01(C)(1), a claimant 
must sustain physical injury or occupational disease as a prerequisite to 
recovering workers’ compensation benefits for a mental condition.  A psychiatric 
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condition is not a workers’ compensation injury except when the condition has 
“arisen from an injury or occupational disease sustained by that claimant.”  R.C. 
4123.01(C)(1).  R.C. 4123.01(C)(1) “explicitly codified that ‘mental-mental’ 
claims—psychiatric conditions arising solely from job-related emotional stress—
were not compensable under the system.”  Bailey at 44 (Cook, J., dissenting); see 
also Rambaldo, 65 Ohio St.3d at 283, 603 N.E.2d 975 (“No Ohio appellate court 
has ever recognized a workers’ compensation claim for mental injury or mental 
disease caused solely by job-related stress which is unaccompanied by physical 
injury or occupational disease”). 
{¶ 15} Armstrong and OAJ urge this court to adopt a reading of the term 
“injury” that embraces the entire episode or accident giving rise to a claimant’s 
physical injuries.  We decline to do so.  R.C. 4123.01(C), in its entirety, sets forth 
a comprehensive definition of “injury” for purposes of workers’ compensation.  
We must read the term “injury” in the R.C. 4123.01(C)(1) exception as consistent 
with the general definition in R.C. 4123.01(C), which focuses on the resulting 
harm, not on the cause or means underlying the harm. 
{¶ 16} R.C. 4123.01(C) requires that an injury be “received in the course 
of, and arising out of, the injured employee’s employment.”  The phrase “in the 
course of” relates to the time, place, and circumstances of an injury, and “arising 
out of” contemplates a causal connection between the injury and the employment.  
Fisher v. Mayfield, 49 Ohio St.3d 275, 277-278, 551 N.E.3d 1271 (1990).  The 
“injury,” however, is distinct from those considerations.  While the cause and 
underlying circumstances are relevant to the question of compensability, once the 
prerequisites to coverage are met, it is the resultant harm that constitutes the 
“injury” received or sustained by the claimant, and it is from that harm that the 
claimant’s psychiatric condition must arise. 
{¶ 17} Beyond requiring physical injury or occupational disease, R.C. 
4123.01(C)(1) also defines the required nexus between the physical injury or 
January Term, 2013 
 
7
occupational disease and a corresponding mental condition.  As relevant here, to 
be compensable, the mental condition must have “arisen from an injury * * * 
sustained by th[e] claimant.”  (Emphasis added.)  R.C. 4123.01(C)(1).  “Arisen 
from,” as used in R.C. 4123.01(C)(1), contemplates a causal connection between 
the mental condition and the claimant’s compensable physical injury.  “Arise” 
means “to originate from a specified source[;] to come into being[;] to become 
operative.”  Webster’s Third New International Dictionary 117 (1986).  “From” is 
“a function word to indicate a starting point: * * * [or] to indicate the source or 
original or moving force of something as * * * the source, cause, means, or 
ultimate agent of an action or condition.”  Id. at 913.  Based on the language of 
R.C. 4123.01(C)(1), the court of appeals held that “[t]o be compensable, a 
psychiatric condition must have been started by and therefore result from a 
physical injury or occupational disease the claimant suffered.”  Armstrong, 2d 
Dist. No. 2011-CA-6, 2011-Ohio-6708, at ¶ 35.  We agree, reading these terms 
together in context, that the statute requires a causal connection between a 
claimant’s physical injury and the claimant’s mental condition. 
{¶ 18} The phrase “arisen from” in R.C. 4123.01(C)(1) parallels the 
language in R.C.  4123.01(C), which states that “injury” includes any injury 
“received in the course of, and arising out of, the injured employee's 
employment.”  (Emphasis added.)  “[A]rising out of” contemplates a causal 
connection between the injury and the employment.  Fisher at  277-278.  
Armstrong would have us construe the analogous language in R.C. 4123.01(C)(1) 
as devoid of a similar causative element, thus setting a broad standard requiring 
only temporal proximity.  We discern no basis for distinction and will not 
overlook the well-established construction of the phrase “arising out of” as 
relating to causation.  The plain language of R.C. 4123.01(C) and (C)(1) requires 
that to constitute a compensable injury for purposes of workers’ compensation, a 
SUPREME COURT OF OHIO 
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psychiatric condition must be causally related to the claimant’s compensable 
physical injury.  Accordingly, the statute must be applied as written. 
{¶ 19} Despite the plain statutory text, Armstrong maintains that Ohio 
courts have concluded that under R.C. 4123.01(C)(1), psychiatric or 
psychological 
conditions 
with 
contemporaneous 
physical 
injuries 
are 
compensable, 
while 
psychiatric 
or 
psychological 
conditions 
without 
contemporaneous physical injuries are not.  Armstrong relies heavily on 
McCrone, 107 Ohio St.3d 272, 2005-Ohio-6505, 839 N.E.2d 1, which addressed 
limitations on workers’ compensation coverage for mental conditions in the 
context of an equal-protection challenge to R.C. 4123.01(C)(1). 
{¶ 20} The McCrone claimant applied for workers’ compensation for 
PTSD, which she developed after two robberies of the bank where she worked as 
a teller.  The claimant suffered no physical injuries in the robberies, and, as a 
result, BWC denied her application for benefits.  On appeal, the claimant argued 
that R.C. 4123.01(C)(1) violated the Equal Protection Clauses of the United States 
and Ohio Constitutions. 
{¶ 21} Tracking 
the 
statutory 
language, 
this 
court 
held 
that 
“psychological or psychiatric conditions that do not arise from a compensable 
physical injury or occupational disease are excluded from the definition of 
‘injury’ under R.C. 4123.01(C)(1) and from workers’ compensation coverage.”  
McCrone at ¶ 18 and paragraph one of the syllabus.  McCrone did not address 
whether a relationship between the mental condition and the physical injury was 
necessary because the claimant, unlike Armstrong here, had not suffered a 
physical injury.  Thus, the court considered only whether the requirement of a 
physical injury or occupational disease in R.C. 4123.01(C)(1) violated equal 
protection. 
{¶ 22} Based on several sentences in McCrone, Armstrong argues that 
“arisen from” is interchangeable with “contemporaneous with.”  For example, 
January Term, 2013 
 
9
Armstrong cites a portion of the following statement:  “The General Assembly 
has determined that those who have mental conditions along with a compensable 
physical injury or occupational disease are covered within the workers’ 
compensation system, while those claimants with purely psychiatric or 
psychological conditions are excluded from coverage.”  (Emphasis added.)  
McCrone, 107 Ohio St.3d 272, 2005-Ohio-6505, 839 N.E.2d 1, ¶ 30.  Elsewhere 
in McCrone, the court stated that “[p]sychological or psychiatric conditions, 
without an accompanying physical injury or occupational disease, are not 
compensable under R.C. 4123.01(C)(1).”  (Emphasis added.)  Id. at ¶ 29.  Those 
statements, however, must be read in the larger context of the case, which 
involved no physical injury at all.  The court notes the importance of that factor 
just prior to those quotations, in its rejection of the appellate court’s reliance on 
Bailey, 91 Ohio St.3d 38, 741 N.E.2d 121, because, unlike in Bailey, “[i]n 
McCrone’s case, there was no physical injury whatsoever.”  McCrone at ¶ 28. 
{¶ 23} In McCrone, the absence of physical injury, not the nexus 
between a physical injury and a mental condition, was determinative.  In holding 
that R.C. 4123.01(C)(1) did not violate equal protection, we considered whether 
there was a rational basis for the General Assembly’s requirement of a physical 
injury or occupational disease.  Because the relationship between mental 
conditions and physical injuries was not at issue, use of the terms 
“accompanying” and “along with” to describe that relationship does not constitute 
a holding that mental conditions arising contemporaneously with a physical injury 
are compensable under R.C. 4123.01(C) without regard to a causal connection.  
Likewise, the absence of a specific statement that a mental condition must be 
caused by the physical injury does not amount to a contrary holding.  Instead, it 
represents this court’s apposite exercise of judicial restraint in not deciding an 
unnecessary issue.  See State ex rel. Ohio Democratic Party v. Blackwell, 111 
Ohio St.3d 246, 2006-Ohio-5202, 855 N.E.2d 1188, ¶ 50 (recognizing the 
SUPREME COURT OF OHIO 
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cardinal principle that a court must not decide more than is necessary).  McCrone 
does not answer the question before this court, nor does it compel a different 
result than we have reached based on the unambiguous statutory language. 
{¶ 24} Like McCrone, the other cases upon which Armstrong relies are 
not only distinguishable but also silent on the specific question now before this 
court.  Bunger v. Lawson Co., 82 Ohio St.3d 463, 696 N.E.2d 1029 (1998), and 
Rambaldo, 65 Ohio St.3d 281, 603 N.E.2d 975, both concerned applications for 
workers’ compensation coverage for purely psychiatric conditions, when the 
claimant had not suffered a physical injury.  While State ex rel. Clark v. Indus. 
Comm., 92 Ohio St.3d 455, 751 N.E.2d 967 (2001), involved a claimant who 
suffered both physical injuries and severe stress and anxiety as a direct result of 
having been held hostage and beaten, the sole issue on appeal was whether the 
claimant was entitled to receive workers’ compensation benefits for the same 
period he was receiving hostage-leave benefits under his collective bargaining 
contract.  Although BWC allowed the claimant’s PTSD as a compensable 
condition, no party challenged the allowance, and thus the compensability of that 
condition was not an issue on appeal.  Simply put, this court has never held that a 
mental condition is compensable solely because it developed contemporaneously 
with a compensable physical injury. 
{¶ 25} Consistent with the plain language of R.C. 4123.01(C)(1), several 
Ohio courts of appeals have recognized that mental conditions are compensable 
under the workers’ compensation system only when a physical injury causes 
them.  See Dunn v. Mayfield, 66 Ohio App.3d 336, 341, 584 N.E.2d 37 (4th 
Dist.1990) (“to state a claim upon which relief can be granted for an emotional 
disability, an employee must allege either that a physical injury proximately 
caused the emotional disability * * * or that the emotional stress proximately 
caused a physical injury”); Neil v. Mayfield, 2d Dist. No. 10881, 1988 WL 76179, 
* 1 (July 22, 1988), citing Lengel v. Griswold, Inc., 8th Dist. No. 53054, 1987 WL 
January Term, 2013 
 
11
20459 (Nov. 25, 1987) (“an emotional injury is not compensable, despite a 
contemporaneous physical injury, unless the physical injury causes the emotional 
problems”); Karavolos v. Brown Derby, Inc., 99 Ohio App.3d 548, 552, 651 
N.E.2d 435 (11th Dist.1994) (R.C. 4123.01(C)(1) “prohibits compensation for 
psychiatric conditions unless they are found to have ‘arisen from’ a physical 
injury, i.e., were proximately caused by a physical injury received in the course of 
employment”); Jones v. Catholic Healthcare Partners, Inc., 7th Dist. No. 11 MA 
23, 2012-Ohio-6269, ¶ 31 (rejecting an argument that physical injury must be the 
sole cause of a mental condition, but affirming summary judgment for a claimant 
based on the uncontested evidence that a compensable physical injury was a 
proximate cause of her psychiatric condition). 
{¶ 26} In addition to the arguments asserted by Armstrong, OAJ argues 
that requiring a claimant to prove a causal connection between a mental condition 
and a compensable physical injury would make recovery for many claimants 
“nearly impossible.”  While we appreciate and respect OAJ’s concerns regarding 
the difficulty of proving causation, that argument is more properly addressed to 
the General Assembly, the branch of state government charged by the Ohio 
Constitution with making policy choices for the workers’ compensation fund.  
The General Assembly may determine that mental conditions that develop 
contemporaneously with compensable physical injuries, or that arise out of the 
same accident or occurrence as the physical injuries, should be compensable, and 
amend the statutory language accordingly.  Absent a mandate from the General 
Assembly that such conditions are compensable, however, we will not expand 
workers’ compensation coverage to them. 
{¶ 27} Armstrong’s final argument concerns the effect of the 2006 
amendment to R.C. 4123.01(C)(1), which added the following italicized language 
to the statute: injury does not include “[p]sychiatric conditions except where the 
claimant’s psychiatric conditions have arisen from an injury or occupational 
SUPREME COURT OF OHIO 
12 
 
disease sustained by that claimant.”  Am.Sub.S.B. No. 7, 151 Ohio Laws, Part I, 
1019, 1046.  The parties agree that the purpose of the amendment was to counter 
the decision in Bailey, 91 Ohio St.3d 38, 741 N.E.2d 121, which allowed a claim 
for depression after the claimant accidentally killed a coworker, even though the 
claimant did not suffer any physical injury himself.  By amending the statute, the 
General Assembly clarified that the claimant, not a third party, must sustain the 
physical injury required under R.C. 4123.01(C)(1).  The amendment did not alter 
the statutory language regarding the necessary nexus between a physical injury 
and a psychiatric condition, and the sole effect of the amendment here is to 
preclude Armstrong from establishing the compensability of his PTSD by arguing 
that it arose from the other driver’s injuries or death. 
{¶ 28} The court of appeals noted Armstrong’s reliance on case law that 
predated Am.Sub.S.B. No. 7, but it did not suggest that its rejection of 
Armstrong’s contemporaneous-injury argument was related to the amendment.  
Rather, the court focused on statutory language that Am.Sub.S.B. No. 7 did not 
change and concluded that Armstrong did not establish that his PTSD arose from 
the physical injuries he had sustained in the accident. 
Conclusion 
{¶ 29} Armstrong undisputedly suffered compensable physical injuries 
as a result of the accident, and his PTSD undisputedly arose contemporaneously 
as a result of the accident.  For Armstrong’s PTSD to qualify as a compensable 
injury under R.C. 4123.01(C)(1), however, more is required; he must establish 
that his PTSD was causally related to his compensable physical injuries and not 
simply to his involvement in the accident.  The record contains contradictory 
evidence of whether Armstrong’s physical injuries were a contributing cause of 
his PTSD.  Dr. Howard testified that Armstrong’s physical injuries did not cause 
his PTSD, while Dr. Stoeckel testified that Armstrong’s physical injuries were 
causal factors in his development of PTSD.  The trial court, having heard all the 
January Term, 2013 
 
13
evidence, found Dr. Howard’s testimony more credible.  The court of appeals 
appropriately determined that the record contains competent, credible evidence 
supporting the trial court’s finding that Armstrong’s physical injuries did not 
cause his PTSD and that Armstrong’s PTSD is, therefore, not a compensable 
injury under R.C. 4123.01(C)(1). 
{¶ 30} For these reasons, we affirm the judgment of the court of appeals. 
 
Judgment affirmed. 
O’CONNOR, C.J., and O’DONNELL, LANZINGER, and KENNEDY, JJ., concur. 
PFEIFER and O’NEILL, JJ., dissent. 
____________________ 
PFEIFER, J., dissenting. 
{¶ 31} This case boils down to whether “arisen from” means the same 
thing as “caused by.”  Given that we are required to liberally construe the 
provisions of R.C. Chapter 4123 in favor of employees, R.C. 4123.95, I would 
hold that there is a distinction between the two terms and that the condition in 
R.C. 4123.01(C)(1) that psychological injuries are compensable only if they have 
“arisen from” physical injuries requires that the physical and psychological 
injuries be related but does not necessarily require a direct causal link between the 
two. 
{¶ 32} In McCrone v. Bank One Corp., 107 Ohio St.3d 272, 2005-Ohio-
6505, 839 N.E.2d 1, this court considered whether R.C. 4123.01(C)(1) violated 
equal protection by excluding psychological or psychiatric injuries from workers’ 
compensation coverage.  This court held that the one substantive reason 
supporting the continued disparate treatment between workers who suffer 
psychological injuries in the workplace and workers who suffer physical injuries 
in the workplace is the issue of proof.  That is, it is harder to prove psychological 
injuries than physical injuries.  (The only other rational basis offered in McCrone 
was that the discrimination saves money.)  This court stated, “In mental injury 
SUPREME COURT OF OHIO 
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claims, the problem arises of establishing the existence of the injury itself.  
Although a physical injury may or may not cause a psychological or psychiatric 
condition, it may furnish some proof of a legitimate mental claim.”  (Emphasis 
added.)  Id. at ¶ 33. 
{¶ 33} Thus, the court concentrated not on causation, but on the evidence 
that a contemporaneous physical injury provides that supports the existence of a 
psychological injury.  In this case, we have no issue of proof.  Armstrong’s 
employer stipulates that Armstrong suffers from posttraumatic-stress disorder 
(“PTSD”), and there is no dispute that the accident occurred while Armstrong was 
on the clock and performing job-related duties.  Armstrong suffered a 
contemporaneous physical injury, which, in the words of McCrone, may or may 
not have caused a psychological or psychiatric condition, but furnished proof of 
that condition.  Why shouldn’t Armstrong recover? 
{¶ 34} Elsewhere in McCrone, this court discounted the requirement of a 
direct causal link between the physical injury and the compensable psychological 
trauma.  Instead, the physical injury and psychological injury need only have 
arisen from the same series of events: “Psychological or psychiatric conditions, 
without an accompanying physical injury or occupational disease, are not 
compensable under R.C. 4123.01(C)(1).”  (Emphasis added.)  Id. at ¶ 29.  This 
court also stated that “those who have mental conditions along with a 
compensable physical injury * * * are covered within the workers’ compensation 
system.” Id. at ¶ 30.  “Accompanying” and “along with” are entirely different 
from “caused by.” 
{¶ 35} McCrone was decided in 2005; the General Assembly did not 
make the relevant amendment to R.C. 4123.01(C) until 2006.  Thus, the General 
Assembly knew of this court’s interpretation of the physical-injury requirement 
for psychological injuries when amending the statute.  The General Assembly 
knew that this court had written in McCrone that “a physical injury may or may 
January Term, 2013 
 
15
not cause a psychological * * * condition” but may simply furnish proof thereof, 
that mental conditions are not compensable “without an accompanying physical 
injury,” and that workers “who have mental conditions along with a compensable 
physical injury” are covered under the system.  Did the General Assembly change 
the language of the statute to address this court’s interpretation of the statute that 
there need not be a direct causal connection between a physical injury and a 
compensable psychological condition?   
{¶ 36} It did not.  In neither the present version of the statute nor in its 
predecessor did R.C. 4123.01(C)(1) require a direct causal connection between 
physical and psychological injuries.  The General Assembly otherwise uses the 
word “cause” in R.C. 4123.01(C); it uses it in defining “injury” as including an 
injury “caused by external accidental means.”  In that same definition, it uses the 
phrase “arising out of” in describing a compensable injury—the injury must be 
“received in the course of, and arising out of, the injured employee’s 
employment.”  (Emphasis added.)  In that use of the phrase “arising out of,” does 
the General Assembly mean to say that the injury must be caused by the 
employee’s employment?  No—it means that the employee had to be engaged in 
activity related to his employment when the injury-causing accident occurred in 
order to receive compensation.  Likewise, R.C. 4123.01(C)(1) allows 
compensation for psychiatric injuries that have “arisen from an injury * * * 
sustained by that claimant.”  (Emphasis added.)  The “arisen from” language has 
the same meaning as earlier in the statute—it requires a relationship between the 
physical and psychological injuries rather than a direct causal link. 
{¶ 37} In Bailey v. Republic Engineered Steels, Inc., 91 Ohio St.3d 38, 
741 N.E.2d 121 (2001), syllabus, this court held, “A psychiatric condition of an 
employee arising from a compensable injury or an occupational disease suffered 
by a third party is compensable under R.C. 4123.01(C)(1).”  In Bailey, the 
claimant was operating a tow motor and accidentally ran over and killed a 
SUPREME COURT OF OHIO 
16 
 
coworker.  As a result of the accident, Bailey received treatment for severe 
depression.  In Bailey, there was not a direct causal link between the death 
suffered by the coworker and the claimant’s depression.  Rather, it was Bailey’s 
involvement in and responsibility for the deadly accident that caused his 
depression.  Thus, his psychological injury was related to the accident that caused 
his coworker’s death.  Likewise, in this case, Armstrong’s psychological injuries 
are related to the accident that caused his own injuries. 
{¶ 38} Where does today’s decision leave employees who suffer from 
PTSD?  If an employee is horribly injured in an accident, can he receive 
compensation only for being depressed over the state of his body but not for 
psychological injuries due to being haunted by the trauma of the original event?  
Are those the kind of distinctions the General Assembly really intended—
depression over injuries is compensable but psychological effects arising from the 
accident causing the traumatic injuries is not?  Is it not enough that a worker’s 
broken body provides the “proof” of psychological injury that this court said the 
statute requires in McCrone, proof that a specific traumatic event has occurred?  
Hasn’t Armstrong paid the required pound of flesh? 
{¶ 39} Finally, as I set forth in McCrone, I would find that R.C. 
4123.01(C)(1) violates the Equal Protection Clauses of the United States and Ohio 
Constitutions because it allows disparate treatment of persons suffering from 
psychological injuries.  McCrone, 107 Ohio St.3d 272, 2005-Ohio-6505, 839 
N.E.2d 1, at ¶ 57 (Pfeifer, J., dissenting). 
____________________ 
O’NEILL, J., dissenting. 
{¶ 40} I must respectfully dissent from the well-reasoned majority opinion 
because this case presents a perfect opportunity to right a wrong in the area of 
workers’ compensation law.  The claimant here was involved in a truly gruesome 
motor-vehicle accident, in the course and scope of his employment, that left him 
January Term, 2013 
 
17
traumatically psychologically impaired.  He witnessed the sudden death of a 
fellow motorist, and he suffers as a result of that accident to this day.  That is 
what the record reflects.  From a legal-analysis standpoint, it is wholly irrelevant 
whether the psychological condition arose from the accident or from the trauma 
and drama incident to the allowed physical injuries.  Either way he was injured in 
the course and scope of his employment.  It is that simple. 
{¶ 41} As noted by the majority, this issue was addressed, I believe 
wrongly, to some extent in this court’s earlier decision of McCrone v. Bank One 
Corp., 107 Ohio St.3d 272, 2005-Ohio-6505, 839 N.E.2d 1.  In that case, the 
psychologically injured worker, an employee of a bank that was robbed twice, 
was denied workers’ compensation benefits because she had not received a 
contemporaneous physical injury during the traumatic events.  That she could not 
return to work due to having been traumatized at work simply was not enough to 
entitle her to workers’ compensation benefits. 
{¶ 42} Simply stated, the whole theory of workers’ compensation is to 
ensure that when an injury occurs in the workplace and it is supported by 
competent medical evidence, whether physical or mental, it is compensable under 
the Workers’ Compensation Act.  As aptly stated in dissent by Justice Resnick: 
 
Not only are workers’ compensation claims routinely amended to 
include psychological injuries resulting from previously allowed 
physical injuries, but the time has long since passed when denying 
recoveries for “purely psychological” injuries can be excused on 
grounds of evidentiary difficulties or illusory claims.  We are no 
longer living in the 19th century when it was considered 
impossible to accurately diagnose psychological injuries. 
 
Id. at ¶ 45. 
SUPREME COURT OF OHIO 
18 
 
{¶ 43} On the other hand, if the justification for not allowing 
psychological injuries is purely economic, drawing the line at psychological 
injuries that occur simultaneously with a physical injury versus those that occur 
without a physical injury is arbitrary at best.  They are both real injuries.  They 
both result in loss to the worker.  And they both are directly related to the incident 
on the job.  As stated by Justice Pfeiffer in a dissent in McCrone: 
 
There is no rational basis to treat injured employees differently 
when both the physically injured and the nonphysically injured 
employees each can identify the genesis of their psychological 
condition.  A cognizable triggering event, whether resulting in a 
physical injury or not, is the proper determinant for proof of 
psychological injury.  A professional can evaluate the injury and 
the event to determine whether compensation is appropriate. 
 
Id. at ¶ 55. 
{¶ 44} Reducing government costs, while an admirable goal, is not 
acceptable when it nullifies the protections of the Ohio Constitution.  Justice 
Resnick asked the question “Is there a specific dollar amount of savings that must 
be realized before ignoring the Equal Protection Clause is justified?”  Id. at ¶ 50.  
The answer must be a resounding no.  The reality is that there is no 
constitutionally adequate explanation for the practice of treating psychologically 
traumatized workers in a distinctly different manner from their counterparts who, 
for example, break their arm or leg.  It is government-sanctioned discrimination 
with tragic results, as demonstrated by this case. 
{¶ 45} From an examination of the relevant code section, the conclusion I 
reach is consistent with the law.  R.C. 4123.01(C)(1) allows for psychiatric 
conditions to be compensable as long as the condition arose from an injury 
January Term, 2013 
 
19
sustained by the claimant.  This version of the statute was enacted in 2006 to 
ensure that compensation was permitted only when the physical injury was 
sustained by the claimant rather than a third party.  However, unlike the majority, 
I believe it is sufficient that the psychological injury occurred contemporaneously 
with the physical injury.  The record in this matter is clear that the psychological 
injury happened contemporaneously with the allowed physical injury.  Therefore, 
it was error for the trial court, and then the court of appeals, to disallow the claim.  
It happened on the job, it is real, and it is compensable.  The Bureau of Workers’ 
Compensation, and the Industrial Commission of Ohio, got it right. 
{¶ 46} Accordingly, I respectfully dissent. 
____________________ 
 
Harris & Burgin, L.P.A., and Jeffrey Harris, for appellant. 
 
Ice Miller L.L.P., Corey V. Crognale, and Meghan M. Majernik, for 
appellee John R. Jurgensen Co. 
 
Michael DeWine, Attorney General, and Colleen C. Erdman, Assistant 
Attorney General, for appellee Administrator, Ohio Bureau of Workers’ 
Compensation. 
 
Philip J. Fulton Law Office, Philip J. Fulton, and Chelsea J. Fulton, urging 
reversal on behalf of amicus curiae Ohio Association for Justice. 
________________________