Opinion ID: 1947893
Heading Depth: 1
Heading Rank: 4

Heading: the standards for demonstrating entitlement to compensation for mental injuries unrelated to physical trauma

Text: Our decision is premised on the principle that all injuries, whether mental or physical, should be compensable when the necessary prerequisites to coverage are established by a claimant. Nevertheless, we recognize that determining the cause of a mental injury can be far more complex than diagnosing the cause of a physical injury. A person's psychological well-being will normally be affected by circumstances unrelated to work, such as his or her family life, background, social relationships, temperament, abuse of drugs or alcohol, and so forth. While it may be easy to link repeated strenuous work-related activity to a physical injury, it will often be more difficult to show that job-related stress, as distinct from non-work pressures, was a substantial cause of a mental disorder. Therefore, appropriate standards must be applied to prevent mental problems resulting from non-work causes from being compensated under the Act. Courts and legislatures outside of Delaware have adopted a variety of different standards for determining the compensability of work-related mental disorders. Ten states (Alabama, [5] Florida, [6] Georgia, [7] Kansas, [8] Minnesota, [9] Montana, [10] Nebraska, [11] Ohio, [12] Oklahoma, [13] and South Dakota [14] ) require that a physical injury be present and thereby deny compensation for mental injuries caused solely by stress. Six states (Illinois, [15] Louisiana, [16] New Mexico, [17] Tennessee, [18] Texas, [19] and Virginia [20] ) require that the mental injury be the result of a specific incident or event, such as a sudden shock, and therefore deny compensation where the sustained stress and strain of employment is responsible. Of those states that permit recovery where the mental injury is caused by gradual stimuli, thirteen states (Alaska, [21] Arkansas, [22] Arizona, [23] Colorado, [24] Maine, [25] Mississippi, [26] Missouri, [27] Pennsylvania, [28] Rhode Island, [29] South Carolina, [30] Washington, [31] West Virginia, [32] and Wisconsin [33] ) limit compensation to cases where the day-to-day stress responsible for the mental disorder is significantly greater than that normally experienced by employees. Such states often require the stress to be extraordinary or unusual when compared to the pressures faced by other workers generally or similarly situated workers. Finally, eight states (California, [34] Hawaii, [35] Indiana, [36] Massachusetts, [37] Michigan, [38] New Jersey, [39] New York, [40] and Oregon [41] ) compensate mental injuries caused gradually by the ordinary stress of employment. In addition, two standards for establishing legal causation have developed in workers' compensation cases involving mental and nervous injuries: (1) the subjective causal nexus test and (2) the objective causal nexus test. The Michigan Supreme Court in 1978 described the subjective causal nexus test as follows: Under a strictly subjective causal nexus standard, a claimant is entitled to compensation if it is factually established that claimant honestly perceives some personal injury incurred during the ordinary work of his employment caused his disability. This standard applies where the plaintiff alleges a disability resulting from either a physical or mental stimulus and honestly, even though mistakenly, believes that he is disabled due to that work-related injury and therefore cannot resume his normal employment. . . . . ... The focal point of this standard is the plaintiff's own perception of reality. Deziel v. Difco Lab., Inc., 403 Mich. 1, 268 N.W.2d 1, 11 (1978) (emphasis supplied). It is significant that the subjective causal nexus test was repudiated by the Michigan legislature only four years after its adoption by that state's supreme court. [42] Many other states have similarly rejected the doctrine. Larson, § 42.23(d). The vast majority of jurisdictions, therefore, have opted for an objective causal nexus test, but the precise formulation of this test varies from state to state. The fact that there are varying formulations is not surprising in light of the diversity in the standards used to analyze mental injury cases. See supra, pp. 25-27; Larson, § 42.25. A representative description of the objective causal nexus test is whether the stress [of employment], admittedly subjective, stemmed from objectively proven stressful work conditions, rather than conditions which only the petitioner found stressful (or, perhaps, conditions which were not shown objectively to exist at all). Goyden v. State , Ct.App.Div., 256 N.J.Super. 438, 607 A.2d 651, 655 (1991) (per curiam), aff'd, 128 N.J. 54, 607 A.2d 622 (1992). See also Williams v. Western Electric Co., Ct.App.Div., 178 N.J.Super. 571, 429 A.2d 1063, 1070-1071 (1981) (holding that [t]here must be objective evidence which, when viewed realistically, carries petitioner's burden of proof to demonstrate that the alleged work exposure was to a material degree a contributing factor). It is our opinion that an objective causal nexus test should be applied in Delaware. Such a test is consistent with the remedial purposes of the Act because it permits consideration of both subjective and objective evidence in arriving at an equitable and informed decision. Consistent with the standards enunciated in Duvall and Reese, we hold that, in order to be compensated for a mental injury in the absence of a specific and identifiable industrial accident (i.e., a mental injury which is gradually caused by stress), a claimant must offer evidence demonstrating objectively that his or her work conditions were actually stressful and that such conditions were a substantial cause of claimant's mental disorder. Duvall, 564 A.2d at 1136; Reese, 619 A.2d at 911. The stress causing the injury need not be unusual or extraordinary, but it must be real and proved by objective evidence. Where a claimant merely imagines or subjectively concludes that his or her work conditions have caused a psychological illness, there is no basis for holding the employer responsible since the connection between work and injury is perceived only by the impaired worker. [43] The State expresses concern regarding the potential for a significant increase in questionable claims if workers' compensation is provided for mental injuries allegedly caused by job-related stress. Although the State's concern is not unfounded, [44] there are a number of safeguards to prevent abuse. First, a claimant must establish that he or she has an actual disabling mental injury. Simply being tired or overworked is obviously insufficient to justify workers' compensation benefits. Second, the adversarial nature of the proceedings before the IAB permits the employer to test the legitimacy of the employee's claim. See Beattie v. Beattie, Del.Supr., 630 A.2d 1096, 1099 (1993) (similar concerns arising out of abolition of interspousal immunity are unfounded, in part because the judicial system is adept at ferreting out frivolous and unfounded cases); Daubert v. Merrell Dow Pharmaceuticals, Inc., ___ U.S. ___, ___, 113 S.Ct. 2786, 2798, 125 L.Ed.2d 469 (1993) (adversary system, including vigorous cross-examination, provides appropriate safeguards for testing the validity of new or controversial types of scientific evidence). Third, the experience and common sense of the IAB must be relied upon, as in many physical injury cases, to deny compensation where it is not deserved and not proven, and to award it where it is deserved and proven. Fourth, our adoption of an objective causal nexus test will require a claimant to prove both the existence of stressful working conditions and the connection between those conditions and the claimant's mental disorder. The final safeguard against excessive numbers of dubious mental injury awards is the General Assembly. It is the General Assembly and not this Court which has the prerogative to legislate. This Court's role is to construe existing legislation. The Act presently in force does not distinguish between physical and mental injuries. If the General Assembly should deem it advisable in the future, it can amend the Act to provide more stringent standards. [45] The absence of any differentiation between mental and physical injuries in the Act precludes this Court from unilaterally imposing more burdensome requirements on those seeking recovery for mental injuries than the Act provides. To do so would border on judicial legislation. Nixon v. Blackwell, Del. Supr., 626 A.2d 1366, 1380-81 (1993). Accordingly, we hold that the substantial cause standard in Duvall applies in mental injury cases resulting from gradual stress so long as the objective test set forth herein for proving causation can be satisfied.