Opinion ID: 1846026
Heading Depth: 1
Heading Rank: 7

Heading: There Was Sufficient Proof in the Record of Causation Between the Accident and the Recurrence of Manchester's Depression and Agoraphobia.

Text: We next address Drivers Management's argument on cross-appeal that the Workers' Compensation Court erred in finding that there was sufficient evidence in the record to conclude that the recurrence of Manchester's depression and agoraphobia was causally related to the accident and her subsequent injuries. Specifically, Drivers Management argues that the causation opinion of Guinane was insufficient to establish the necessary causal link between the accident and Manchester's depression and agoraphobia. Drivers Management claims that the majority of the evidence in the record shows that Manchester's depression and agoraphobia may have worsened after the accident, but that this was due to family problems and other stressors. The review panel affirmed the decision of the trial judge to the effect that there was a causal link between the accident and Manchester's psychological issues. After reviewing Guinane's opinion in its entirety, the review panel concluded that the trial judge had a sufficient basis in fact to substantiate or, otherwise, justify the conclusion he reached on causation. It is well settled in Nebraska workers' compensation law that a worker is entitled to recover compensation for a mental illness if it is a proximate result of the worker's injury and results in disability. Sweeney v. Kerstens & Lee, Inc., 268 Neb. 752, 688 N.W.2d 350 (2004); Kraft v. Paul Reed Constr. & Supply, 239 Neb. 257, 475 N.W.2d 513 (1991). In order to recover under the Nebraska Workers' Compensation Act, a claimant has the burden of proving by a preponderance of the evidence that an accident or occupational disease arising out of and occurring in the course of employment proximately caused an injury which resulted in disability compensable under the act. Sweeney, supra . A proximate cause is a cause that produces a result in a natural and continuous sequence and without which the result would not have occurred. Id. Further, a preexisting disease and an aggravation of that disease may combine to produce a compensable injury. Miller v. Goodyear Tire & Rubber Co., 239 Neb. 1014, 480 N.W.2d 162 (1992). This court has expressly disapproved of a heightened standard of proof when a preexisting disease or condition was involved, stating: `[A] workers' compensation claimant may recover when an injury, arising out of and in the course of employment, combines with a preexisting condition to produce disability, notwithstanding that in the absence of the preexisting condition no disability would have resulted....' Id. at 1020, 480 N.W.2d at 167 (quoting Heiliger v. Walters & Heiliger Electric, Inc., 236 Neb. 459, 461 N.W.2d 565 (1990)). Drivers Management argues that the instant case is similar to Sweeney, where this court concluded that an employee had not established the requisite causal link between the employee's mental health issues and his physical pain. In Sweeney, the expert opinion relied on for causation stated that the employee's depression was entirely attributable to the loss of earning capacity report that the employee believed would have a negative impact on the compensation litigation. The expert testified that in his opinion, the depression was triggered by the employee's unhappiness with a court ruling. Id. The court in Sweeney distinguished that case from Kraft, supra, where the expert testified that a worker's neurosis was attributed to both his physical injury and the psychological loss resulting from the worker's immobility and inability to work and was therefore compensable. The causation opinion upon which the Workers' Compensation Court relied in this case was that of Guinane, which stated: It is my professional opinion that [Manchester's] depressive and anxiety related symptoms were substantially caused (mainly depressive symptoms) and significantly exacerbated (panic disorder with agoraphobia) subsequent to the physical injuries, as well as her unexpected and perceived unfair dismissal from her previous place of employment. Guinane also opined that Manchester's psychological condition combined with her physical injuries to render her disabled from working. Guinane expressly stated that Manchester's depression and anxiety were reactivated by her accident and subsequent release from her employment. Importantly, Guinane further concluded that Manchester had not reached maximum medical improvement in her psychological functioning because of her constant physical pain related to her work injury. On appellate review, the findings of the Workers' Compensation Court will not be reversed unless clearly wrong. We will affirm the order of the Workers' Compensation Court unless there is insufficient evidence in the record to support its decision. Here, based on the reports of Guinane, there was sufficient evidence to support the conclusion that Manchester's depression and agoraphobia were caused and exacerbated by her accident. Guinane expressly stated that Manchester's depression and anxiety were reactivated by the accident and her mental health conditions were related to the physical pain she suffered from the accident. In addition to the reports of Guinane, it is notable that Manchester had not sought psychological help while employed with Drivers Management until after her accident. Based on the record in this case, we reject Drivers Management's argument, and we affirm the decision of the review panel on this issue.