Vast numbers of people are getting anxious and depressed, and experiencing a variety of psychologically produced physical symptoms as a result of the Covid-19 pandemic. These symptoms can be caused by fear of illness to themselves, relatives and friends; by occupational events such as their employer closing its business; or events unrelated to their occupation. In addition to serious illnesses and deaths, there are significant post-infection complications, some psychological, that we still do not understand. The list is astounding.
In workers’ compensation, the most important considerations are whether the circumstances that cause the problem are work-related and whether the condition constitutes a mental health injury as defined by the Labor Code and/or legal regulations in your jurisdiction. In some locales, if you get Covid-19 at work and become psychologically symptomatic, that psychological illness is legally not work-related. In other jurisdictions, psychopathology is only compensable if it was produced by physical symptoms of the coronavirus. In yet others, the specific cause is irrelevant as long as it is due to the work environment.
Regardless of locale, the most important point can be the definition of a mental disorder. The Diagnostic and Statistical Manual of Mental Disorders is clear in stating that for a person to be considered to have a psychological disorder, his or her condition “must not be merely an expectable and culturally sanctioned response to a particular event.” Accordingly, if a person’s symptoms are a normal, reasonable and understandable reaction to the environment, that is not a compensable psychiatric disorder.
How is what is “normal, reasonable and understandable” defined? The answer is up to the doctor’s clinical judgment. For example, is it normal to become fearful, worried, or depressed or to have physical symptoms as a result of your experiences? Or are these abnormal reactions?
The most crucial component in any workers comp litigation is a complete psychological examination in which the doctor has not simply provided a summary conclusion without substantial reasoning or the considerable objective data obtained during a comprehensive examination. The doctor must take a complete history of the patient’s symptoms, including information about their qualitative nature, frequency, intensity, duration, onset and course over time, and a complete history of what occurred.
The doctor should also give a battery of psychological tests including an instrument capable of determining claimant credibility, such as the Minnesota Multiphasic Personality Inventory, as well as observational data pertaining to the claimed symptoms. In addition, medical and/or non-medical records can back up the patient’s history. Then there must be a decision about the cause of those symptoms. Without this data, neither the attorneys nor the court can decide if there has been a psychiatric injury.
Bruce Leckart received his Ph.D. in psychology from Michigan State University and taught at Ohio University and San Diego State University for 30 years. He is a critic of the way psychological evaluations in workers’ compensation cases are often written. He has evaluated many claims in both personal injury and workers’ compensation cases and has critiqued numerous psychiatric reports for such cases.