Earlier this year, this blog summarized a Massachusetts reviewing board decision that affirmed workers may be compensated for mental and emotional disabilities whether they are directly caused by an accident or whether they arise from a physical injury. The issue of how psychiatric injuries should be compensated and to what extent came up again in a recent workers’ compensation case.
The case (Robert Litchfield v. Town of Westford) arose when an employee hurt his shoulder and elbow while at work in 2001. The liability for this injury and the psychiatric issues it raised were established through three hearings. Later, in 2007, the employee filed a claim for loss of function benefits for his shoulder and elbow. A few months later this claim was adjusted. Then the employee filed for permanent loss of psychiatric function in the amount of $5317.70. This sum was based on one of the doctor’s evaluations that the employee still had 40% of his psychiatric function.
The judge denied the claim at a conference. The employee appealed. The report of a psychiatrist qualified as an impartial medical examiner was admitted into evidence at a hearing. However, the judge deemed the report inadequate and allowed the parties to submit additional medical evidence. Two other doctors’ reports were admitted into evidence.
The employee argued for an award for loss of psychiatric function based upon the ratings in an AMA guide. Massachusetts workers’ compensation judges use AMA Guides to determine, among other things, the numbers that are attributable to an employee’s specific loss of function.
The insurer argued that the employee was not yet entitled to those benefits because he wasn’t at maximum medical improvement. It argued that use of the guides would be inappropriate where the psychiatric injury arose from the pain from a physical impairment that still had the chance to improve.
The judge found that pain from physical injuries had in fact caused the employee’s psychiatric distress. He also found that while the AMA guide recognized loss of psychiatric function, it specifically excluded loss of function ratings for the employee’s type of psychiatric injury—one caused by physical pain. Rather, the impairment rating for a physical condition already incorporated the psychological distress associated with the impairment. Therefore, the judge dismissed the employee’s claim.
Both the employee and the insurer appealed. The employee argued that the rating system for psychiatric injuries applied to his case, while the insurer argued that Massachusetts hadn’t adopted the 6th edition of the Guides, relied upon by the judge. The insurer also argued that the psychiatric injury was part of the calculation for his physical injury rating.
The board agreed with the workers’ compensation judge that a psychiatric reaction to physical pain was subsumed into the impairment rating for the physical condition. To be compensable as an independent workers’ compensation injury, a psychiatric injury or disability must be unrelated to a physical injury. Since the employee in this case had already been compensated for a physical impairment that included psychological injury, he was not entitled to a separate benefit for loss of psychiatric function.
If you are concerned about your employer’s workers’ compensation coverage, ask an experienced Massachusetts workers’ compensation attorney what you should do. Contact the Massachusetts workplace injury lawyers at Kantrovitz & Associates, P.C., at 800-367-0871 or through our online contact form.
More Blog Posts
Massachusetts Workers’ Compensation and Pre-Existing Conditions, March 20, 2013
After a Workplace Injury, Is Someone Watching You? March 14, 2013