In psychiatric injury claim, Board denies claimant’s DCD petition, finding she failed to meet burden of proof as there was no objective evidence that her work environment was actually stressful or caused her anxiety and depression.
The claimant filed a Petition to Determine Compensation Due, alleging a work injury in the nature of depression and anxiety caused by a stressful work environment with a manifestation date of April 5, 2017. The employer denied any relationship between the claimant’s alleged psychological injury and the workplace activities.
The claimant had been a nurse with the employer since September 24, 2001. She was 55 years old as of April 5, 2017, and had been working as a triage nurse for the previous five years. Her job duties involved telephone triage for patients who called with problems, and she would handle from 25 to 50 calls per day. The claimant was required to handle the calls in a timely manner and provide correct advice for emergency calls, or else a patient could die. The subject matter of the urgent calls included babies with high bilirubin and patients who were taking blood thinners. The evidence showed the claimant received a Performance Improvement Plan dated April 5, 2017, which she reviewed with her superiors. The plan included comments that a staff member had complained about how the claimant spoke to her, and the claimant responded that what she was being asked to do by the co-worker was not possible and took time away from her triage calls. The claimant testified that after the plan was reviewed with her, it increased her depression due to the threat of termination of her job, and she became very upset. She stated that she became more depressed, ate and slept poorly, and also lost weight. Her primary care physician increased her anti-depressant medications, and she ended up missing 12 weeks of work after April 5, 2017.
Dr. Dettwyler, who is a licensed clinical psychologist, testified as the claimant’s expert. His diagnosis was an adjustment disorder with depression and anxiety, secondary to work stress. In his opinion, the claimant was experiencing her stress from her situation at work, and he did not believe she had a personality disorder.
The employer presented testimony from a human resources officer and a co-worker of the claimant. This testimony revealed that the workload for a triage nurse with the employer was manageable and the job was not unusually stressful. The evidence also revealed that the claimant had a long history of inter-personal and behavior issues with co-workers, as documented in her performance reviews over the years. The employer’s evidence also indicated that the claimant was not in danger of being fired after the April 2017 improvement plan. Rather, the employer was taking steps to improve the claimant’s work performance rather than to fire her. Dr. Langan, a clinical neuropsychologist who testified as the employer’s expert, indicated that the psychological testing he performed on the claimant produced normal results and showed no clinically significant levels of anxiety or depression. He opined the claimant did not sustain a psychological injury due to her work experiences. Dr. Langan concluded that the claimant had a history of depression and a history of documented discourteous behavior towards staff members dating back to 2005. He believed the stress the claimant experienced came from her own personality and communication style in relating to other people but was not from any work stress.
The Board cited the case of State v. Cephas, 637 A.2d 20 (Del. 1994) for the applicable legal standard. In that case, the Delaware Supreme Court established the standard for determining causation in a situation where a mental injury is alleged to have resulted from work stress. This standard requires a claimant “to offer evidence demonstrating objectively that his or her work conditions were actually stressful and that such conditions were a substantial cause” of her injury. The stress causing the injury need not be unusual or extraordinary, but it must be real and proved by objective evidence.
The Board found that the claimant had failed to prove that her work environment was actually stressful and a substantial cause of her psychological diagnosis and treatment. In so finding, the Board accepted the testimony of Dr. Langan, the employer’s expert, and the managers who testified for the employer, which evidence revealed that the employer had made efforts over the years to work with the claimant to improve her interpersonal skills. It also showed the reasonable nature of the claimant’s job duties and her workload. Further, the evidence indicated the claimant had an inability or an unwillingness to accept criticism or improve her behavior. The Board did not find any evidence that the claimant was mistreated by the employer or her co-workers, or that the employer was unfair in how it handled the claimant’s interpersonal problems. The Board stated that, if anything, it was the claimant’s perception of how she interacted with others that appeared to be skewed. They also pointed out that the claimant had a preexisting history of chronic depression for which she had been receiving ongoing treatment and medication for many years.
Therefore, the Board found there was insufficient objective evidence that the work environment was actually stressful or the cause of the claimant’s anxiety and depression. As a consequence, the claimant’s Petition to Determine Compensation Due was denied.
What’s Hot in Workers’ Comp, Vol. 24, No. 9, September 2020
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