The Workers’ Compensation Appeals Board recently overturned a ruling of a workers’ compensation administrative law judge who denied an injured employee’s benefits claims under SB 863. Although the employee suffered physical injuries in a vehicle accident, he alleged that he also suffered psyche injuries or emotional trauma. Because the incident took place in 2013, the injury was subject to a section that states that a violent act needs to be present when physical workplace injuries cause permanent psychiatric disability. The California worker claimed his psychological disorder did not result from the injuries, but from the traumatic experience of the accident itself.
Reportedly, the claimant suffers from claustrophobia, and the crash trapped him in the cab of the overturned truck for more than 30 minutes. He was pinned upside down, fearing the running engine could cause the truck’s two full fuel tanks to explode. He experienced problems breathing, and rescue workers had to use the Jaws of Life to extricate him. Reports indicate that a qualified medical evaluator did a Global Assessment of Functioning test, showing that 95 percent of his psychological damage was the result of the vehicle accident.
The applicant asked for reconsideration of the initial ruling, which held that the crash was not a violent act perpetrated by another person, but rather the result of negligence; as such, permanent disability benefits were not awarded due to the lack of violence, as interpreted by the administrative law judge. However, the Workers’ Compensation Appeals Board included a psychiatric impairment award when it substituted the original Findings and Reward in Oct. 2016. The replacement includes psyche injuries resulting directly from occupational events.
It was the unmistakable opinion of the Qualified Medical Evaluator that, although this worker suffered compensable workplace injuries, the psychiatric disorder was the direct result of the industrial accident in which he was involved. The physical injuries included head, shoulder and neck injuries along with damage to his nervous system. The ultimate ruling was that the psychiatric impairment preclusion was not applicable in this case, which underscores the intricacies of workers’ compensation claims. For this reason, many California injured workers seek the support and guidance of experienced attorneys to navigate benefits claims for them.
Source: workerscompensation.com, “WCAB Rejects SB 863 Limits on Psychiatric PD“, March 29, 2017