Divided state court ruling sparks uncertainty about workers' comp for mental injuries
An Arizona Court of Appeals concluded the Arizona Constitution never contemplated mental injuries when it used the term 'injury,' and the state's high court agreed.
A 6-1 Arizona Supreme Court majority concluded that workers’ compensation coverage for mental illnesses must arise from “unexpected, unusual or extraordinary stress” and that such limitations are not unconstitutional for those already employed in high-stress jobs, like first responders.
However, Laura Clymer, counsel for a Tucson police officer who was denied compensation for his claim of job-induced post-traumatic stress disorder, said it’s unclear whether the court’s opinion simply reaffirms the state Legislature’s right to limit workers’ compensation benefits or “takes our workers’ compensation law back 90 years by narrowly defining what an ‘injury’ and ‘accident’ are.”
“You can read it as saying that a workers’ comp injury has to be a physical harm related to an unexpected incident at work or the cause of which was unseen. If that’s the case, this decision breaks the grand bargain that was struck in 1912 between Arizona workers and Arizona industry. The court doesn’t seem to appreciate how destabilizing that could be,” Clymer said of the court’s majority opinion filed Nov. 23.
Clymer and her older brother, Brian Clymer, both workers’ compensation attorneys in Tucson, represented Detective Timothy Matthews. Matthews was assigned to inspect the body of a suspect who died due to an apparent self-inflicted gunshot wound at the scene of a domestic violence barricade situation in June 2018. After the incident, Matthews began experiencing nightmares, flashbacks and difficulties concentrating.
Both his treating psychiatrist and the City of Tucson’s physician recommended that Matthews be relieved from his work duties, and the detective filed an industrial injury claim arising from the incident, claiming that it exacerbated his pre-existing PTSD. However, the city’s insurer, Tristar Risk Management, denied Matthews’ claim.
At a hearing before Administrative Law Judge Gary M. Israel, a defense expert testified that the June 2018 incident “was not unusual for a law enforcement officer and that stress is an expected part of the job.” Israel affirmed the denial of Matthews’ claim because the incident was not an “unexpected, unusual or extraordinary stress” situation as required under Arizona Revised Statute §23-1043.01(B), according to the state high court’s majority opinion.
A divided Arizona Court of Appeals upheld the denial. The majority concluded that §23-1043.01(B) “did not unconstitutionally restrict compensation but instead expanded it because the framers of the Arizona Constitution never contemplated mental injuries when they used the term ‘injury.’”
The dissent argued that “injury” should be read more broadly and in the context of article 18, section 8 workers’ compensation law language “of any accident arising out of and in the course of employment,” the majority opinion cited.
The Arizona Supreme Court followed suit.
“There is no question that this is how he [Matthews] got PTSD and for there to be these legal semantics that end up denying his claim — it saddens me to be quite honest with you. It saddens me because it’s easily traced to his work, and if you read decades of Arizona workers’ compensation cases and have the understanding of our law, it should have been a compensable claim,” Laura Clymer said, adding that the court’s decision “potentially creates a lot of uncertainty about the direction of workers’ comp” in the state.
Matthews argued that requiring workers’ compensation claimants to prove their mental injuries were caused by “‘unexpected, unusual or extraordinary stress’” unconstitutionally restricts legal causation by creating an assumption of the risk defense. By adding the statutory modifier “unexpected, unusual or extraordinary,” Matthews argued that the legislature unconstitutionally constrained the types of risks that could trigger eligibility, the opinion said.
“But that begs the question: what claims are encompassed by article 18, section 8? All agree that an injury by accident is the predicate for coverage. If the definition of those terms when our constitution was adopted in 1912 did not encompass mental stress injuries, then such coverage exists only to the extent it has subsequently been made available by the legislature,” Justice Clint Bolick wrote on behalf of the majority, citing Atkinson, Kier Bros. Spicer Co. v. Indus. Comm’n, a 1929 case upholding the legislature’s action to provide coverage beyond “‘workmen engaged in manual or mechanical labor’ as originally provided in article 18, section 8.”
In 1912, “injury” was defined as “‘that which occasions harm morally or physically; detriment; loss; damage,’” while “accident” was defined as “‘an event which is unexpected, or the cause of which was unforeseen; a contingency, casualty, or mishap.’” Both plain meanings from 1912 make no reference to any type of illness or mental harm, Bolick wrote.
“[I]n Pierce [v. Phelps Dodge Corp.], the seminal 1933 case construing ‘injury by accident,’ the Court meticulously examined the meaning of the constitutional language. Using dictionary meaning, the Court, much as we have done above, defined ‘injury’ as ‘damage,’ and ‘accident’ as ‘an undesigned, sudden and unexpected event’ … The Court also focuses on the preposition ‘by,’ noting that in isolation, an accident can be a cause or a result; but that when preceded by the preposition, it can only be a cause.
Matthews maintained that the meaning of “injury by accident,” as reflected in several post-Pierce cases evolved over time.
“He cited a workers’ compensation treatise for the proposition that ‘modern medical opinion’ supports the view that ‘there really is no valid distinction between physical and ‘nervous’ injury,’ and that the legal theory is ‘constantly adapting itself to accommodate new advances and knowledge in medical theory,’” Bolick wrote. “We do not hitch constitutional meaning to the evolving state of scientific art or ‘modern medical opinion.’ Such changes or advances are relevant to medical causation, which the parties agree is established in this case, but not to legal causation, which is defined here by the constitution. It may be that our organic law and statutes should be revised to reflect advances in medical understanding. The power to do so, however, resides exclusively in the people and their elected representatives, not the courts.”
Chief Justice Robert Brutinel, along with Justices John R. Lopez IV, James Beene, William Montgomery, and Kathryn H. King joined the majority opinion in holding that the adoption of §23-1043.01(B), mental stress caused by mental trauma was recognized as an injury in Arizona law and that it does not violate article 18, section 8′s limited mandate.
Brian Clymer said he was also disappointed with the majority’s statement in paragraph 49, which said, “We do not here revisit past cases to the extent they are consistent with this opinion” and that the court only commented that §23-1043.01(B) does not violate article 18, section’s 8.
“If you read this very narrowly, it doesn’t mean much. But if you read it broader, there are a number of state supreme court cases that this case calls into question,” Brian Clymer told Law.com. “Personally, I think it is unfair of the court not to list what those cases are so that we have some guidance and knowledge of what they are. That’s what makes this decision so unclear.”
The majority further rejected Matthews’ claim that §23-1043.01(B) requires workers who have suffered mental stress injuries to meet a higher standard of proof in order to qualify for workers’ compensation.
In a dissenting opinion, Vice Chief Justice Ann A. Scott Timmer said she agreed with the majority that §23-1043.01(B) does not violate equal protection guarantees, but she interpreted article 18, section 8 differently — concluding that §23-1043.01(B) violates Section Eight of the Arizona Constitution.
She said she disagreed with the majority’s holding that “injury” and “personal injury” only referred to physical trauma in 1912.
“‘Injury’ and ‘personal injury’ are general terms with wide-ranging ordinary meanings, and we should apply those meanings within the framework of Section Eight … Dictionaries and writings from the turn of last century support concluding that the ordinary meaning of ‘injury’ and ‘personal injury’ encompasses mental injuries,” Timmer wrote. “Thus, in my view, a covered worker who incurs a mental injury from an on-the-job accident caused at least partially by ‘a necessary risk or danger’ of the employment or the failure of the employer to ‘exercise due care’ or follow an employment law, is constitutionally entitled to workers’ compensation.”
Ted Moeller, of Moeller Law Office, an attorney representing the defendants, did not return a message seeking comment.
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