Stress of Navigating Oregon Workers’ Compensation: Possible Ground for Mental Health Condition?
Filing an Oregon Workers’ Compensation claim includes a range of administrative processes, from injury reports to claim closure, encompassing medical treatment, independent medical evaluations, entitlement issues, and several other factors critical to successfully processing a claim. Can this process alone be a valid basis for a compensable mental health condition, independent of the actual compensable injury?
The Court of Appeals addressed this issue in Roseburg Forest Products v. Zimbelman, 136 Or App 75 (1995). In this case, the claimant’s beneficiary sought compensation for the claimant’s mental health condition, which stemmed from his intense anxiety and agitation about not receiving the compensation he believed he was owed. When the compensation check arrived, the claimant felt the amount was insufficient. This led to heightened distress, ultimately resulting in a myocardial infarction that caused his death. The beneficiary argued the myocardial infarction was compensable as a consequential condition of claimant’s original compensable injuries. The employer denied the claim. At the hearing, the Administrative Law Judge (ALJ) set aside this denial, concluding the heart attack qualified as a compensable consequential condition. The Board affirmed this decision. On appeal, the beneficiary contended that the circumstances surrounding the compensable injury should be considered part of the injury for determining the major contributing cause of the consequential condition. However, the Court of Appeal rejected this argument, overturning the Board’s findings and ruling that, in cases of consequential conditions, the compensable injury refers specifically to the medical condition resulting from the accidental injury, rather than the subsequent effects of that condition. (emphasis added).
Similarly, in Zoya M. Khrul, 55 Van Natta 803 (2003), claimant requested reconsideration after his mental disorder claim was closed. Upon review, the arbiter assigned an impairment rating that took into account various social and vocational factors, including the claimant’s persistent stress and depression stemming from her workers’ compensation claim administration. The employer subsequently appealed the Order on Reconsideration, which had granted 55 percent permanent disability based on the arbiter’s findings. The Board rejected the arbiter findings and ruled that the portion of the claimant’s current psychological condition caused by her reaction to claims processing is not considered to be caused by the compensable injury. (emphasis added).
While mental health conditions resulting from a compensable claim may be acceptable as a consequential condition, the Court has generally ruled that such conditions must be caused in major part by the compensable injury itself and not the claim administration resulting from the injury.
If you have questions about compensable mental health claims, you can contact me at or (503) 776-5423.
Posted by Dee Akinbosade.
