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Second Injury Fund not liable for worker’s mental injury

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mental injury

The Missouri Court of Appeals upheld a determination that the state-run Second Injury Fund was not liable for a worker’s permanent total disability benefits for a psychological injury she reported following a physical injury.

A worker for wire manufacturer WireCo World Group for 28 years, the woman had injured her shoulder at work in 2015 and later claimed she suffered from diabetes, hypertension, anxiety and depression, two preexisting mental conditions once connected to a car accident and her mother dying but later attached to her work injury, according to No. WD86436, filed May 21.

In 2018, she settled her claim with WireCo for her shoulder injury.

That same year she underwent a psychological evaluation, of which an evaluator opined that her physically demanding, dangerous, third-shift work for WireCo was the direct, proximate and prevailing factor for her development of depression. The evaluator said her psychological disabilities were “complex, long-standing and taken as a whole are overwhelming.”

In 2019, she underwent a vocational assessment, which resulted in a report that she was totally disabled by the combined effects of her psychological issues, diabetes, migraine headaches and 2015 shoulder injury.

An administrative law judge found that she failed to meet her burden of proof to establish Second Injury Fund liability. The Labor and Industrial Relations Commission affirmed, as did The Missouri Court of Appeals, which explained that her claim did not meet the parameters that would trigger the fund’s liability.

The court noted that the woman suffered from a variety of ailments before September 2015, including anxiety and depression. At the psychological evaluation in January 2016, the death of her mother, her voluntary layoff as a result, fear that she may not be able to work up to her own standards, and fear of job loss were all noted as increased stressors that impacted her anxiety. The work injury from September 2015 was not mentioned as a stressor.

The court also said there was no evidence that the woman sought psychiatric treatment or addressed her anxiety and depression in any manner over the next two years other than how she had always addressed her anxiety and depression — via prescriptions of the same medications she had been taking before September 2015.

The court also said the timing of the post-settlement evidence was significant because (she) claimed to have suffered a psychological injury from the September 2015 work accident. But two years later, when she settled with her employer and after having undergone numerous consultations, treatment and surgery on her shoulder, there was no evidence to support a psychological work injury or disability specifically related to September 2015.

WorkCompCentral is a sister publication of Business Insurance. More stories here.