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November 28, 2016

Eligibility for workers’ compensation benefits based on work-related stress

Eligibility for workers’ compensation benefits based on work-related stress
Matter of State Insurance Fund and Workers’ Compensation Board, 2016 NY Slip Op 07734, Appellate Division, Third Department

A supervisor [Claimant] filed for workers’ compensation benefits contending that she that had felt threatened as the result of a work-related incident involving one of her subordinates and that the incident had resulted in stress, panic attacks and digestive problems.* 

After a series of hearings and the submission of Claimant's medical records and the reports and deposition testimony of her treating physician, as well as an independent medical exam by the workers' compensation carrier's consultant, a Workers' Compensation Law Judge [WCLJ] ultimately issued a decision disallowing the claim on the grounds, among others, that Claimant did not experience work-related stress greater than what is experienced in a normal work environment, and that "the exacerbation of her mental health symptoms did not arise out of and in the course of the incident or its aftermath."

The Workers' Compensation Board affirmed the WCLJ’s findings and determination denying Claimant's allegations that she suffered a work-related injury or disease arising out of and in the course of her employment. Her claim denied  for workers' compensation benefits by the Board, Claimant then appealed the Board’s decision.

The Appellate Division affirmed the Board’s ruling, citing Matter of Lozowski v Wiz, 134 AD3d 1177. In Lozowski the court held that it was "well established that ‘mental injuries caused by work-related stress are compensable if the claimant can establish that the stress that caused the injury was greater than that which other similarly situated workers experienced in the normal work environment.’"

However, said the court, in resolving that factual question, the Board's determination will not be disturbed provided that it is supported by substantial evidence.

In this instance, although the medical evidence concluded, based upon Claimant's self reporting, that the incident caused or exacerbated her mental health problems, substantial evidence supports the Board's factual determination that the incident was not compensable on the ground that the work-related stress suffered by Claimant that led to her anxiety, PTSD and depression was not "greater than that which other similarly situated workers experienced in the normal work environment."

In contrast to Claimant’s description of the events constituting the incident, including Claimant’s testimony that her subordinate “swore at her during the encounter,” the WCLJ credited the evidence given by a coworker who testified that she had overheard "a work interaction" in which Claimant and the subordinate "disagreed" and that she had informed Claimant, after the incident, that the subordinate used profanity after Claimant walked away from the disagreement.

In addition the WCLJ discreded Claimant's account of the incident and her claim that this brief episode left her terrified based upon her testimonial demeanor as well as her inconsistent accounts and actions after the incident, including Claimant's return to her subordinate's work area shortly after the incident to speak with a coworker and her testimony that “the day after the incident, she had a meeting with the [subordinate]" and later reported that the matter was "settled" and that they were "moving forward with a good working relationship."

The Appellate Division, deferring to the Board's credibility determinations, found that the record as a whole supported its conclusion that this was, at most, "an isolated incident of insubordination" to which the employer appropriately responded, which was not so improper or extraordinary as to give rise to a viable claim for a work-related injury.

Finding “… no basis to disturb the Board's determination that Claimant's work-related stress did not exceed that which could be expected by a supervisor in a normal work environment,” the Appellate Division denied Claimant’s appeal.

* The Appellate Division’s decision notes that “After the incident, Claimant, who had a history of treatment for non-work-related anxiety, depression and posttraumatic stress disorder [PTSD], reportedly experienced increased symptoms of anxiety and depression, as well as panic attacks, insomnia and difficulty concentrating for which she sought treatment from her internal medicine physician.” 

The decision is posted on the Internet at:

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