Bedini v. Frost

Johnson, J.,

dissenting. I cannot accept the majority’s brief affirmance of the standard adopted by the Commissioner for mental stress claims, both because the Commissioner, and now this Court, have departed from the statutory scheme for workers’ compensation claims, and because the Commissioner’s conclusions confuse, rather than clarify, the precise standard applied in stress claims. I therefore respectfully dissent. Although I believe that the final decision on this question must come from the Legislature, I would reverse this case, and remand for further explanation of the standard for stress claims, and the application of that standard to this case.

I.

Plaintiff seeks workers’ compensation benefits based on a mental stress claim. Although the majority uses the term “mental injury claim” to describe this case, this case is more specifically about the standard applied to mental stress claims. Stress claims are a subcategory of what are often called “mental-mental” claims — mental injury for which the cause is a mental or emotional, rather than physical, impact or stimulus. IB A. Larson, The Law of Workmen’s Compensation § 42.23, at 7-876 (1995). In stress claims, as the name suggests, the cause of the injury is gradual, rather than sudden. See id. § 42.25(a), at 7-958.

Although Vermont’s workers’ compensation statute does not explicitly authorize benefits for stress claims, the Commissioner has recognized such claims for some time. See Mazut v. General Elec. Co., Vt. Dep’t of Labor & Indus. Opinion #3-89 (1990); Lockwood v. Vermont Dep’t of Corrections, Vt. Dep’t of Labor & Indus. Opinion #20-85WC (1986). As no party in this case challenges the Commissioner’s policy of granting benefits for stress claims, this Court need not review the Commissioner’s overall policy. In fact, we have never addressed the issue.

Instead, squarely raised in this case is the appropriateness of the standard applied by the Commissioner to mental stress claims. The *172Commissioner has chosen to treat stress claims differently from other workers’ compensation claims, by requiring a claimant to show not only that the injury was work-related, but also that the claimant’s work experience was unusually stressful. Specifically, the Commissioner required plaintiff to “show that the stresses at work were of a significantly greater dimension than the daily stresses encountered by all employees.”

l am troubled by the Commissioner’s unsupported and inconsistent application of the quoted standard in this case. The opinion includes only a brief finding that plaintiff was not “subjected to any unusual working conditions,” and does not explain why plaintiff did not meet this standard. Absent is a description of “normal” working conditions. I am concerned that the Commissioner has applied a standard too vague and generalized to permit a meaningful comparison. How is the average level of workplace stress to be proven? Is the level of stress described by a claimant simply measured against an unstated norm? See Graves v. Utah Power & Light Co., 713 P.2d 187, 193 (Wyo. 1986) (standard requiring comparison to all employees in the working world at large “too amorphous to be practical”).

Rather than evaluate plaintiff’s experience against some measure of average workplace stress, the Commissioner focuses on two facts that are not directly related to the standard: first, that plaintiff was hired for a job for which she was not suited, and second, that subsequent employees taking the position were able to accomplish the job. The Commissioner’s emphasis on plaintiff’s unsuitability for the job is puzzling, because the Commissioner’s own standard requires a showing by plaintiff only that the stresses she encountered at work were significantly greater than the daily stresses encountered by all employees. A person who is hired for a job who is not qualified may very well experience significantly greater stress than most employees.

Instead of comparing plaintiff to “all employees,” however, the Commissioner apparently compared her to the employees who replaced her. Assuming that the employer hired more qualified replacements, their ability to master the job tells us little about the level of stress encountered by plaintiff. Given the broad standard for measuring unusual stress that the Commissioner has adopted, I cannot understand why the specific experience of a claimant’s replacement would ever be relevant in such a case. Nor can I find any reported decision that measures a claimant’s experience against that of her successor.

*173II.

Unusual workplace stress has been measured in at least three different ways. See id. at 192 (discussing different approaches to unusual-stress standard). The approach that comes closest to what the Commissioner has actually done requires the claimant to show an unusually stressful work environment compared to other employees in the same workplace with similar responsibilities. The obvious advantage is the ease of proof — information about the comparison group is readily available. This standard, however, seems too lenient on employers. As long as all similar employees are treated equally badly, no individual employee who suffers a stress-related mental injury would have a claim. Employees in quite stressful situations could be excluded. See id. at 193.

Another approach, which gives more breadth to the unusual-stress standard, measures the claimant’s work environment against that of all similarly situated employees, regardless of employer. See Dunlavey v. Economy Fire & Casualty Co., 526 N.W.2d 845, 857 (Iowa 1995) (stress claim compensable only where workplace stress was greater than day-to-day mental stresses experienced by other workers in same or similar jobs). Proof becomes more difficult, of course, as the comparison group expands, but experts in a particular industry or field might be able to describe typical working conditions. Again, however, although for different reasons, the choice of comparison group seems unfair. A person in a job that is typically very low-stress might meet this standard easily, while a person in a particularly stressful occupation would rarely be able to show unusual stress. For example, what would an air traffic controller or homicide detective have to show to recover for mental injury caused by job stress?

Finally, some states have adopted the standard articulated by the Commissioner, requiring a showing that a claimant’s work environment was unusually stressful compared to that of all employees. See School Dish #1 v. Department of Indus., 215 N.W.2d 373, 377 (Wis. 1974) (claimant must show level of stress greater than day-to-day emotional strain and tension that all employees must experience). Although this approach sounds fair, the comparison group is too large and generalized to allow for consistent and predictable application of the standard. The vagueness of the standard may have prompted the Commissioner in this case to rely instead on facts that were irrelevant but more easily grasped, including plaintiff’s lack of qualifications and the success of her replacements.

*174I recognize the Commissioner’s concern that workers’ compensation benefits may not be the appropriate remedy when employees suffer stress-related mental injury because they were hired for a job for which they were not qualified. I am also concerned, however, that claimants know the standard for stress claims and understand how that standard is applied. The Commissioner has, without doubt, chosen a standard that is difficult to apply. Nonetheless, as long as the Commissioner claims to be guided by this standard, decisions on mental stress claims should reflect a meaningful comparison of the stress encountered by the claimant and the stress encountered by all employees, a comparison conspicuously absent from this decision.

III.

Plaintiff makes a broader claim in this case, however, arguing that the Commissioner’s policy of applying a different, higher burden of proof to mental stress claims is without legal basis. The Commissioner argues, and the majority agrees, that the unusual-stress standard is supported by “reasonable policy concerns.” 165 Vt. at 170, 678 A.2d at 894. Specifically, the majority maintains that fraudulent mental injury claims are easier to make, because generally the only evidence of causation comes from the claimant. This argument has some merit, but its logic can be extended to various types of physical injuries as well; soft-tissue injuries and back and neck complaints are notoriously difficult to diagnose, and pain itself can be described only by the sufferer. See Reyer v. Pearl River Tung Co., 68 So. 2d 442, 444-45 (Miss. 1953) (reversing denial of benefits where doctors could neither account for nor controvert claimant’s complaints of pain).

In fact, fraudulent complaints are only part of the problem. Work environments that most people perceive as normal and manageable may overwhelm others. For some people, under some circumstances, the stress of any job might be enough to cause mental illness. Although such claims would not be fraudulent, these may not be the kinds of injuries that workers’ compensation is intended to insure. See Board of Educ. v. Industrial Comm’n, 538 N.E.2d 830, 834 (Ill. App. Ct. 1989) (permitting compensation for any mental illness caused by on-the-job stressful events or conditions would open floodgate for workers who succumb to everyday pressures of life); Townsend v. Maine Bureau of Public Safety, 404 A.2d 1014, 1018 (Me. 1979) (under standard requiring only causal connection between conditions of employment and resulting mental disability, virtually every psychoneurotic injury would be compensable).

*175I agree that important policy concerns support requiring a higher standard for mental stress claims.1 These concerns, however, must be balanced against the explicit provisions of the workers’ compensation statute. Although the statute does not refer to mental injury claims of any kind, the statute does require that benefits be paid to “a worker [who] receives a personal injury by accident arising out of and in the course of his employment.” 21 V.S.A. § 618. By adopting the “unusual stress” standard for stress claims, the Commissioner has determined that some injuries that “aris[e] out of and in the course of . . . employment” will not be compensated. Creating a separate category of injury, and requiring some showing other than causation, is not authorized by and is inconsistent with the workers’ compensation statute. See Candelaria v. General Elec. Co., 730 P.2d 470, 477 (N.M. Ct. App. 1986) (noting that statute contains no basis for applying different “arising” standard to mental injury produced by mental or emotional stimulus; changing standard for mental injury is province of legislature).

The choice between the different approaches to mental stress claims, and their relative advantages and shortcomings, is a difficult one. Granting benefits for mental stress claims, but adopting an unusual stress standard, may be the best compromise. Perhaps a better solution awaits discovery. Most troubling to me, however, is that this complex policy decision has been made by the Commissioner, rather than the Legislature.2 Although I recognize that this Court must give deference to the Commissioner’s interpretation of the workers’ compensation statute, In re Duncan, 155 Vt. 402, 408, 584 A.2d 1140, 1144 (1990), the Commissioner has moved some distance from the underlying statutory scheme in developing the standard for stress claims. Moreover, the Commissioner has failed to provide a *176coherent explanation of the standard or its application. Without more, I am unable to join in affirming the Commissioner’s decision in this case.

Faced with the same policy concerns, some states have chosen to deny benefits for mental stress claims altogether. See Larson, supra, § 42.25(d) & (e), at 7-963-64 (eight states deny compensation for mental-mental claims altogether, while seven states award benefits for mental-mental claims only where stimulus is sudden). A number of other states, however, permit recovery in stress cases whether or not the claimant encountered unusual stress. Id. § 42.25(g), at 7-968; see, e.g., Wade v. Anchorage Sch. Dist., 741 P.2d 634, 637-38 (Alaska 1987) (stress claim analyzed in same way as any other workers’ compensation claim; showing of stress greater than that in profession not required).

A number of states have adopted statutory standards (some quite detailed) for mental stress claims. See, e.g., Ala. Code § 25-5-1(9) (1992); Cal. Lab. Code § 3208.3 (West Supp. 1995); Colo. Rev. Stat. § 8-41-301(2)(a) (Supp. 1995); La. Rev. Stat. Ann. § 23:1021(7)(b) & (c) (West Supp. 1995); Me. Rev. Stat. Ann. tit. 39-A, § 201(3) (West Supp. 1995).