Overview of Mental Health Injuries in Iowa Workers’ Compensation

. Under Iowa law mental injuries are compensable in the workers’ compensation system. Mental injuries are unscheduled injuries. Therefore, the emphasis in figuring out the amount of damages is based on determining how much the mental injury reduces the injured worker’s future earning capacity. (See here and here for longer discussions on how industrial disability injuries are valued).

Similar to physical injuries, an aggravation of a pre-existing mental health issue is still compensable under Iowa law as long as the aggravation is substantial. As an example, look at the Iowa Supreme Court case of Cedar Rapids Community School District v. Pease, 807 N.W.2d 839 (Iowa 2011). In the Pease case the claimant did have a pre-existing history of depression. However, the Workers’ Compensation Commissioner, and later the Iowa Supreme Court, found that the claimant’s physical injury caused a substantial aggravation of her depression, and that the claimant was entitled to receive weekly benefits for this increase in her depression.

Mental health injuries that arise without physical injury are frequently called “mental-mental” injuries. By contrast, mental injuries which are connected to a physical work injury are called “physical-mental” injuries. There are some important differences in how these two different types of mental injuries are treated. I will first talk about mental-mental injuries.

Village Credit Union v. Bryant, 819 N.W.2d 427 (Iowa App 2010)
has a good discussion of what a claimant has to show to establish a mental-mental injury. It is not enough for the worker to show that the mental injury was actually caused by the employment. Additionally, the worker has to prove that the mental injury was caused by “workplace stress of greater magnitude than day-to-day mental stresses experienced by other workers employed in the same or similar jobs, regardless of their employer.”

As a practical matter it is very difficult for a worker to succeed in a mental claim that does not have a related physical injury. An example of one of the few mental-mental claims that did succeed was the case of Humboldt Community Schools v. Fleming, 603 N.W.2d 759 (Iowa 1999). In the Humboldt Community Schools case the claimants were the surviving family of a school district superintendent that committed suicide. The superintendent was trying to implement a new curriculum which was unpopular in the community. The plaintiffs had testimony from other superintendents that had worked through similar controversial changes, and who explained that such a process was significantly worse than the regular day-to-day stresses of a school district superintendent.

The facts of the Village Credit Union case represent an exception to the difficult requirements for a mental-mental claim. In the Village Credit Union case the court of appeals cites to the rule that, “When a claim is based on a manifest happening of a sudden traumatic nature from an unexpected cause or unusual strain, the legal-causation test is met irrespective of the absence of similar stress on other employees.” The injured worker In Village Credit Union succeeded with a mental-mental claim based on working as a teller in a credit union and being robbed twice. Although the teller was not physically injured, she did suffer substantial mental health problems as a result of these two robberies. Other examples of mental-mental cases which have succeeded under this “sudden trauma” exception include a hotel worker who had to clean a room after a suicide, and a counselor who suffered mental health problems of her own after one of her clients committed suicide.

PHYSICAL-MENTAL INJURIES. In situations where a worker suffers a physical injury, and then later develops mental health problems as a result of the physical injury, both the physical injury and the mental health injury are compensable as an Iowa workers’ compensation injury. Where a worker has a physical-mental injury they only need to show that the physical work injury caused a new mental injury, or aggravated a pre-existing mental injury.

If the physical injury was a scheduled member injury, the results of the physical injury and the mental injury are combined together and assessed as an industrial disability claim. Therefore, as discussed in the first paragraph of this post, the emphasis in determining the value of the claim is the effect of the physical and mental injury on the worker’s future earning capacity.

The case of Cedar Rapids Community School District v. Pease that I mentioned earlier is an example of a physical-mental injury. The worker initially suffered a right ankle injury at work. The right ankle injury in turn aggravated pre-existing problems that the claimant had with her other ankle, her low back, and depression. The Iowa Supreme Court ultimately decided that the ankle injury that occurred at work, and the aggravation of the claimant’s pre-existing mental health problems rendered her unable to work and entitled her to permanent total disability benefits.

You can look here to see my April 25, 2013 blog post explaining how permanent total disability works in Iowa work comp.