BY: John Dealy, Hassett & Donnelly, P.C. & Michael Melville, Hassett & Donnelly, P.C.
On August 28, 2014, the Massachusetts Appeals Court decided Litchfield’s Case, which held that an employee was not entitled to benefits for loss of psychiatric function stemming from a physical injury. 86 Mass. App. Ct. 216, 15 N.E.3d 251 (2014). As many workers’ compensation practitioners are aware, employees are often diagnosed with depression or other psychological conditions triggered by their pain and inability to work. Accordingly, this case had the potential for expanding the scope of potential benefits awarded to injured employees. Nevertheless, as discussed below, despite the decision limiting benefits, this case portends of a future controversy.
Robert Litchfield was a heavy equipment mechanic from 1984 to 2001, when he suffered an industrial injury to his elbow and shoulder. Mr. Litchfield had no history of anxiety or depression prior to his work injury. Following his industrial accident, Mr. Litchfield was unable to work, except as a poll worker on election days. After his injury, Mr. Litchfield began to suffer from anxiety and depression caused by his pain and inability to work.
Prior to the litigation of his alleged psychiatric impairment, Mr. Litchfield had previously brought multiple claims before the Department of Industrial Accidents related to his 2001 industrial accident. In 2004, Mr. Litchfield was awarded weekly partial incapacity benefits, pursuant to M.G.L. c. 152, § 35. In 2007, Mr. Litchfield was awarded weekly temporary total incapacity benefits, pursuant to M.G.L. c. 152, § 34. In 2009, Mr. Litchfield was awarded permanent and total weekly benefits under M.G.L. c. 152, § 34A.
In addition to weekly benefits, the Massachusetts Workers’ Compensation Act allows employees to receive payments—called “Section 36 benefits”— for scarring, disfigurement, and loss of function. See M.G.L. c. 152, § 36. These benefits represent one-time payments to the employee based on specific criteria established by the Massachusetts Department of Industrial Accidents. In 2007, Mr. Litchfield received Section 36 benefits for his shoulder and elbow injuries.
In 2010, Mr. Litchfield filed a claim for loss of psychiatric function, which was the basis for the 2014 Appeals Court decision. Mr. Litchfield based his claim for Section 36 benefits on the American Medical Association Guides to the Evaluation of Permanent Impairment, Sixth Edition, which was published in 2008. Mr. Litchfield had previously been given a 40% loss of psychiatric function by a doctor, though this doctor reduced the impairment rating to 20% during his deposition. Litchfield v. Town of Westford, 27 Mass. Workers' Comp. Rep. 71 (Mass. Dept. Ind. Acc. May 21, 2013).
A hearing at the Department of Industrial Accidents was held before an administrative judge. The administrative judge held that “[Mr. Litchfield]’s ‘pain and inability to work, directly caused by the physical injuries, have caused his psychiatric conditions of depression and anxiety.’” Litchfield v. Town of Westford, 27 Mass. Workers' Comp. Rep. 71. The judge then relied upon the AMA Guides 6th edition, and denied Mr. Litchfield’s claim for loss of psychiatric function. The claim was appealed to a panel of the Massachusetts Department of Industrial Accidents Reviewing Board, which also denied Mr. Litchfield’s claim. Litchfield v. Town of Westford, 27 Mass. Workers' Comp. Rep. 71.
Mr. Litchfield argued that Chapter 14 of the AMA Guides 6th edition recognized loss of psychiatric function for the first time. It was his position that under Chapter 14, his mental injury was compensable regardless of whether or not it stemmed from his physical injury. Litchfield’s Case, 86 Mass. App. Ct. 216. He based his argument upon the rule for applying Chapter 14, which states: “In the event of a mental and behavioral disorder that is judged independently compensable by the jurisdiction involved, the mental and behavioral impairment is combined with the physical impairment.” See id. Mr. Litchfield argued that since Massachusetts recognizes recovery for the psychological effects of workplace injuries, that language entitled him to recover. See id.
The Appeals Court agreed that the 6th edition should be used because it contains the most current scientific and clinical knowledge. Nevertheless, the court disagreed with Mr. Litchfield’s interpretation of the 6th edition’s impairment rating of psychological injury. The Appeals Court looked at several portions of the AMA Guides which gave guidance to the method used to interpret impairment ratings under the Guides 6th edition. As the Appeals Court explained, the 6th edition of the AMA Guides makes clear that the pain associated with an injury is meant to be captured within the rating for the injury itself. “[I]n no circumstances should the [pain related impairments] developed using this chapter be considered as an add-on to impairment determinations based on the criteria listed in [c]hapters 4 to 17.” Litchfield’s Case, 86 Mass. App. Ct. 216, 15 N.E.3d 251 (quoting American Medical Association Guides to the Evaluation of Permanent Impairment (6th ed. 2008) at p. 36). Further, "[t]he impairment ratings in the body organ system chapters make allowance for most of the functional losses accompanying pain." Id. (quoting the AMA Guides 6th edition at p. 25). Most importantly, for the interpretation of Mr. Litchfield’s specific claims, Chapter 14, the chapter relating to psychological impairment, explains that generally, the “mental and behavioral disorder” which accompanies a physical impairment is encompassed within the rating for the physical impairment. A Chapter 14 mental impairment rating only applies where there is a psychological impairment without a physical or pain impairment. Id. (quoting AMA Guides 6th edition).
In Mr. Litchfield’s case, the psychiatric conditions of depression and anxiety were caused by his pain and his inability to work. Accordingly, the Appeals Court determined that any psychiatric condition that Mr. Litchfield had stemmed from his physical injuries. Under the AMA Guides, 6th edition, the conditions were not independently compensable. This decision, therefore, can be read as preventing a form of double recovery.
Nevertheless, in Litchfield’s Case, the Appeals Court left open the potential for a loss of psychiatric function claim that is independent of an employee’s physical injury. For example, one could envision a case where an employee suffered post-traumatic stress disorder following an assault at work, without an accompanying physical injury. Such a claim could lead to an employee being entitled to Section 36 benefits for his psychiatric injury under AMA Guides, 6th edition. Thus, determining whether a worker is suffering post-traumatic stress because he underwent a traumatic life event, or whether the worker is simply depressed because he is unable to work, is an issue that one can expect to be litigated soon.