Can a worker with a head injury get workers’ compensation benefits for conditions involving headaches, depression and anxiety that began after she was injured?
The West Virginia Supreme Court of Appeals found that the worker was entitled to benefits since all of the medical evidence supported the fact that her headaches, depression and anxiety were causally related to the head injury she sustained at work.
Post-injury headaches different than her past migraines
A nurse’s aide who the court identifies only by her initials, D.N., was injured on Feb. 2, 2012, when she struck her head on a television stand while picking up a bag of trash off the floor.
Following the incident, the nurse’s aide was seen by a doctor for increased headaches related to her injury. The same doctor had treated the nurse’s aide in the past for migraine headaches.
During a 2013 independent medical examination, the nurse’s aide reported that the headaches resulting from her head injury were different than those she suffered in the past. The independent doctor noted her complaints of an abnormal sensation across her forehead, which was sensitive to touch and spread around both temples and the face. The doctor also noted this condition was related to the compensable work injury.
The independent doctor later amended his notes to reflect that he was aware of the nurse’s aide’s pre-injury migraines. He mentioned that her current headaches, combined with other neurological symptoms, were different than the headaches she suffered in the past.
‘Physical, mental status put her, others at risk’
From August 2014 through January 2020, the nurse’s aide was seen by various doctors and neuropsychological specialists for:
- head and neck mobility deficits
- pain and tingling associated with muscle spasms and headaches
- abnormal blood pressure
- chronic migraines
- generalized anxiety disorder, and
- major depressive disorder.
She expressed feelings of sadness and discouragement regarding her future, a loss of interest in pleasurable activities, an increase in crying, restlessness and agitation, loss of energy, and feelings of fatigue.
One doctor noted that the nurse’s aide couldn’t return to work because her “physical and mental status from the compensable injury may put her and other people at risk.”
All of the nurse’s aide’s doctors said her headaches and psychiatric problems were related to her occupational head injury and were compensable.
Request to add conditions denied
On Dec. 4, 2019, a claims administrator denied a request to add major depressive disorder and generalized anxiety disorder to the claim. The nurse’s aide filed a protest, which she supported with testimony regarding her headaches, saying, “It is like a throbbing sensation in the top of my head … a lot of burning in my forehead area … like somebody taking the tip of a knife and just cutting my face. I also have a lot of numbness and tingling in my facial area.”
She also explained the stress resulting from her chronic condition and her belief that her depression and anxiety were related to her chronic compensable condition.
The Office of Judges reversed the claims administrator’s decision, finding that the nurse’s aide proved, by a preponderance of evidence, that her headaches, depression and anxiety were covered under West Virginia’s laws regarding the compensability of psychiatric disorders.
Decision supported by years of treatment notes
On appeal, the nurse’s aide’s employer, Genesis Healthcare, argued that the Office of Judges erred by allowing compensability to be determined under a preponderance of the evidence standard after the submission of additional evidence. Genesis asked the court to remand the case back to the claims administrator.
However, the appeals court agreed with the reasoning of the Office of Judges. It found that the nurse’s aide’s conditions met all the criteria of being compensable under state law. The court said the Office of Judges’ decision was supported by medical evidence with years of treatment notes and testimony from many doctors regarding the issue of compensability.