Reese v. Home Budget Center

• Decision Date: 17 November 1992
• Citation: 619 A.2d 907
• Parties: Joseph REESE, Claimant Below, Appellant, v. HOME BUDGET CENTER, Employer Below, Appellee. . Submitted:
• Court: United States State Supreme Court of Delaware

Page 907

619 A.2d 907

Joseph REESE, Claimant Below, Appellant, v. HOME BUDGET CENTER, Employer Below, Appellee.

Supreme Court of Delaware.

Submitted: Nov. 17, 1992.

Decided: Dec. 23, 1992.

Appeal from Superior Court. Reversed and Remanded.

Frederick T. Haase, Jr. (argued), Haase & Kelly, Wilmington, for appellant.

Michael P. Freebery (argued), Prickett, Jones, Elliott, Kristol and Schnee, Wilmington, for appellee.

Before MOORE, WALSH, and HOLLAND, JJ.

WALSH, Justice:

This is an appeal from a decision of the Superior Court that affirmed a denial by the Industrial Accident Board ("Board") of a claim for medical payments asserted by the appellant, Joseph Reese ("Reese"). The Board ruled that Reese's treatment for the emotional effects of an earlier industrial accident were not linked by substantial causation. We conclude that the Board applied an erroneous standard of recovery for the emotional effects of an industrial accident and that the Superior Court erred in the affirmance of that application. Accordingly, we reverse.

I

There is no dispute concerning the origin of Reese's physical disability. On February 5, 1990, while employed by Home Budget Center, Reese sustained a lower back injury delivering a mattress. He subsequently filed a petition with the Board which resulted in the receipt of temporary total disability benefits from the date of the accident until June 14, 1991. In addition, his employer's compensation carrier agreed to pay for all medical expenses related to treatment of his back injury. The carrier, however, refused to pay for any expense attributable to psychiatric treatment for emotional and anxiety problems which Reese began to experience approximately five months after the accident. Upon the refusal of the carrier to pay for these psychiatric expenses, Reese filed a second petition with the Board to require such payments.

The evidence presented to the Board consisted of the testimony of the claimant and the deposition testimony of two psychiatrists, Dr. Harold Graff, Reese's treating psychiatrist, and Dr. Steven Mechanick who testified for the carrier. Reese testified that prior to the accident he had never been treated for any emotional or mental impairment. During his adolescence, however, Reese had abused drugs and alcohol but claimed to have been addiction free for more than a year before his injury. Following his accident, Reese became severely depressed, withdrawn and anxious about his loss of employment, including the termination of his service with the National Guard attributable to his back injury. He experienced marital difficulty and at one point contemplated suicide. His emotional condition also manifested itself in dizziness, insomnia and physical symptoms which caused him to believe he was experiencing a heart attack. In October, 1990 he consulted Dr. Graff.

On his first visit, Dr. Graff found Reese to be nervous, restless and unable to concentrate. His treatment included psychotherapy, sleep medication and anti-depressant drugs. Later Dr. Graff admitted Reese to a private psychiatric hospital where he continued to display signs of agitation and nervousness. Dr. Graff discharged Reese as asymptomatic on June 5, 1991. His final diagnosis was that of posttraumatic stress disorder and panic disorder.

Dr. Mechanick, who examined Reese at the request of the compensation carrier, agreed that Reese suffered from "several psychiatric disorders" during the period following his accident. He was of the view that Reese suffered from a panic disorder characterized by severe episodes of acute anxiety with accompanying symptoms but no identifiable physical cause. He also diagnosed two somatoform pain or conversion disorders with leg numbness and spinal muscle pain without a physical basis. Dr. Mechanick disagreed with Dr. Graff's diagnosis of posttraumatic stress disorder because, in his view, Reese had sustained no traumatic event sufficient to produce such a disorder.

As to the panic disorder and somatoform pain disorder, Dr. Mechanick opined that Reese's biological makeup predisposed him to that type of emotional reaction. Given Reese's prior alcohol and drug abuse and the emotional experience of the murder of his brother's wife, with whom he was intimate, his industrial accident provided a setting for the manifestation of his disorder. Dr. Mechanick did not believe that the accident was a substantial causative factor for the panic disorder.

The Board rejected the claim for psychiatric expenses, ruling that Reese had failed to establish a causative link between his back injury and the emotional aftermath. On appeal the Superior Court affirmed.

II

In its decision rejecting Reese's claim for the expense of psychiatric treatment, the Board noted that "[b]oth psychiatrists believe that claimant had a panic disorder" but disagreed concerning the connection between the back injury and its emotional aftermath. The Board resolved the clash of expert opinion by accepting the view of Dr. Mechanick that Reese did not suffer a posttraumatic stress syndrome and that the panic disorder and somatoform pain disorder he experienced were attributable more to his physiological/biological makeup than to the accident. The Board also adopted Dr. Mechanick's explanation that the accident provided a setting or vehicle for causing a latent condition to become overt. Despite the concurrence of expert testimony linking the lower back injury to the subsequent emotional conditions, the Board, through application of a standard of "substantial cause," ruled the claim not compensable. Relying upon this Court's opinion in Duvall v. Charles Connell Roofing, Del.Supr., 564 A.2d 1132 (1989), the Board ruled that the work accident must be "the substantial cause of the claimant's psychiatric condition" in order for the expenses of treating that condition to be compensable. In so ruling the Board misapprehended the application of Duvall and applied an erroneous legal standard. In affirming the Board's conclusion on the same rationale the Superior Court compounded the error.

There is no dispute that Reese suffered a compensable injury within the purview of the Delaware Workmen's Compensation Law. 19 Del.C. Ch. 23. Indeed, he has been fully compensated for the physical effects of that injury. At issue here is the extent of compensability for the non-physical or psychological consequences of a physical injury and, more importantly, the required nexus between the two.

The term injury is broadly defined for workers' compensation purposes:

" 'Injury' and 'personal injury' mean violence to the physical structure of the body, such disease or infection as naturally results directly therefrom when reasonably treated and compensable...