Iowa Supreme Court lowers bar to get workers' comp for PTSD for first responders
First responders were at a disadvantage when trying to prove work-related PTSD, justices determined
By Thomas Geyer
Quad City Times, Davenport, Iowa
DES MOINES, Iowa — In a 4-3 decision, the Iowa Supreme Court has in effect lowered the bar for workers' compensation claims by emergency responders to receive benefits for trauma-induced mental injuries suffered on the job.
The decision was released Friday with Chief Justice Susan Christensen and Justices Brent Appel, Dana Oxley and Matthew McDermott siding with the appellant, Mandy Tripp. Justices Tom Waterman, Edward Mansfield and Christopher McDonald dissented.
The case was brought by Tripp, who began her career as an emergency dispatcher for the Davenport Police Department, and who later transitioned to the Scott County Emergency Communications Center when dispatching in Scott County was consolidated.
According to the case, Tripp was a 16-year veteran of the dispatch center when on the morning of Sept. 30, 2018, she answered a 911 call from a woman "screaming at a very high pitch, 'Help me, my baby is dead. Help me, my baby is dead,' over and over and over."
The screaming continued for 2 minutes and 15 seconds. Tripp struggled to calm the women enough to get an address to dispatch an ambulance. She ultimately got an address and transferred the call to a medical dispatcher who tried to instruct the mother on lifesaving measures until the ambulance arrived.
Tripp continued to hear ongoing radio traffic about the incident after she transferred the call. She heard the medical dispatcher tell the mother how to perform CPR on an infant. She heard the emergency medics who arrived by ambulance at the scene say that "rigor was already set in." And she heard police officers talking about "a potential crime scene" at the mother's home.
Injuries to the child's face, according to one investigating officer speaking over the radio, suggested that the child had been beaten with a claw hammer. All the while, the child's mother screamed in the background. Tripp's supervisor asked Tripp if she needed a break. Tripp declined, responding that she "needed another call" to get the mother's screams "out of my head."
An autopsy and subsequent investigation by Davenport Police revealed the child's death was accidental suffocation.
Although she had taken emergency calls involving serious injuries to children in the past from people at the scene of fatal incidents, including three calls involving a dead infant, she had never before answered a call from a dead child's own mother. Tripp described the mother's screams as something beyond "normal" sounds: "guttural, awful."
Tripp went through counseling and was eventually diagnosed by a mental health counselor, a psychologist and a psychiatrist as suffering from Post-Traumatic Stress Disorder, or PTSD.
Tripp eventually filed an application for workers' compensation benefits based on her PTSD, but it was denied, despite her mental health counselors saying that her PTSD was caused by that one phone call.
The deputy workers' compensation commissioner said that dispatchers "routinely" took calls involving death and traumatic injuries, and that Tripp failed to prove that the PTSD-inducing call was "unusual" or "unexpected" as required under the Iowa court's prior mental injury cases.
That ruling was upheld by the workers' compensation commissioner and the Scott County District Court.
Tripp's appeal went to the Iowa Supreme Court.
Writing for the majority, McDermott said the majority found that Tripp's PTSD diagnosis qualifies as a "personal injury" under the current statute.
The majority also found that Tripp's PTSD arose out of and in the course of her employment as an emergency dispatcher.
The way the district court interpreted the Iowa's workers' compensation statute would put emergency dispatchers, paramedics, police officers and firefighters at a disadvantage compared with other workers.
Emergency responders would have to prove hyper-unexpected causes and hyper-unusual strains above and beyond the perilous events that they regularly confront to qualify for benefits that those in less hazardous professions receive by meeting a lower bar.
Christensen said in her concurrence that Iowa's legislature adopted a statute similar to Minnesota's law that said that a diagnoses of PTSD was taken as fact as being caused by the first responder's job, unless it could be proved otherwise.
Waterman said in his dissent that substantial evidence supported the commissioner's factual determination that Tripp's phone call with the hysterical mother was not an unexpected event for an emergency dispatcher, as other witnesses testified.
"We are required to affirm the agency's determination under our deferential standard of review. The majority's ill-advised change to the legal causation element in mental injury claims opens the floodgates to fraudulent claims that are difficult to disprove and will drive up the cost of doing business in Iowa."
Waterman said the majority "overrules our case law that required employees claiming purely mental injuries to show that the triggering event was sudden, traumatic and unexpected in their occupation.
First, Waterman said, the majority's new holding begs the question: "unexpected" compared to what? As the district court noted, "the Commissioner must first establish a baseline of what is expected or usual" by looking to the claimant's occupation. What is expected or unexpected necessarily varies by occupation.
Witnessing a death on the job would be unexpected for most occupations; not so for a hospice nurse. Police, firefighters and medics routinely face life-threatening emergencies as part of the job.
Waterman said the majority relied on a flawed premise: that first responders couldn't recover for their purely mental injuries under current case law because stressful emergencies were part of the job.
The majority, he said, wants an easier path for mental disability benefits for emergency workers, including 911 operators who are not physically present at the crime or accident scene.
Such a policy should be left to the legislature, which for has left the case law regarding the same-or-similar-job proof requirement intact.
Waterman also said that agency fact finders applying Iowa case law had repeatedly allowed first responders to recover for purely mental injuries triggered by specific events.
"The bar is not set too high," he said.
Waterman said the stress of Tripp's phone call was not unusual or unexpected for an emergency dispatcher.
(c)2022 Quad City Times, Davenport, Iowa