Work it Out Blog

Workers’ Compensation: Second Appellate District Limits Substantial Aggravation of Psychological Conditions

Mar 10, 2015

We have often wondered how someone can prove a substantial aggravation of a preexisting psychological condition. As we know, Ohio law clearly requires objective proof of a substantial aggravation by way of diagnostic findings, clinical findings, or test results and that the claimant’s own subjective complaints are not sufficient unless you have objective evidence to go along with it. How can a workers’ compensation claimant ever show an objective substantial aggravation in a subjective field like psychology? The Second Appellate District recently touched on this issue in Little v. Dayton Public Schools.

Little sustained an injury to her left arm and hand in 2007 and filed a workers’ compensation claim that was allowed for sprains to her left hand and forearm and a contusion to her left hand. Eventually, the condition of “substantial aggravation of preexisting pain disorder associated with psychological factors and a general medical condition” was requested and appealed into court. Little’s expert allegedly relied upon the DSM-IV, Little’s history, and the psychological testing that he administered. However, the court concluded that these three factors were not objective.  

Addressing the DSM-IV, the court referred to the expert’s own trial testimony during which he characterized it as a “diagnostic book” that had “patterns of symptoms to allow psychiatrists and psychologists to uniformly diagnose patients pursuant to nationally recognized standard[s].” However, he did not testify that “the DSM-IV in any way objectively established the substantial aggravation of Little’s pain disorder.” The court therefore determined that the DSM-IV was not objective evidence that could be relied upon. Turning to the claimant’s history, the court determined that her self-reported history was plainly subjective because it was based off of things that Littleindicatedreported, or described. Lastly, the court determined that the psychological testing in the form of the “mood disorder questionnaire” and “Beck Depression Inventory” were not objective test results that the court could rely upon. The expert testified that both forms of testing were subjective and that “you can’t do a blood test to diagnose” a psychological condition.

We have been questioning the validity of allowing workers’ compensation claims for substantial aggravation of preexisting psychological conditions. Like the expert in Little testified, there are not any blood tests, range of motion tests, or MRIs that can objectively show a person suffers from a psychological condition, let alone that a psychological condition has been substantially aggravated. The Little opinion is limited in that it relies upon the expert’s testimony instead of the fact that psychological conditions are inherently subjective. However, it is a step in the right direction for Ohio case law.

The content of this blog is for informational purposes only and is not intended as legal advice for any purpose. This blog is not intended to present an exhaustive summary of all applicable laws, or to take the place of legal advice.  If you have any questions regarding the law, please contact us for assistance.