Claims adjustor blames harassment, humiliation from supervisor for condition
In a recent case, a doctor attributed 45% of the applicant’s psychiatric injury to severe stress due to ongoing alleged harassment, humiliation, and a hostile work environment caused by her supervisor and 30% to a combination of personnel actions.
The applicant in the case of Puga vs. Sedgwick Claims Management Services and Property & Casualty Insurance Company of Hartford, administered by Sedgwick Claims Management Services worked as a claims adjustor for the defendant employer. She claimed that she sustained a psychiatric injury while employed during the period from Oct. 25, 2017 to Oct. 25, 2018.
Dr. Yatin Patel was the psychiatric qualified medical examiner. The doctor evaluated and interviewed the applicant, took her history, reviewed her medical record, did psychological testing, and conducted an analysis in line with the case of Rolda v. Pitney Bowes (2001).
Dr. Patel diagnosed the applicant with the following: adjustment disorder with mixed anxiety and depressed mood and panic disorder without agoraphobia. The doctor found both conditions to be in partial remission.
The workers’ compensation administrative law judge found that the applicant suffered a psychiatric injury arising out of and occurring in the course of employment, that she should receive further medical treatment to cure or to relieve her from the injury’s effects, and that the injury caused no temporary disability or permanent disability.
The defendant asked for a reconsideration. The defendant argued that this case did not meet the requirements for finding a psychiatric injury under section 3208.3 of California’s Labor Code.
The defendant asserted that the claimed psychiatric injury would be 55-percent attributed to nonindustrial causes if the judge properly applied the defense of “good faith personnel action” under section 3208.3(h).
A panel of the Workers’ Compensation Appeals Board of California agreed with the workers’ compensation judge’s decision.
First, the panel held that the judge gave a detailed explanation of his Rolda analysis and that Dr. Patel’s report also included a Rolda analysis. The panel noted that the judge’s report addressed and resolved any deficiency in the decision.
Second, the panel found no evidence showing that harassment, humiliation, and a hostile work environment – to which Dr. Patel attributed 45% of the injury’s cause – were lawful, non-discriminatory, and good-faith personnel actions for the purposes of section 3208.3(h).
Third, the panel found no evidence supporting the defendant’s argument that the judge should add the 30% of the applicant’s psychiatric injury, which Dr. Patel attributed to a combination of personnel actions, to the 25% of the psychiatric injury that the doctor attributed to outside factors.
Lastly, the panel found no basis for the defendant’s argument that the 30% of the applicant’s psychiatric injury that the judge attributed to personnel actions should be considered non-industrial.
