Category Archives: Work Injury

PTSD in the Aftermath of a Work Injury

PTSD following a work injury can be compensable

Today’s post comes from guest author Charlie Domer, from The Domer Law Firm.

Recovery from a work injury is more than just the physical aspect.  After bones heal, joints are repaired, and spines are fixed, many workers still face psychological scars from the injury’s impact.  Some workers suffer from post-traumatic stress disorder (PTSD) after a trauma.  Workers with PTSD need to heal psychologically too.

The silver lining is that the Wisconsin workers’ compensation law covers that psychological treatment.  An “injury” under Wisconsin law can be either physical or mental harm from the effects of an injury.  If a worker experiences a psychological diagnosis (and need for treatment) stemming from a traumatic physical injury, the applicable legal standard is the same, as those for a physical injury.  Specifically, the psychological care, and corresponding benefits (for lost time and permanency), is compensable if the physical work injury is the direct cause of the need psychological care or even if the injury aggravated, accelerated, and precipitated a pre-existing psychological condition beyond its normal progression.  (i.e., if the work event made the person’s psychological condition permanently worse).    

A purely mental/emotional stress injury, however, has a different, higher standard.  These are claims where the worker alleges their workplace environment (without a physical injury) causes their psychological condition (examples would inlcude witnessing a horrendous event, a berating supervisor, or an unbearable workload).  In these “mental-mental” circumstances, the worker must meet the extraordinary stress test–showing their experience was greater than the day to day emotional strains all workers must undergo.   Suffice to say, this is a tough standard for most workers to meet, making these claims difficult to pursue.

In stark contrast, if a worker suffers a physical injury and then begins to experience PTSD, such claims and medical treatment expenses generally are compensable–if the psychologist or psychiatrist provides their support.   Medical support for the psychological condition and care is key.

A recent article in the Milwaukee Journal Sentinel offers excellent insight for PTSD sufferers following a traumatic incident: Life After a Car Crash: Could You Be Experiencing PTSD?  In the article, Dr. Terri deRoon-Cassini seeks to spread awareness of the prevalence of PTSD symptoms and need for treatment after an accident.  She offers a litany of specific symptoms that individuals may experience in their post-injury recovery, including:

  • intrusive flashbacks/nightmares
  • avoidance behaviors
  • hyper-arousal, or
  • negative mood/thinking.

More importantly, Dr. deRoon-Cassini higlights the need for proper and timely psychological care–along with the ability to achieve a positive recovery. 

Workers can receive compensation during their psychological recovery, as well as vocational benefits if their psychological limits do not allow a return to their pre-injury employment.   No matter what, injured workers need to be aware of their psychological/emotional state and to not be afraid to get the needed psychological care.

Watching a Paraplegic Walk!: A Work Comp Success Story

The ReWalk Device

Today’s post comes from guest author Charlie Domer, from The Domer Law Firm.

I just witnessed someone without the use of their legs actually walk! 

A young paraplegic—supposedly bound to a wheelchair on a permanent basis—used a robotic device and actually stood upright and walked forward.  The emotions involved defy adequate description, especially for someone included on the team that made this event happened.


CBS 58

This story begins, like many work injuries, with an unexpected traumatic event.  On November 13, 2008, Matt Nevaranta was a 22-year-old working a construction job in hopes of saving enough money to continue his college career.  Those dreams were cut short when 3,000 pounds of metal forms fell on Matt, severing his spinal cord.  Matt was lucky to be alive.  However, the injury damage resulted in permanent paraplegia—an inability to use his legs and all bodily functions below his waist.   Matt presumably was constrained to a wheelchair for his life.

For many individuals, such an injury could drastically alter their outlook on life.  Matt, though, is a unique young man, who I had the privilege to get to know and represent as his worker’s compensation attorney.  Despite his condition, Matt remained positive and persevered daily.  He continued to better himself since his traumatic injury.

Matt vigorously pursued his educational opportunities.  After the initial shock and recovery from the injury, Matt reenrolled in college, beginning online.  He ultimately attended full-time at Cardinal Stritch University (in Milwaukee, WI)—actually driving himself and using his wheelchair for classes.  While many worker’s compensation insurance companies demean or question the motivation level of injured workers, Matt disproved those misplaced assumptions.  Matt graduated from Cardinal Stritch in the spring 2016 while his bachelor’s degree.  Moreover, he volunteers at the Milwaukee County Courthouse in a legal clinic, and he now has applied for law school!

Matt also forcefully pursued his physical betterment and the necessary medical equipment.  Under the Worker’s Compensation law, an injured worker receives medical treatment that is reasonably required to cure and relieve from the effects of the injury.  (Wis. Stat. Section 102.42(1)).   In Matt’s case, his worker’s compensation insurance company provided a number of medical items since the injury, including a seated wheelchair, an upright wheelchair, and home and car accommodation modifications.  None of this treatment, however, resulted in Matt walking.

ReWalk allowed Matt to walk.  ReWalk is a wearable robotic, motorized exoskeleton that allows individuals with spinal cord injuries to stand upright and actually walk.   During my representation, Matt asked if his worker’s compensation insurance company would pay for the ReWalk device.   Matt met all of the necessary criteria (as established by ReWalk) and had medical clearance to obtain the device.  More importantly, Matt’s treating spinal cord specialist and psychologist provided their medical opinions about the significant physical and psychology benefits involved in the potential use of this device.

A legal battle ensued.   In part, due to the “not-cheap” device cost, the worker’s compensation insurance company denied payment for the device.  The insurance company also hired their own “independent” medical record reviewer to question the benefits of the device.  We filed numerous medical literature studies showing the physical benefits of an upright motorized exoskeleton for paraplegics (notably, many of these devices have been used to assist returning military veterans).  We also filed medical opinions noting the potential cardiovascular, gastrointestinal, spasticity, life expectancy, and psychological benefits to the device.

The dispute over the ReWalk device went to a worker’s compensation trial.  (Note that worker’s compensation attorneys cannot receive a fee on medical treatment expenses, so this was pro bono representation).  Matt testified about his desire to use the ReWalk device.

And we won.  In a first-of-its-kind case in Wisconsin, the administrative law judge ruled that the ReWalk exoskeleton device was a reasonably required medical treatment or modality to cure and/or relieve from the effects of the work injury.  Thus, the worker’s compensation insurance company was ordered to pay for the device.

The parties struck a subsequent reasonable deal for the cost of the device to avoid further appellate litigation.  As part of this deal, we worked with the amazing crew at Marquette University’s physical therapy department (shown in the video clip in detail), who provided further training to Matt free of charge.   Matt now goes to training at Marquette, and I was privileged to watch Matt in action. 

I watched a paraplegic walk!

Such a worker’s compensation success would not be possible without an entire team supporting Matt, including the efforts from Domer Law, Matt’s family, the ReWalk team (especially Craig Peters), the physicians at Froedtert/Medical College of Wisconsin (especially Drs. Merle Orr and Brad Grunert), and Marquette University physical therapists.  But, of course, none of this would occur without the personal drive to excel found in Matt Nevaranta.  Great work Matt, and I wish you nothing but continued success. 

Workers’ Compensation Basics: What is a Workers’ Compensation Accident?

Today’s post comes from guest author Brody Ockander, from Rehm, Bennett & Moore.

This blog post is the third in a series that examines the basics of workers’ compensation.

To be a covered workers’ compensation claim, an employee’s personal injury must be caused by an accident or occupational disease, but what does that mean?

The Nebraska Workers’ Compensation Act defines accident as: “an unexpected or unforeseen injury happening suddenly and violently, with or without human fault, and producing at the time objective symptoms of an injury. The claimant shall have a burden of proof to establish by a preponderance of the evidence that such unexpected or unforeseen injury was in fact caused by the employment. There shall be no presumption from the mere occurrence of such unexpected or unforeseen injury that the injury was in fact caused by the employment. …” Nebraska Revised Statute 48-151 (2)

Of course, many workers’ compensation injuries are not as simple or as clear as a broken arm that was the result of a fall. Some injuries are caused by repetitive motion or cumulative trauma on the job. In those cases, the injuries are still considered workers’ compensation “accidents” under the definition above, even though the injuries did not truly occur “suddenly and violently” as required by the statute. 

As for an occupational disease, the Workers’ Compensation Act defines it as “a disease which is due to causes and conditions which are characteristic of and peculiar to a particular trade, occupation, process, or employment and shall exclude all ordinary diseases of life to which the general public is exposed.” Nebraska Revised Statute 48-151 (3) Examples to think about would be mesothelioma for asbestos workers or black lung for coal miners.

In sum, pretty much any injury or illness that an employee receives from work can fit into the definition of “accident” under the Nebraska Workers’ Compensation Act. However, proving the injury is much more difficult and may require the help of a lawyer.

Read the previous blog posts in the series by clicking on these links: Workers’ Compensation Basics: Are You an Employee? and What is Workers’ Compensation?