Armstrong v. John R. Jurgensen Co. , 136 Ohio St. 3d 58 ( 2013 )


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  • [Cite as Armstrong v. John R. Jurgensen Co., 
    136 Ohio St. 3d 58
    , 2013-Ohio-2237.]
    ARMSTRONG, APPELLANT, v. JOHN R. JURGENSEN COMPANY ET AL.,
    APPELLEES.
    [Cite as Armstrong v. John R. Jurgensen Co., 
    136 Ohio St. 3d 58
    ,
    2013-Ohio-2237.]
    Workers’ compensation—R.C. 4123.01(C)(1)—PTSD—No compensable physical
    injury—Judgment denying benefits affirmed.
    (No. 2012-0244—Submitted January 23, 2013—Decided June 4, 2013.)
    APPEAL from the Court of Appeals for Clark County,
    No. 2011-CA-6, 2011-Ohio-6708.
    ____________________
    FRENCH, J.
    {¶ 1} In this appeal, we consider whether, for a mental condition to be
    compensable under the Ohio workers’ compensation system, a compensable
    physical injury sustained by the claimant must cause the mental condition. We
    hold that it must.
    Facts and Procedural History
    {¶ 2} On August 27, 2009, appellant, Shaun Armstrong, was involved in
    a motor-vehicle accident while operating a one-ton dump truck within the course
    of his employment by appellee John R. Jurgensen Company. While stopped at a
    yield sign on an access ramp to I-70 east, Armstrong observed a vehicle
    approaching from behind with increasing speed.                Armstrong braced for a
    collision, afraid he was going to be seriously injured. The approaching vehicle
    struck the dump truck from behind, pushed it forward, and came to rest “basically
    underneath” the dump truck.
    {¶ 3} After the collision, Armstrong was in shock and did not know the
    extent of his injuries. Looking in his mirror, Armstrong saw the other driver with
    SUPREME COURT OF OHIO
    his head down and observed fluid leaking from the vehicles. Armstrong exited
    the dump truck, afraid the vehicles would catch fire, and called 9-1-1. Armstrong
    then noticed that the other driver was not moving and that blood was coming from
    his nose; he suspected the driver was dead.        After being transported to the
    emergency room, Armstrong was treated for physical injuries and released. He
    was distressed to learn, while in the emergency room, that the other driver had, in
    fact, died.
    {¶ 4} Armstrong filed a workers’ compensation claim for his physical
    injuries, and his claim was allowed for cervical strain, thoracic strain, and lumbar
    strain. He subsequently requested an additional allowance for posttraumatic-
    stress disorder (“PTSD”). An Industrial Commission staff hearing officer allowed
    Armstrong’s additional claim, finding his PTSD compensable because it was
    causally related to his industrial injury and his previously recognized conditions.
    Jurgensen appealed to the Industrial Commission, which refused the
    administrative appeal.
    {¶ 5} After the Industrial Commission refused Jurgensen’s administrative
    appeal, Jurgensen appealed to the Clark County Court of Common Pleas pursuant
    to R.C. 4123.512. The parties stipulated that Armstrong suffers from PTSD, and
    the trial court conducted a bench trial to determine Armstrong’s right to workers’
    compensation benefits for that condition.
    {¶ 6} Both Armstrong and Jurgensen presented expert testimony
    regarding the cause of Armstrong’s PTSD. Armstrong presented the videotaped
    deposition testimony of Jennifer J. Stoeckel, Ph.D., who evaluated Armstrong and
    diagnosed his PTSD. Dr. Stoeckel testified that Armstrong developed PTSD as a
    result of the accident and that his physical injuries contributed to and were causal
    factors in his development of PTSD. Jurgensen, on the other hand, presented the
    testimony of William L. Howard, Ph.D., who agreed with Dr. Stoeckel that
    Armstrong suffered from PTSD as a result of the accident, but opined that
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    January Term, 2013
    Armstrong’s physical injuries did not cause his PTSD. Dr. Howard testified that
    the PTSD was caused by witnessing the accident and “the mental observation of
    the severity of the injury, the fatality, [and] the fact that it could have been life-
    threatening to him at some point.” Dr. Howard believed that Armstrong would
    have developed PTSD even without his physical injuries.
    {¶ 7} The trial court held that Armstrong’s PTSD was not compensable,
    because it did not arise from his physical injuries. The Second District Court of
    Appeals affirmed, holding that the applicable statutory definition of “injury”
    includes psychiatric conditions only when they arise from a compensable physical
    injury. The court of appeals further determined that competent, credible evidence
    supported the trial court’s factual finding that Armstrong’s PTSD did not arise
    from his physical injuries. 2011-Ohio-6708, 
    2011 WL 6884238
    , ¶ 39 (2d Dist.).
    Question Presented
    {¶ 8} The question before us is whether R.C. 4123.01(C)(1) limits
    workers’ compensation coverage for psychiatric conditions to those conditions
    caused by the claimant’s compensable physical injury.
    Analysis
    {¶ 9}    The Ohio Constitution, Article II, Section 35 vests in the General
    Assembly the right to establish a workers’ compensation system for the purpose
    of providing workers and their dependents with compensation for death, injuries,
    and occupational disease occasioned in the course of employment. Article II,
    Section 35 “gives the General Assembly the sole authority to determine [workers’
    compensation] coverage and to define which occupational injuries will be
    covered.” McCrone v. Bank One Corp., 
    107 Ohio St. 3d 272
    , 2005-Ohio-6505,
    
    839 N.E.2d 1
    , ¶ 34, citing Rambaldo v. Accurate Die Casting, 
    65 Ohio St. 3d 281
    ,
    288, 
    603 N.E.2d 975
    (1992).
    {¶ 10} Aside from certain statutory exceptions, R.C. 4123.54(A)
    provides that every employee who is injured or contracts an occupational disease
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    is entitled to receive compensation for loss sustained on account of the injury or
    occupational disease. R.C. 4123.01(C) defines “injury” for purposes of workers’
    compensation: “ ‘Injury’ includes any injury, whether caused by external
    accidental means or accidental in character and result, received in the course of,
    and arising out of, the injured employee's employment.” Psychiatric conditions
    are excluded from the general definition of “injury,” “except where the claimant's
    psychiatric conditions have arisen from an injury or occupational disease
    sustained by that claimant.” R.C. 4123.01(C)(1).
    {¶ 11} This case presents an issue of statutory construction, centering on
    whether Armstrong’s PTSD qualifies as an “injury” under R.C. 4123.01(C)(1).
    Specifically, we must determine what nexus is required between a psychiatric
    condition and a compensable physical injury for the psychiatric condition to
    qualify as a compensable injury. Jurgensen maintains that R.C. 4123.01(C)(1)
    requires a direct and proximate causal relationship between the physical injury
    and the mental condition, but Armstrong maintains that Ohio courts have always
    allowed compensation for mental conditions that arise contemporaneously with
    physical injury, regardless of a causal relationship between the two. The Ohio
    Association for Justice (“OAJ”), as amicus curiae, has filed a brief in support of
    Armstrong’s position.
    {¶ 12} A court’s paramount concern in construing a statute is legislative
    intent. State ex rel. Dispatch Printing Co. v. Johnson, 
    106 Ohio St. 3d 160
    , 2005-
    Ohio-4384, 
    833 N.E.2d 274
    , ¶ 21, citing State ex rel. Steele v. Morrissey, 
    103 Ohio St. 3d 355
    , 2004-Ohio-4960, 
    815 N.E.2d 1107
    , ¶ 21. To discern legislative
    intent, we first consider the statutory language, reading the words and phrases in
    context, according to rules of grammar and common usage. R.C. 1.42; State ex
    rel. Choices for South-Western City Schools v. Anthony, 
    108 Ohio St. 3d 1
    , 2005-
    Ohio-5362, 
    840 N.E.2d 582
    , ¶ 40. The court may not delete or insert words, but
    must give effect to the words the General Assembly has chosen.          Bailey v.
    4
    January Term, 2013
    Republic Engineered Steels, Inc., 
    91 Ohio St. 3d 38
    , 39-40, 
    741 N.E.2d 121
    (2001). When a statute is unambiguous, a court must apply it as written. 
    Id. at 40.
           {¶ 13} R.C. 4123.95 prescribes that the provisions of R.C. Chapter 4123
    “shall be liberally construed in favor of employees.” R.C. 4123.95 does not,
    however, license alteration of unambiguous statutory language.          Kilgore v.
    Chrysler Corp., 
    92 Ohio St. 3d 184
    , 189, 
    749 N.E.2d 267
    (2001) (Moyer, C.J.,
    dissenting) (“R.C. 4123.95 does not authorize this court to effectively rewrite the
    statutory system in favor of claimants and their lawyers to assure them favorable
    results”); Gleich v. J.C. Penney Co., Inc., 10th Dist. No. 85AP-276, 
    1985 WL 10104
    , *2 (Aug. 8, 1985). The language of R.C. 4123.01(C) is unambiguous, and
    we must apply it as written. We will not rewrite the statute under the guise of
    liberal construction.
    {¶ 14} Pursuant to the plain language of R.C. 4123.01(C)(1), a claimant
    must sustain physical injury or occupational disease as a prerequisite to
    recovering workers’ compensation benefits for a mental condition. A psychiatric
    condition is not a workers’ compensation injury except when the condition has
    “arisen from an injury or occupational disease sustained by that claimant.” R.C.
    4123.01(C)(1).    R.C. 4123.01(C)(1) “explicitly codified that ‘mental-mental’
    claims—psychiatric conditions arising solely from job-related emotional stress—
    were not compensable under the system.” Bailey at 44 (Cook, J., dissenting); see
    also 
    Rambaldo, 65 Ohio St. 3d at 283
    , 
    603 N.E.2d 975
    (“No Ohio appellate court
    has ever recognized a workers’ compensation claim for mental injury or mental
    disease caused solely by job-related stress which is unaccompanied by physical
    injury or occupational disease”).
    {¶ 15} Armstrong and OAJ urge this court to adopt a reading of the term
    “injury” that embraces the entire episode or accident giving rise to a claimant’s
    physical injuries. We decline to do so. R.C. 4123.01(C), in its entirety, sets forth
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    SUPREME COURT OF OHIO
    a comprehensive definition of “injury” for purposes of workers’ compensation.
    We must read the term “injury” in the R.C. 4123.01(C)(1) exception as consistent
    with the general definition in R.C. 4123.01(C), which focuses on the resulting
    harm, not on the cause or means underlying the harm.
    {¶ 16} R.C. 4123.01(C) requires that an injury be “received in the course
    of, and arising out of, the injured employee’s employment.” The phrase “in the
    course of” relates to the time, place, and circumstances of an injury, and “arising
    out of” contemplates a causal connection between the injury and the employment.
    Fisher v. Mayfield, 
    49 Ohio St. 3d 275
    , 277-278, 
    551 N.E.2d 1271
    (1990). The
    “injury,” however, is distinct from those considerations. While the cause and
    underlying circumstances are relevant to the question of compensability, once the
    prerequisites to coverage are met, it is the resultant harm that constitutes the
    “injury” received or sustained by the claimant, and it is from that harm that the
    claimant’s psychiatric condition must arise.
    {¶ 17} Beyond requiring physical injury or occupational disease, R.C.
    4123.01(C)(1) also defines the required nexus between the physical injury or
    occupational disease and a corresponding mental condition. As relevant here, to
    be compensable, the mental condition must have “arisen from an injury * * *
    sustained by th[e] claimant.” (Emphasis added.) R.C. 4123.01(C)(1). “Arisen
    from,” as used in R.C. 4123.01(C)(1), contemplates a causal connection between
    the mental condition and the claimant’s compensable physical injury. “Arise”
    means “to originate from a specified source[;] to come into being[;] to become
    operative.” Webster’s Third New International Dictionary 117 (1986). “From” is
    “a function word to indicate a starting point: * * * [or] to indicate the source or
    original or moving force of something as * * * the source, cause, means, or
    ultimate agent of an action or condition.” 
    Id. at 913.
    Based on the language of
    R.C. 4123.01(C)(1), the court of appeals held that “[t]o be compensable, a
    psychiatric condition must have been started by and therefore result from a
    6
    January Term, 2013
    physical injury or occupational disease the claimant suffered.” 2011-Ohio-6708,
    
    2011 WL 6884238
    , at ¶ 35. We agree, reading these terms together in context,
    that the statute requires a causal connection between a claimant’s physical injury
    and the claimant’s mental condition.
    {¶ 18} The phrase “arisen from” in R.C. 4123.01(C)(1) parallels the
    language in R.C. 4123.01(C), which states that “injury” includes any injury
    “received in the course of, and arising out of, the injured employee's
    employment.”     (Emphasis added.)      “[A]rising out of” contemplates a causal
    connection between the injury and the employment.             Fisher at 277-278.
    Armstrong would have us construe the analogous language in R.C. 4123.01(C)(1)
    as devoid of a similar causative element, thus setting a broad standard requiring
    only temporal proximity.     We discern no basis for distinction and will not
    overlook the well-established construction of the phrase “arising out of” as
    relating to causation. The plain language of R.C. 4123.01(C) and (C)(1) requires
    that to constitute a compensable injury for purposes of workers’ compensation, a
    psychiatric condition must be causally related to the claimant’s compensable
    physical injury. Accordingly, the statute must be applied as written.
    {¶ 19} Despite the plain statutory text, Armstrong maintains that Ohio
    courts have concluded that under R.C. 4123.01(C)(1), psychiatric or
    psychological   conditions    with     contemporaneous    physical      injuries   are
    compensable,    while    psychiatric    or   psychological    conditions      without
    contemporaneous physical injuries are not.         Armstrong relies heavily on
    McCrone, 
    107 Ohio St. 3d 272
    , 2005-Ohio-6505, 
    839 N.E.2d 1
    , which addressed
    limitations on workers’ compensation coverage for mental conditions in the
    context of an equal-protection challenge to R.C. 4123.01(C)(1).
    {¶ 20} The McCrone claimant applied for workers’ compensation for
    PTSD, which she developed after two robberies of the bank where she worked as
    a teller. The claimant suffered no physical injuries in the robberies, and, as a
    7
    SUPREME COURT OF OHIO
    result, the Bureau of Workers’ Compensation (“BWC”) denied her application for
    benefits. On appeal, the claimant argued that R.C. 4123.01(C)(1) violated the
    Equal Protection Clauses of the United States and Ohio Constitutions.
    {¶ 21} Tracking      the   statutory   language,    this   court   held   that
    “psychological or psychiatric conditions that do not arise from a compensable
    physical injury or occupational disease are excluded from the definition of
    ‘injury’ under R.C. 4123.01(C)(1) and from workers’ compensation coverage.”
    McCrone at ¶ 18 and paragraph one of the syllabus. McCrone did not address
    whether a relationship between the mental condition and the physical injury was
    necessary because the claimant, unlike Armstrong here, had not suffered a
    physical injury. Thus, the court considered only whether the requirement of a
    physical injury or occupational disease in R.C. 4123.01(C)(1) violated equal
    protection.
    {¶ 22} Based on several sentences in McCrone, Armstrong argues that
    “arisen from” is interchangeable with “contemporaneous with.” For example,
    Armstrong cites a portion of the following statement: “The General Assembly
    has determined that those who have mental conditions along with a compensable
    physical injury or occupational disease are covered within the workers’
    compensation system, while those claimants with purely psychiatric or
    psychological conditions are excluded from coverage.”             (Emphasis added.)
    McCrone, 
    107 Ohio St. 3d 272
    , 2005-Ohio-6505, 
    839 N.E.2d 1
    , at ¶ 30.
    Elsewhere in McCrone, the court stated that “[p]sychological or psychiatric
    conditions, without an accompanying physical injury or occupational disease, are
    not compensable under R.C. 4123.01(C)(1).” (Emphasis added.) 
    Id. at ¶
    29.
    Those statements, however, must be read in the larger context of the case, which
    involved no physical injury at all. The court noted the importance of that factor
    just prior to those quotations, in its rejection of the appellate court’s reliance on
    8
    January Term, 2013
    Bailey, 
    91 Ohio St. 3d 38
    , 
    741 N.E.2d 121
    , because, unlike in Bailey, “[i]n
    McCrone’s case, there was no physical injury whatsoever.” McCrone at ¶ 28.
    {¶ 23} In McCrone, the absence of physical injury, not the nexus
    between a physical injury and a mental condition, was determinative. In holding
    that R.C. 4123.01(C)(1) did not violate equal protection, we considered whether
    there was a rational basis for the General Assembly’s requirement of a physical
    injury or occupational disease.      Because the relationship between mental
    conditions and physical injuries was not at issue, use of the terms
    “accompanying” and “along with” to describe that relationship does not constitute
    a holding that mental conditions arising contemporaneously with a physical injury
    are compensable under R.C. 4123.01(C) without regard to a causal connection.
    Likewise, the absence of a specific statement that a mental condition must be
    caused by the physical injury does not amount to a contrary holding. Instead, it
    represents this court’s apposite exercise of judicial restraint in not deciding an
    unnecessary issue. See State ex rel. Ohio Democratic Party v. Blackwell, 
    111 Ohio St. 3d 246
    , 2006-Ohio-5202, 
    855 N.E.2d 1188
    , ¶ 50 (recognizing the
    cardinal principle that a court must not decide more than is necessary). McCrone
    does not answer the question before this court, nor does it compel a different
    result than we have reached based on the unambiguous statutory language.
    {¶ 24} Like McCrone, the other cases upon which Armstrong relies are
    not only distinguishable but also silent on the specific question now before this
    court. Bunger v. Lawson Co., 
    82 Ohio St. 3d 463
    , 
    696 N.E.2d 1029
    (1998), and
    Rambaldo, 
    65 Ohio St. 3d 281
    , 
    603 N.E.2d 975
    , both concerned applications for
    workers’ compensation coverage for purely psychiatric conditions, when the
    claimant had not suffered a physical injury. While State ex rel. Clark v. Indus.
    Comm., 
    92 Ohio St. 3d 455
    , 
    751 N.E.2d 967
    (2001), involved a claimant who
    suffered both physical injuries and severe stress and anxiety as a direct result of
    having been held hostage and beaten, the sole issue on appeal was whether the
    9
    SUPREME COURT OF OHIO
    claimant was entitled to receive workers’ compensation benefits for the same
    period he was receiving hostage-leave benefits under his collective-bargaining
    contract.   Although BWC allowed the claimant’s PTSD as a compensable
    condition, no party challenged the allowance, and thus the compensability of that
    condition was not an issue on appeal. Simply put, this court has never held that a
    mental condition is compensable solely because it developed contemporaneously
    with a compensable physical injury.
    {¶ 25} Consistent with the plain language of R.C. 4123.01(C)(1), several
    Ohio courts of appeals have recognized that mental conditions are compensable
    under the workers’ compensation system only when a physical injury causes
    them. See Dunn v. Mayfield, 
    66 Ohio App. 3d 336
    , 341, 
    584 N.E.2d 37
    (4th
    Dist.1990) (“to state a claim upon which relief can be granted for an emotional
    disability, an employee must allege either that a physical injury proximately
    caused the emotional disability * * * or that the emotional stress proximately
    caused a physical injury”); Neil v. Mayfield, 2d Dist. No. 10881, 
    1988 WL 76179
    ,
    * 1 (July 22, 1988), citing Lengel v. Griswold, Inc., 8th Dist. No. 53054, 
    1987 WL 20459
    (Nov. 25, 1987) (“an emotional injury is not compensable, despite a
    contemporaneous physical injury, unless the physical injury causes the emotional
    problems”); Karavolos v. Brown Derby, Inc., 
    99 Ohio App. 3d 548
    , 552, 
    651 N.E.2d 435
    (11th Dist.1994) (R.C. 4123.01(C)(1) “prohibits compensation for
    psychiatric conditions unless they are found to have ‘arisen from’ a physical
    injury, i.e., were proximately caused by a physical injury received in the course of
    employment”); Jones v. Catholic Healthcare Partners, Inc., 2012-Ohio-6269, 
    986 N.E.2d 486
    , ¶ 31 (7th Dist.) (rejecting an argument that physical injury must be
    the sole cause of a mental condition, but affirming summary judgment for a
    claimant based on the uncontested evidence that a compensable physical injury
    was a proximate cause of her psychiatric condition).
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    January Term, 2013
    {¶ 26} In addition to the arguments asserted by Armstrong, OAJ argues
    that requiring a claimant to prove a causal connection between a mental condition
    and a compensable physical injury would make recovery for many claimants
    “nearly impossible.” While we appreciate and respect OAJ’s concerns regarding
    the difficulty of proving causation, that argument is more properly addressed to
    the General Assembly, the branch of state government charged by the Ohio
    Constitution with making policy choices for the workers’ compensation fund.
    The General Assembly may determine that mental conditions that develop
    contemporaneously with compensable physical injuries, or that arise out of the
    same accident or occurrence as the physical injuries, should be compensable, and
    amend the statutory language accordingly. Absent a mandate from the General
    Assembly that such conditions are compensable, however, we will not expand
    workers’ compensation coverage to them.
    {¶ 27} Armstrong’s final argument concerns the effect of the 2006
    amendment to R.C. 4123.01(C)(1), which added the following italicized language
    to the statute: injury does not include “[p]sychiatric conditions except where the
    claimant’s psychiatric conditions have arisen from an injury or occupational
    disease sustained by that claimant.” Am.Sub.S.B. No. 7, 151 Ohio Laws, Part I,
    1019, 1046. The parties agree that the purpose of the amendment was to counter
    the decision in Bailey, 
    91 Ohio St. 3d 38
    , 
    741 N.E.2d 121
    , which allowed a claim
    for depression after the claimant accidentally killed a coworker, even though the
    claimant did not suffer any physical injury himself. By amending the statute, the
    General Assembly clarified that the claimant, not a third party, must sustain the
    physical injury required under R.C. 4123.01(C)(1). The amendment did not alter
    the statutory language regarding the necessary nexus between a physical injury
    and a psychiatric condition, and the sole effect of the amendment here is to
    preclude Armstrong from establishing the compensability of his PTSD by arguing
    that it arose from the other driver’s injuries or death.
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    SUPREME COURT OF OHIO
    {¶ 28} The court of appeals noted Armstrong’s reliance on case law that
    predated Am.Sub.S.B. No. 7, but it did not suggest that its rejection of
    Armstrong’s contemporaneous-injury argument was related to the amendment.
    Rather, the court focused on statutory language that Am.Sub.S.B. No. 7 did not
    change and concluded that Armstrong did not establish that his PTSD arose from
    the physical injuries he had sustained in the accident.
    Conclusion
    {¶ 29} Armstrong undisputedly suffered compensable physical injuries
    as a result of the accident, and his PTSD undisputedly arose contemporaneously
    as a result of the accident. For Armstrong’s PTSD to qualify as a compensable
    injury under R.C. 4123.01(C)(1), however, more is required; he must establish
    that his PTSD was causally related to his compensable physical injuries and not
    simply to his involvement in the accident. The record contains contradictory
    evidence of whether Armstrong’s physical injuries were a contributing cause of
    his PTSD. Dr. Howard testified that Armstrong’s physical injuries did not cause
    his PTSD, while Dr. Stoeckel testified that Armstrong’s physical injuries were
    causal factors in his development of PTSD. The trial court, having heard all the
    evidence, found Dr. Howard’s testimony more credible. The court of appeals
    appropriately determined that the record contains competent, credible evidence
    supporting the trial court’s finding that Armstrong’s physical injuries did not
    cause his PTSD and that Armstrong’s PTSD is, therefore, not a compensable
    injury under R.C. 4123.01(C)(1).
    {¶ 30} For these reasons, we affirm the judgment of the court of appeals.
    Judgment affirmed.
    O’CONNOR, C.J., and O’DONNELL, LANZINGER, and KENNEDY, JJ., concur.
    PFEIFER and O’NEILL, JJ., dissent.
    ____________________
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    January Term, 2013
    PFEIFER, J., dissenting.
    {¶ 31} This case boils down to whether “arisen from” means the same
    thing as “caused by.”     Given that we are required to liberally construe the
    provisions of R.C. Chapter 4123 in favor of employees, R.C. 4123.95, I would
    hold that there is a distinction between the two terms and that the condition in
    R.C. 4123.01(C)(1) that psychological injuries are compensable only if they have
    “arisen from” physical injuries requires that the physical and psychological
    injuries be related but does not necessarily require a direct causal link between the
    two.
    {¶ 32} In McCrone v. Bank One Corp., 
    107 Ohio St. 3d 272
    , 2005-Ohio-
    6505, 
    839 N.E.2d 1
    , this court considered whether R.C. 4123.01(C)(1) violated
    equal protection by excluding psychological or psychiatric injuries from workers’
    compensation coverage.       This court held that the one substantive reason
    supporting the continued disparate treatment between workers who suffer
    psychological injuries in the workplace and workers who suffer physical injuries
    in the workplace is the issue of proof. That is, it is harder to prove psychological
    injuries than physical injuries. (The only other rational basis offered in McCrone
    was that the discrimination saves money.) This court stated, “In mental injury
    claims, the problem arises of establishing the existence of the injury itself.
    Although a physical injury may or may not cause a psychological or psychiatric
    condition, it may furnish some proof of a legitimate mental claim.” (Emphasis
    added.) 
    Id. at ¶
    33.
    {¶ 33} Thus, the court concentrated not on causation, but on the evidence
    that a contemporaneous physical injury provides that supports the existence of a
    psychological injury. In this case, we have no issue of proof. Armstrong’s
    employer stipulates that Armstrong suffers from posttraumatic-stress disorder
    (“PTSD”), and there is no dispute that the accident occurred while Armstrong was
    on the clock and performing job-related duties.             Armstrong suffered a
    13
    SUPREME COURT OF OHIO
    contemporaneous physical injury, which, in the words of McCrone, may or may
    not have caused a psychological or psychiatric condition, but furnished proof of
    that condition. Why shouldn’t Armstrong recover?
    {¶ 34} Elsewhere in McCrone, this court discounted the requirement of a
    direct causal link between the physical injury and the compensable psychological
    trauma. Instead, the physical injury and psychological injury need only have
    arisen from the same series of events: “Psychological or psychiatric conditions,
    without an accompanying physical injury or occupational disease, are not
    compensable under R.C. 4123.01(C)(1).” (Emphasis added.) 
    Id. at ¶
    29. This
    court also stated that “those who have mental conditions along with a
    compensable physical injury * * * are covered within the workers’ compensation
    system.” (Emphasis added.) 
    Id. at ¶
    30. “Accompanying” and “along with” are
    entirely different from “caused by.”
    {¶ 35} McCrone was decided in 2005; the General Assembly did not
    make the relevant amendment to R.C. 4123.01(C) until 2006. Thus, the General
    Assembly knew of this court’s interpretation of the physical-injury requirement
    for psychological injuries when amending the statute. The General Assembly
    knew that this court had written in McCrone that “a physical injury may or may
    not cause a psychological * * * condition” but may simply furnish proof thereof,
    that mental conditions are not compensable “without an accompanying physical
    injury,” and that workers “who have mental conditions along with a compensable
    physical injury” are covered under the system. Did the General Assembly change
    the language of the statute to address this court’s interpretation of the statute that
    there need not be a direct causal connection between a physical injury and a
    compensable psychological condition?
    {¶ 36} It did not. In neither the present version of the statute nor in its
    predecessor did R.C. 4123.01(C)(1) require a direct causal connection between
    physical and psychological injuries. The General Assembly otherwise uses the
    14
    January Term, 2013
    word “cause” in R.C. 4123.01(C); it uses it in defining “injury” as including an
    injury “caused by external accidental means.” In that same definition, it uses the
    phrase “arising out of” in describing a compensable injury—the injury must be
    “received in the course of, and arising out of, the injured employee’s
    employment.” (Emphasis added.) In that use of the phrase “arising out of,” does
    the General Assembly mean to say that the injury must be caused by the
    employee’s employment? No—it means that the employee had to be engaged in
    activity related to his employment when the injury-causing accident occurred in
    order to receive compensation.           Likewise, R.C. 4123.01(C)(1) allows
    compensation for psychiatric injuries that have “arisen from an injury * * *
    sustained by that claimant.” (Emphasis added.) The “arisen from” language has
    the same meaning as earlier in the statute—it requires a relationship between the
    physical and psychological injuries rather than a direct causal link.
    {¶ 37} In Bailey v. Republic Engineered Steels, Inc., 
    91 Ohio St. 3d 38
    ,
    
    741 N.E.2d 121
    (2001), syllabus, this court held, “A psychiatric condition of an
    employee arising from a compensable injury or an occupational disease suffered
    by a third party is compensable under R.C. 4123.01(C)(1).”              In Bailey, the
    claimant was operating a tow motor and accidentally ran over and killed a
    coworker.     As a result of the accident, Bailey received treatment for severe
    depression.    In Bailey, there was not a direct causal link between the death
    suffered by the coworker and the claimant’s depression. Rather, it was Bailey’s
    involvement in and responsibility for the deadly accident that caused his
    depression. Thus, his psychological injury was related to the accident that caused
    his coworker’s death. Likewise, in this case, Armstrong’s psychological injuries
    are related to the accident that caused his own injuries.
    {¶ 38} Where does today’s decision leave employees who suffer from
    PTSD?       If an employee is horribly injured in an accident, can he receive
    compensation only for being depressed over the state of his body but not for
    15
    SUPREME COURT OF OHIO
    psychological injuries due to being haunted by the trauma of the original event?
    Are those the kind of distinctions the General Assembly really intended—
    depression over injuries is compensable but psychological effects arising from the
    accident causing the traumatic injuries is not? Is it not enough that a worker’s
    broken body provides the “proof” of psychological injury that this court said the
    statute requires in McCrone, proof that a specific traumatic event has occurred?
    Hasn’t Armstrong paid the required pound of flesh?
    {¶ 39} Finally, as I set forth in McCrone, I would find that R.C.
    4123.01(C)(1) violates the Equal Protection Clauses of the United States and Ohio
    Constitutions because it allows disparate treatment of persons suffering from
    psychological injuries. McCrone, 
    107 Ohio St. 3d 272
    , 2005-Ohio-6505, 
    839 N.E.2d 1
    , at ¶ 57 (Pfeifer, J., dissenting).
    ____________________
    O’NEILL, J., dissenting.
    {¶ 40} I must respectfully dissent from the well-reasoned majority opinion
    because this case presents a perfect opportunity to right a wrong in the area of
    workers’ compensation law. The claimant here was involved in a truly gruesome
    motor-vehicle accident, in the course and scope of his employment, that left him
    traumatically psychologically impaired. He witnessed the sudden death of a
    fellow motorist, and he suffers as a result of that accident to this day. That is
    what the record reflects. From a legal-analysis standpoint, it is wholly irrelevant
    whether the psychological condition arose from the accident or from the trauma
    and drama incident to the allowed physical injuries. Either way, he was injured in
    the course and scope of his employment. It is that simple.
    {¶ 41} As noted by the majority, this issue was addressed, I believe
    wrongly, to some extent in this court’s earlier decision of McCrone v. Bank One
    Corp., 
    107 Ohio St. 3d 272
    , 2005-Ohio-6505, 
    839 N.E.2d 1
    . In that case, the
    psychologically injured worker, an employee of a bank that was robbed twice,
    16
    January Term, 2013
    was denied workers’ compensation benefits because she had not received a
    contemporaneous physical injury during the traumatic events. That she could not
    return to work due to having been traumatized at work simply was not enough to
    entitle her to workers’ compensation benefits.
    {¶ 42} Simply stated, the whole theory of workers’ compensation is to
    ensure that when an injury, whether physical or mental, occurs in the workplace
    and it is supported by competent medical evidence, it is compensable under the
    Workers’ Compensation Act. As aptly stated in dissent by Justice Resnick:
    Not only are workers’ compensation claims routinely amended to
    include psychological injuries resulting from previously allowed
    physical injuries, but the time has long since passed when denying
    recoveries for “purely psychological” injuries can be excused on
    grounds of evidentiary difficulties or illusory claims. We are no
    longer living in the 19th century when it was considered
    impossible to accurately diagnose psychological injuries.
    
    Id. at ¶
    45.
    {¶ 43} On the other hand, if the justification for not allowing
    psychological injuries is purely economic, drawing the line at psychological
    injuries that occur simultaneously with a physical injury versus those that occur
    without a physical injury is arbitrary at best. They are both real injuries. They
    both result in loss to the worker. And they both are directly related to the incident
    on the job. As stated by Justice Pfeifer in a dissent in McCrone:
    There is no rational basis to treat injured employees differently
    when both the physically injured and the nonphysically injured
    employees each can identify the genesis of their psychological
    17
    SUPREME COURT OF OHIO
    condition. A cognizable triggering event, whether resulting in a
    physical injury or not, is the proper determinant for proof of
    psychological injury. A professional can evaluate the injury and
    the event to determine whether compensation is appropriate.
    
    Id. at ¶
    55.
    {¶ 44} Reducing government costs, while an admirable goal, is not
    acceptable when it nullifies the protections of the Ohio Constitution. Justice
    Resnick asked the question “Is there a specific dollar amount of savings that must
    be realized before ignoring the Equal Protection Clause is justified?” 
    Id. at ¶
    50.
    The answer must be a resounding no.              The reality is that there is no
    constitutionally adequate explanation for the practice of treating psychologically
    traumatized workers in a distinctly different manner from their counterparts who,
    for example, break their arm or leg. It is government-sanctioned discrimination
    with tragic results, as demonstrated by this case.
    {¶ 45} From an examination of the relevant code section, the conclusion I
    reach is consistent with the law.      R.C. 4123.01(C)(1) allows for psychiatric
    conditions to be compensable as long as the condition arose from an injury
    sustained by the claimant. This version of the statute was enacted in 2006 to
    ensure that compensation was permitted only when the physical injury was
    sustained by the claimant rather than a third party. However, unlike the majority,
    I believe it is sufficient that the psychological injury occurred contemporaneously
    with the physical injury. The record in this matter is clear that the psychological
    injury happened contemporaneously with the allowed physical injury. Therefore,
    it was error for the trial court, and then the court of appeals, to disallow the claim.
    It happened on the job, it is real, and it is compensable. The Bureau of Workers’
    Compensation, and the Industrial Commission of Ohio, got it right.
    {¶ 46} Accordingly, I respectfully dissent.
    18
    January Term, 2013
    ____________________
    Harris & Burgin, L.P.A., and Jeffrey Harris, for appellant.
    Ice Miller L.L.P., Corey V. Crognale, and Meghan M. Majernik, for
    appellee John R. Jurgensen Co.
    Michael DeWine, Attorney General, and Colleen C. Erdman, Assistant
    Attorney General, for appellee Administrator, Ohio Bureau of Workers’
    Compensation.
    Philip J. Fulton Law Office, Philip J. Fulton, and Chelsea J. Fulton, urging
    reversal on behalf of amicus curiae Ohio Association for Justice.
    ________________________
    19