You have probably read lots of stories about employees engaged in workers’ comp fraud. But in a recent case in North Dakota, an employee had her WC claim denied because she was too honest!
Unbelievably, a bank teller in the small town of Gilby, North Dakota (population 226) found herself in her second armed robbery attempt about a year ago.
Unfortunately, this robber meant business; he handcuffed the teller’s arms tightly together and made her lie face down on the floor while he put a gun to her head as other bank staff got the money for him. When the bandit left with $50,000, the teller told authorities that nothing hurt. However she was left so frightened and unnerved by the incident that she couldn’t return to that building for a while.
She went to a doctor and was diagnosed with post traumatic stress disorder (PSTD), but no physical injuries. The medical bill came to around $1.000, and the teller filed a WC claim because the PSTD was a result of the workplace robbery.
No so fast said the state of North Dakota, which said the PSTD was not compensable under WC because it resulted from a mental, not a physical trauma, according to an article in The Jamestown [ND] Sun. After requesting 20 years of the teller’s medical history, the state determined that the illness was caused by the handcuffing and terrifying time on the floor—mental stimuli—and the teller was left with no resulting physical impairments.
This determination has caused a brouhaha in the state legislature and bad publicity for the state Workforce Safety and Insurance agency. The chairman of the House WC Committee says that coverage for mental trauma under workers’ compensation “comes up in every legislative session,” but now has a good chance of passing.
The teller’s lawyer told the newspaper that her PSTD is a legitimate condition directly caused by a job-related occurrence in the workplace, and that her medical bills should be paid.
Ironically, say some bloggers on the Internet, if the teller had fibbed and said her wrists hurt from the handcuffs and her neck hurt from the robber pushing the gun into her head, the bills probably would have been covered.
The controversial case is headed to a district judge next month for review.
The Jamestown Sun