Proving work-related psychological injuries has always presented a unique challenge to the workers’ compensation practitioner, as the burden of demonstrating a disability caused by a psychological or mental condition is more involved than that stemming from a physical injury. As those in the practice are aware, psychological injuries fall into three distinct categories: physical/mental, mental/physical and mental/mental. The first category addresses psychological injuries caused by work-related physical injuries, such as a closed head trauma. Mental/physical psychiatric conditions are those that pertain to psychological stress that actually causes a physical injury, such as high blood pressure, irritable bowel syndrome or a heart attack. Finally, the mental/mental category deals with psychological injuries caused by nonphysical stimuli at work.

Even extremely experienced attorneys are leery of taking the mental/mental claim, as it has a much higher burden of proof than the other classifications. According to the 1990 Supreme Court case of Martin v. Ketchum, 568 A.2d 159 (Pa. 1990), and its increasingly defense-friendly progeny, injured workers claiming a mental/mental injury must prove “abnormal working conditions” in order to demonstrate that the work-related disability is not caused merely by “subjective, perceived or imagined” employment stressors. Since the imposition of the “abnormal working conditions” burden, the appellate courts have found very few fact patterns to rise to the level of an abnormal working condition.

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