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Saturday, April 27, 2024

No PTSD workers' comp for school nurse after child chokes to death

State Supreme Court
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ANCHORAGE, Alaska (Legal Newsline) - An elementary school nurse who was exposed to bodily fluids while trying to save a child choking on his lunch can’t collect workers’ compensation benefits over the stress of the incident, the Alaska Supreme Court ruled, agreeing the evidence suggested the woman had preexisting emotional difficulties.

The high court criticized Alaska’s Workers’ Compensation Board for improperly evaluating the nurse’s mental-stress claim, but said the error was harmless since the weight of the evidence was still against her.

Shannon Patterson was an elementary school nurse in the Matanuska-Susitna Borough School District in September 2014 when children ran into her office screaming because a child was choking on his lunch. Patterson tried to clear the child’s airway and performed CPR but he died after being transported to hospital. Patterson was exposed to the child’s bodily fluids but tested negative for disease.

The district reported Patterson was injured in “multiple body parts” due to “absorption, ingestion or inhalation” and paid her temporary total disability benefits for three months. 

Patterson returned to work in February 2015 on recommendations by her counselor and physician, but she immediately filed for disability benefits. She declined an offer to renew her contract in 2016 because she mistakenly thought she had vested retirement benefits. She resigned, then filed another claim for workers’ comp in which she said she suffered from “PTSD, Anxiety, Depression” that was aggravated by continuing to work after the choking incident.

Patterson underwent a required psychiatric examination by Dr. David Glass, who diagnosed a non-work-related mood disorder related to her dissatisfaction working as an elementary school nurse. The choking incident was “not a common occurrence” but could be expected for a school nurse, the doctor said. He also said she might have borderline personality disorder. 

The Alaska Workers’ Compensation Board held a hearing during which Patterson’s witnesses said she didn’t suffer from borderline personality disorder. The board rejected Patterson’s claim, however, finding that her need for counseling stemmed from a preexisting condition, not PTSD. The board found Patterson’s claim she loved her job “not credible.” Patterson appealed and lost again, then her case went to the Supreme Court.

Alaska law prohibits workers’ comp payments for purely mental stress unless it is “extraordinary and unusual” and “the predominant cause of the mental injury.” The state has also allowed mental-stress claims over exposure to a bodily fluids, including for a worker who was splashed in the eye with HIV-positive blood but never contracted the disease. The Board incorrectly rejected this possibility in Patterson’s case, the high court said, because it failed to fully investigate how unusual or severe the choking incident was for her or for school nurses in general.

This error was “troubling but ultimately harmless because substantial evidence supports the Board’s alternative conclusion that the stress was not the predominant cause of Patterson’s mental injury,” the court concluded. 

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