Courts have always been skeptical of mental injuries. With increased awareness of the reality of mental illness, courts and the law have generally decreased the scrutiny to which mental injury claims are subject. However, in South Carolina, as well as in some other states, on the job mental injury is not compensable (meaning the employer is not liable in a workers' compensation claim) unless extra requirements are met. The law requires one of the following:
That the mental injury be accompanied by a physical injury (Physical-Mental injuries). SC Code § 42-1-160(B)(1).
That the mental injury arise out of "employment conditions . . . extraordinary and unusual in comparison to the normal conditions of the particular employment" (Mental-Mental injuries) SC Code § 42-1-160(B)(1).
Types of Claims for Mental Injuries
In examining workers’ compensation mental injury cases, lawyers and academics have split claims into three groups: Physical-Mental, Mental-Physical, and Mental-Mental.
1. Physical-Mental Injuries
Those mental injuries caused by physical events. These are clearly compensable under the statute. They are historically the mental injuries that courts have looked upon with the most favor. Their reasoning was basically: "Look at what happened to that guy; he should have mental issues after that."
2. Mental-Physical Injuries
When mental stimulus causes physical injuries. These are subjected to extra scrutiny under SC Code §42-1-160(C), but are not truly mental injuries. The skepticism here: the idea that a claimant’s testimony regarding mental stimulus is not reliable. In any case, if the mental stimulus was caused by the employer, and the mental stimulus was unusual or extraordinary, the employee can recover for the physical injuries sustained.
3. Mental-Mental Injuries
When mental stimulus causes mental injury. These are the cases where SC Code § 42-1-160(B)(1) controls, i.e. the employee claimant only recovers if his or her injury arises out of "employment conditions . . . extraordinary and unusual in comparison to the normal conditions of the particular employment."
The "Heart Attack" Standard
Thus, if an employee is to recover for a mental injury that lacks physical manifestation, they must show extraordinary and unusual employment conditions for their particular employment (also, the employee cannot create the stimulus that causes the mental illness). This standard, known as the "heart attack" standard, is dependent on the employee's actual employment, and in application, it is highly fact dependent. Extraordinary and unusual conditions for a police officer will be far different than those for a convenience store clerk.
In fact one can imagine a situation where both a police officer responding to a robbery at a convenience store and the clerk at the convenience store both sustain mental-mental injuries on the job arising from the police officer shooting the robbery suspect in front of the clerk.
Even if both of them can prove medical causation of their resulting mental illness, likely only the clerk will be able to recover. Bentley v. Spartanburg County, 394 S.C. 224 (2011) (refused to overturn, under the substantial evidence workers’ compensation appeal standard, a commission decision ruling a sheriff deputy’s shooting of a suspect not extraordinary and unusual employment condition for a Spartanburg County sheriff deputy).
While this may seem unfair, it is simply the system the legislature has put into place to ensure that employee and employer interests are balanced. The current public policy is to place the burden on the plaintiff’s side in mental illness cases. However, South Carolina may in the coming years follow the large number of states that have abolished the heightened restrictions on mental injuries. After all, individuals in South Carolina still have to prove that the mental injury was caused by an event on the job using expert medical evidence after they fall into the mental illness compensability exceptions.