Heidi Shaffer, Published July 18 2010
Bank teller still seeking benefits
Workforce Safety & Insurance, in a May letter, denied 56-year-old Edith Johnson’s claim because state law provides benefits only for physical injuries incurred at work.
Now Johnson’s attorney, Tom Dickson, said the state changed the reason for denial a week before a May appeals hearing and is simply trying to get out of paying the claim that totals less than $1,000 in medical costs.
“This whole process is set up to make as many roadblocks as they can for injured workers.” Dickson said.
Dickson accuses WSI of changing “the rules in the middle of the game” to include pre-existing conditions as part of the agency’s denial and requesting 20 years of Johnson’s medical records.
State law prohibits WSI officials from speaking about specific cases, but speaking generally, director Bryan Klipfel said reasons for denial are spelled out by North Dakota statutes.
“There is no provision in North Dakota law that would provide benefits to a worker that does not have a physical injury that occurred at work,” Klipfel said.
According to the state’s Century Code, workers’ comp claims are denied for a “mental injury arising from a mental stimulus.”
Another provision states that a mental illness can be covered but only if it arises from a physical workplace injury, which cannot be a pre-existing condition.
Johnson’s claim stems from the May 26, 2009, robbery of more than $50,000 from Gilby’s Bremer Bank. Clifton Patterson of Grand Forks and William Collins of Nashville, Tenn., are charged in federal court with the crime.
Following the robbery, Johnson’s physician diagnosed her with PTSD, and she eventually had to quit her teller job, Dickson said.
Dickson said Johnson’s mental trauma was caused by a “very physical act” and should be covered.
“This isn’t a mental stimulus,” he said. “This isn’t one of the stresses of the job. This was a violent physical stimulus that caused the injury.”
Klipfel said WSI can only compensate for injuries spelled out by state law.
“I really do sympathize with the woman … but the law does not allow us to cover a mental injury,” he said.
Rep. George Kesier, R-Bismarck, chairs the Industry, Business and Labor Committee, which hears legislative proposals on workers’ comp.
“It probably comes up in every legislative session” on whether to cover mental illness under workers’ comp, Keiser said.
Keiser said the publicity over Johnson’s case will likely spur discussion in the next session as well.
A district judge in Grand Forks will rule in the next month on Dickson’s claims that WSI changed the reason for denial before it goes to an appeal.
“This is a compensable claim,” Dickson said. “She was injured at work. They should pay the medical bills.”
Readers can reach Forum reporter Heidi Shaffer at (701) 241-5511