RACHEL GLISKE, Employee/Appellant, v. MINNEAPOLIS PUB. SCHS., Self-Insured, with CLAIMS ADMIN. BY CORVEL CORP., Self-Insured Employer-Insurer/Respondents, and UCARE, Intervenor.

The employee appeals a compensation judge’s findings that the employee did not develop post-traumatic stress disorder (PTSD) following a physical injury at work, that any claim for PTSD was closed out in a subsequent stipulation for settlement, and that the employee did not later aggravate the previous PTSD injury as a result of her work activities in 2021.  We affirm the findings that the employee’s 2021 PTSD claim was foreclosed by the prior stipulation for settlement, and that the employee failed to prove a 2021 PTSD injury.

Rachel Gliske, the employee, was a teacher for Minneapolis Public Schools, the self-insured employer, for 21 years.  For the last eight years she taught kindergarten.  On January 29, 2016, while teaching her class, she was attacked by a physically large and disruptive student.  She was hit in the back and neck with a chair, kicked, and bitten.  As a result of her physical injuries, she sought treatment through urgent care and was diagnosed with low back and neck pain.  Due to the extent of these injuries, she was restricted from work for three months.  Upon her return to work, she discovered that the student who attacked her had not been removed from her classroom, although a full-time staffer had been assigned to attend to his needs.  In July 2016, she began treatment with a licensed psychologist, David Kearn, M.A., L.P., who diagnosed the employee with PTSD as a result of the incident.

In August 2017 the parties entered into a full, final, and complete settlement of the January 29, 2016, injuries.  The settlement expressly listed injuries to the spine, legs, and torso, as well as consequential PTSD and depression.  An award on stipulation was issued on August 24, 2017.  No petition to vacate the award on stipulation has been received by this court.

By fall 2017, the employee had returned to full-time, unrestricted work and felt her PTSD symptoms had improved.  She continued treatment for her physical injuries, including her low back and neck pain. 

In March 2020, in-person classes were discontinued due to the COVID-19 pandemic in favor of hybrid or virtual classes.  The employee continued working by distance teaching through the 2020 school year.  By April 2021, the employee was required to return to in-person classroom teaching.  She testified that she was at high risk for COVID-19 complications when teaching in person due to her asthma condition, and that she suffered from anxiety upon returning to in-person work.

On May 14, 2021, the employee was reported absent from the classroom.  Her family searched her home and found her in bed in a state of confusion.  She was transported to the Fairview MHealth emergency room and was told that she had suffered a seizure.  She returned to work to the end of the school year but continued having spells that she described as seizures.

On June 17, 2021, the employee was hospitalized for seven days to evaluate and monitor her seizure condition.  The employee’s EEG results were normal and did not correlate with her symptoms, which were accordingly considered psychogenic and nonepileptic.  A psychiatric consultation and therapy were recommended.

Therapy continued with Dr. Kearn until his retirement.  The employee then began therapy with a psychotherapist, Jack Hinrichs, M.A., LMFT, who assessed the employee with PTSD, psychogenic nonepileptic seizures, generalized anxiety disorder, and depressive disorder.  In a narrative report dated August 30, 2022, Mr. Hinrichs opined that the employee’s return to the classroom in 2021, “was a substantial contributing factor causing her need to stay away from classroom teaching.”  (Ex. F.)  Mr. Hinrichs explained that the employee’s PTSD symptoms were cumulative, having improved when she left the classroom in 2020 and worsened when she returned to classroom work in April 2021.  Id.

The employee saw Steven Lesk, M.D., for a psychiatric evaluation on December 24, 2021.  He also diagnosed the employee with PTSD and depression, prescribed medication, and recommended ongoing psychological therapy.

Nicole Slavik, Psy.D., L.P., a licensed psychologist, conducted a psychological evaluation on behalf of the employee, reviewing multiple medical records, taking a medical history, and examining the employee.  In her narrative reports of July 31, 2022, and October 27, 2022, Dr. Slavik opined that the employee met the DSM-5 criteria for PTSD as a result of the 2016 injury.  With respect to the events of 2021, Dr. Slavik opined that the employee’s return to the classroom setting in April 2021 was a substantial contributing factor that caused, aggravated or accelerated her symptoms of PTSD and the nonepileptic seizures.  Dr. Slavik also explained that PTSD can fluctuate over time.  She concluded that the employee was disabled from employment as of June 17, 2021, due to her continued trauma-related symptoms.

The self-insured employer retained a psychiatrist, Thomas Gratzer, M.D., who reviewed multiple medical records, took a medical history, and examined the employee.  He drafted a narrative report on May 13, 2022.  He opined that the employee did not develop PTSD in 2016, in that she did not meet the criteria of the DSM-5 for PTSD.  He opined that the employee similarly did not develop PTSD in 2021, again because she did not meet the DSM-5 criteria.  He noted that PTSD is typically not associated with pseudoseizures, which he concluded were unrelated to her work activities as a teacher.  In his view, the employee was “deliberately exaggerating her pseudoseizures as a way of extricating herself from an unsafe work environment.” (Ex. 10.)

The employee filed a claim petition claiming that on June 17, 2021, she sustained an occupational disease, in the form of PTSD, pursuant to Minn. Stat. § 176.011, subd. 15(a) and (d), which resulted in ongoing medical treatment and temporary total disability.  The self-insured employer denied primary liability, arguing that the employee’s claims were barred by the 2017 stipulation for settlement.  The matter was heard before a compensation judge on December 23, 2022.  The compensation judge found that the employee did not develop PTSD in 2021 as a result of her work activities, and that the 2017 settlement barred the employee’s claims for PTSD-related benefits.  The judge denied the employee’s claims.

On appeal, the Workers’ Compensation Court of Appeals must determine whether “the findings of fact and order [are] clearly erroneous and unsupported by substantial evidence in view of the entire record as submitted.”  Minn. Stat. § 176.421, subd. 1(3).  Substantial evidence supports the findings if, in the context of the entire record, “they are supported by evidence that a reasonable mind might accept as adequate.”  Hengemuhle v. Long Prairie Jaycees, 358 N.W.2d 54, 59, 37 W.C.D. 235, 239 (Minn. 1984).  Where evidence conflicts or more than one inference may reasonably be drawn from the evidence, the findings are to be affirmed.  Id. at 60, 37 W.C.D. at 240.  Similarly, findings of fact should not be disturbed, even though the reviewing court might disagree with them, “unless they are clearly erroneous in the sense that they are manifestly contrary to the weight of evidence or not reasonably supported by the evidence as a whole.”  Northern States Power Co. v. Lyon Food Prods., Inc., 304 Minn. 196, 201, 229 N.W.2d 521, 524 (1975).

A decision which rests upon the application of a statute or rule to essentially undisputed facts generally involves a question of law which the Workers’ Compensation Court of Appeals may consider de novo.  Krovchuk v. Koch Oil Refinery, 48 W.C.D. 607, 608 (W.C.C.A. 1993), summarily aff’d (Minn. June 3, 1993).

On appeal, the employee argues that the compensation judge erred in finding that the employee did not develop PTSD on June 17, 2021.  She contends that substantial evidence does not support the judge’s denial of the PTSD claim since nine medical experts supported the employee’s position, while only the employer’s medical expert supported a contrary position.  She also argues that the judge erred in concluding that the 2016 work injury did not cause PTSD. 

At trial, the employee alleged only a 2021 PTSD claim.  The judge made no findings regarding the nature and extent of the employee’s 2016 injury.^[1]

With respect to the issues raised at the hearing, it was reasonable for the judge to conclude that the employee did not sustain an occupational disease in the nature of PTSD pursuant to Minn. Stat. § 176.011, subd. 15(a) and (d) on June 17, 2021.  Relying on Dr. Gratzer’s expert opinion, the judge determined that the employee did not develop PTSD, pseudoseizures, or any psychological condition arising out of the work activities on or about June 17, 2021.  As the trier of fact, the judge has the discretion to choose between conflicting well-founded medical expert opinions.  Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 364 (Minn. 1985).  The question for this court is not whether there were more medical expert opinions supporting the employee’s claim.  Instead, our standard of review is limited to whether the judge’s findings are supported by substantial evidence.  Minn. Stat. § 176.421, subd. 1(3); see also Northern States Power Co., 304 Minn. at 201.  We conclude that the judge did not abuse his discretion in adopting Dr. Gratzer’s opinion.  Dr. Gratzer reviewed the employee’s medical records and history, examined the employee, and as a licensed psychiatrist, did not lack the foundation or credentials needed to render an expert opinion.  Mattick v. Hy-Vee Foods Stores, 898 N.W.2d 616, 77 W.C.D. 617 (Minn. 2017).  We also note that the employee did not object to the foundation of Dr. Gratzer’s report at the time it was admitted into evidence at the hearing.  We conclude that the judge did not err in denying the employee’s claim.

The judge found that the employee’s claims for PTSD are barred by the 2017 stipulation for settlement, which closed out the 2016 work injury and sequelae.  As he noted, the stipulation specifically stated that the employee was then making a claim based on PTSD, and expressly closed out all workers’ compensation benefits related to that condition.  The judge reasoned that since the medical records, the expert medical opinions, and the employee’s own testimony related her current claims to the 2016 incident, the stipulation precludes those claims.

On appeal, the employee argues that she suffered a new, separate injury in 2021, such that the settlement does not bar her claim.  She argues that the 2021 event is an aggravation of the preexisting PTSD which should be treated as a new and separate injury.  We are not persuaded.  Any consequential PTSD claim flowing from the original 2016 injury and any claim related to it had been closed out by the stipulation for settlement.  To prove a PTSD claim as a new injury, the employee had the burden to prove her case as a mental-mental occupational disease under Minn. Stat. § 176.011, subd. 15(a) and (d).  The compensation judge reasonably determined that the employee failed to prove that she met the requirements of the statute.  Therefore, the judge did not err in finding that the employee’s 2021 claim was barred.

We affirm.