Supreme Court revives PTSD police benefits dispute

In Brief

• The Minnesota Supreme Court ruled that an expert opinion based on an older edition of the DSM is admissible in a workers’ compensation PTSD case.
• A Minneapolis police officer sought PTSD benefits, but the city disputed the diagnosis through an independent psychological evaluation.
• The court held that using an earlier DSM edition affects the weight of an expert’s opinion, not its admissibility.
• The case was remanded for further proceedings on the officer’s remaining challenges and potential entitlement to workers’ compensation benefits.

A veteran Minneapolis police officer was determined to have PTSD by one psychologist but was denied benefits after a second psychologist asserted that he did not meet the diagnostic criteria. Although the second psychologist used an older version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) to make his diagnosis, the Minnesota Supreme Court held that his expert opinion should not have been excluded on that basis.

Under Minnesota’s Workers’ Compensation Act, post-traumatic stress disorder is compensable if it arises out of employment and is diagnosed by a licensed psychiatrist or psychologist according to the criteria in the most recently published edition of the DSM. Certain first responders, including police officers, are entitled to a statutory presumption that their PTSD is work-related once they present a qualifying diagnosis, unless the employer rebuts that presumption with “substantial factors.”

Nicholas Rowe served as a Minneapolis police officer for about 25 years and entered the profession after a pre-employment psychological evaluation found no significant personality or emotional problems. During his career, he responded to five mass shootings, six officer-involved shootings, hundreds of homicide calls, and six incidents involving deceased children.

In October 2021, Rowe sought psychological treatment for the first time, reporting depression, anger, anxiety, lack of motivation, and intrusive thoughts. His counselor diagnosed him with PTSD and recommended that he stop working as a police officer.

Dr. Kasey Aleknavicius evaluated Rowe in early 2022 using a clinical interview, a review of his medical history, and standardized psychological testing, including the PTSD Scale for DSM-5 (CAPS-5) and the Minnesota Multiphasic Personality Inventory-3 (MMPI-3). She diagnosed Rowe with PTSD and major depressive disorder under the DSM-5, also concluding that alcohol abuse disorder was secondary to his PTSD and that his symptoms prevented him from continuing to work as a Minneapolis police officer.

After Rowe stopped working and sought disability benefits, the city denied liability and challenged whether he satisfied the statutory requirements for a compensable PTSD claim. At the city’s request, psychologist Dr. Kenneth Young conducted an independent psychological evaluation (IPE) in November 2022.

Although Young administered the same standardized tests, he concluded that Rowe did not meet the diagnostic criteria for PTSD in the DSM-5 and instead suffered from alcohol abuse disorder. Young criticized Aleknavicius’s methodology, asserting that she failed to adequately assess symptom severity, account for Rowe’s alcohol consumption, or consider his complete medical history.

Following a second evaluation in 2023, Aleknavicius reaffirmed her PTSD diagnosis under the DSM-5-TR (a text revision published by the American Psychiatric Association in March 2022). She described Rowe as having “lifetime” PTSD despite finding that he no longer met one diagnostic criterion in the revised text.

After hearing testimony from both experts, the workers’ compensation judge credited Young’s opinions. The judge found that the city had rebutted the statutory PTSD presumption and denied benefits. However, the Workers’ Compensation Court of Appeals vacated the order denying benefits, citing Young’s use of the older DSM.

Anthony Gabor of Gries Lenhardt Allen PLLP, who represented the city, said, “The court has always said that the interpretation of the DSM is best left to the experts, not the courts. [The WCCA] determined that the DSM-5 should not have been considered. What it should have done instead, it should have listened to the experts on that.”

Representing Rowe, Ashley Bierman, attorney at Meshbesher & Spence, argued, “The plain language of subdivision 15(d) [of the Workers’ Compensation Act] requires that evaluators rely on the most recently published edition of the DSM when assessing for post-traumatic stress disorder. Dr. Young’s decision is legally deficient and should not have been relied upon by the compensation judge.”

While the Minnesota Supreme Court agreed with the WCCA that the DSM-5-TR is the most-recently published edition, it rejected the WCCA’s broader conclusion that an employer may rebut the PTSD presumption only through an IPE based on the latest DSM edition. The court explained that the statute merely requires employers to present “substantial factors” to rebut the presumption and does not limit rebuttal evidence to a single form. The court emphasized that employers may challenge the validity or credibility of a PTSD diagnosis through competing expert testimony, critiques of the diagnosing expert’s methodology, or other substantial evidence.

Additionally, the court held that reliance on an older DSM affects the weight of an expert’s opinion rather than its admissibility. A compensation judge may consider an IPE based on an earlier DSM edition and determine how persuasive it is in light of all the evidence. Because the WCCA excluded Dr. Young’s opinion solely due to his reliance on the DSM-5, the court determined that it improperly substituted its legal interpretation for the compensation judge’s role in weighing evidence.

The Minnesota Supreme Court reversed the WCCA’s decision and remanded the case for consideration of Rowe’s remaining arguments concerning the foundation of Young’s opinion and his entitlement to additional benefits.