Philadelphia Police Officer Wins Delayed Workers’ Compensation Claim for PTSD

A Philadelphia police officer who was severely beaten by a robbery suspect in 2017 has won his right to add a psychological injury to his already settled workers’ compensation claim for physical injuries suffered in the incident.

The officer’s employer, the city of Philadelphia, had opposed the officer’s post-traumatic stress disorder (PTSD) claim on res judicata grounds that the prior agreed-upon work injury description, already amended once by the officer, precluded him from again amending it to add a mental health injury because the claim had already been resolved.

However, the Commonwealth Court found that his claim for PTSD was not barred by res judicata, which prevents relitigating of a claim once it has been decided, because the earlier injury claim from the work incident dealt with other issues and the PTSD was not known at that time of the earlier agreement. The intermediate appellate court thus reversed a March 2024 decision by the Workers’ Compensation Appeal Board that had disallowed the PTSD claim.

Evidence showed that the officer was suffering from depression right after the robbery incident but was embarrassed about having a mental health issue so he delayed getting treatment and did not bring it up or think of it as compensable when first claiming benefits. He got concerned and raised it as an issue only after his symptoms worsened and he had suicidal thoughts and flashbacks.

What Happened

Michael N. Lewis, Sr. had been a Philadelphia police officer for more than 24 years. On February 4, 2017, when he responded to a burglary at a pet store, he grabbed the suspect—a 5’9″, 180-pound former U.S. Marine— and attempted to place him in handcuffs. The suspect resisted, turned around, and hit Lewis in the forehead and temples and continued to hit him in the head with closed fists until Lewis felt faint. During the altercation, the suspect charged Lewis, pushing him backward so that his his head struck a steel shelf. The suspect kept hitting Lewis, who continued to fight until he “had nothing left in him.” Lewis drew but did not discharge his firearm at the suspect right before other officers arrived. Lewis was rushed to the hospital. He said he feared for his life during the incident. He did not perform police duties after the incident and subsequently retired.

Lewis initially submitted— and his employer ultimately accepted—claims for physical injuries including a concussion, injuries to his hand and back, and facial abrasions. The city acknowledged his work injury through a Notice of Compensation Payable (NCP).

Lewis later petitioned to amend that injury description but the city initially balked. On August 19, 2021, after proceedings, the parties agreed and a state workers’ compensation judge approved an amendment to the NCP to include concussion, headaches, balance issues, and vision issues. The stipulation also stated: “The parties agree that this Stipulation does not prevent the parties from filing future petitions and other relief as appropriate pursuant to the Worker’s Compensation Act.” There was no indication or mention of psychological injury at this time except Lewis said he felt “hopeless.”

Second Petition

On September 20, 2021, Lewis filed a second review petition seeking to include a psychological injury as a result of physical injury. The city denied the petition, arguing that it was barred by the doctrines of res judicata and/or collateral estoppel. A workers’ compensation judge held hearings between October 2021 and September 2022.

Lewis testified that he never had any psychological treatment before the February 4, 2017 incident. A few months after the incident, he began to feel irritable, unhappy, overwhelmed, anxious, frustrated, and helpless. He “was crying a lot” and “began isolating himself.” In June and July of 2019, he was briefly treated with a psychologist who said Lewis “was in denial” about his symptoms and “felt embarrassed talking about how he was feeling.” After Lewis stopped seeing the psychologist in July 2019, his symptoms intensified. He said there were times when he thought about suicide, which prompted him to return to the psychologist in April 2021. He takes an antidepressant but his symptoms have only moderately improved. Seeing a police vehicle or hearing a siren causes him to experience flashbacks to the incident.

His psychologist diagnosed him as having major depressive disorder directly related to the work incident. The doctor confirmed that Lewis was embarrassed to receive treatment for mental health issues and that he experiences occasional suicidal ideation. He noted that Lewis was never advised to seek psychological care after the incident.

His employer noted there was no previous mention of psychological issues. A doctor who examined Lewis for the city opined that although he exhibited symptoms of depression, the condition was not caused by the work incident. She based that opinion on the fact that he did not seek treatment for his psychological symptoms until two years after the incident.

The workers’ compensation judge specifically found that the delays and gaps in his mental health treatment were attributable to his aversion to seeking that treatment and the fact that his symptoms waxed and waned over time. The judge concluded that although his mental injuries may have been manifest during the review proceeding, they were not part of that earlier litigation and so were not precluded.

Appeal

The city appealed and the Workers’ Compensation Appeal Board reversed the judge’s decision. The board reasoned that although Lewis did not actually litigate in that first proceeding the injuries he sought to add in the second proceeding, he should have done so because he was aware of those injuries at the time of the first proceeding.

In his appeal, Lewis and his psychologist reiterated that he was not aware that his psychological injury was compensable at the time of the first proceeding.

In reversing the workers’ compensation board, the Commonwealth Court noted that both Lewis and his psychologist acknowledged he was diagnosed with depression before he filed the petition to add psychological injury, but Lewis was unaware that his depression was a compensable work injury at the time. He testified that it was a gradual worsening of the symptoms of his depression—and suicidal ideation in particular—that prompted him to return to treatment despite his reluctance to receive treatment.

Thus, the court noted, the nature of his psychological injury changed over time. However, unlike with physical injuries that can be tracked through diagnostic imaging or other direct observation, there are no such tests for psychological injuries. Rather, a trained physician or psychologist would need to make professional judgments based on Lewis’s history and clinical presentation, and Lewis would likely not realize the severity or cause of his psychological injury on his own.

The court found that the evidence did not suggest that Lewis or his doctor understood his psychological injury to the point that he “should have litigated” it before September 2021, which was only six months into his consistent treatment with his psychologist. Thus the Workers’ Compensation Appeals Board erred in finding that the petition for psychological injury was subject to technical res judicata, the Commonwealth Court ruled in reversing.

Lewis had also argued that the board erred in ignoring the language in their stipulation in the first review that expressly said new petitions are permitted if they are consistent with the workers’ compensation law. The Commonwealth Court did not rule on the effect of the language of the stipulation.

Topics Workers' Compensation Talent Law Enforcement