Worker’s mental health may be relevant in ankle injury claim

The mental health history of a woman who broke her ankle after slipping on ice in workplace parking lot in 2015 and continued to have ankle pain for years may be relevant to her workers compensation pain and disability, the Supreme Court of Alaska ruled Friday.

The worker’s recovery from the fracture, and subsequent surgery “has been complicated” and included additional ankle surgeries along with complaints of continuing pain that led to disability and an examining physician to write that she suffered from “disability conviction,” according to court records in No. 7464, filed in Fairbanks, Alaska.

Court proceedings noted that the worker had several preexisting conditions not directly associated with her work injury: “Her mental health records are at issue here; she has attention deficit disorder (ADD), anxiety, and a mood disorder, and takes medication for these conditions.” The woman had refused modified work following a diagnosis of being medically stable, the employer argued.

A nurse practitioner who managed the woman’s psychiatric medications and acted as a mental health counselor submitted four records to the workers compensation carrier for payment in 2015. The employer controverted the mental health counseling bills because the woman’s orthopedic doctor said “that mental health counseling is not related” to the ankle injury, documents states.

The worker, in turn, said the bills for the mental health visits had been sent in error and petitioned for a protective order regarding mental health records. The state Workers’ Compensation Board then ordered the employer to remove the language related to mental health from the releases, according to documents.

Three years after the injury, her employer requested that she sign a release allowing it to access all of her mental health records for the preceding 19 years because of her pain complaints, according to documents. 

The worker asked for a protective order from the board, which granted the protective order. On appeal, a board panel reversed the decision. The worker then petitioned the Alaska Workers’ Compensation Appeals Commission for review, but the commission declined review.

On appeal to the state’s highest court, the judges unanimously held that state law “permits an employer to access the mental health records of employees when it is relevant to the claim, even if the employee does not make a claim related to a mental health condition.

“Even though (the worker) did not directly seek compensation related to mental health benefits, the record contains multiple references to the impact her mental health conditions might have on her treatment as well as her pain complaints, which are part of her claim for both medical treatment and disability. The Board appropriately decided that (her) mental health records were potentially relevant to a defense,” documents state.

On remand, the court said the board can impose limits on what in the mental health record can be released, writing that the woman began seeking mental health treatment as a child: “The Board must on remand carefully scrutinize the information requested to determine whether it is overly broad, particularly with respect to the time period covered by the release.”