It is well established that as long as the resulting disability, meets statutory requirements, mental impairments are compensable in North Carolina. These injuries arise in multiple ways. 

For example, a bank teller is assaulted in the course of a bank robbery and, after recovering from physical injuries, cannot return to work due to anxiety. It could also be an ER doctor developing depression due to stressful nature of administering treatment each day. 

To determine compensability of these injuries, the employee’s disability must be a result of an accident arising out of and, in the course of, employment or an occupational disease. 

Injury by Accident:

Like physical injuries, the plaintiff must establish the existence of the accident. An accidental injury will be inferred when there is an interruption of the work routine that will introduce unusual conditions and unexpected consequences. 

For example, in Jordan v. CPCC, 124 N.C. App. 112, 476 S.E.2d 410 (1996), the prison instructor suffered a compensable accident when she developed PTSD after watching inmate students violently fight while she was isolated from other prison employees and guards. 

In contrast, in Pitillo v. N.C. Dep’t. of Envtl. Health & Natural Res., 151 N.C.  App. 641, 566 S.E.2d 807 (2002)the Plaintiff did not suffer a compensable injury when he had a nervous breakdown after a performance review. Due to Plaintiff’s request for the review and the courteous manner of the meeting, the meeting was an ordinary incident of employment and therefore not an accident. 

Occupational Disease:

In an occupational disease claim, the plaintiff must prove the mental illness or injury was due to stresses or conditions different from those borne by the general public.  Accordingly, the plaintiff has the burden to prove three elements: 

  1. the disease is characteristic of and peculiar to persons engaged in a particular trade or occupation in which the plaintiff is engaged; 
  2. the disease is not an ordinary disease of life to which the public is equally exposed; and 
  3. there is a causal connection between the disease and the plaintiff’s employment.

The disability need not originate exclusively from a particular trade, but rather the employee must have a greater risk of developing the disease than the general public. 

To illustrate, we contrast Smith–Price v. Charter Pines Behavioral Ctr., 160 N.C. App. 161, 584 S.E.2d 881(2003), with Lewis v. Duke University, 163 N.C. App. 408, 594 S.E.2d 100 (2004). In Smith, the Court awarded benefits to a nurse who suffered from PTSD. Due to the nature of caring for mentally ill patients with problems ranging from suicide to severe depression and anxiety, the nurse worked in an atmosphere permeated with stress not common of the workplace.

Whereas, in Lewis, the nurse argued stressors, such as staffing decisions and feeling undervalued, in the context of the nursing profession placed her at a higher risk of developing depression because it was while dealing in matters of life and death. The Court did not award benefits to the nurse because these stressors were ordinary to most workplaces.