On certification to the Superior Court, Appellate Division, whose opinion is reported at 348 N.J. Super. 180 (2002).
These consolidated appeals address the issue of whether Post Traumatic Stress Disorder (PTSD) is an "accidental injury" or an "occupational disease" under the New Jersey Workers' Compensation Act (Act).
The facts surrounding the Brunell matter are as follows. In 1995, Diana Brunell was employed by the Wildwood Crest Police Department (Wildwood Crest) as a civilian police dispatcher. On June 2, Brunell dispatched Officer Miglio to the scene of a vehicle stop. A suspect scuffled with the officer, resulting in his suffering cardiac arrest. Officer Miglio died later that evening. Brunell did not witness the incident directly, but she sent the officer to the scene, called for medical assistance, consoled members of the department, and arranged for notification of Officer Miglio's widow. Immediately after the incident, Brunell suffered from symptoms of anxiety, depression, nightmares, irritability, fatigue, insomnia, and exaggerated startle response. She became increasingly tense as time passed. In 1999, Brunell experienced problems at work and was suspended for a week. She was diagnosed in August of 1999 with PTSD as the direct result of the incident in 1995. In January 2000, Brunell filed a claim petition seeking workers' compensation benefits. In the petition, she stated that the date of her accident or occupational exposure was June 2, 1995, and that she suffered from delayed onset PTSD as a result of Officer Miglio's death. In April 2000, Wildwood Crest denied relief for failure to timely file her claim petition and, ultimately, moved to dismiss the claim petition.
The facts underlying the Stango matter are as follows. Samuel Stango was a uniformed patrolman for the Lower Township Police Department (Lower Township) for nine years before he resigned in 2000. On February 18, 1994, Stango and a fellow officer, David Douglass, responded to the scene of a domestic dispute. Officer Douglass was shot in the throat at the scene. Stango came upon Douglass after the shots had been fired. Stango held Douglass, who was bleeding from the mouth and ears, and watched him die. Following the incident, Stango noticed an increased anxiety level and began having problems with panic attacks at night, as well as flashbacks and bad dreams. Stango continued to work and did not report his symptoms to Lower Township, believing that his symptoms would disappear over time. In February 2000, Stango experienced a "trigger incident" while carrying a balloon that burst, which led to an increase in his anxiety level. The "pop" sound of the bursting balloon triggered a flashback, which, in turn, led to a series of disturbing dreams involving snipers. After this incident, Stango reached out to various sources for help. On April 5, 2000, Stango was relieved of his duties and referred to an employee-assistance program.
On April 13, 2000, Stango filed two claim petitions for workers' compensation benefits, one alleging that the date of his accident or occupational exposure was February 13, 2000 (the date of the balloon-popping flashback), and the other alleging the date as February 18, 1994 (the initial shooting incident). Lower Township's compensation carrier refused to cover Stango's treatment. On May 3, 2000, a psychiatrist diagnosed Stango with ongoing, chronic PTSD relating back to the shooting incident, and recommended treatment. On June 6, 2000, Stango filed a motion for medical and temporary disability benefits, requesting payment for psychological/psychiatric treatment and payment for time lost from work as a result of his work-related injury. Lower Township filed an answer and a motion to dismiss the petitions for failure to comply with the relevant statutory limitations period.
The Stango and Brunell cases were consolidated before the Division of Workers' Compensation for adjudication. The judge of compensation granted the motions to dismiss because the claim petitions were not timely filed within two years of the "accident."
On appeal, the Appellate Division focused on whether the claims for compensation based on PTSD should be adjudicated under the two-year "accident" statute of limitations, or under the discovery-rule limitations period prescribed for "occupational diseases." Relying on case law, the Appellate Division affirmed, holding that PTSD is compensable under the "accident" provisions of the Act when it arises from a single event. Because the accidents suffered by Brunell and Stango preceded the filings by more than two years, the Appellate Division ruled that the claims were properly dismissed.
The Supreme Court granted certification.
HELD: Depending on the circumstances, Post Traumatic Stress Disorder may qualify as either an accidental injury or an occupational disease and, when the facts of the case fit both categories, a worker is entitled to file both claims. Moreover, in the narrow class of accident cases that result in latent or insidiously progressive injury, the accident statute of limitations does not begin to run until a worker knows or should know that he or she has sustained a compensable injury.
1. Because of the ameliorative effect that the Act was intended to achieve (swift payment to injured employees), it has been characterized as important social legislation entitled to liberal construction. Overall, the Act is to be construed to bring as many cases as possible within its coverage. The Act provides a remedy to an employee who suffers injury "arising out of and in the course of employment" either by accident or by contracting a compensable occupational disease. Different notice and claim provisions apply to each of those categories. (Pp. 8-11)
2. To be a compensable accident, there must be an unintended or unexpected occurrence that produces hurt or loss. The occurrence of the injury is the trigger for the worker to notify the employer. The injury must be traceable, within reasonable limits, to a definite time, place, occasion, or cause. To be a compensable occupational disease, the injury is due in a material degree to causes and conditions that are or were characteristic of, or peculiar to, a particular trade, occupation, process, or place of employment. The basic unexpectedness ingredient of an accident is missing in an occupational disease. (Pp. 11-17)
3. A diagnosis of PTSD can cover a broad variety of stressors and symptoms and may result from a single traumatic event, such as a fire or explosion, or from continued exposure to traumatic events, such as occurs in combat or domestic abuse. Symptoms of PTSD can lay dormant until at least six or more months have passed, in which case it is classified as delayed onset PTSD. PTSD is cognizable under the Act and is recognized in case law. The courts in Colorado, Maryland, North Carolina, and Virginia have concluded that, depending on the facts, PTSD may be either an occupational disease or an accidental injury. Generally, each of those cases found PTSD to be an occupational disease when it developed over time from multiple stressors unique to the employment. These cases aptly apply to the situations presented here. There is nothing inherent in a diagnosis of PTSD that would preclude its treatment either as an accidental injury or an occupational disease, depending on the facts. That reading of the Act accords most fully with its beneficial aims of providing coverage to as broad a class of workers as possible. (Pp. 17-29)
4. The mere happening of a definable, traumatic event does not automatically equate with an accident for workers' compensation purposes. There is nothing about a single, traumatic event, standing alone, that would preclude a worker from filing an occupational-disease claim, so long as the claimant otherwise met the relevant statutory standards. A worker could actually file both claims. (Pp. 29-32)
5. An employee claiming an occupational disease must notify his employer within ninety days after the employee knew or should have known the nature of his disability and its relation to his employment. He must file a compensation claim petition within two years after he knew the nature of the disability and its relation to the employment. In respect of accidental injury, an employee must give notice to the employer within ninety days of the occurrence of injury and must file a claim petition within two years of the date the accident occurred. PTSD is an example of an insidious disease process of which the worker is unaware at the time of the original traumatic event because ascertainable disease symptoms surface much later in time. Thus, in the limited class of cases in which an unexpected traumatic event occurs and the injury it generates is latent or insidiously progressive, an accident for workers' compensation filing purposes has not taken place until the signs and symptoms are such that they would alert a reasonable person that he had sustained a compensable injury. (Pp. 32-47)
6. Nothing in the history of the Legislature's enactment of the discovery rule in the occupational-disease statute suggests that the Legislature would not have been concerned equally over the fate of workers who suffer a traumatic event resulting in a delayed onset or insidiously developing disease. Had the Legislature been faced with the narrow class of accident cases involving latency and insidious onset diseases, it would have included them under the discovery-rule umbrella. (Pp. 47-52)
7. Stango and Brunell should have an opportunity, in separate trials, to present their proofs to the compensation court, which shall determine whether the facts established fit best within the occupational disease model, the accidental injury model, or neither. If on remand, the court concludes that one or more of the claims meet the requirements of occupational-disease statute, timeliness remains to be decided. If the court characterizes either of the claims as accidental, it will be necessary to assess its timeliness in light of the standards established here. (Pp. 52-55)
8. The Court's disposition should not be taken as a commentary on the quality, sufficiency, or timeliness of the parties' claims, but only as a ruling that the claimants are not prohibited from raising them. (P. 56)
Judgment of the Appellate Division is REVERSED and the cases are REMANDED to the Division of Workers' Compensation for consideration of that substance and timeliness of the claimants' contentions under the standards to which we have averted.
CHIEF JUSTICE PORITZ and JUSTICES COLEMAN, VERNIERO, LaVECCHIA, ZAZZALI, and ALBIN join in JUSTICE LONG'S opinion.
The opinion of the court was delivered by: Long, J.
These consolidated appeals present the issue of whether Post Traumatic Stress Disorder (PTSD) is an "accidental injury" or an "occupational disease" under the workers' compensation statute. We conclude that the condition may qualify, depending on the circumstances, as either and that when the facts of a case straddle both categories, a worker is entitled to file both claims. Finally, we hold that in the narrow band of accident cases that result in latent or insidiously progressive injury, the accident statute of limitations does not begin to run until the worker knows or should know that he has sustained a compensable injury.
A. Brunell v. Wildwood Crest Police Department
In 1995, Petitioner Diana Brunell was employed by respondent Wildwood Crest Police Department as a civilian police dispatcher. On June 2, she dispatched Officer Eugene Miglio to the scene of a vehicle stop. A scuffle ensued, during which the suspect struck Miglio on the chest. As a result, Miglio suffered a cardiac arrest and died later that night. Although Brunell did not witness the incident directly, in addition to sending Miglio to the scene of his death, she called for medical assistance, informed and consoled other members of the police department, and arranged for notification of Officer Miglio's widow. Immediately after the incident, Brunell suffered "symptoms of anxiety, depression, nightmares, irritability, fatigue, insomnia, and exaggerated startle response." She became more tense as time passed.
In June 1999, Brunell began to experience difficulty at work, including disagreements with co-workers and other "emotional problems." As a result, she was suspended for a week. The following month, a psychologist retained by the Department, Dr. Richard Cohen, diagnosed Brunell with a major depressive disorder. Brunell continued to see Dr. Cohen, who, on a subsequent visit, advised that Brunell "should not return to work." Dr. Cohen also referred Brunell for further psychological evaluation. On August 20, 1999, Brunell was examined by Dr. William Miley and was diagnosed with PTSD as the direct result of Officer Miglio's death in 1995.
On September 9, 1999, the Department's insurer informed Brunell that her claim had been denied "for failure to report it in a timely fashion" and suggested that she pursue recovery through her private insurer. Dr. Miley then notified the insurer that:
Ms. Diana Brunell is suffering from Post Traumatic Stress Disorder, with Delayed Onset (DSM IV-309.81). In this disorder, the symptoms do not occur until at least six months after the critical incident that initiated the condition. Ms. Brunell has noticed recently that she is experiencing symptoms of this disorder over which she has no control.
Dr. Miley reaffirmed that Brunell's symptoms were the direct result of the 1995 incident.
On January 6, 2000, Brunell filed a claim petition seeking workers' compensation. In the petition, she declared that the date of her accident or occupational exposure was June 2, 1995, and that she suffered from delayed onset PTSD as a result of Officer Miglio's death. On April 3, 2000, the Department denied relief for "failure to timely file a claim for an injury which occurred on June 2, 1995" and ultimately moved to dismiss the claim petition.
B. Stango v. Lower Township Police Department
Petitioner Samuel Stango was a uniformed patrolman for the Lower Township Police Department for nine years, prior to his honorable resignation in 2000. On February 18, 1994, Stango and a fellow officer, David Douglass, responded to the scene of a domestic dispute. When they arrived, the officers split up and took separate routes around the property. As Stango approached the backyard, he heard what sounded like gunshots. Stango found Douglass lying on the ground, the victim of a shooting in the throat. Stango held Douglass, who was bleeding from the mouth and ears, and watched him die. Following the incident, Stango noticed an increased anxiety level and began "having problems with awakening at night with panic feelings, anxiety and sweats, coupled with flashbacks and bad dreams." He continued to work, however, without reporting his symptoms to the Lower Township Police Department because he felt that "it would just go away over time."
In February 2000, Stango experienced what he called a "trigger incident" that led to a considerable increase in his anxiety level. He was carrying balloons into his house for his twin daughters' birthday party when one of the balloons burst. The "pop" sound triggered a flashback that was "extremely intense and anxiety provoking." That experience, in turn, set off a series of disturbing dreams involving snipers.
After the February incident, Stango sought help from several sources, including fellow officers, an FBI agent, and a "Stress Unit" on the Internet that referred him to a psychologist. On April 5, 2000, Stango discussed his troubles with his lieutenant who relieved him of his duties, requested the surrender of his service weapon, and referred him to an Employee Assistance Program.
On April 13, 2000, Stango filed two claim petitions for Workers' Compensation, one alleging that the date of his accident or occupational exposure was February 13, 2000 (the date of the balloon-popping flashback), and the other identifying the date as February 18, 1994 (the initial shooting incident). The Department's insurer refused to cover Stango's treatment.
On May 3, 2000, Stango was treated by Dr. Lawrence Clinton, a psychiatrist who concluded that he suffers from "an ongoing, chronic post traumatic stress disorder with anxiety reaction secondary to the work related incident when his partner was shot and Mr. Stango observed his death." The doctor recommended psychotherapy, biofeedback, and medication.
On June 6, 2000, Stango filed a motion for medical and temporary disability benefits requesting payment for psychological/psychiatric treatment and payment for time lost due to his work-related injury. The Department filed an answer and a motion to dismiss for failure to comply with the time limitations set forth in N.J.S.A. 34:15-41 and -51.
Although the facts of their cases are quite distinct, because Brunell and Stango raised many of the same legal issues, and because both the Wildwood Crest and Lower Township Police Departments were represented by the same lawyer, the two cases were consolidated and argued together before a single Judge of Compensation. The judge granted the motions to dismiss because neither petition was filed within two years of the "accident."
The Appellate Division affirmed. Brunell v. Wildwood Crest Police Dep't, 348 N.J. Super. 180 (2002). In so doing, the panel focused on whether the claims for compensation based on PTSD should be adjudicated under the two-year "accident" statute of limitations, N.J.S.A. 34:15-41 and N.J.S.A. 34:15-51, or under the less onerous discovery-rule limitations period prescribed for "occupational diseases." N.J.S.A. 34:15-34. Relying on Prettyman v. State, 298 N.J. Super. 580 (App. Div. 1997), and Schwarz v. Federal Shipbuilding & Dry Dock Co., 16 N.J. 243 (1954), the court held that PTSD is compensable under the "accident" provision of the workers' compensation statute when it arises from a single event. Id. at 189-92. Citing Schwarz, the panel stated: "[O]urs is an 'accident' statute and not an 'injury' statute. Our courts have found no indication of a legislative purpose to suspend the running of the statute until the injury becomes manifest." Brunell, supra, 348 N.J. Super. at 191 (citing Schwarz, supra, 16 N.J. at 251). Because the "accidents" suffered by Brunell and Stango preceded the filings by more than two years, the court ruled that the claims were properly dismissed. We granted certification, Stango v. Lower Township Police Dep't, 172 N.J. 359 (2002) and Brunell v. Wildwood Crest Police Dep't, 174 N.J. 40 (2002), and now reverse.
Brunell and Stango (collectively "claimants") essentially maintain that PTSD is an occupational disease; that their time to file did not begin to run until they knew of their injuries; and that their claims are not barred by the two-year accident statute of limitations. The Departments acknowledge that PTSD can be characterized as either an accidental injury or an occupational disease, depending on the circumstances, but argue that when it arises out of a single unexpected or untoward event, it is classifiable only as an accidental injury, and thus is subject to the two-year accident statute of limitations. According to the Departments, therefore, both claimants are out of time. In order to evaluate the claimants' contentions, both the relevant statutes and PTSD require explication.
With the passage of the New Jersey Workers' Compensation Act in 1911, employees who previously had encountered great difficulty in obtaining tort recompense for work-connected injuries became entitled to compensation for medical expenses and lost wages for such injuries, without proving fault. Monroe Berkowitz, Workmen's Compensation: The New Jersey Experience 3- 5 (1960); L. 1911, c. 95, § 7. The statute initially swept in only typical industrial accidents; however, "it rapidly became apparent that the new law failed to cover many of the developing hazards of industrial production, specifically the hazards of occupational disease resulting from exposure to toxic substances." Suzanne Nussbaum & James Boskey, The Consumers League of New Jersey and the Development of Occupational Disease Legislation, 4 Seton Hall Legis. J. 101, 110-11 (1979).
In 1924, the Legislature amended the compensation statutes to include toxic exposure cases. L. 1924, c. 124, § 1(22b). Under the 1924 statute, a worker was covered for specifically delineated diseases *fn1 but only if the disability was reported within five months of the last exposure and the claim was filed within one year thereof. Ibid. Because "many of these diseases could manifest years after exposure, the limitations posed a serious problem." Nussbaum & Boskey, supra, 4 Seton H. Legisl. J. at 124. It was not until 1948 that the Legislature loosened the statute of limitations for occupational diseases by adding a two-year discovery rule, although maintaining an absolute five- year statute of repose. L. 1948, c. 468, § 2. A year later, the Legislature amended the section to cover all occupational diseases. L. 1949, c. 29, § 2. Eventually in 1974, in recognition of the insidious nature and delayed onset of many occupational diseases and the difficulty in pinpointing the exact date the disease process began, the five-year statute of repose was repealed, leaving only the discovery rule. L. 1974, c. 65, § 1. *fn2 Because of the ameliorative effect that the Act was intended to achieve (swift recompense for injured employees), it has been characterized as important social legislation. Torres v. Trenton Times Newspaper, 64 N.J. 458, 461 (1974); Churukian v. Unarco Indus., Inc., 169 N.J. Super. 122, 125 (App. Div.), certif. denied 81 N.J. 352 (1979). As a salutary remedial enactment, it is entitled to liberal construction in order to comport with its presumptive beneficence. See Fiore v. Consolidated Freightways, 140 N.J. 452, 465 (1995) (using liberal construction of workers' compensation statute to find that heart disease arising from occupational exposure to carbon monoxide was compensable); Paul v. Baltimore Upholstering Co., 66 N.J. 111, 136 (1974) ("[O]ur courts have not hesitated in the past to construe the workmen's compensation act so as to comport with its presumptive beneficent and remedial objectives."). Overall, the statute is to be construed to bring as many cases as possible within its coverage. Lindquist v. City of Jersey City Fire Dept., 175 N.J. 244, 258 (2003) (stating that social goal of Act to "implement legislative policy of affording coverage to as many workers as possible" applied "whether the claim involves an ...