McCamey v. District of Columbia Department of Employment Services
Full Opinion (html_with_citations)
Charlene McCamey petitioned this court to review a decision of the Director of the District of Columbia Department of Employment Services (D.C.DOES) that denied her workersâ compensation claim for psychological injuries she alleges resulted from an accidental physical injury suffered in the course of her employment. A three-judge division of this court affirmed the Directorâs decision, holding that the Directorâs application of an objective test to workersâ compensation claims involving psychological injuries was consistent with this courtâs prior decisions. We granted Ms. McCameyâs petition for rehearing en banc to consider whether application of an objective standard, as currently defined, to psychological injuries that are related to work-related physical injuries is consistent with the language and purpose of our workersâ compensation law. We conclude that it is not and accordingly must reverse.
I.
Ms. McCamey was employed by the District of Columbia Public Schools (DCPS) as a visiting instructor for homebound students. On September 29, 2000, while on the job, Ms. McCamey suffered injuries to her forehead, lower back and neck when she fell as a result of the collapse of a table that she and another instructor were moving. The Administrative Law Judge (ALJ) who heard her case found that as a result of the fall, Ms. McCamey suffered frequent, extensive, and excruciating headaches. In addition, following the accident, McCamey was afflicted with âdepression, panic attacks, confusion, auditory hallucinations, and memory loss.â
The foregoing events, however, occurred in the context of a serious pre-existing psychological illness. During the mid-1990s, several years prior to the accident, Ms. McCamey had begun to experience psychological problems attributable in substantial part to the death of her father, who had spent most of his life in a mental hospital. 1 Ms. McCamey was treated by a *1195 psychiatrist, Dr. Maria C. Hammill, and subsequently returned to work. It is undisputed that after completing her treatment regimen, Ms. McCamey was capable of performing her regular employment duties without incident. Indeed, the ALJ found that Ms. McCamey had not seen Dr. Hammill for several years prior to the workplace accident.
At issue in this case is Ms. McCameyâs claim for temporary total disability benefits arising from the psychological injuries that she attributes to her workplace accident. Dr. Hammill, the treating psychiatrist, was of the opinion that the workplace incident exacerbated Ms. McCameyâs preexisting psychological disorder. Dr. Bruce Smoller, a psychiatrist who examined Ms. McCamey on behalf of DCPS, and who relied in part on an MRI scan of Ms. McCameyâs brain and on thyroid tests, opined that the source of Ms. McCameyâs psychological injury was not her accident, but rather a pre-existing psychosis. In a âRecommended Compensation Orderâ entered on April 22, 2003, the ALJ denied Ms. McCameyâs claim for psychological injury. Applying to the record before him the Directorâs analysis in Dailey v. 3M Co. & Northwest Natâl Ins. Co., H & AS No. 85-259 (May 19, 1988), and this courtâs decision in Porter v. District of Columbia Depât of Employment Servs., 625 A.2d 886 (D.C.1993), the ALJ found
1. that âclaimant herein has presented substantial evidence of a cognizable injuryâ;
2. that Ms. McCameyâs âstressors,â i.e., the aggravation of her pre-exist-ing psychological condition, âdid arise in the course of her employment,â 2 but
3. that Ms. McCamey failed to satisfy the âobjectiveâ standard approved in Porter, i.e., that a person of normal sensibilities with no history of mental illness would have suffered a similar psychological injury.
Ms. McCamey appealed to the Director of D.C. DOES. On February 10, 2004, the Director affirmed the AL Jâs decision. The Director found, as had the ALJ, that âClaimantâs pre-existing condition was exacerbated by a physical injury.â Nevertheless, the Director upheld the denial of compensation, reasoning that although Dr. Hammill and Dr. Smoller expressed different opinions, â[n]either opined, and the evidence did not show, that an individual who did not have a pre-existing anxiety disorder would have suffered a psychological injury as a result of trauma to the head.â
Ms. McCamey filed a timely petition for review of the Directorâs decision. A three-judge panel of this court affirmed, holding that while Ms. McCameyâs position was not âimplausible in principle,â it was nevertheless foreclosed due to the courtâs decisions in Porter, supra, 625 A.2d at 888-89, and Landesberg v. District of Columbia Depât of Employment Servs., 794 A.2d 607, 614-15 (D.C.2002). See McCamey v. District of Columbia Depât of Employment Servs., 886 A.2d 543, 548 (D.C.2005). Subsequently, this court granted Ms. McCameyâs petition for rehearing en banc. McCamey v. District of Columbia Depât of Employment Servs., 896 A.2d 191 (D.C.2006).
II.
A. Standard of Review.
This court âwill not disturb an agency decision if it rationally flows from the factual findings on which it is based and if those findings are supported by *1196 substantial evidence.â Childrenâs Defense Fund v. District of Columbia Depât of Employment Servs., 726 A.2d 1242, 1247 (D.C.1999). Therefore, this court will affirm the agencyâs ruling unless it is arbitrary, capricious, or otherwise an abuse of discretion and not in accordance with the law. See Landesberg, supra, 794 A.2d at 612. Questions of law, however, are reviewed de novo. See King v. District of Columbia Depât of Employment Servs., 742 A.2d 460, 466 (D.C.1999). âTo be sure, âan agencyâs interpretation of its own regulations or of the stĂĄtute which it administers is generally entitled to great deference from this court. There is, however, a well-recognized exception to this rule. When the agencyâs decision is inconsistent with the applicable statute ... we owe it far less deference, if indeed we owe it any deference at all.â â Id. (quoting Columbia Realty Venture v. District of Columbia Rental Hous. Commân, 590 A.2d 1043, 1046 (D.C.1991)). As we have noted before, â âthe agencyâs interpretation of the statute it administers is not binding upon this court [if] it conflicts with the plain meaning of the statute or its legislative history.â â Murphy v. District of Columbia Depât of Employment Servs., 935 A.2d 1066, 1070 (D.C.2007) (quoting Lincoln Hockey LLC v. District of Columbia Depât of Employment Servs., 810 A.2d 862, 866 (D.C.2002)) (citations omitted). â[T]he judiciary is the final authority on issues of statutory construction.â Harris v. District of Columbia Office of Workerâs Comp., 660 A.2d 404, 407 (D.C.1995) (citing Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc., 467 U.S. 837, 843 n. 9, 104 S.Ct. 2778 (1984)).
Panel decisions by this court bind future divisions of the court. See M.A.P. v. Ryan, 285 A.2d 310, 312 (D.C. 1971). The court sitting en banc, however, may overrule the decisions of prior divisions. See id. âAlthough the doctrine of stare decisis has considerable force in statutory analysis because [the legislature] can correct a courtâs interpretive mistakes through legislation, we should not âappl[y] stare decisis mechanically to prohibit overturning our earlier decision determining the meaning of statutes.â â In re McBride, 602 A.2d 626, 636 (D.C.1992) (en banc) (quoting Monell v. New York City Depât of Social Servs., 436 U.S. 658, 695, 98 S.Ct. 2018, 56 L.Ed.2d 611 (1978)).
B. Principles of Workersâ Compensation Law.
The District of Columbia Workersâ Compensation Act (âWCAâ) provides for the compensation of employees who suffer disabilities that are causally connected to workplace injuries. The WCA covers â[t]he injury or death of an employee that occurs in the District of Columbia if the employee performed work for the employer, at the time of the injury or death, while in the District of Columbia.â D.C.Code § 32-1503(a)(l) (2001). The Act further defines âinjuryâ as
[A]ccidental injury or death arising out of and in the course of employment, and such occupational disease or infection as arises naturally out of such employment or as naturally or unavoidably results from such accidental injury, and includes an injury caused by the willful act of third persons directed against an employee because of his employment.
D.C.Code § 32-1501(12) (2001).
Workersâ Compensation laws reflect a compromise between employees and employers regarding injuries arising out of employment. âThe District of Columbia Workersâ Compensation Act of 1979, like its 1928 predecessor, was enacted to provide a reasonably quick and efficient manner to compensate employees for disabilities resulting from employment-bred injuries. Employees and employers were both thought to gain by a system in which common law tort remedies were dis *1197 carded for assured compensation regardless of negligence or fault.â Ferreira v. District of Columbia Depât of Employment Sews., 531 A.2d 651, 654 (D.C.1987) (footnote omitted); cf. D.C.Code § 32-1504(b) (2001) (providing that compensation under the Act is the employeeâs exclusive remedy against the employer for âany illness, injury, or death arising out of and in the course of his employmentâ). The purpose of workersâ compensation laws, âwhich is to provide financial and medical benefits to employees injured in work-related accidents,â is a humanitarian one. Grayson v. District of Columbia Depât of Employment Servs., 516 A.2d 909, 912 (D.C.1986). This court follows the principle that âworkersâ compensation statutes should be liberally construed to achieve their humanitarian purpose.â Vieira v. District of Columbia Depât of Employment Servs., 721 A.2d 579, 584 (D.C.1998); see also Ferreira, supra, 531 A.2d at 655.
The aggravation rule is an obvious example of meeting the humanitarian nature of the Act. âIt is well-settled that âan aggravation of a preexisting condition may [also] constitute a compensable accidental injury under the Act.â â King, supra, 742 A.2d at 468 (quoting Ferreira, supra, 531 A.2d at 660) (internal quotation omitted). âThe fact that other, nonemployment related factors may also have contributed to, or additionally aggravated [petitionerâs] malady, does not affect [the] right to compensation under the âaggravation rule.â â Ferreira, supra, 531 A.2d at 660 (internal quotation omitted). 3 âIf an employee experiences a work-related injury which, combined with a previous disability or physical impairment (work-related or non-work related) causes substantially greater disability or death, the liability of the employer shall be as if the subsequent injury alone caused the subsequent amount of disability.â Georgetown Univ. v. District of Columbia Depât of Employment Servs., 830 A.2d 865, 873 (D.C.2003). In Harris, supra, 660 A.2d at 408, the court distinguished the aggravation of a pre-existing injury from a mere recurrence of the injury by requiring some intervening work-related event: âThis is not a case, however, in which the ârecurrenceâ was the result of the natural progression of the condition, unaffected by any intervening work-connected cause.â See id. (internal citation and quotation omitted); see also 9 Arthur LaRSOn, Larsonâs Workersâ Compensation Law § 153.02[3] (2007) [âLarsonâsâ] (âTo find that there has been an aggravation, it must be shown that the second episode contributed independently to the final disability.â).
The aggravation rule stems from the principle that the employer must take the employee as it finds him or her. âEmployers must accept with their employees the frailties that predispose them to bodily hurt ... and if petitionerâs disability arose even in part out of and in the course of [her] employment, compensation is appropriate.â Ferreira, supra, 531 A.2d at 660 (internal citations and quotations omitted; emphasis in original). Professor Larson concurs:
Preexisting disease or infirmity of the employee does not disqualify a claim *1198 under the âarising out of employmentâ requirement if the employment aggravated, accelerated, or combined with the disease or infirmity to produce the death or disability for which compensation is sought. This is sometimes expressed by saying that the employer takes the employee as it finds that employee.
1 Larsonâs, supra, at § 9.02[1]; see id. at § 9.02D[1] (citing cases expressing that employer takes the employee as it finds him or her). 4
Similarly, âDOES has recognized that the [WCA] covers complications flowing from a compensable injury.â Brown v. District of Columbia Depât of Employment Servs., 700 A.2d 787, 791-92 (D.C.1997). âThe rule is that a subsequent injury, whether an aggravation of the original injury or a new and distinct injury, is compensable if it is the direct and natural result of a compensable primary injury.â Id. (internal quotation omitted); see 1 Larsonâs, supra, at § 10.01 (same test). Larson notes that âcases in which an initial medical condition itself progresses into complications more serious than the original injuryâ present no legal controversy and âthe added complications are of course compensable.â Id. § 10.02. â[0]nce the work-connected character of any injury, such as a back injury, has been established, the subsequent progression of that condition remains compensable so long as the worsening is not shown to have been produced by an independent nonindustrial cause.â Id. 5
Moreover, â[t]his jurisdiction has repeatedly rejected the notion that a âspecific traumatic injuryâ is necessary to establish a prima facie case of an âaccidental injury.â Ferreira, supra, 531 A.2d at 656. â[T]he statutory language âaccidental injuryâ does not require that an unusual incident be the cause of the injury, but is satisfied if something unexpectedly goes wrong within the human frame.â Washington Metro. Area Trans. Auth. v. District of Columbia Depât of Employment Servs., 506 A.2d 1127, 1130 (D.C.1986). âWhile the precise meaning of the-âhuman frameâ definition of âaccidental injuryâ is undeniably elusive, it clearly encompasses two concepts.â Ferreira, supra, 531 A.2d at 656. âFirst, the nature of the activity or event which results in or contributes to the injury may occur in the âusual and ordinary course of work.â The work need not be unusual or unexpected.â Id. âSecond, the nature of the potential cause of the disability need not be a discrete, particularized event.â Id.
Indeed, the WCA features a statutory presumption of compensability. Under D.C.Code § 32-1521 (2001), it is presumed that a âclaim comes within the provisions of this chapterâ in the absence of any evidence to the contrary. âThis sound presumption, designed to effectuate the humanitarian purposes of the statute, reflects a âstrong legislative policy favoring awards in arguable cases.â â Ferreira, supra, 531 A.2d at 655 (quoting Wheatley v. Adler, 132 U.SApp. D.C. 177, 183, 407 F.2d 307, 313 (1968) (en banc)). âIn order to benefit from the presumption, a claimant needs to make some âinitial demonstrationâ of the employment-connection of the disability.â Id. (quoting 1 Arthur Larson, Workmenâs Compensation Law § 10.33, at 3-138 (1986)). âThe initial demonstration *1199 consists in providing some evidence of the existence of two âbasic factsâ: a death or disability and a work-related event, activity, or requirement which has the potential of resulting in or contributing to the death or disability.â Id. (emphasis in original). âThe presumption then operates to establish a causal connection between the disability and the work-related event, activity, or requirement.â Id. âOnce the presumption is triggered, the burden is upon the employer to bring forth âsubstantial evidenceâ showing that the death or disability did not arise out of and in the course of employment.â Id. This court has held that expert testimony is not required to invoke the presumption. See McNeal v. District of Columbia Depât of Employment Servs., 917 A.2d 652, 658 (D.C.2007) (â[Claimant] was not obliged to present expert opinion of causation in order to enjoy the benefit of the presumption. It was not [his] burden to do that unless and until the employer presented sufficient evidence to rebut the presumed causal connection.â) (internal quotation omitted). 6
C. D.C. Government Comprehensive Merit Personnel Act.
While the WCA applies to private-sector employees in the District, Chapter 28 of the District of Columbia Government Comprehensive Merit Personnel Act (âCMPAâ) governs disability claims of District of Columbia employees. 7 See D.C.Code § 1-628.01 et seq. (2001); Kralick v. District of Columbia Depât of Employment Servs., 842 A.2d 705, 710 (D.C. 2004); see also Jackson v. District of Columbia Employeesâ Compensation Appeals Bd., 537 A.2d 576, 577 n. 1 (D.C.1988) (â[A] comparable system for providing disability benefits has been established under the District of Columbia Government Comprehensive Merit Personnel Actâ). The CMPA provides for the compensation of disabilities causally connected to workplace injuries:
The District of Columbia shall pay compensation as specified by this subchapter for the disability or death of an employee resulting from personal injury sustained while in the performance of his or her duty, unless the injury or death is: (1) caused by willful misconduct of the employee; (2) caused by the employeeâs intention to bring about the injury or death of himself or herself or of another; or (3) proximately caused by the intoxication of the injured employee.
D.C.Code § 1-623.02. 8
The two acts are conceptually close, see District of Columbia v. Thompson, 570 A.2d 277, 286 (D.C.1990), aff'd in relevant part, 593 A.2d 621, 635-36 (D.C.1991), and this court has considered case law under one act to be âinformativeâ as to the other. See Estate of Underwood v. Natâl Credit Union Admin., 665 A.2d 621, 631 (D.C.1995). 9 For example, the CMPA defines *1200 âinjury,â inter alia, as âinjury by accident,â see D.C.Code § 1-623.01(5), while the WCA defines âinjuryâ as âaccidental injury or death arising out of and in the course of employment,â see D.C.Code § 32-1501(12). Moreover, CMPAâs âinjury sustained while in the performance of his or her dutyâ provision has been construed as requiring that the âinjury arise out of and in the course of employment,â the same standard used under the WCA. See Wright v. D.C. Depât of Public Works, ECAB No. 88-40, 1991 D.C. Wrk. Comp. LEXIS 1, **3-4 (D.C. Depât of Employment Servs., Sept. 13, 1991) (looking to case law involving the Federal Employeesâ Compensation Act to define âwhile in the performance of duty,â and noting that â â[ajrising out of and in the course of are generally accepted as the coverage formula in most jurisdictionsâ); see also In re Christine Lawrence, 36 ECAB 422, 424 (1985) (âThe phrase âwhile in the performance of dutjf has been interpreted by the [Employeesâ Compensation Appeals] Board to be the equivalent of the commonly found prerequisite in workmenâs compensation law of âarising out of and in the course of employment.â â).
Though there are some differences between the two statutes, they do not materi-
ally alter the analysis of this case involving a psychological injury that is related to a physical injury suffered in the course of employment. Of note, however, is the aggravation rule, which the WCA expressly codifies, see D.C.Code § 32-1508(6)(A) (2001) 10 , but the CMPA does not. The D.C. Council based Chapter 23 of the CMPA on its pre-existing federal counterpart, the Federal Employeesâ Compensation Act (âFECAâ), 5 U.S.C. § 8101 et seq. See RepoRT of the Committee on Government Operations, Bill No. 2-10, District of Columbia Government Comprehensive Merit Personnel Act of 1978 (July 5, 1978) [D.C. Law No. 2-139] at 112 (providing that Chapter 23âs program of disability compensation âis essentially an enactment of current federal law.â). Consistent with the Actâs genesis, this court has analogized provisions of the CMPA to FECA. See Thompson, supra, 570 A.2d at 285 (construing a provision in CMPA by citing to case law construing the Federal Employees Compensation Act, âwhich is identical to the disability compensation portion of CMPAâ); cf. Wright, supra, 1991 D.C. Wrk. Comp. LEXIS 1 at *4 (D.C. Department of Employment Services adopting Employeesâ Compensation Appeals Board interpretation of identical FECA provi *1201 sion). Similar to the CMPA, FECA does not statutorily provide for the aggravation rule 11 ; however, the Employeesâ Compensation Appeals Board (âECABâ) â the administrative adjudicatory body charged with reviewing FECA claims 12 â has made it clear that aggravations of pre-existing injuries are compensable under FECA:
The [ECAB] has held that it matters not what the state or condition of the health of the employee might be; if the conditions of employment constitute the precipitating cause of disability, such disability is compensable as having resulted from accidental injury arising out of the employment. The aggravation of a preexisting disease or defect is as com-pensable as an original or new injury.
In re Eloise C. West, Dkt. No. 94-1439, 1996 WL 1357781, *4 (E.C.A.B.1996). Indeed, the ECAB has applied this principle to claims involving emotional injury as well:
A preexisting condition, which may be mental or nervous in character, does not disqualify a claim if the employment aggravated, accelerated, or combined with the condition to produce the death or disability for which compensation is sought. This is sometimes expressed by saying that the employer takes the employee as he finds him.
In re Victor I. Hasson, 42 ECAB 153, 159 (1990) (citing, inter alia, LaRsonâs WORKERSâ CompensatioN treatise). Thus, just as this court, the ECAB has justified the application of the aggravation rule via the well-settled proposition that employers must take their employees as they find them. Therefore, in light of the conceptual closeness of the CMPA to the WCA, as well as the CMPA to FECA, along with the underlying humanitarian purpose of those Acts, we can discern no reason why this fundamental principle of workersâ compensation law would not apply in the context of the CMPA. See 1 Laesonâs, supra, at § 9.02[1] (explaining the basis for the aggravation rule).
D. District of Columbia tests regarding psychological injuries.
The present dispute concerns the application of a so-called objective test or standard for determining entitlement to compensation, a test defined as requiring an employee seeking compensation for psychological injuries to show that an average person not predisposed to such injury would have suffered a similar injury. In this case, McCamey, supra, 886 A.2d at 548 the panel rejected Ms. McCameyâs argument that this objective standard should not apply to cases involving psychological injuries that result from accidental physical injuries occurring in the workplace. The panel concluded that Ms. McCameyâs position, while not âimplausible in principle,â was foreclosed due to the courtâs decisions in Porter, supra, 625 A.2d at 888-89 and Landesberg, supra, 794 A.2d at 614-15. In those cases, this court held that the objective test, which had up to then been applied only in cases involving psychological injuries caused by emotional or mental stress (âmental-mentalâ cases), could properly be applied by DOES to psychological injuries stemming from physical accidents (âphysical-mentalâ). See McCamey, supra, 886 A.2d at 547-48. On rehearing en banc, McCamey urges that such an expansion was improper, contrary to the test that is applied universally throughout the United States, and inconsistent with the workersâ compensation statute.
*1202 A review of the historical development of the objective test in the District as well as a review of jurisprudence from other jurisdictions provides strong support for Ms. McCameyâs position. The expansion of the objective test from mental-mental cases to physical-mental cases is inconsistent with the language, legislative history, and purpose of the Workersâ Compensation Act and the CMPA. Its application deprives an entire class of employees (including claimants with pre-existing psychological conditions) of compensation for injuries that they can prove are connected to workplace accidents. Because the workersâ compensation statutes â exist for the purpose of compensating employees for work-related injuries, the objective test (at least as applied to physical-mental claims) is inconsistent with the statute and must be overturned.
1. McEvily to Dailey to Spartin.
Our review of D.C. case law involving the application of an objective test to psychological disability claims begins with McEvily v. District of Columbia Depât of Employment Servs., 500 A.2d 1022 (D.C.1985). In McEvily, the claimant served as head of WMATAâs employee benefits branch. Despite initially having a positive work experience, claimant began to experience frustration as a result of managerial changes in the personnel department. Id. at 1022. Although McEvilyâs new supervisor did not criticize or embarrass him, he grew frustrated over her inattentiveness and her failure to act on or approve his proposals. Id. at 1022-23. âBelieving that it was necessary for his mental health to give up his job, petitioner stopped working on December 1, 1982.â Id. at 1023. Subsequently, he filed a workersâ compensation claim for a psychiatric disability (depressive reaction). Id.
âAt the hearing, he testified on his own behalf; meanwhile, WMATA called a board-certified psychiatrist, who testified based on an independent medical examination that (1) McEvily suffered from a cyclothymic disorder and a narcissistic personality disorder, but that (2) both disorders pre-existed his employment with WMATA. Id. Therefore, the doctor opined âthat there was no connection between his work situation and his predisposition to the illness which he experienced.â Id. According to the court, âDr. Schulman could not find any incident, experience, or ongoing occurrence that represented a significant stressor that would have affected anyone who was not so predisposed. He concluded that there could be no reasonable assessment of job-related stress, because the nature of that stress was highly subjective to petitioner.â Id. The examiner denied his claim, finding that the depression did not arise out of the employment. Id. The Director' affirmed, âconcluding that petitionerâs evidence did not give a ârationalized account of the causal relationship between the depression and [petitionerâs] work.â Id. Based on its review of the record, this court affirmed, âfinding] substantial evidence to support the conclusion that petitioner did not suffer a compensable injury under the Act.â Id. at 1024. Notably, this court affirmed on substantial evidence grounds (in a case where the claimant did not produce medical evidence himself). The court did not enunciate an objective test, but rather held that the employerâs expertâs opinion that there was no work-related connection supported the examinerâs conclusion that the depression was not connected to the employment.
Drawing partly on McEvily, the Director set forth the objective test in Dailey v. 3M Co. & Northwest Natâl Ins. Co., H & AS No. 85-259 (May 19,1988). Dailey was a secretary who worked in Indianapolis but accepted relocation to Washington, D.C. in lieu of the termination of her position. Id. at *1. However, after relocation, *1203 she began to suffer from depression and an ulcer; she then stopped working and returned to her family in Indiana. Id. at **1-2. After the hearing examiner denied her claim â finding that her depression did not arise out of her employment â she appealed to the Director, claiming that her âpredisposition to a depressive condition should not bar her eligibility for benefits when work-related events aggravated her pre-existing condition.â Id. at **2-3. The hearing examiner noted the testimony of the claimantâs psychiatrist that the claimant âwas intactâ prior to her move as well as his conclusion that her condition was caused by her work, but further noted the doctorâs opinion that the claimant suffered from obsessive-compulsive disorder âand a significant inability to deal with lifeâs difficulties.â Id. at **3-4. Based on this information, the examiner âconclude[d] ... that, had claimant not been otherwise so predisposed, the changes in her job situation would not have affected claimant in the manner in which they did 13 .... Furthermore, [the examiner did] not find those changes occurring in claimantâs life unusual or uncommon to the workplace.â Id. at *4. The examiner also noted that other life events affected claimant as well. Id.
On administrative appeal, the Director reviewed case law from the Agency and D.C. regarding claims of mental disabilities arising from employment. The Director cited McEvily and interpreted this courtâs McEvily decision as holding âthat for persons having a significant predisposition to a particular emotional injury, there must be some type of incident, experience, or occurrence at work which could have affected someone who was not significantly predisposed to that type of injury.â Id. at *5 (citing McEvily, supra, 500 A.2d at 1023). The Director then examined the Agencyâs prior decision in Chaney v. Southeastern Univ., H & AS No. 84-350 (Apr. 6, 1986) as it was summarized by the Directorâs decision in Wenzel v. British Airways:
The Chaney decision held that, at the very least, the concept of âarising out of the employmentâ requires a showing that there were obligations placed on employee or conditions under which the employee performed which exposed him to risks or dangers which could have [led] to the kind of psychological injury actually suffered.... Thus, to support the ultimate finding that a psychological injury arises out of the employment there must be a finding, supported by the evidence, that within the conditions of the workplace there was a specific, articulable source of injury in the workplace and a finding, supported by medical evidence, that the alleged source of the injury could have produced the kind of injury the employee suffered....
In requiring more than a showing that an employee had a medically harmful, psychologically adverse reaction to the work environment, Chaney emphasized that it is the employment, and not the make-up of the employee, which must account for the source of the employeeâs stress. If there is nothing discernible in the employment which for articulable reasons would ordinarily account for the employeeâs severe reaction, then the employeeâs injury does not arise out of the employment. Thus, inasmuch as Chaney directs attention to the work environment, and not to the employeeâs perception of his work environment, a factfinder has an objective basis on which to make his findings.
Id. at **6-7 (quoting Wenzel v. British Airways, H & AS No. 84-308, * *6-7 (Oct. 6, 1985)) (emphasis added). In Chaney, therefore, the Director had established an objective test requiring the claimant to *1204 proffer evidence of âa specific, articulable source of injuryâ â that is, something tangible about the work environmentâ rather than relying on the claimantâs purely subjective perceptions or on the mere evidence that an adverse reaction occurred.
However, the Director then read McEvily and Chaney/Wenzel together to require a different test. The Directorâs understanding of McEvily (as noted above) is quite similar to the Directorâs view of Chaney/Wenzel; however, McEvily involved someone pre-disposed to psychological injury. The Director combined the interpretation of McEvily, that a claimant predisposed to injury must offer evidence of âsome type of incident, experience, or occurrence at work which could have affected someone who was not significantly predisposed to that type of injury,â with its requirement of a specific, articulable source of injury from Chaney/Wenzel to produce the test we now refer to as the Dailey test:
[T]he Director now specifically holds, that in order for a claimant to establish that an emotional injury arises out of the mental stress or mental stimulus of employment, the claimant must show that actual conditions of employment, as determined by an objective standard and not merely the claimantâs subjective perception of his working conditions, were the cause of his emotional injury. The objective standard is satisfied where the claimant shows that the actual working conditions could have caused similar emotional injury in a person who was not significantly predisposed to such injury.
Dailey, supra, at **7-8. This test shifted the focus from an objective examination of the workplace environment to an examination of both the environment and the employee. 14 This had the added effect of erecting a stricter barrier for those claimants who had previously suffered from psychological conditions â because these claimants could no longer point to themselves as examples, the focus necessarily shifted to a hypothetical, average third person.
This court confronted the Dailey test in Spartin v. District of Columbia Depât of Employment Servs., 584 A.2d 564 (D.C.1990), a case involving another mental-mental claim. The petitioner in Spartin had been the president of a large human resources consulting firm. Id. at 565. Although he had to work hard, he viewed his job as âfun and excitingâ until a larger London based firm bought out his company, made him Chairman of the Board of an international recruiting company, and assigned him numerous new responsibilities on top of his already substantial job. Id. at 565-66. Eventually, petitioner sought medical care for what he thought was a heart attack; his physician, however, diagnosed him as suffering from depression-related disorders and referred him for psychiatric and psychological care. Id. at 566. After being diagnosed with serious depression, he quit working and filed a workersâ compensation claim. Id. His employer of *1205 fered the testimony of a psychiatrist who opined that claimant suffered from depression and dementia, but that those conditions were not attributable to his jobâ apparently suggesting that the dementia was related to some type of metabolic disturbance and the depression to his experience of chest pain. Id. at 567-68. The hearing examiner credited the employerâs psychiatrist and concluded that âpetitioner had not met his burden of demonstrating that the actual conditions of employment, as determined by an objective standard and not merely the petitionerâs subjective perception of his working condition, caused the emotional injury.â Id. at 568.
On review by this court, the petitioner challenged the application of the Dailey test. Id. This court noted that â[although the general rule of causation in workersâ compensation cases is to be liberally construed ... the Director has crafted special standards for certain types of claimed injuries,â and that Dailey was such a test. Id. (internal quotations and citation omitted). According to the court,
Viewed generally, insofar as it requires an objective demonstration of job stres-sors, Dailey fits within the modern trend to compensate workers for emotional injury caused by job stress.... Professor Larson advocates an âobjectiveâ standard for such cases that is very similar to the Dailey test: âin order for non-traumatically caused mental injury to be compensable in a workmenâs compensation case, the injury must have resulted from a situation of greater dimensions than the day-to-day mental stress and tensions which all employees must experience.â
Id. at 569 (quoting IB A. LaRSOn, WORKMENâS Compensation Law § 42.28(b) (1987)) (internal citation and footnote omitted). This comparison between Dailey and Larsonâs view of the modern trend reveals two important points: (1) they relate to compensation âfor emotional injury caused by job stress,â and (2) the objective test examines the conditions of the workplace environment.
The court went on, however, to state that neither the hearing examiner nor the Director had properly applied Dailey, explaining,
The Dailey test is objective: it focuses on whether the stresses of the job were so great that they could have caused harm to an average worker. As the Director explained in Dailey, job stresses are to be âmeasured against the usual stressors or mental stimuli of employment in general.â... Thus, a claimant must show under the Dailey test that his current job conditions are unusually stressful as compared to employment conditions in general, not as compared to his work history.
Spartin, supra, 584 A.2d at 569 (internal citation omitted).
The court then noted that the Director in Dailey acknowledged that â âa work related aggravation of a pre-existing condition can be compensable under the law of workersâ compensation.â Id. at 570 (quoting Dailey, supra, at 9). 15 The court then opined,
*1206 [although recovery for aggravation of a preexisting condition may seem incompatible with the Dailey testâs focus on a hypothetical employee who is not âpredisposedâ to injury, we do not read Dai-ley to preclude recovery where a claimant comes to the job with a preexisting psychological condition. Under Dailey, an employee predisposed to psychic injury could recover if he is exposed to work conditions so stressful that a normal employee might have suffered similar injury. Thus, an employee with a predisposition to mental illness is not precluded from recovering under Dailey. Only when so interpreted is the Dailey standard compatible with the Workersâ Compensation Act.
Id. (emphasis added). As interpreted by Spartin, therefore, the Dailey test was intended to preserve the right of persons predisposed to mental injury to recover in some cases, but only where a ânormal person might have suffered similar injury.â In succeeding decisions, the Dailey rule has continued to be applied in a way that forecloses compensation unless a ânormalâ or âaverageâ employee would experience similar injury.
This review demonstrates that the courtâs development of the objective standard occurred wholly within the context of mental-mental claims; indeed, entirely within mental-mental claims involving non-traumatic or gradual stress. It is clear that the Director and this court have acknowledged the difficulty inherent in evaluating claims of psychological disability and have attempted to address the problem by imposing a measure of objectivity: â[Cjlaims of work related emotional injury are among the most difficult to handle and adjudicate. While in theory work related mental injuries are as compensable as work related physical injuries, the adjudication of mental injury claims clearly presents more difficult problems. Mental injury claims are more difficult because of the inherent difficulties of objectively determining the existence of an injury and its source.â Dailey, supra, at 15. However, as noted, the test shifted over time from an objective examination of the employeeâs workplace environment to one that examined both the environment and the employeeâs particular susceptibilities. If an employee was predisposed to injury, then that employee would have to point to a hypothetical third person. It is within this admittedly unsettled context that the court expanded the application of the objective test to physical-mental claims.
2. Porter and Landesberg.
This court first considered application of the objective test to a psychological injury claim springing from a physical workplace accident, as opposed to one arising from gradual workplace stress, in Porter, supra, 625 A.2d at 886. In Porter, the petitioner was injured when a gurney struck her while she performed duties as a nursing assistant at George Washington University Hospital. Id. at 888. The petitioner contended that she suffered a disability due to post-traumatic stress disorder and that the disability was traceable to the gurney incident; her board-certified psychiatrist supported this theory at her hearing. Id. In response, her employer relied on testimony from another board-certified psychiatrist who opined that the petitionerâs severe depression was linked not to the gurney incident, but stemmed from a preexisting hysterical/hypochon-driacal personality disorder marked by cy-clothymic features. Id. The Hearing Ex *1207 aminer credited the latter testimony and found that the disability stemmed from a preexisting mental condition; the Director affirmed. Id.
On review, this court considered whether the administrative adjudicators applied a standard consistent with the Act, and concluded that they did. The court first reviewed McEvily, and noted that in that case, both the Hearing Examiner and Director âimplicitly approved the test for causation reflected in the [testifying] psychiatristâs evaluation .... â[the psychiatrist] could not find any incident, experience, or ongoing occurrence that represented a significant stressor that would have affected anyone who was not so predisposed [to the depressive reaction]. He concluded that there could be no reasonable assessment of job-related stress, because the nature of that stress was highly subjective to petitioner.ââ Porter, supra, 625 A.2d at 888 (quoting McEvily, supra, 500 A.2d at 1022) (emphasis in Porter). Next, the court reviewed Spartin, and confirmed that this court adopted the Dailey objective test. Notably, the court quoted the following passage from Spartin: â âan employee predisposed to psychic injury could recover if he is exposed to work conditions so stressful that a nomal employee might have suffered similar injury. Thus, an employee with a predisposition to mental illness is not precluded from recovering under Dailey.â â Porter, supra, 625 A.2d at 889 (quoting Spartin, supra, 584 A.2d at 570) (emphasis in Porter). The court reaffirmed that Dai-ley fit within the modern trend of compensating âemotional injury caused by job stress,â regardless of predisposition, âbut that the test âis objective: it focuses on whether the stresses of the job were so great that they could have caused harm to an average worker.ââ Porter, supra, 625 A.2d at 889 (quoting Spartin, supra, 584 A.2d at 569) (emphasis in Porter). Thus, to this point in the Porter decision, the court merely reaffirmed Spartinâs adoption of the Dailey testâ which itself is a conflation of an objective test focused purely on stressors within the workplace environment with one that takes into account a particular employeeâs predisposition to a certain injury.
According to the court, the hearing examiner found that the petitionerâs condition was not causally related to her work injuries, but was related solely to her preexisting disability. Porter, supra, 625 A.2d at 889. The Director affirmed that it was not work-related âbecause no âspecific, articulable sourceâ rooted in the job, no âconcrete non-personal stressorsâ had been identified as its cause.â Id. (quoting Director) (emphasis in Porter). The court interpreted these conclusions: â[b]oth the examiner and the Director concluded, in other words, that the gurney accident would not have caused a person lacking petitionerâs subjective, pre-existing personality disorder to suffer the disability she now experienced.â Id. 16
With this as background, the court stated, â[a]s in Spartin, we perceive no reason here why the agencyâs application of an objective causal test to petitionerâs claim of *1208 emotional injury is inconsistent with the Workersâ Compensation Act.â Id. Moreover, the court in Porter went on to expand Dailey to cover physical-mental claims as well:
Nor is it decisive that petitioner, unlike the claimant in Spartin, cites a specific job-related accident as the cause of her disorder rather than less easily identified conditions of stress in the employment. Whatever the triggering event or condition, the Director may properly apply a rule for causation in this difficult area of emotional injury that discourages spurious claims â one focusing on [1] the objective conditions of the job and [2] their effect on the ânormal employee â not predisposed to the injury by a mental disorder.
Porter, supra, 625 A.2d at 889 (brackets and emphasis added). The court cites no additional authority for this expansion.
Clearly, the court seems to defer to the Director to interpret the Act reasonably in such a way that discourages spurious claims for compensation. However, this expansion reveals the flaw in the Dailey test that becomes particularly heightened in the context of physical-mental claims. In such cases, the physical accident supplies the âobjective conditions of the jobâ far more clearly than a general allegation of gradual workplace stress, which almost necessarily develops over time. But the Directorâs concern with the difficulties of proving workplace causation in the case of persons predisposed to mental injury may not displace the protections of the Act. More precisely, neither the Director nor this court may interpret the Act in such a way that prevents those with preexisting conditions from establishing that they are entitled to compensation as to do so would ignore the aggravation rule and be inconsistent with a humanitarian act whose principal purpose is to compensate employees for injuries they prove to be work-related. See Spartin, supra, 584 A.2d at 570 (â[A]n employee with a predisposition to mental illness is not precluded from recovering under Dailey. Only when so interpreted is the Dailey standard compatible with the Workersâ Compensation Act.â).
In Dailey, the reason the Director rejected the aggravation of a pre-existing injury argument was because claimant failed to prove legal causation â the examiner did not credit her psychiatristsâ testimony that her emotional injury was related to her work conditions. 17 The reason that the objective test was required was because of the inability to pinpoint something different about the work environment or conditions of that job. In the context of physical-mental disabilities, the physical accident is the unexpected occurrence supplying the necessary (and objective) workplace connection. Thus, in cases of physical injury, so long as the claimant proffers competent medical evidence connecting the mental disability to the physical accident (legal causation), the claimant has either established a prima facie case of aggravation or a new injury. That being *1209 the case, the objective test is simply unnecessary. Put another way, the pure objective test is always met in physical-mental cases, provided that the claimant proves the connection between the mental condition and the physical accident.
Following Porter, this court has continued to apply the Dailey standard to physical mental claims. In Landesberg, the court affirmed the Director and hearing examinerâs denial of benefits to an employee who claimed she developed post-traumatic stress disorder following a workplace accident involving the closing of Metro bus doors based on findings that (1) the claimant was predisposed to psychological problems, and (2) per a psychiatristâs opinion, the conditions causing the emotional injury were not âso stressful that a reasonable person not predisposed to psychological injury might suffer the same injury.â 794 A.2d at 613-14. Relying on Porter, the court noted, âpsychological injuries are only compensable under the Act if the accident constitutes a sufficient stressor.â Id. at 614 (citing Porter, supra, 625 A.2d at 889). The division in McCamey followed Porter and Landesberg:
[W]e have held that the statute reaches the aggravation of an employeeâs physical condition resulting from work-place injuries. But in light of Porter and Landesberg, as well as McEvily and other authorities cited in Porter, Ms. McCameyâs position, though ably and conscientiously presented, founders upon our precedents, and it cannot prevail unless those precedents are overruled by the court sitting en banc.
McCamey, supra, 886 A.2d at 548 (emphasis in original).
We are now presented with that opportunity. In light of the humanitarian nature of the statute, we hold, in cases involving physical-mental claims, that the objective test is inconsistent with the statuteâs principal purpose of compensating employees who prove a connection between a disability and their work. Accordingly, its use must be overturned. Further, just as the aggravation rule in purely physical claims stems from the general principle that an employer must take an employee as it finds him or her, so too should the aggravation rule apply in physical-mental claims without requiring the employee to point to a hypothetical third person â an additional, heightened burden that is necessarily speculative and unnecessary -within the context of physical-mental claims where the work-related cause is distinct. Alternatively, if the psychological injury is tied not to the work-related accident, but rather a physical injury that itself arose from the work-related accident, the reviewing body could analyze it as a subsequently occurring injury that could be causally tied to the injury sustained in the workplace accident. Once complainant has established a compensable primary injury (either through the presumption or testimony), the necessary causal connection standard is enunciated in Brown, supra, 700 A.2d at 791-92.
DOESâs most-recent attempt to elucidate the objective test further reveals the testâs flaws and demonstrates that DOES has expanded its applicability beyond a general concern for objectivity to a test that is practically impossible for someone with a predisposition of psychological problems to meet. In West v. Washington Hosp. Ctr., the Compensation Review Board (âBoardâ) squarely confronted âwhether a psychological condition claimed to be the consequence or medical sequelae of a physical injury arising out of and in the course of employment, rather than the result of workplace stress, must meet the same standard for invoking the presumption of compensability under the Act as a psychological injury alleged to have result *1210 ed from workplace stress without a physical injury.â CRB (Dir.Dkt.) No. 99-97, *6 (Aug. 5, 2005). 18 In West, the claimant suffered a back injury in a slip-and-fall accident at work and eventually developed chronic depression which she claimed was connected to the accident. Id. at *2. The hearing examiner declined to apply the Dailey test, believing it to be unnecessary in the context of a physical accident, and instead applied the subsequent medical injury causation standard from Whittaker v. District of Columbia Depât of Employment Servs., supra note 3, 668 A.2d at 844. West, supra, at **3-4. On review, the Board examined post-Dailey cases, including cases wherein the Director or this court applied the Dailey objective test to physical-mental claims. The Board conceded that Dailey involved a claim involving job stress, rather than a physical accident, but asserted that the test applied to physical-mental claims as well:
[I]t would require an overly restrictive reading of Dailey, and a misapplication of the body of law that Dailey represents, to limit the standard enunciated therein to job stress induced emotional and psychological claims only.... It is the nature of the injury asserted (i.e. emotional and/or psychological injury), rather than the conditions of the workplace environment, that warrants application of the Dailey standard. This is because mental and emotional injury claims are, as the Director explained, inherently more difficult to objectively determine than are claims of physical injury.
West, supra, at **12-13. As support, the Board cites to the Directorâs statement in Dailey that â â[mjental injury claims are more difficult because of the inherent difficulties of objectively determining the existence of an injury and its source.â â Id. at *13 (quoting Dailey, supra, at *15) (emphasis added). Our reading of the Agencyâs decisions and our own cases, however, suggests that it is not the fact of injury that is elusive, it is the cause of the injury and the determination of whether that causal event is work-related â a concern included in the italicized portion of Dailey referenced above, but neglected in West. Instead, West reflects a skepticism of whether the employee suffers an injury at all.
The Board goes on to set forth its view of Daileyâs requirements:
[T]he Dailey standard may be satisfied notwithstanding the lack of evidence showing that the psychological or emotional injury sustained by the claimant would have similarly resulted to a non-predisposed individual of normal sensibilities. Required in such instances is evidence as to the nature of the employment-related physical injury sustained, that the claimantâs psychological/emotional impairment is at least partially attributable to the sustained physical injury or its aftereffects, and that the claimant was not predisposed to the emotional/psychological injury of which he/she complains.
West, supra, at **28-29. Lest there be any doubt as to the Boardâs view of the importance of the predisposition element, the Board reiterated, â[i]t is not, however, the lack of evidence of predisposition that is required, but the affirmative showing of evidence that Respondent was not predisposed that is required.â Id. at 29 (emphasis added). As an example of the potential application of this rule, the Board had earlier cited a case where the claimant had met the objective standard by establishing through medical evidence that the claimant was not pre-disposed to the emo *1211 tional injury she suffered. See West, supra, at *18 n. 9 (citing Aycock v. Am. Assoc, of Retired Persons, Dir. Dkt. No. 01-30 (Jan. 15, 2002)).
This reformulation of the Dailey test exposes its fatal flaw. The shift in focus from the objective work conditions to the individual person and his or her predisposition to injury led not only to the necessity of speculating about hypothetical ânormalâ employees, it has led inexorably to the conclusion that persons with pre-exist-ing psychological conditions cannot recover disability benefits if they suffer from the aggravation of their preexisting condition. This is directly antithetical to the well-established aggravation rule, against the well-established principle that the employer must take the employee as it finds him or her, and against the principal purpose of the statute to compensate employees for injuries they can prove are related to employment. Further, it is contrary to this courtâs admonition in Spartin that the objective test must permit those predisposed to emotional conditions to receive compensation if they have met their burden of proof or else it would contravene the Act.
E. Other jurisdictionsâ tests regarding psychological injuries within the context of physical-mental claims.
In Spartin, this court viewed Dailey as fitting âwithin the modern trend to compensate workers for emotional injury caused by job stress,â and further noted that Professor Larson advocated a form of an objective test for mental-mental claims involving job stress. See Spartin, supra, 584 A.2d at 569. Thus, this court has turned to outside jurisdictions for guidance on these issues. Secondary sources reviewing case law from around the country confirm that the compensability of emotional injuries stemming from physical accidents is uniformly accepted. Larson states,
[W]hen there has been a physical accident or trauma, and claimantâs disability is increased or prolonged by traumatic neurosis, conversion hysteria, or hysterical paralysis, it is now uniformly held that the full disability including the effects of the neurosis is compensable. Dozens of cases, involving almost every conceivable kind of neurotic, psychotic, psychosomatic, depressive, or hysterical symptom, functional overlay, or personality disorder, have accepted this rule.
3 Larsonâs, supra, at § 56.03[1] (emphasis added); see also id. at § 53.06D (compiling cases nationwide that accept physical-mental claims). Further, â[a]s in other connections, a preexisting weakness in the form of a neurotic tendency does not lessen the compensability of an injury which precipitates a disabling neurosis.â Id. at § 56.03[2]; see also 3 LaRSOnâs, supra, at § 56.04[3] (discussing the aggravation rule and noting, â[tjhere appears to be no reported decision in which compensation was denied in this type of case solely because there was a preexisting neurotic tendencyâ).
Other commentators agree: âCourts uniformly have held that a mental injury which implicates the existence of a physical impact stimulus or a physical injury satisfies the personal injury requirement [of workersâ compensation laws]. The analogy to negligence cases concerning mental injuries is obvious. The existence of an objective, traumatic, work connected physical impact or injury provides an intuitive guarantee that the mental disorder is genuine and that the employment genuinely caused it.â Lawrence Joseph, The Causation Issue in Workersâ Compensation Mental Disability Cases: an Analysis, So *1212 lutions, and a Perspective, 36 Vand. L.Rev. 263, 288 (1983); see id. at 288 n. 104 (citing supportive cases). Joseph further explains how courts can appropriately deal with predisposition:
Courts generally have recognized â consistent with present medical knowledge â that an individualâs personal psychological disposition in part causes employment related mental injuries. Accordingly, courts have interpreted the arise-out-of employment requirement to account for this element of personal susceptibility. This interpretation arises from the axiom in workersâ compensation law that employers must take employees as they are â with their personal bodily and mental deficiencies. Therefore, the appropriate arise-out-of employment inquiry in mental disability eases is whether the workersâ employment aggravates, accelerates, or combines with his personal mental disposition to produce his disability.
Id. at 299.
Both Larson and Joseph cite to numerous cases throughout the country that recognize physical-mental claims without imposition of an objective test. A review of some of them demonstrates that while courts may apply slightly different language in the causation standard, they are straightforward tests that connect disability to the accident. For example, in Gartrell v. Depât of Correction, 259 Conn. 29, 787 A.2d 541, 548-49 (C2002), the Connecticut Supreme Court agreed with the plaintiff that the aggravation of a preexisting psychiatric condition was compensable as a distinct injury when it was the direct consequence of a work-related physical injury; the court so held in part in recognition of âa fundamental tenet of workersâ compensation law ... that an employer takes the employee in the state of health in which if finds the employee.â Id. at 549 (internal quotation omitted). Regarding a causal standard, the court held that the physical injury had to be a âbut forâ cause of the aggravation. Id.
In Illinois, psychological disabilities are compensable where a physical injury is a causative factor:
[A] disability caused by a neurosis is compensable if it resulted from an accidental injury. The work-related accident need not be the sole causative factor of the neurosis but need be only a causative factor of the condition. Further, even where the psychological condition was a preexisting one, if the work-related accident aggravated the condition, it is compensable.
Amoco Oil Co. v. Industrial Commân, 218 Ill.App.3d 737, 161 Ill.Dec. 397, 578 N.E.2d 1043, 1050 (1991) (internal citations omitted). 19 Illinoisâs ready compensation of physical-mental claims dates back at least to 1924. See United States Fuel Co. v. Industrial Commân, 313 Ill. 590, 145 N.E. 122, 123 (1924) (âIt is immaterial whether this [permanent incapacity to work] is caused by a physical injury or a mental disorder resulting from the injury.â).
The case of Love v. McDonaldâs Restaurant illustrates an example of another court that struggled to reach a proper standard in physical-mental claims. See 13 Kan.App.2d 397, 771 P.2d 557 (1989). In Love, the claimant fell down some stairs at work and later claimed that her neurosis was connected to that workplace accident. Id. at 558. Kansasâs early cases *1213 had involved physical injuries, wherein the court applied the rule that the neurosis was compensable if directly traceable to the physical injury. Id. The court then considered mental-mental claims and added a causal element that sought to link the workplace to the ultimate disability. Id. This was because the statute specifically called for âpersonal injury by accident;â thus, absent the accident, the court imposed a causal connection requirement linking the claimed emotional disability to the workplace environment â a clearly distinct test for the distinct situation presented by gradual stress mental-mental claims. However, in a later case, the court then conflated the two tests, such that âtraumatic neurosis was compensable only if the mental disability [was] directly traceable to a work-related physical injury and could also be causally connected to the conditions and requirements of claimantâs job.â Id. at 559 (emphasis in Love; internal quotation and citation omitted). The appeals court in Love rejected the conflated test and returned to the straightforward requirement that the disability be directly traceable to a workplace accident. Id. at 560.
This case further supports the distinction between physical-mental and mental-mental claims. The Kansas courts only created a new causal test in the absence of the physical accident because it was only then that work-connectedness was in doubt. If the employee proves the disability and proves that it is connected to a physical workplace accident (âdirectly traceableâ in Kansas; âcausative factorâ in Illinois; âbut forâ in Connecticut), then there is no problem establishing that the disability arose out of employment.
III.
The objective test as applied cannot be reconciled with the clear language of either the WCA or the CMPA, both of which provide in straightforward language that the Acts compensate workers for injuries they suffer on the job. The WCA covers â[t]he injury or death of an employee that occurs in the District of Columbia if the employee performed work for the employer, at the time of the injury or death, while in the District of Columbia,â D.C.Code § 32-1503(a)(l), while the CMPA covers âthe disability or death of an employee resulting from personal injury sustained while in the performance of his or her duty,â D.C.Code § 1-623.02. Further, the test as applied fails to meet the humanitarian purpose of the statute, it neglects to award compensation in arguable cases, and it is contrary to the aggravation rule and the general principle that employers must accept employees as they find them. Moreover, as demonstrated above, it is simply unnecessary in physical-mental cases because the accident supplies the necessary objective work connection. Accordingly, the test must be overturned.
Though the workplace accident supplies the necessary and objective workplace connection, the claimant must still ultimately prove that his or her disability is causally connected to that accident. While a review of decisions from other jurisdictions reveals different terminology for defining causation in this context, those jurisdictions do not offer any particular reason for adopting any particular test (e.g., âbut for,â âcausative factor,â âdirectly traceableâ). Thus, we hold that it is appropriate to apply the causal standards seen throughout D.C. workersâ compensation cases. In cases where the statutory presumption is applicable, the claimant must show that the physical accident had the potential of resulting in or contributing to the psychological injury. See Smith, supra, 934 A.2d at 435 (quoting Mexicano v. District of Columbia Depât of *1214 Employment Servs., 806 A.2d 198, 204 (D.C.2002)) (â âTo benefit from the statutory presumption, the employee need only show some evidence of a disability and a work-related event or activity which has the potential of resulting in or contributing to the disability.â â). Where the presumption is either inapplicable or has been rebutted, the burden falls on the claimant to prove by a preponderance of the evidence that the physical accident caused or contributed to the psychological injury. See Washington Post v. District of Columbia Depât of Employment Servs., 852 A.2d 909, 911 (D.C.2004). In determining whether a claimant has met his or her burden, a hearing examiner must weigh and consider the evidence as well as make credibility determinations. In this regard, the examiner may of course consider the reasonableness of the testimony and whether or not particular testimony has been contradicted or corroborated by other evidence.
While neither the West case nor the application of the objective test to mental-mental claims is squarely before the court in this case, our analysis in this ease necessarily affects the scope of the objective standard in mental-mental cases as well. The reason that the objective test is unnecessary in the physical-mental contextâ that the physical accident supplies the necessary work-connection-flows back to Dai-leyâs conflation of the desire for objective verification of a work-related event with the Directorâs concern that an employeeâs predisposition to mental injury would make the determination that the disability was caused by workplace stress more difficult. In some mental-mental claims, this objectively verifiable work connection may be far less apparent; thus, the imposition of a carefully crafted test to establish the necessary connection between mental injury and work may be appropriate for such cases. We do not purport to say here what such a test should be. However, any test that prevents persons predisposed to psychological injury from recovering in all cases is inconsistent with the legislative history and humanitarian purpose of the D.C. WCA and CMPA. Accordingly, if the Board decides that a special test for mental-mental claims remains desirable, it must be one focused purely on verifying the factual reality of stressors in the workplace environment, rather than one requiring the claimant to prove that he or she was not predisposed to psychological injury or illness, or that a hypothetical average or healthy person would have suffered a similar psychological injury, before recovery is authorized. 20
Although we defer to an Agencyâs reasonable interpretation of the statute it is empowered to administer, we cannot defer when the interpretation is inconsistent with the language and purpose of the statute. Because the objective test, as applied to physical-mental claims, is inconsistent with the language of the WCA and the CMPA and is contrary to the purposes underlying the Districtâs workersâ compensation laws, it is unreasonable and therefore its use must be overturned. Accordingly, the decision of the Director is reversed and the case is remanded for further proceedings consistent with this opinion.
So ordered.
. Ms. McCameyâs condition was further aggravated by the death of her mother.
. Although the ALJ did not expressly so state, it appears that he credited Dr. HammiUâs opinion over that of Dr. Smoller.
. A presumption of compensability applies within the context of the aggravation rule:
Under this jurisdictionâs "aggravation rule,â there is no question that "a particular medical condition [that] is a result of the compensable work injuryâ may itself be compensable and thus covered by the presumption. Where there is a dispute ... about whether the disabling aggravated condition ... is causally related to or "arose out ofâ the claimantâs employment, the presumption applies and is triggered if the claimant produces "some evidenceâ of the two basic facts described in Ferreira.
Whittaker v. District of Columbia Depât of Employment Servs., 668 A.2d 844, 846-47 (D.C. 1995).
. According to Larson, "[t]he preexisting condition may be any kind of weakness.... It may be mental or nervous in character." 1 Larsonâs, supra, at § 9.02[3]; see id. at § 9.02D[3] at D9-77 (citing cases).
. Relevant to this case, Larson notes, in the section on subsequent injuries, â[t]he situation is no different when the subsequent complication takes the form of a neurosis rather than a physical exacerbation.â 1 Larsonâs, supra, at § 10.02 (2007).
. However, "[njotwithstanding the statutory presumption of compensability, the burden ultimately falls on the claimant to show by a preponderance of the evidence that his or her disability was caused by a work-related injury.â Washington Hosp. Ctr. v. District of Columbia Depât of Employment Servs., 744 A.2d 992, 998 (D.C.2000).
. The CMPA was "enacted to create a modern, flexible, and comprehensive system of public personnel administration in the District of Columbia government.â Council of School Officers v. Vaughn, 553 A.2d 1222, 1225 (D.C.1989).
. By contrast, the WCA covers â[t]he injury or death of an employee that occurs in the District of Columbia if the employee performed work for the employer, at the time of the injury or death, while in the District of Columbia.â D.C.Code § 32 â 1503(a)(1).
. We note as well that the D.C. Council has amended the CMPA on more than one occasion to align it more closely with the WCA. See Report of the Council of the District of *1200 Columbia, Bill No. 8-74, District of Columbia Workers' Compensation Equity Amendment Act of 1990 (July 6, 1990) [D.C. Law No. 8-198] at 3 (explaining that the purpose of the Bill "is to amend the District of Columbia Workersâ Compensation Act of 1979 (âActâ) and title 23 of the District of Columbia Merit Personnel Act of 1978 in order to standardize certain workersâ compensation benefits of public and private employees in the District of Columbia (âDistrictâ), promote a fairer system of compensation, and establish a commission for the review of the procedure and method of rate making for the District.ââ); Report of the Council of the District of Columbia, Bill No. 12-618, Fiscal Year 1999 Budget Support Act of 1998 (May 5, 1998) [D.C. Law No. 12-175] at 12 ("Section 2102 [of the Bill] amends provisions in the CMPA that establish the disability program for District employees. The amendments are designed to make disability hearing procedures for public employees substantially similar to the procedures for private employees under the workersâ compensation statute. They are intended to make the procedures speedier and to permit the District, as employer, the same rights to present evidence and to appeal decisions to which private sector employers are entitled.").
. "If an employee receives an injury, which combined with a previous occupational or nonoccupational disability or physical impairment causes substantially greater disability or death, the liability of the employer shall be as if the subsequent injury alone caused the subsequent amount of disability....â D.C.Code § 32-1508(6)(A).
. The CMPA and the FECA provisions regarding compensation for disability or death of an employee and their definitions of âinjuryâ are identical. Compare D.C.Code §§ 1-623.02, -623.05(5), with 5 U.S.C. §§ 8102, 8101(5).
. See 5 U.S.C. § 8149.
. The Director recognized the alteration of the test:
The objective standard which the Director establishes in this decision is a departure from the Chaney decision which only uses an objective standard to determine whether there are actual specific articulable sources of stress in the work place. Assuming that an actual specific articulable source of stress is identified and established, and assuming that the medical evidence establishes a causal connection between the actual specific articulable source of stress and the alleged work injury, Chaney would allow for a finding that the injury arose out of the employment even if the source of stress would not have affected a person who was not predisposed to the particular injury.
Dailey, supra, at *8 n. 1.
. In Dailey, the Director confirmed that aggravation of pre-existing injuries via workplace accidents is compensable; however, the Director suggested its application was inappropriate in that case because the claimant could not establish legal causation â that is, that the examiner had found that the claimantâs mental injury was "caused by her own personal make up and non-work related factors, as opposed to being caused by events or conditions of her employment.â Dailey, supra, at **10-11. Thus, under this reading, the claimant would have to prove a connection between her mental injury' and the workplace environment by showing that someone who was not predisposed would have suffered her injuries. If she demonstrated that the hypothetical person would have so suffered, then she receives compensation despite her predis *1206 position because the pre-existing injury would have been shown to have been aggravated by a work-place condition.
. However, another possible interpretation is that the hearing examinerâs conclusion that the injury "related solely toâ her preexisting disorder demonstrates a factual credibility determination finding that the employerâs psychiatrist fully rebutted the petitionerâs evidence of causal connection. Thus, it is possible that the hearing examiner or director may have reached a different conclusion had the examiner believed that the gurney incident contributed to the injury. As the court in Porter notes, the hearing examiner issued her findings three months prior to the Directorâs Dailey decision. See Porter, supra, 625 A.2d at 889 n. 3.
. "While the Director readily agrees that a work related aggravation of a pre-existing condition can be compensable under the law of workersâ compensation, in this case, there was a specific finding that claimantâs injury did not arise out of her employment. In other words, to say that oneâs working conditions have aggravated a pre-existing condition, presupposes that legal causation has already been established between the pre-existing condition and the injury which is attributed to the employment conditions; but in this case, legal causation was never established. The thrust of the Hearing Examinerâs finding was that whatever emotional problems claimant experienced were caused by her own personal make up and non-work related factors, as opposed to being caused by events or conditions of her employment.â Dailey, supra, at 10-11.
. Review of this case is currently pending before this court.
. Amoco features similarities to Ms. McCam-eyâs situation. In Amoco, the claimant had a pre-existing psychological condition, but the condition was never so disabling as to prevent him from working. See 161 Ill.Dec. 397, 578 N.E.2d at 1050. The claimantâs mental condition, however, deteriorated after the work-related accident. Id.
. The issue is discussed at length in Larson, supra, at § 56.06.