Lucas Peterson, Respondent, vs. City of Minneapolis, Self-Insured, Relator
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Opinion
STATE OF MINNESOTA
IN SUPREME COURT
A24-1205
Workers’ Compensation Court of Appeals Gaïtas, J. Concurring in part, dissenting in part, Moore, III, Thissen, JJ. Lucas Peterson,
Respondent,
vs. Filed: July 16, 2025 Office of Appellate Courts City of Minneapolis, Self-Insured,
Relator.
________________________
Ashley N. Biermann, Alexa R. Hottle, Meshbesher & Spence, Minneapolis, Minnesota, for respondent.
Jeffrey J. Lindquist, Anthony Gabor, Justine K. Wagner, Gries Lenhardt Allen, P.L.L.P., Saint Michael, Minnesota, for relator.
Paul A. Merwin, Patricia Y. Beety, General Counsel, League of Minnesota Cities, Saint Paul, Minnesota, for amicus curiae League of Minnesota Cities.
Timothy P. Jung, Lind Jensen Sullivan & Peterson, Minneapolis, Minnesota, for amicus curiae Minnesota Counties Intergovernmental Trust.
Joshua W. Laabs, Minnetonka, Minnesota; and
Lindsey M. Rowland, Meuser, Yackley & Rowland, Eden Prairie, Minnesota, for amicus curiae Minnesota Association for Justice.
1 SYLLABUS
1. The Workers’ Compensation Court of Appeals did not err in affirming the
compensation judge’s finding that the employee has a compensable mental injury because
that finding is not manifestly contrary to the evidence, which included testimony by a
licensed professional psychologist that, based on the most recent edition of the Diagnostic
and Statistical Manual of Mental Disorders, the employee has a present diagnosis of
post-traumatic stress disorder (PTSD).
2. The Workers’ Compensation Court of Appeals erred in addressing the
employee’s argument that he was entitled to compensation benefits for a diagnosis of other
specified trauma and stressor-related disorder (OSTD) as a consequential mental injury of
PTSD because that issue was moot given the record here, where the employee’s expert
psychologist opined that the employee’s OSTD diagnosis was “subthreshold PTSD” and
the Workers’ Compensation Court of Appeals decided that the employee is entitled to
compensation benefits for a present diagnosis of PTSD.
3. The Workers’ Compensation Court of Appeals did not err in affirming the
compensation judge’s award of a penalty for frivolous denial of primary liability.
Affirmed in part and reversed in part.
OPINION
GAÏTAS, Justice.
In this case, we are asked to decide whether the Workers’ Compensation Court of
Appeals (WCCA) erred in affirming the compensation judge’s determination that the
employee, Lucas Peterson, is entitled to workers’ compensation benefits under Minnesota
2 Statutes section 176.66 (2024) for a mental impairment. We are further asked to decide
whether the WCCA erred in affirming the compensation judge’s award of penalties against
the employer, City of Minneapolis. The City argues that the WCCA committed errors of
law by (1) affirming the compensation judge’s determination that Peterson is entitled to
workers’ compensation benefits for a present diagnosis of post-traumatic stress disorder
(PTSD); (2) sua sponte referring the case back to the compensation judge for a finding
regarding Peterson’s claim for benefits based on a diagnosis of other specified trauma and
stressor-related disorder (OSTD) as a consequential mental injury of PTSD; (3) affirming
the compensation judge’s determination following the referral that Peterson is entitled to
workers’ compensation benefits for OSTD as a consequential mental injury of PTSD; and
(4) affirming the compensation judge’s award of penalties against the City for frivolous
denial of liability. We conclude that the WCCA did not err by affirming the compensation
judge’s determination that Peterson is entitled to workers’ compensation benefits for a
present diagnosis of PTSD or by affirming the award of penalties, and thus, we affirm its
decision in part. But because the WCCA erred when it decided that Peterson is also entitled
to workers’ compensation benefits for OSTD, even though that issue was moot, we reverse
in part.
FACTS
Respondent Lucas Peterson worked as a police officer for relator City of
Minneapolis for 22 years. In 2021, Peterson informed the City that he could no longer
3 serve as a police officer due to PTSD,1 and he sought workers’ compensation benefits. The
City denied liability, and Peterson filed a claim petition. Following a hearing, a workers’
compensation judge ruled that Peterson was entitled to benefits and awarded penalties
against the City for frivolously denying benefits. The WCCA affirmed. In this appeal, the
City challenges the decision of the WCCA.
Based on the record before us, the relevant facts are as follows. The City of
Minneapolis hired Peterson in 1999 as a community service officer. Before beginning his
employment, Peterson underwent a pre-employment mental health exam by a licensed
psychologist. The psychologist reported that Peterson “[did] not appear to have any
significant personality or emotional problems.” After serving as a community service
officer for approximately one year, the City hired Peterson to be a patrol officer. He
underwent another pre-employment mental health exam. Again, the evaluating
psychologist reported that Peterson “[did] not appear to have any significant personality or
emotional problems.”
In 2003, Peterson joined the Minneapolis Police Department’s special weapons and
tactics (SWAT) team. He later served as a sergeant and supervisor with the SWAT team.
During Peterson’s 22 years with the police department, he experienced numerous
traumatic events. Peterson estimated that he responded to 30 to 50 homicide calls—five
or six involving the death of a child. He responded to a mass shooting with an active
1 PTSD is a mental health disorder that can develop after an individual is exposed to traumatic events. Am. Psychiatric Ass’n, Diagnostic and Statistical Manual of Mental Disorders, Text Revision 301–03 (5th ed. 2022) (DSM-5-TR). Symptom presentation and severity vary widely depending on the individual. See id.
4 shooter. And he was present for 10 to 15 officer-involved shootings. According to
Peterson, he feared for his life and the lives of others on multiple occasions while
performing his job.
In March 2021, Peterson began twice-weekly therapy with a counselor. At the
therapist’s recommendation, Peterson visited a physician, who diagnosed him with anxiety
related to his work. Following that diagnosis, Peterson hired a lawyer to pursue workers’
compensation benefits.
A licensed psychologist, Dr. John Cronin, performed an extensive evaluation of
Peterson in May and June 2021. In a report dated June 21, 2021, Dr. Cronin diagnosed
Peterson with PTSD and recommended that Peterson stop working as a police officer.
Peterson notified the City that he was unable to work as of May 2021, due to PTSD, and
he sought workers’ compensation benefits.
In September 2021, the City denied primary liability for Peterson’s PTSD claim,
maintaining that Peterson did not meet the criteria for a PTSD diagnosis and that any
presumption of compensability did not apply. See Minn. Stat. § 176.011, subd. 15(e)
(2024)2 (establishing a presumption—for certain active-duty employees, including police
officers—that PTSD is “an occupational disease and shall be presumed to have been due
to the nature of employment” so long as the employee “had not been diagnosed with
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STATE OF MINNESOTA
IN SUPREME COURT
A24-1205
Workers’ Compensation Court of Appeals Gaïtas, J. Concurring in part, dissenting in part, Moore, III, Thissen, JJ. Lucas Peterson,
Respondent,
vs. Filed: July 16, 2025 Office of Appellate Courts City of Minneapolis, Self-Insured,
Relator.
________________________
Ashley N. Biermann, Alexa R. Hottle, Meshbesher & Spence, Minneapolis, Minnesota, for respondent.
Jeffrey J. Lindquist, Anthony Gabor, Justine K. Wagner, Gries Lenhardt Allen, P.L.L.P., Saint Michael, Minnesota, for relator.
Paul A. Merwin, Patricia Y. Beety, General Counsel, League of Minnesota Cities, Saint Paul, Minnesota, for amicus curiae League of Minnesota Cities.
Timothy P. Jung, Lind Jensen Sullivan & Peterson, Minneapolis, Minnesota, for amicus curiae Minnesota Counties Intergovernmental Trust.
Joshua W. Laabs, Minnetonka, Minnesota; and
Lindsey M. Rowland, Meuser, Yackley & Rowland, Eden Prairie, Minnesota, for amicus curiae Minnesota Association for Justice.
1 SYLLABUS
1. The Workers’ Compensation Court of Appeals did not err in affirming the
compensation judge’s finding that the employee has a compensable mental injury because
that finding is not manifestly contrary to the evidence, which included testimony by a
licensed professional psychologist that, based on the most recent edition of the Diagnostic
and Statistical Manual of Mental Disorders, the employee has a present diagnosis of
post-traumatic stress disorder (PTSD).
2. The Workers’ Compensation Court of Appeals erred in addressing the
employee’s argument that he was entitled to compensation benefits for a diagnosis of other
specified trauma and stressor-related disorder (OSTD) as a consequential mental injury of
PTSD because that issue was moot given the record here, where the employee’s expert
psychologist opined that the employee’s OSTD diagnosis was “subthreshold PTSD” and
the Workers’ Compensation Court of Appeals decided that the employee is entitled to
compensation benefits for a present diagnosis of PTSD.
3. The Workers’ Compensation Court of Appeals did not err in affirming the
compensation judge’s award of a penalty for frivolous denial of primary liability.
Affirmed in part and reversed in part.
OPINION
GAÏTAS, Justice.
In this case, we are asked to decide whether the Workers’ Compensation Court of
Appeals (WCCA) erred in affirming the compensation judge’s determination that the
employee, Lucas Peterson, is entitled to workers’ compensation benefits under Minnesota
2 Statutes section 176.66 (2024) for a mental impairment. We are further asked to decide
whether the WCCA erred in affirming the compensation judge’s award of penalties against
the employer, City of Minneapolis. The City argues that the WCCA committed errors of
law by (1) affirming the compensation judge’s determination that Peterson is entitled to
workers’ compensation benefits for a present diagnosis of post-traumatic stress disorder
(PTSD); (2) sua sponte referring the case back to the compensation judge for a finding
regarding Peterson’s claim for benefits based on a diagnosis of other specified trauma and
stressor-related disorder (OSTD) as a consequential mental injury of PTSD; (3) affirming
the compensation judge’s determination following the referral that Peterson is entitled to
workers’ compensation benefits for OSTD as a consequential mental injury of PTSD; and
(4) affirming the compensation judge’s award of penalties against the City for frivolous
denial of liability. We conclude that the WCCA did not err by affirming the compensation
judge’s determination that Peterson is entitled to workers’ compensation benefits for a
present diagnosis of PTSD or by affirming the award of penalties, and thus, we affirm its
decision in part. But because the WCCA erred when it decided that Peterson is also entitled
to workers’ compensation benefits for OSTD, even though that issue was moot, we reverse
in part.
FACTS
Respondent Lucas Peterson worked as a police officer for relator City of
Minneapolis for 22 years. In 2021, Peterson informed the City that he could no longer
3 serve as a police officer due to PTSD,1 and he sought workers’ compensation benefits. The
City denied liability, and Peterson filed a claim petition. Following a hearing, a workers’
compensation judge ruled that Peterson was entitled to benefits and awarded penalties
against the City for frivolously denying benefits. The WCCA affirmed. In this appeal, the
City challenges the decision of the WCCA.
Based on the record before us, the relevant facts are as follows. The City of
Minneapolis hired Peterson in 1999 as a community service officer. Before beginning his
employment, Peterson underwent a pre-employment mental health exam by a licensed
psychologist. The psychologist reported that Peterson “[did] not appear to have any
significant personality or emotional problems.” After serving as a community service
officer for approximately one year, the City hired Peterson to be a patrol officer. He
underwent another pre-employment mental health exam. Again, the evaluating
psychologist reported that Peterson “[did] not appear to have any significant personality or
emotional problems.”
In 2003, Peterson joined the Minneapolis Police Department’s special weapons and
tactics (SWAT) team. He later served as a sergeant and supervisor with the SWAT team.
During Peterson’s 22 years with the police department, he experienced numerous
traumatic events. Peterson estimated that he responded to 30 to 50 homicide calls—five
or six involving the death of a child. He responded to a mass shooting with an active
1 PTSD is a mental health disorder that can develop after an individual is exposed to traumatic events. Am. Psychiatric Ass’n, Diagnostic and Statistical Manual of Mental Disorders, Text Revision 301–03 (5th ed. 2022) (DSM-5-TR). Symptom presentation and severity vary widely depending on the individual. See id.
4 shooter. And he was present for 10 to 15 officer-involved shootings. According to
Peterson, he feared for his life and the lives of others on multiple occasions while
performing his job.
In March 2021, Peterson began twice-weekly therapy with a counselor. At the
therapist’s recommendation, Peterson visited a physician, who diagnosed him with anxiety
related to his work. Following that diagnosis, Peterson hired a lawyer to pursue workers’
compensation benefits.
A licensed psychologist, Dr. John Cronin, performed an extensive evaluation of
Peterson in May and June 2021. In a report dated June 21, 2021, Dr. Cronin diagnosed
Peterson with PTSD and recommended that Peterson stop working as a police officer.
Peterson notified the City that he was unable to work as of May 2021, due to PTSD, and
he sought workers’ compensation benefits.
In September 2021, the City denied primary liability for Peterson’s PTSD claim,
maintaining that Peterson did not meet the criteria for a PTSD diagnosis and that any
presumption of compensability did not apply. See Minn. Stat. § 176.011, subd. 15(e)
(2024)2 (establishing a presumption—for certain active-duty employees, including police
officers—that PTSD is “an occupational disease and shall be presumed to have been due
to the nature of employment” so long as the employee “had not been diagnosed with
2 Throughout this opinion, we apply the statutes in effect on Peterson’s date of injury, May 26, 2021, which is the date Peterson stopped working as a police officer. See Joyce v. Lewis Bolt & Nut Co., 412 N.W.2d 304, 307 (Minn. 1987) (explaining that workers’ compensation cases are governed by “the law in effect on the date of the controlling event,” which is the date of “the most recent occurrence of a compensable personal injury”). The parties do not dispute the date of injury.
5 [PTSD] previously”). To rebut any presumption of compensability, the City alleged that
Peterson had a history of mental health conditions before his employment. See id.
(providing that the presumption “may be rebutted by substantial factors brought by the
employer or insurer”). The City did not investigate Peterson’s claim at that time.
Peterson filed a claim petition with the Office of Administrative Hearings on
November 8, 2021, claiming entitlement to workers’ compensation benefits as a result of
a work-related PTSD diagnosis with a May 26, 2021 date of injury.
The City hired Dr. Kenneth Ray Young, a licensed psychologist, to perform
an independent psychological examination of Peterson on March 12, 2022. Dr. Young
issued a report concluding that Peterson did not satisfy the criteria for a PTSD diagnosis or
any other mental health disorder under the Diagnostic and Statistical Manual of Mental
Disorders (5th ed. 2013) (DSM-5).3
At the request of Peterson’s attorney, another licensed psychologist, Dr. Kasey
Aleknavicius, performed an independent psychiatric evaluation of Peterson on May 25,
2022, and issued a written report. Her written report stated that Peterson did not presently
meet the criteria for a PTSD diagnosis under the DSM-5, “likely due to his participation in
treatment during the last year.” But Dr. Aleknavicius’s report determined that Peterson did
3 The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook used by medical professionals to assist in the diagnosis of patients’ mental disorders. See Smith v. Carver County, 931 N.W.2d 390, 397 (Minn. 2019). PTSD is defined by Minnesota statute as “the condition as described in the most recently published edition of the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association.” Minn. Stat. § 176.011, subd. 15(d) (2020). It is the only mental impairment recognized as an occupational disease for the purposes of Minnesota’s workers’ compensation law. See id.
6 previously meet the full criteria for PTSD under the DSM-5, citing to an assessment dated
May 3, 2021, which diagnosed Peterson with PTSD, and Dr. Cronin’s June 21, 2021 report.
Dr. Aleknavicius concluded that Peterson currently met the DSM-5 criteria for OSTD,
which her report characterized as “subthreshold PTSD.” Dr. Aleknavicius opined in her
report that Peterson’s OSTD was a “direct result” of Peterson’s “previous PTSD
diagnosis.” Her report noted that the diagnosis of OSTD “is consistent with repeated
exposure to aversive details of trauma, witnessing trauma as it occurred to others, and
fearing for his own safety, and that of others, while performing his duties as a police officer
for the [Minneapolis Police Department].” Dr. Aleknavicius’s report further explained
that, although Peterson’s consistent mental health treatment helped “reliev[e] the
severity/frequency of some symptoms,” he was still experiencing “persisting symptoms”
that “continue[d] to result in significant distress and impairment in his occupational and
social functioning.”
Following Dr. Aleknavicius’s report, Peterson filed an amended claim petition on
November 7, 2022. The amended petition claimed that Peterson was entitled to
compensation benefits as a result of the May 26, 2021 PTSD injury. And it alleged a new
claim of consequential injury in the nature of OSTD.
Proceedings Before the Compensation Judge
The compensation judge held a hearing on March 23 and April 27, 2023, to
determine Peterson’s eligibility for workers’ compensation benefits.
Peterson and his wife testified on the first day of the hearing. During Peterson’s
testimony, he described his work as a Minneapolis police officer, the traumatic incidents
7 he experienced at work, and the onset and exacerbation of his mental health symptoms. He
testified that he has improved with therapy, but he still has poor concentration, negative
thoughts, loss of empathy, sleep disturbance, anxiety, depression, feelings of isolation, and
unregulated anger and emotions. Peterson’s wife testified that she has been married to
Peterson since 2006. She explained that she observed significant changes in Peterson’s
demeanor and behavior over the course of his work as a police officer.
On the second day of the hearing, Dr. Aleknavicius testified on behalf of Peterson,
and Dr. Young testified on behalf of the City. They offered diverging opinions about
Peterson’s mental health.
Dr. Aleknavicius described her process of evaluating Peterson and her conclusions.
She testified that, in her opinion, “the stressors that [Peterson] . . . experienced and had
exposure to in his career [were] more than [she] would say [w]as typical in the first
responders that [she had] assessed or treated.”
Dr. Aleknavicius agreed that Peterson met the criteria for PTSD when he was
initially diagnosed in May 2021. But she testified that when she evaluated Peterson in
May 2022 using the DSM-5—the version of the DSM in effect at that time—she
determined that Peterson no longer satisfied the criteria for a diagnosis of PTSD. This was
because some of Peterson’s symptoms had improved due to therapy and treatment, and
they no longer met “the threshold during the last month to be endorsed as a current
symptom of PTSD.” Dr. Aleknavicius testified that an OSTD diagnosis “is a DSM-5
diagnosis that was added as a way to describe other individuals who don’t quite meet the
full criteria for PTSD.” She explained that PTSD can “cause” OSTD, describing Peterson’s
8 OSTD as “subthreshold PTSD” caused by “persisting PTSD symptoms.” Dr. Aleknavicius
elaborated that, in such cases, “the PTSD hasn’t quite resolved itself, but it’s not meeting
the full criteria. So what happens is that as a result, [the person] now ha[s] [OSTD].” Dr.
Aleknavicius testified that, despite Peterson’s improvement, he remained impaired when
she evaluated him because other symptoms persisted, including avoidance of
trauma-related reminders and intrusive experiences. According to Dr. Aleknavicius, at the
time of her evaluation, Peterson’s symptoms were “subthreshold . . . not quite meeting full
criteria and full threshold for PTSD.” Therefore, her written evaluation diagnosed Peterson
with OSTD, “specifically specifying subthreshold PTSD.”
However, Dr. Aleknavicius testified that after she prepared her written report, she
learned that there was a “text revision” of the DSM-5.4 According to Dr. Aleknavicius, the
most recent version of the DSM was no longer the DSM-5, which she had relied on at the
time of Peterson’s evaluation and her written report. Instead, at the time of the hearing
before the compensation judge in 2023, the most recent version was the DSM-5-TR. See
Am. Psychiatric Ass’n, Diagnostic and Statistical Manual of Mental Disorders, Text
Revision (5th ed. 2022) (DSM-5-TR). Dr. Aleknavicius testified that the DSM-5-TR did
not include changes to the diagnostic criteria, but it did include changes to the text. And
given changes to the text in the PTSD section of the DSM-5-TR, Dr. Aleknavicius revised
4 Dr. Aleknavicius testified that the DSM-5-TR was published in March 2022, which was a few months before her evaluation of Peterson.
9 her diagnosis of Peterson to be a present diagnosis of PTSD.5 She explained that the text
revision to the PTSD section states that for a “lifetime diagnosis” of PTSD “there must be
a period of time lasting more than one month during which criterion B, C, D, and E have
all been met for the same one[-]month period of time.”6 Dr. Aleknavicius testified that,
because Peterson previously met all criteria for a diagnosis of PTSD for more than a one-
month period, and “[h]e continues to meet some but not all of the criteria for PTSD,” he
has a present diagnosis of PTSD “based on the lifetime diagnosis” provision in the
DSM-5-TR.
In Dr. Aleknavicius’s opinion, Peterson should never return to a job in law
enforcement in any capacity. She testified that Peterson would be at “significant risk for
additional trauma or exposure and worsening of [his] symptoms or reoccurrence of [his]
symptoms.” However, Dr. Aleknavicius stated, “The only work restriction I issued was
not to return to work in law enforcement as a first responder or in any safety sensitive
position.” She opined that Peterson could return to full-time work in another field. Dr.
Aleknavicius recommended that Peterson continue to treat his ongoing symptoms.
5 The City objected to Dr. Aleknavicius’s revised opinion testimony. But the compensation judge permitted it, in part, because the City’s expert, Dr. Young, appeared at the hearing and would have an opportunity to rebut Dr. Aleknavicius’s testimony. 6 Criterion B concerns intrusion symptoms associated with the traumatic event(s) (e.g., recurrent distressing dreams or memories, dissociative flashbacks). Am. Psychiatric Ass’n, Diagnostic and Statistical Manual of Mental Disorders, Text Revision 301 (5th ed. 2022). Criterion C concerns persistent avoidance of stimuli associated with the traumatic event(s). Id. at 302. Criterion D concerns negative changes in thinking and mood associated with the traumatic event(s). Id. Criterion E includes trauma-related reactivity, such as irritability, aggression, or risky behavior. Id.
10 The City’s expert, Dr. Young, testified that, in his opinion, Peterson “didn’t meet
criteria for any mental health disorder” at the time of his evaluation. He also disagreed
with the two experts who had diagnosed Peterson with PTSD. Dr. Young criticized the
methodologies and conclusions of both Dr. Aleknavicius and Dr. Cronin, the psychologist
who evaluated Peterson in 2021.
As to his own evaluation of Peterson, Dr. Young observed that Peterson
demonstrated no difficulty discussing the traumatic events he had experienced as a police
officer. In his view this was atypical for someone with PTSD. He acknowledged that
Peterson had some symptoms related to PTSD. But he did not believe that Peterson
satisfied the criteria for a PTSD diagnosis.
Dr. Young also disagreed with Dr. Aleknavicius’s testimony that, given the new
language in the DSM-5-TR concerning “lifetime PTSD,” Peterson satisfied the criteria for
a present diagnosis of PTSD. He testified that “lifetime PTSD” is not a diagnosis. Rather,
the term refers to “looking at . . . lifetime prevalence of PTSD or if someone has ever met
criteria for PTSD over the course of their lifetime.”
Finally, Dr. Young disagreed with Dr. Aleknavicius’s opinions regarding OSTD.
He testified that Peterson did not suffer from OSTD. And he disagreed that PTSD causes
OSTD. Dr. Young explained that “trauma-related disorders are more on a spectrum, not
one thing kind of causing another thing.” According to Dr. Young, the DSM-5 requires a
“rule-out”—one trauma disorder does not cause another, but instead, a practitioner must
diagnose one such disorder or another.
11 Following the hearing, the compensation judge issued his findings and order. The
compensation judge found the testimony of Peterson and his wife to be credible. According
to the compensation judge, Peterson experienced nine specific traumatic events while
working as a police officer. Following these events, Peterson “experienced numbness,
disconnection, lack of empathy, isolation, anger, detachment, and depression.” The
compensation judge found that Peterson had been diagnosed with PTSD by several
professionals. As to the opinions of the experts who testified at the hearing, the
compensation judge credited the testimony of Dr. Aleknavicius. The compensation judge
found that her opinions were more persuasive than Dr. Young’s, and the compensation
judge explained the basis for this finding.7 Accordingly, the compensation judge
determined that Peterson “continued to meet the diagnosis of PTSD through the second
day of [the] hearing as that condition is described in the most recently published edition of
the DSM-5-TR.” The compensation judge concluded that the City had failed to rebut the
statutory presumption of compensability, and thus Peterson was entitled to workers’
7 According to the compensation judge, Dr. Aleknavicius’s opinions were more persuasive than Dr. Young’s because (1) Peterson “credibly testified to the gravity of the traumatic events he encountered in his job”; (2) Peterson “credibly testified to his ongoing symptoms”; (3) Peterson’s wife “credibly testified” to Peterson’s “ongoing symptoms”; (4) Dr. Aleknavicius’s opinions are “mostly consistent” with assessments of four other professionals who interacted with Peterson; (5) “Dr. Aleknavicius’[s] opinions comport with [Peterson’s] credible testimony and history of treatment”; and (6) Dr. Young acknowledged that Peterson had experienced traumatic events that would satisfy the first diagnostic criterion for PTSD.
12 Furthermore, the compensation judge found that the City had frivolously denied
payment of disability benefits between June 21, 2021, and March 12, 2022—between the
time of Peterson’s PTSD diagnosis by Dr. Cronin and when the City opposed the diagnosis
following Dr. Young’s examination of Peterson. The compensation judge imposed a
30 percent statutory penalty for the frivolous denial of payment during this period. See
Minn. Stat. § 1 76.225, subd. 1(5) (2024).
Proceedings Before the WCCA
The City appealed the compensation judge’s decision to the WCCA. Before the
WCCA, the City challenged the compensation judge’s (1) finding that Peterson had a
present PTSD diagnosis and (2) award of a penalty for the City’s frivolous denial of
primary liability.
Following oral argument, the WCCA filed an order of referral directing the
compensation judge to make findings based on the existing record regarding whether
Peterson had also experienced a consequential mental injury. The order stated:
Although the [consequential mental injury] issue was prefaced with ‘in the alternative,’ we find it necessary for the [referred] issue listed above to be determined by the compensation judge before this court may make a decision on the employer and insurer’s appeal. This will promote fair and efficient administration of the appeal for all parties.
Subsequently, the compensation judge filed findings on referral from the WCCA.
The compensation judge again found that “[t]he findings and opinions of Dr. Kasey
Aleknavicius were more persuasive than those of Dr. Ken Young.” Additionally, the
compensation judge found that Peterson “sustained a consequential mental health condition
in the nature of [OSTD] as a substantial result of the original PTSD diagnosis.”
13 The WCCA affirmed the decision of the compensation judge in its entirety.
Peterson v. City of Minneapolis, No. WC23-6527, 2024 WL 3363123, at *1 (Minn. WCCA
June 28, 2024). It determined that substantial evidence supported the compensation
judge’s finding that Peterson has a present diagnosis of PTSD. Id. at *15. The WCCA
also determined as a matter of law that once an employee has established a compensable
PTSD injury, any mental health condition substantially caused by, aggravated by, or
accelerated by the PTSD diagnosis is also compensable as a consequential injury, and that
it was reasonable for the compensation judge to find that Peterson’s OSTD condition was
compensable. Id. at *17. Finally, the WCCA determined that the compensation judge did
not clearly err in finding that the City had frivolously denied primary liability, and it
affirmed the compensation judge’s award of a penalty. Id. at *18.
The City appealed the WCCA’s decision by writ of certiorari.8
ANALYSIS
I.
We first consider whether the WCCA erred in affirming the compensation judge’s
decision that Peterson was entitled to workers’ compensation benefits for PTSD. The City
argues that the WCCA “committed errors of law when it determined that an individual who
no longer meets the criteria for PTSD can still qualify for benefits simply because he once
had PTSD.” Peterson responds that the City’s argument does not concern an error of law,
8 In addition to the parties’ briefs, we received amicus curiae briefs from League of Minnesota Cities, Minnesota Counties Intergovernmental Trust, and Minnesota Association for Justice. The Court appreciates the assistance of these organizations in our consideration of the issues presented here.
14 but is instead a challenge to the factual findings of the compensation judge and the WCCA
decision upholding those findings. He points out that an expert testified that he has a
present diagnosis of PTSD based on the most recent edition of the DSM, and thus, the
record supports the finding that he is entitled to workers’ compensation for PTSD.
A.
To determine the applicable standard of review, we must initially decide whether
the City’s argument presents a question of law or a question of fact. We begin our analysis
of this issue by considering the relevant law and the decisions of the lower courts in this
case.
PTSD is the only “mental impairment” recognized by the Workers’ Compensation
Act. Minn. Stat. § 176.011, subd. 15(d) (2024). Under Minnesota law, when a police
officer experiences PTSD and has not been previously diagnosed with this condition, there
is a presumption that it is an occupational disease “due to the nature of employment.” Id.,
subd. 15(e). A compensation judge can award compensation for PTSD if the employee
proves that “(1) a psychiatrist or psychologist has diagnosed the employee with PTSD, and
(2) the professional based the employee’s diagnosis on the latest version of the DSM.”
Chrz v. Mower County, 986 N.W.2d 481, 485 (Minn. 2023). When medical experts offer
divergent diagnoses, the compensation judge must first decide whether the experts’
opinions “have adequate foundation.” Tea v. Ramsey County, 5 N.W.3d 114, 120
(Minn. 2024) (citation omitted) (internal quotation marks omitted). If there is adequate
foundation, the compensation judge must then “decide which of the professional diagnoses
is more credible and persuasive.” Id. (citation omitted) (internal quotation marks omitted).
15 Here, two licensed psychologists performed independent psychological
examinations of Peterson and offered conflicting opinions as to whether he had a present
diagnosis of PTSD. Peterson’s expert, Dr. Aleknavicius, testified that Peterson had a
present diagnosis of PTSD under the most recent version of the DSM. The City’s expert,
Dr. Young, testified that Peterson did not meet the diagnostic criteria for PTSD or any other
mental health disorder.
The compensation judge found that Dr. Aleknavicius’s opinions were more credible
and persuasive than Dr. Young’s opinions and explained this finding. Further, the
compensation judge adopted Dr. Aleknavicius’s opinion that Peterson “has PTSD as
described in the most recently published edition of the DSM.” On review, the WCCA
affirmed the compensation judge’s factual findings. Peterson, 2024 WL 3363123,
at *14–15. It determined that substantial evidence in the record—Dr. Aleknavicius’s
testimony—supported the compensation judge’s ultimate factual finding that Peterson has
a current PTSD diagnosis based on the most recent version of the DSM. Id. at *15.
The decisions below were based on the compensation judge’s factual findings as to
“which of the professional diagnoses [was] more credible and persuasive.” Tea, 5 N.W.3d
at 120 (citation omitted) (internal quotation marks omitted). To decide whether the
compensation judge and the WCCA erred in finding that Peterson has a present PTSD
diagnosis that entitles him to workers’ compensation benefits, our review must focus on
the factual findings regarding the experts’ testimony. Thus, we apply our standard of
review for factual findings. See id. at 119–21 (applying the standard of review for factual
16 findings in reviewing the WCCA’s affirmance of the compensation judge’s finding that the
employee has compensable PTSD).
In a workers’ compensation case, our standard of review for factual findings
depends on “whether a conflict exists between the findings of the workers’ compensation
court and the findings of the WCCA.” Lagasse v. Horton, 982 N.W.2d 189, 201
(Minn. 2022). When no conflict exists—as here, where the WCCA affirmed the
compensation judge’s factual findings—we “view the facts in the light most favorable to
the findings and must uphold those findings unless they are ‘manifestly contrary to the
evidence.’ ” Tea, 5 N.W.3d at 119 (quoting Schmidt v. Wal-Mart Stores, 988 N.W.2d 124,
129 (Minn. 2023)). A finding is manifestly contrary to evidence when the evidence
“clearly requires reasonable minds to adopt a contrary conclusion.” Lagasse, 982 N.W.2d
at 202.
B.
Applying this standard of review, we now consider whether the WCCA erred in
affirming the compensation judge’s finding that Peterson has compensable PTSD. As
noted, Dr. Aleknavicius explained during her testimony that Peterson no longer met all of
the diagnostic criteria for PTSD when she evaluated him because some of his symptoms
had improved over time with treatment. But Dr. Aleknavicius testified that a text revision
to the DSM in March 2022 clarified that, when Criteria B, C, D, and E are simultaneously
met for more than one month, they are considered satisfied for an individual’s lifetime.
Dr. Aleknavicius testified that Peterson previously met all of the criteria for PTSD for more
than one month and that he presently satisfied the other criteria necessary for a PTSD
17 diagnosis. Thus, she concluded, Peterson presently has PTSD as defined by the most recent
version of the DSM.
Based on this evidence in the record, we conclude that the finding that Peterson has
a present PTSD diagnosis is not manifestly contrary to the evidence. Stated differently,
the evidence presented does not clearly require “reasonable minds to adopt a contrary
conclusion.” Lagasse, 982 N.W.2d at 202. Although the City introduced conflicting
evidence regarding Peterson’s mental health, the compensation judge was not required to
accept it. Instead, it had authority to decide which expert’s testimony was “more credible
and persuasive.” Tea, 5 N.W.3d at 120 (citation omitted) (internal quotation marks
omitted). The compensation judge determined that Dr. Aleknavicius’s testimony
prevailed. Because the compensation judge’s choice was not clearly unreasonable, the
WCCA’s affirmance of the compensation judge’s finding is not manifestly contrary to the
evidence.
The City argues that this case is “strikingly similar” to Chrz, where we affirmed the
WCCA’s decision that an employee who was previously—but not currently—diagnosed
with PTSD was not entitled to workers’ compensation benefits. 986 N.W.2d at 487. In
Chrz, two psychologists testified before the compensation judge that the employee no
longer met the diagnostic criteria for PTSD. Id. at 483–84. We agreed with the WCCA
that only a present diagnosis of PTSD qualifies as an occupational disease under the
Workers’ Compensation Act. Id. at 486. Here, however, an expert testified that Peterson
did presently meet the diagnostic criteria for PTSD. And the compensation judge expressly
credited that testimony over conflicting expert testimony that Peterson did not meet the
18 criteria for PTSD or any other mental health disorder. Thus, our decision in Chrz does not
control.
The City also challenges the substance of Dr. Aleknavicius’s opinions regarding the
revisions in the DSM-TR-5. It argues that the DSM-TR-5 is not a “new edition” of the
DSM because it is still the “Fifth Edition.”9 It contends that Dr. Aleknavicius
misinterpreted the revised text of the DSM-TR-5, which includes the language regarding
“lifetime PTSD.” And it argues that the opinions of its expert, Dr. Young, are more
consistent with the text of the DSM. But these arguments are challenges to the factual
findings of the compensation judge, which we have already determined are not clearly
unreasonable. Moreover, the City’s arguments suggest that it is appropriate for a
compensation judge or the WCCA to make its own diagnosis of an employee by applying
the DSM or to perform a “legalistic analysis” of the DSM. In Tea, however, we clarified
that a compensation judge’s factual findings “must be in relation to evidence offered by
another medical professional—not based upon the judge’s own application of the DSM
criteria to the employee’s symptoms.” 5 N.W.3d at 122.
Finally, the City suggests that the compensation judge erred by failing to
acknowledge in its factual findings Dr. Young’s “interpretation” of the relevant revisions
to the DSM-5-TR. It further contends that the WCCA’s finding that Dr. Young “offered
no other interpretation of the new text” is manifestly contrary to the evidence. Peterson,
2024 WL 3363123, at *13. We disagree. During his testimony, Dr. Young only briefly
9 Notably, the City’s expert, Dr. Young, acknowledged during his testimony that the DSM-5-TR is the most recent version of the DSM.
19 referenced the term “lifetime PTSD” as used in the DSM-5-TR. He testified that he had
“heard” the phrase “in a sense that if you’re looking at . . . lifetime prevalence of PTSD or
if someone has ever met criteria for PTSD over the course of their lifetime, in that kind of
discussion context, but not as a diagnosis.” Considering the facts in the light most
favorable to the findings, the compensation judge’s failure to reference this specific portion
of Dr. Young’s testimony did not result in factual findings that are manifestly contrary to
the evidence. Moreover, given Dr. Young’s testimony, the WCCA’s finding that Dr.
Young offered no competing interpretation of the new text is supported by the record.
To be clear, we do not endorse any interpretation of the DSM here. Our decision is
based on the application of our standard of review. The standard of review does not allow
us to substitute our judgment for the judgment of the compensation judge as to “which of
the professional diagnoses [was] more credible and persuasive.” Tea, 5 N.W.3d at 120
(citation omitted) (internal quotation marks omitted).
Applying our standard of review, we discern no error in the WCCA’s decision to
affirm the compensation judge’s factual finding that Peterson has a current PTSD diagnosis
because the WCCA’s decision is not manifestly contrary to the evidence. Furthermore,
because Peterson has a present diagnosis of PTSD under the most recent version of the
DSM, the WCCA did not err in concluding that Peterson is entitled to workers’
II.
The City argues that the WCCA erred when it directed the compensation judge to
make additional findings regarding Peterson’s claim that he was entitled to workers’
20 compensation benefits for OSTD as a consequential injury of PTSD. Further, the City
contends that the WCCA erred by addressing this claim after concluding that Peterson was
entitled to workers’ compensation benefits for a present diagnosis of PTSD because the
issue was moot. Peterson concedes that resolution of this issue may be unnecessary. But
he requests a decision from this court because the issue of whether OSTD is a compensable
mental impairment “has been percolating in the lower courts” and this court’s guidance is
needed.
We agree with the City that the WCCA erred when it addressed the issue because
the issue was moot. An issue is moot if “a decision on the merits is no longer necessary or
an award of effective relief is no longer possible.” Dean v. City of Winona, 868 N.W.2d
1, 5 (Minn. 2015). The WCCA’s determination that Peterson is entitled to compensation
benefits for a present diagnosis of PTSD rendered a further decision regarding the merits
of Peterson’s OSTD consequential injury claim unnecessary.
We reach this conclusion based on the record. Peterson’s initial claim petition
alleged that he had compensable PTSD. After Dr. Aleknavicius prepared her evaluation,
which stated that Peterson’s diagnosis was “OSTD (subthreshold PTSD),” Peterson
amended his claim petition, adding a second claim for a consequential mental injury of
OSTD. But at the hearing before the compensation judge, Dr. Aleknavicius modified the
earlier opinion that she had provided in her evaluation. She testified that, based on the
most recent edition of the DSM, Peterson has a present diagnosis of PTSD. Dr.
Aleknavicius explained that, although she had previously diagnosed OSTD, Peterson’s
OSTD diagnosis was “subthreshold PTSD.” In other words, she diagnosed OSTD because
21 Peterson’s PTSD symptoms had decreased when she met with him for the evaluation. The
City’s expert, Dr. Young, did not disagree with Dr. Aleknavicius’s characterization of
OSTD as a milder form of PTSD, noting that such disorders fall on a “spectrum.”10
Following the hearing, the compensation judge found Dr. Aleknavicius’s testimony to be
credible and persuasive. The compensation judge concluded that Peterson has
compensable PTSD, and the WCCA affirmed the compensation judge’s findings.
Peterson, 2024 WL 3363123, at *15. Given Dr. Aleknavicius’s opinion that Peterson’s
OSTD diagnosis was “subthreshold PTSD” and the WCCA’s decision that Peterson was
entitled to compensation benefits for a present diagnosis of PTSD, a decision as to whether
Peterson’s OSTD diagnosis was a compensable mental impairment was no longer
necessary.11 Thus, the issue was moot.12
Because the WCCA erred in addressing the question of whether Peterson was
entitled to workers’ compensation benefits for OSTD as a consequential mental injury, we
10 As noted, however, Dr. Young disagreed with Dr. Aleknavicius’s opinion that Peterson has a mental health disorder. 11 We may avoid the mootness doctrine and exercise our discretion to consider the merits of an issue if the issue is “ ‘functionally justiciable’ and presents an important question of ‘statewide significance that should be decided immediately.’ ” Dean, 868 N.W.2d at 6 (quoting State v. Rud, 359 N.W.2d 573, 576 (Minn. 1984)); see also Winkowski v. Winkowski, 989 N.W.2d 302, 309 (Minn. 2023). An issue is functionally justiciable if the record includes “the raw material . . . traditionally associated with effective judicial decision-making”—namely, “effective presentation of both sides of the issues raised.” Rud, 359 N.W.2d at 576. We decline to exercise our discretion to consider the merits of the issue here. 12 In its challenges to the WCCA’s referral order and holding regarding the compensability of OSTD, the City raised multiple additional arguments that we do not reach given our decision to reverse the WCCA’s decision on the ground of mootness.
22 reverse the WCCA’s decision as to this issue. Additionally, we reverse the WCCA’s
holding that OSTD is a compensable consequential injury of PTSD.
III.
Finally, the City argues that the WCCA erred in upholding the compensation judge’s
award of a penalty against the City for frivolously denying primary liability in response to
Peterson’s claim for workers’ compensation benefits. Peterson responds that the
compensation judge’s decision to award a penalty was an appropriate exercise of
discretion.
As noted, when a police officer experiences PTSD and has not been previously
diagnosed with this condition, there is a presumption that it is an occupational disease “due
to the nature of employment.” Minn. Stat. § 176.011, subd. 15(e). The officer’s employer
or insurer can rebut this presumption, but the employer or insurer “faces a higher burden
than in a case in which no presumption applies.” Juntunen v. Carlton County, 982 N.W.2d
729, 741 (Minn. 2022). The presumption can be rebutted only by “substantial factors.”
Minn. Stat. § 176.011, subd. 15(e). “If rebutted . . . , the presumption disappear[s].”
Juntunen, 982 N.W.2d at 741 (alteration in original) (citation omitted) (internal quotation
marks omitted). An employer or insurer that rebuts the presumption with substantial
factors and denies liability must communicate known substantial factors to the employee
at the time of denial of liability. Minn. Stat. § 176.011, subd. 15(e). Denial of a claim
must be served on the employee within 14 days after the employer receives notice of or
knows of an alleged compensable injury. Minn. Stat. § 176.221, subd. 1 (2024).
23 If an employer or insurer denies an employee’s workers’ compensation claim
without a “good faith investigation of the facts” or if the basis for denial “is clearly contrary
to fact or law,” it is considered a “frivolous[]” denial. Minn. Stat. § 176.225, subd. 1
(2024). When an employer or insurer frivolously denies an employee’s claim, the
employee is entitled to a penalty award “of up to 30 percent of th[e] total amount” of the
compensation award. Id.
Here, the compensation judge concluded that the presumption of compensability
under section 176.011, subdivision 15(e), applied to Peterson, and the City failed to rebut
the presumption. The compensation judge further concluded that the denial was frivolous
because the City did not perform any investigation into Peterson’s claim before denying it,
and because the City’s “primary denial of liability inaccurately stated that the employee
had a ‘history of personal mental health conditions caused by personal emotional stressors
unrelated to employment.’ ” The compensation judge therefore decided that Peterson was
entitled to a penalty award under section 176.225, subdivision 1, in the amount of
30 percent of the total compensation award.
The WCCA affirmed the compensation judge’s award of a penalty. Peterson,
2024 WL 3363123, at *18. It determined that Peterson established that he was entitled to
the presumption that his PTSD diagnosis was work related. Id. The WCCA observed that
the City denied that the presumption applied, claiming that Peterson had a history of
personal mental health conditions unrelated to his employment as a police officer and that
these mental health conditions were being further investigated. Id. But the WCCA noted
that the record contradicts the City’s assertions. Id. The record shows that Peterson
24 underwent two separate mental health examinations at the outset of his work for the City,
and both examinations concluded that Peterson did not have pre-existing mental health
issues. Id. Based on these findings, the WCCA concluded that the City’s denial of primary
liability was frivolous and the compensation judge’s award of a penalty was a proper
exercise of discretion. Id.
We will overturn the WCCA’s findings “only if, viewing the facts in the light most
favorable to the findings, it appears that the findings are manifestly contrary to the evidence
or that it is clear reasonable minds would adopt a contrary conclusion.” Juntunen,
982 N.W.2d at 742 (citation omitted) (internal quotation marks omitted). Here, the
WCCA’s findings are not manifestly contrary to the evidence. Moreover, those findings
support the compensation judge’s decision to award a penalty.
The City contends that it is unfair to require employers to rebut the presumption
within the statutory period of just 14 days. But as we have previously observed, we are
bound to follow the clear mandate of the statute, which serves a competing legislative
purpose. See Juntunen, 982 N.W.2d at 743 (“The Legislature determined that employees
suffering from PTSD need timely access to medical care, and the PTSD presumption puts
the onus on employers to quickly resolve such claims.”); Chrz, 986 N.W.2d at 487 (stating
that “we ‘must read this state’s laws as they are, not as some argue they should be’ ”
(quoting State v. Carson, 902 N.W.2d 441, 446 (Minn. 2017))); see also Minn. Stat.
§§ 176.011, subd. 15(e), 176.221.
The facts in the record support the WCCA’s decision to affirm the compensation
judge’s award of a 30 percent penalty against the City for its frivolous denial of primary
25 liability. Thus, we conclude that the WCCA did not err in affirming the award of the
penalty.
CONCLUSION
For the foregoing reasons, we affirm the decision of the Workers’ Compensation
Court of Appeals in part, and we reverse in part.
26 CONCURRENCE&DISSENT
MOORE, III, Justice (concurring in part and dissenting in part).
I write separately because I believe that the Workers’ Compensation Court of
Appeals (WCCA) committed an error of law in affirming the factual finding that Lucas
Peterson has a current diagnosis of post-traumatic stress disorder (PTSD) under the most
recent version of the Diagnostic and Statistical Manual of Mental Disorders, Textual
Revision (5th ed. 2022) (DSM-5-TR), based on a diagnosis of “lifetime” PTSD. The
WCCA’s acceptance of the compensation judge’s finding that Peterson met criteria for a
current PTSD diagnosis based on the new “lifetime” PTSD text referenced in the 2022
textual revision of the DSM-5-TR, notwithstanding the fact Peterson no longer met the
criteria for a current diagnosis of PTSD, is contrary to our opinion in Chrz v. Mower
County, 986 N.W.2d 481, 486 (2023). The WCCA’s finding that the respondent’s expert,
Dr. Young, “offered no interpretation of the new text” in the DSM-5-TR is also manifestly
contrary to the evidence. While I acknowledge that the court resolves this case without
adopting a definitive construction of the DSM-5-TR, I remain concerned that the majority
opinion may be construed as implicitly endorsing an expansive interpretation—one under
which an employee’s eligibility for workers’ compensation benefits based on a diagnosis
of PTSD could extend beyond the period in which the employee presently meets the
diagnostic criteria. Such a construction would allow a PTSD diagnosis to persist
indefinitely for benefit purposes, a result this court rejected in Chrz. Id. at 486. For these
C/D-1 reasons, I respectfully dissent from parts I and III of the court’s opinion, and would reverse
the opinion of the WCCA on all questions presented.1
In 2013, the Legislature amended the Minnesota Workers’ Compensation Act to
allow injured workers to recover workers’ compensation benefits for a diagnosis of PTSD
from a licensed psychiatrist or psychologist that arises out of and in the course of
employment. See Minn. Stat. § 176.011, subds. 15(d), 16 (2024). The Legislature defined
PTSD as the “condition as described in the most recently published edition of the
Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric
Association.” Id., subd. 15(d). At the time of our first case interpreting the 2013 workers’
compensation PTSD amendments, Smith v. Carver County, 931 N.W.2d 390 (Minn. 2019),
that version was “commonly known as the DSM-5.” Id. at 392 (citing Am. Psychiatric
Ass’n, Diagnostic and Statistical Manual of Mental Disorders (5th ed. 2013)). We
reasoned in Smith that the role of the fact-finder in cases involving workers’ compensation
PTSD claims is to review competing expert evaluations and determine which was more
persuasive based on the application of PTSD from the latest edition of the DSM. Id. at 398.
And in Chrz we relied on Smith to reiterate that for an employee to recover workers’
compensation benefits for PTSD under the 2013 statutory amendments, the employee
1 I concur with the opinion of the court as to part II because I agree that, in light of the court’s resolution of the issues in part I, the WCCA should not have reached whether Peterson was entitled to workers’ compensation benefits for other specified trauma and stressor-related disorder (OSTD) as a consequential injury. But I disagree with the majority’s holding regarding Peterson’s eligibility for continuing PTSD benefits, and would also reverse the compensation judge’s finding that the City’s denial of liability was frivolous. I thus dissent from parts I and III of the court’s opinion.
C/D-2 “must prove that (1) a psychiatrist or psychologist has diagnosed the employee with PTSD,
and (2) the professional based the employee’s diagnosis on the latest version of the DSM.”
Chrz, 986 N.W.2d at 485 (citing Smith, 931 N.W.2d at 396).
This case involves the application of a new version of the DSM to the PTSD
diagnosis—the DSM-5-TR, published in 2022. Am. Psychiatric Ass’n, Diagnostic and
Statistical Manual of Mental Disorders, Text Revision (5th ed. 2022). The compensation
judge concluded that, despite Peterson’s symptoms not meeting the DSM-5 criteria for
PTSD, that he still has PTSD based on meeting the criteria for a “lifetime diagnosis” of
PTSD under the DSM-5-TR. The issue before us is whether this conclusion was clearly
unreasonable, and therefore whether the WCCA’s affirmance of that finding was
manifestly contrary to the evidence. I believe that it was.
In May 2022, Dr. Aleknavicius evaluated Peterson and reviewed his medical status
from the prior year. That review included Dr. Cronin’s June 2021 diagnosis of PTSD. Dr.
Aleknavicius concluded that Peterson had met all PTSD diagnostic criteria from around
March through June 2021, though treatment had improved some symptoms. But by the
time of her May 2022 evaluation, Peterson’s symptoms had shifted, and Dr. Aleknavicius
found that he no longer met Criteria F and G for a PTSD diagnosis.2 Dr. Aleknavicius
instead diagnosed him with other specified trauma and stressor-related disorder (OSTD),
cautioning that Peterson remained at significant risk for future PTSD episodes. In a later
2 Criterion F applies when the duration of the symptoms in Criteria B, C, D, and E last more than one month. Am. Psychiatric Ass’n, Diagnostic and Statistical Manual of Mental Disorders, Text Revision 307 (5th ed. 2022). Criterion G applies when the symptoms create distress or functional impairment. Id.
C/D-3 certification prepared in October 2022, Dr. Aleknavicius confirmed these findings and
supported Peterson’s workers’ compensation claim because he had a different condition,
OSTD, rendering him unfit to perform the duties of a police officer.
At the hearing before the compensation judge in April 2023, while testifying, Dr.
Aleknavicius opined for the first time that Peterson met all PTSD criteria under the
March 2022 DSM-5-TR update. She testified that PTSD remains a valid, continuing
diagnosis once the relevant symptom clusters have been simultaneously present for at least
one month. She explained that PTSD is a lifetime condition once the four diagnostic
criteria are met. In other words, Dr. Aleknavicius testified that Peterson’s PTSD diagnosis
is perpetual.
In contrast, Dr. Young conducted an independent medical examination in
March 2022, and concluded that Peterson had no diagnosable mental health condition and
found ongoing treatment unnecessary. During testimony at the hearing, Dr. Young
contested the applicability and significance of the DSM-5-TR update referenced by Dr.
Aleknavicius. Dr. Young asserted that the DSM-5-TR was merely an administrative
revision, not a substantive clinical update, noting that the diagnostic criteria for PTSD were
unchanged from the DSM-5. He rejected the concept of “lifetime PTSD” as a recognized
diagnosis within the mental health profession, asserting instead that PTSD must be
continually reassessed based on a patient’s current symptom presentation, and that the
“lifetime” language refers to PTSD’s prevalence as a disorder.
Despite Dr. Young’s opinions objecting to the interpretations of the DSM-5-TR,
after weighing all expert testimony, the compensation judge credited Dr. Aleknavicius’s
C/D-4 explanations and an earlier evaluation from 2021, finding them consistent with the record
and more persuasive than Dr. Young’s contrary opinions. Consequently, the compensation
judge concluded that Peterson had established a compensable PTSD injury.
The WCCA affirmed the compensation judge’s decision in all respects. Peterson v.
City of Minneapolis, No. WC23-6527, 2024 WL 3363123, at *19 (Minn. WCCA June 28,
2024). It recognized that the compensation judge reasonably credited Dr. Aleknavicius,
who relied on the DSM-5-TR, and her explanation of “lifetime” PTSD once the core
diagnostic criteria have been met. Id. at *14–15. As explained by the WCCA, Dr. Young
based his analysis on the earlier DSM-5 and contested the possibility of a lifetime diagnosis
without offering a different interpretation of the DSM-5-TR. Id. at *15. Because
Minnesota law directs the fact-finder to apply the most recent DSM edition and because
substantial evidence supported Dr. Aleknavicius’s testimony, the WCCA concluded the
compensation judge did not err in finding Dr. Aleknavicius’s testimony more persuasive
than that of Dr. Young. Id.
Our review of factual findings in workers’ compensation cases is limited. Tea v.
Ramsey Cnty., 5 N.W.3d 114, 119 (Minn. 2024). Because the WCCA affirmed the
compensation judge’s factual findings, we “must uphold those findings unless they are
‘manifestly contrary to the evidence.’ ” Id. (quoting Schmidt v. Wal-Mart Stores, Inc.,
988 N.W.2d 124, 129 (Minn. 2023)). To be manifestly contrary to the evidence, the
evidence must “clearly require[] reasonable minds to adopt a contrary conclusion.”
Lagasse v. Horton, 982 N.W.3d 189, 202 (Minn. 2022).
C/D-5 “When medical professionals provide competing diagnoses, the compensation
judge must determine ‘whether the expert diagnoses have adequate foundation and, if both
have adequate foundation, decide which of the professional diagnoses is more credible and
persuasive.’ ” Tea, 5 N.W.3d at 120 (quoting Juntunen v. Carlton Cnty., 982 N.W.2d 729,
743 n.10 (Minn. 2022)). The compensation judge, however, may determine that a PTSD
diagnosis is “inconsistent with the DSM” based on “evidence offered by another medical
professional.” Id. at 122. But that determination is “not based upon the judge’s own
application of the DSM criteria to the employee’s symptoms.” Id. Here, the compensation
judge found Dr. Aleknavicius’s lifetime PTSD diagnosis more credible and persuasive.
But I have serious doubts that the evidence supports Dr. Aleknavicius’s claims about
“lifetime PTSD.” The disputed portion of the DSM-5-TR states:
The diagnosis of PTSD requires that the duration of the symptoms in Criteria B, C, D, and E be more than 1 month (Criterion F).
For a current diagnosis of PTSD, Criteria B, C, D, and E must all be met for more than 1 month, for at least the past month.
For a lifetime diagnosis of PTSD, there must be a period of time lasting more than 1 month during which Criteria B, C, D, and E have all been met for the same 1-month period of time.
Am. Psychiatric Ass’n, Diagnostic and Statistical Manual of Mental Disorders, Text
Revision 307–08 (5th ed. 2022) (emphasis added). The criteria of the last two sentences
seem to operate identically. But it defies logic that the criteria for a present PTSD diagnosis
would be identical to the criteria necessary to sustain a “lifetime” diagnosis. Put another
way, under Dr. Aleknavicius’s reading of this language, any time a person is diagnosed
with PTSD, they have PTSD for a lifetime. But the experts here agreed that the DSM-5-TR
C/D-6 did not change the diagnostic criteria for PTSD.3 Dr. Young’s main objection to Dr.
Aleknavicius’s testimony was that the diagnostic criteria for PTSD in the DSM-5-TR are
no different from the criteria in the DSM-5. Rather, Dr. Young testified that the “lifetime”
language refers to “lifetime prevalence of PTSD or if someone has ever met criteria for
PTSD over the course of their lifetime . . . but not as a diagnosis.”
In Chrz, we confirmed that Minnesota’s workers’ compensation laws treat PTSD as
a condition that can, and does, resolve over time. 986 N.W.2d at 486. There we held that
a deputy sheriff who had been diagnosed with PTSD in 2019 was no longer entitled to
benefits once he no longer had a PTSD diagnosis in early 2021. Id. at 487. We explained
that the statute “plainly decide[s] that an employee is only eligible for workers’
compensation benefits so long as they meet the precise definition of PTSD,” warning that
extending benefits after the diagnosis resolves “would allow an employee’s diagnosis of
PTSD to remain effectively perpetual.” Id. at 486. Chrz therefore suggests that under the
DSM-5—and thus under the DSM-5-TR, because the diagnostic criteria for PTSD are
identical—PTSD cannot be considered a permanent (or lifetime) diagnosis. This is because
once the clinical criteria are no longer met, the law regards the worker as having recovered,
3 The only modification to the PTSD diagnostic criteria in the DSM-5-TR applies exclusively to children. See Am. Psychiatric Ass’n, Rationale for Change: Posttraumatic Stress Disorder (2022), https://www.psychiatry.org/getmedia/eacace92-3964-4350-a0bd- e42fc03e806a/APA-DSM5TR-PTSD.pdf [opinion attachment]. And no changes were made to the PTSD diagnostic criteria for adults in the DSM-5-TR. See U.S. Dep’t of Veterans Aff., PTSD: National Center for PTSD, https://www.ptsd.va.gov/professional/treat/essentials/dsm5_ptsd.asp (last visited June 30, 2025) [opinion attachment] (“With no changes to the diagnostic criteria in DSM-5- TR . . . .”).
C/D-7 terminating the “occupational disease” and any consequent benefits payable because of
that occupational disease. Id.
Because the WCCA affirmed the factual finding of Peterson’s present diagnosis of
PTSD despite his symptoms not meeting the requirements of the DSM-5, the WCCA
necessarily concluded that new language in the DSM-5-TR permits a psychiatrist to make
an active diagnosis of PTSD in circumstances under which the DSM-5 did not. I believe
that conclusion was a legal error, and I therefore would reverse the decision of the WCCA
on that basis.
Accordingly, I respectfully dissent as to parts I and III of the court’s opinion.
THISSEN, Justice (concurring in part and dissenting in part).
I join the opinion of Justice Moore concurring in part and dissenting in part.
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Cite This Page — Counsel Stack
Lucas Peterson, Respondent, vs. City of Minneapolis, Self-Insured, Relator, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lucas-peterson-respondent-vs-city-of-minneapolis-self-insured-relator-minn-2025.