OPINION
LANCASTER, Justice.
By writ of certiorari, relator Arlene Middleton seeks review of a decision of the Workers’ Compensation Court of Appeals (WCCA) affirming the denial of her claim for death benefits following her husband’s suicide. The WCCA concluded that the suicide was not compensable because it was not the result of a work-related physical injury. We reverse and remand the matter to the WCCA for further proceedings.
James Middleton began working for Northwest Airlines as an aircraft mechanic in 1958. At some point in 1990, Middleton began working in the tubing department, fabricating tubing that carried hydraulic fluid, engine oil, oxygen, and other materials throughout an aircraft. The work required attention to detail and precision.
Beginning in 1993, certain changes took place in the department that Middleton felt compromised the department’s work and ultimately aircraft safety. Relator argued before the compensation judge that Middleton suffered from increased work-related stress as a result of certain changes that took place in the tubing department: (1) Northwest management’s decision to change the procedure used to inspect tubing before its use on aircraft; (2) Middleton’s ascent to the position of most senior employee in the tubing department following the retirement of another employee; and (3) the development of a large backlog of work orders for tubing that was the result of a one-time retrofit[708]*708ting of DC-9 aircraft. In early April 1994, it became apparent to family and friends that Middleton’s life had become dominated by mental suffering, which he attributed to work-related stress. On April 21, 1994, Middleton went to see his family doctor for complaints of severe stomach pain and an inability to sleep. Middleton’s physician prescribed both anti-anxiety and anti-depressant medications for Middleton’s symptoms. Middleton’s physician also referred Middleton to a psychologist, who diagnosed a situational depression.
By June 1994, Middleton’s condition had deteriorated significantly. His friends and co-employees began to notice that Middleton was undergoing a dramatic weight loss. They also observed that Middleton’s personality had changed — he had become much more withdrawn. Middleton’s wife noted that by this time her husband had become “extremely * ⅜ * paranoid or psychotic.” Middleton confided to his wife that he had contemplated suicide. On June 21,1994, after Middleton reported his suicidal thoughts to his family physician, the physician placed him on indefinite medical leave. The next day Middleton visited the psychologist who concluded, after neuropsychological testing, that Middleton’s depression had worsened. The psychologist noted that Middleton was “not in jeopardy of self harm or harm to others. Test findings, however are extremely disconcerting * * Middleton underwent a magnetic resonance imaging (MRI) brain scan on June 27. The MRI could not be completed because Middleton complained about the noise coming from the MRI equipment, but a computed tomography (CT) brain scan indicated normal results. On the morning of June 30, 1994, Middleton went down into the cellar of his home and committed suicide by slicing his wrists with a knife. By the time his wife discovered him, he had already lost so much blood that paramedics were unable to resuscitate him.
Middleton’s wife sought workers’ compensation death benefits. Over a three-day hearing before a workers’ compensation judge, friends, family members, and co-employees described Middleton’s descent into depression, and vocational experts commented on the nature and amount of stress that Middleton encountered at work. Additionally, expert medical evidence established that Middleton had a major depressive disorder that led to his suicide. With regard to the psychological impact of Middleton’s work stress, Dr. John Rauenhorst, psychiatric consultant for relator, opined that work-related stress (or at least Middleton’s perception of his job) was the likely cause of Middleton’s major depressive disorder that overrode his rational thinking and judgment. Michael Richardson, psychologist, and Dr. Thomas McPartlin, neurologist, also believed that work stress was a substantial contributing cause of Middleton’s depression.
Dr. Keith Hartman, respondent’s psychiatric consultant, agreed that Middleton’s suicide was the result of a major depressive disorder. However, Dr. Hartman said that stress does not cause depressive disorders but, rather, depressive orders cause stress. Dr. Hartman explained that people frequently use work stress as an excuse for their preexisting depressive disorders. He conceded, however, that stress could cause depression and that the workplace can be a substantial factor that triggers a major depressive disorder.
The compensation judge found that Middleton’s job stress caused his major depressive disorder but denied the relator’s claim, concluding the evidence failed to establish legal causation: that the stress of Middleton’s employment was beyond the ordinary day-to-day stress to which all employees are exposed. On appeal, the WCCA affirmed, concluding that although the evidence supported the determination as to medical causation (that job stress precipitated the major depressive disorder), the claim was nevertheless properly denied because the suicide was the result of a noncompensable mental injury, citing [709]*709Lockwood v. Independent School Dist. No. 877, 312 N.W.2d 924, 926 (Minn.1981), as controlling authority. The WCCA did not reach the issue of legal causation.
In Lockwood we held that in the absence of an indication from the legislature that it intended to impose liability on employers for such injuries, the Workers’ Compensation Act did not cover employees who were mentally disabled by employment-related stress. 312 N.W.2d at 927. The respondents argue that where suicide arises out of a mental trauma that would not, under Lockwood, be independently compensable, the holding of Lockwood demands that the death not be compensable either. We have carefully examined Lockwood to determine whether its holding is so broad. In Lockwood we observed that the statute evidenced no intent to cover the mental injury itself (in that case one psychiatrist diagnosed the mental disability as manic-depressive disorder, and another psychiatrist diagnosed it as a schizophrenic-type reaction). In the end, we leave undisturbed our holding in Lockwood, but are unpersuaded that it is conclusive on the issue of whether the statute contemplates that suicides will be treated differently from “work-related stress without physical trauma.” Lockwood, 312 N.W.2d at 926.1
For analytical convenience, Larson2 places workers’ compensation mental injury claims into three groups: (1) cases in which mental stimulus produces physical injury; (2) eases in which physical stimulus produces mental injury; and (3) cases in which the mental stimulus produces the mental injury. We have observed that, generally speaking, in Minnesota injuries in the first two categories are compensa-ble; but injuries in the third category are not. See, e.g., Lockwood, 312 N.W.2d at 926; Johnson v. Paul’s Auto & Truck Sales, 409 N.W.2d 506, 508 (Minn.1987). Death by suicide does not fall neatly into either category one or category three.
Free access — add to your briefcase to read the full text and ask questions with AI
OPINION
LANCASTER, Justice.
By writ of certiorari, relator Arlene Middleton seeks review of a decision of the Workers’ Compensation Court of Appeals (WCCA) affirming the denial of her claim for death benefits following her husband’s suicide. The WCCA concluded that the suicide was not compensable because it was not the result of a work-related physical injury. We reverse and remand the matter to the WCCA for further proceedings.
James Middleton began working for Northwest Airlines as an aircraft mechanic in 1958. At some point in 1990, Middleton began working in the tubing department, fabricating tubing that carried hydraulic fluid, engine oil, oxygen, and other materials throughout an aircraft. The work required attention to detail and precision.
Beginning in 1993, certain changes took place in the department that Middleton felt compromised the department’s work and ultimately aircraft safety. Relator argued before the compensation judge that Middleton suffered from increased work-related stress as a result of certain changes that took place in the tubing department: (1) Northwest management’s decision to change the procedure used to inspect tubing before its use on aircraft; (2) Middleton’s ascent to the position of most senior employee in the tubing department following the retirement of another employee; and (3) the development of a large backlog of work orders for tubing that was the result of a one-time retrofit[708]*708ting of DC-9 aircraft. In early April 1994, it became apparent to family and friends that Middleton’s life had become dominated by mental suffering, which he attributed to work-related stress. On April 21, 1994, Middleton went to see his family doctor for complaints of severe stomach pain and an inability to sleep. Middleton’s physician prescribed both anti-anxiety and anti-depressant medications for Middleton’s symptoms. Middleton’s physician also referred Middleton to a psychologist, who diagnosed a situational depression.
By June 1994, Middleton’s condition had deteriorated significantly. His friends and co-employees began to notice that Middleton was undergoing a dramatic weight loss. They also observed that Middleton’s personality had changed — he had become much more withdrawn. Middleton’s wife noted that by this time her husband had become “extremely * ⅜ * paranoid or psychotic.” Middleton confided to his wife that he had contemplated suicide. On June 21,1994, after Middleton reported his suicidal thoughts to his family physician, the physician placed him on indefinite medical leave. The next day Middleton visited the psychologist who concluded, after neuropsychological testing, that Middleton’s depression had worsened. The psychologist noted that Middleton was “not in jeopardy of self harm or harm to others. Test findings, however are extremely disconcerting * * Middleton underwent a magnetic resonance imaging (MRI) brain scan on June 27. The MRI could not be completed because Middleton complained about the noise coming from the MRI equipment, but a computed tomography (CT) brain scan indicated normal results. On the morning of June 30, 1994, Middleton went down into the cellar of his home and committed suicide by slicing his wrists with a knife. By the time his wife discovered him, he had already lost so much blood that paramedics were unable to resuscitate him.
Middleton’s wife sought workers’ compensation death benefits. Over a three-day hearing before a workers’ compensation judge, friends, family members, and co-employees described Middleton’s descent into depression, and vocational experts commented on the nature and amount of stress that Middleton encountered at work. Additionally, expert medical evidence established that Middleton had a major depressive disorder that led to his suicide. With regard to the psychological impact of Middleton’s work stress, Dr. John Rauenhorst, psychiatric consultant for relator, opined that work-related stress (or at least Middleton’s perception of his job) was the likely cause of Middleton’s major depressive disorder that overrode his rational thinking and judgment. Michael Richardson, psychologist, and Dr. Thomas McPartlin, neurologist, also believed that work stress was a substantial contributing cause of Middleton’s depression.
Dr. Keith Hartman, respondent’s psychiatric consultant, agreed that Middleton’s suicide was the result of a major depressive disorder. However, Dr. Hartman said that stress does not cause depressive disorders but, rather, depressive orders cause stress. Dr. Hartman explained that people frequently use work stress as an excuse for their preexisting depressive disorders. He conceded, however, that stress could cause depression and that the workplace can be a substantial factor that triggers a major depressive disorder.
The compensation judge found that Middleton’s job stress caused his major depressive disorder but denied the relator’s claim, concluding the evidence failed to establish legal causation: that the stress of Middleton’s employment was beyond the ordinary day-to-day stress to which all employees are exposed. On appeal, the WCCA affirmed, concluding that although the evidence supported the determination as to medical causation (that job stress precipitated the major depressive disorder), the claim was nevertheless properly denied because the suicide was the result of a noncompensable mental injury, citing [709]*709Lockwood v. Independent School Dist. No. 877, 312 N.W.2d 924, 926 (Minn.1981), as controlling authority. The WCCA did not reach the issue of legal causation.
In Lockwood we held that in the absence of an indication from the legislature that it intended to impose liability on employers for such injuries, the Workers’ Compensation Act did not cover employees who were mentally disabled by employment-related stress. 312 N.W.2d at 927. The respondents argue that where suicide arises out of a mental trauma that would not, under Lockwood, be independently compensable, the holding of Lockwood demands that the death not be compensable either. We have carefully examined Lockwood to determine whether its holding is so broad. In Lockwood we observed that the statute evidenced no intent to cover the mental injury itself (in that case one psychiatrist diagnosed the mental disability as manic-depressive disorder, and another psychiatrist diagnosed it as a schizophrenic-type reaction). In the end, we leave undisturbed our holding in Lockwood, but are unpersuaded that it is conclusive on the issue of whether the statute contemplates that suicides will be treated differently from “work-related stress without physical trauma.” Lockwood, 312 N.W.2d at 926.1
For analytical convenience, Larson2 places workers’ compensation mental injury claims into three groups: (1) cases in which mental stimulus produces physical injury; (2) eases in which physical stimulus produces mental injury; and (3) cases in which the mental stimulus produces the mental injury. We have observed that, generally speaking, in Minnesota injuries in the first two categories are compensa-ble; but injuries in the third category are not. See, e.g., Lockwood, 312 N.W.2d at 926; Johnson v. Paul’s Auto & Truck Sales, 409 N.W.2d 506, 508 (Minn.1987). Death by suicide does not fall neatly into either category one or category three. On the one hand, the mental stimulus does not directly cause the physical injury (in this case, death), because the stress-induced mental derangement intervenes. On the other hand, stress-induced suicide cannot simply be classified a mental injury produced by mental stimulus, as death is not merely a state of mind. See, e.g., Eaton v. State of Minnesota, 39 Minn. Workers’ Comp. Dec. 94, 98 (1986) (“[The worker] is now more than simply ‘mentally disabled’ by the work-related stress. Clearly he is also physically disabled as a result of his death * * * ”). Larson’s grouping provides useful analytical guidance, but it does not answer the question presented by this case. For that we turn to our case law and legislative history.
Minnesota Statutes § 176.021, subd. 1 (1994), provides that employers are not liable for compensation when an injury is self-inflicted or is proximately caused by intoxication. In Anderson v. Armour & Co., 257 Minn. 281, 101 N.W.2d 435 (Minn.1960), we recognized as compensable a death by suicide resulting from a psychotic depression precipitated by a work-related incident. Anderson, a truck driver, became despondent after he accidentally struck a pedestrian on a highway. 257 Minn. at 282, 101 N.W.2d at 436. A week later, Anderson’s despondency drove him to suicide. 257 Minn. at 284, 101 N.W.2d at 438. We held that Anderson’s death was compensable under the workers’ compensation laws because an employee’s injuries could not be said to be “intentionally self-inflicted” if the employee had “killed himself while possessed of an uncontrollable or irresistible impulse or while in a delirium of frenzy without rational knowledge of the physical consequences of his act.” 257 Minn. at 289, 101 N.W.2d at 440 (quoting 5 Schneider, Workmen’s Compensation § 1411(e) (3d ed.)); see also Leh[710]*710man v. A.V. Winterer Co., 272 Minn. 79, 82, 136 N.W.2d 649, 651 (1965) (applying Anderson).
In 1967, the Minnesota legislature amended Minn.Stat. § 176.021, subd. 1, so that it specifically excluded coverage for deaths by suicide. Act of June 2, 1967, ch. 40, § 3, 1967 Ex.Sess. Laws, 2227 (inserting clause stating that “suicides are not compensable”). However, the language precluding coverage of suicide deaths was removed by the legislature in 1973. Underscoring its intent to bring suicide within the coverage of the statute, the legislature in 1973 also amended the clause precluding employer liability when an employee’s “injury or death was intentionally self-inflicted” by removing the words “or death.” Act of May 23, 1973, ch. 623, § 1, 1973 Minn. Laws 1491.3
Thereafter, in Meils by Meils v. Northwestern Bell Telephone Co., 355 N.W.2d 710 (Minn.1984), we held to be compensa-ble a suicide death that resulted from depression precipitated by a work-related back injury. In so doing we rejected the Anderson “uncontrollable impulse or delirium of frenzy” test for causation, replacing the causal test with “the familiar common law test of proximate cause and superseding cause.” Id. at 714. Meils specified that death by suicide is compensable if “a work-related injury and its consequences, such as extreme pain and despair, directly cause a mental derangement of such severity that it overrides normal or rational judgment.” Id. at 715. The burden is on the claimant to establish by substantial evidence the unbroken chain of causation between the work-related injury, the mental derangement, and the suicide. Id.
In Meils, a compensable physical injury precipitated the mental derangement, but that fact was not central to disposition of the primary issue: the causal test for com-pensability of a subsequent injury. We are persuaded that imposing such a requirement would be inconsistent with legislative history and prior case law concerning suicide. In the absence of legislative directive to the contrary, we perceive death by suicide to be analogous to other subsequent physical injuries. See, e.g., Aker v. State Dep’t of Natural Resources, [711]*711282 N.W.2d 533 (Minn.1979) (game warden’s heart attack caused by emotional stress of removing decomposed bodies from Boundary Waters Canoe Area held compensable); Egeland v. City of Minneapolis, 344 N.W.2d 597 (Minn.1984) (police officer’s ulcer aggravated by chronic depression caused by work-related emotional stress held compensable). Compensability, of course, depends on whether the work-related stress can be proven to be both the medical and the legal cause of the employee’s suicide. Egeland, 344 N.W.2d at 603. We therefore reverse the WCCA’s determination that a suicide may never be compensable unless it stems from a com-pensable physical injury.
Legal causation was raised, but not reached, by the WCCA in light of its disposition. Given the complexity of the issues involved in determining whether Middleton’s suicide was legally caused by his employment, a remand to the WCCA is appropriate. See Felton v. Anton Chevrolet, 513 N.W.2d 457, 459 (Minn.1994) (remanding case to WCCA for consideration of remaining issues the WCCA had not reached earlier after disposing of case on another issue). Remand will allow the WCCA, which has significant knowledge and expertise in assessing causation issues, to consider an appropriate framework for determining legal causation in instances of stress-induced employee suicide.
Relator is awarded $800 in attorney fees.
Reversed and remanded.