Background
B.C., an electrician, sustained severe multisystem trauma on June 4, 2021, when a rock fell on him in a coal mine operated by United Coal Company. His documented injuries included bilateral rib fractures, multiple vertebral fractures, scapular fracture, displaced ankle fracture, ACL/PCL tears, and other physical trauma. He underwent surgery and reached maximum medical improvement by 2023 with significant functional limitations, unable to return to mining work.
Beginning in 2023, B.C. developed mental health symptoms including anxiety and depression. In October 2023, he was diagnosed with generalized anxiety disorder, and in December 2023, he began treatment with psychiatrist Dr. Omar Hasan. Dr. Hasan diagnosed him with recurrent major depressive disorder and generalized anxiety disorder, relating both conditions to the work injury. B.C. also had a 15-20 year history of alcohol abuse. The claim administrator denied adding these psychiatric diagnoses as compensable conditions in May 2024, and the Encova Select Grievance Board affirmed that denial in July 2024, citing that symptoms did not appear until after unrelated lung surgery.
The Workers’ Compensation Board of Review reversed in October 2025, finding that both recurrent major depressive disorder and generalized anxiety disorder should be added as compensable diagnoses. United Coal appealed.
The Court’s Holding
The Intermediate Court of Appeals affirmed in part and reversed in part. The court held that recurrent major depressive disorder is a compensable condition arising from the work injury. The court found persuasive the treating psychiatrist’s opinion that the diagnosis was causally connected to the compensable injury, corroborated by medical records documenting anxiety and depressive symptoms following the June 2021 accident. No evidence showed B.C. had major depressive disorder prior to the injury. The court deferred to the Board’s findings and weighing of medical evidence on this issue.
However, the court reversed the Board’s decision regarding generalized anxiety disorder. West Virginia Code of State Rules § 85-20 Exhibit A classifies generalized anxiety disorder as a psychiatric diagnosis that is not compensable unless it is documented as “due to a general medical condition” where that medical condition was caused by the work-related injury. Dr. Hasan’s diagnosis and treatment notes failed to include this required language. The court found the Board was “clearly wrong” in finding generalized anxiety disorder compensable under the regulatory framework, citing Gration v. Contura Energy Inc. for the proposition that generalized anxiety disorder must be attributable to a general medical condition to be compensable.
Key Takeaways
- Major depressive disorder can be a compensable psychiatric condition in West Virginia workers’ compensation claims when medical evidence establishes a direct causal connection to the compensable injury and no pre-injury diagnosis exists.
- Generalized anxiety disorder is statutorily restricted and cannot be compensable unless the diagnosis explicitly states it is “due to a general medical condition” caused by the work injury—mere documentation of causation is insufficient.
- Courts will defer to the Workers’ Compensation Board’s factual findings and weighing of medical evidence regarding psychiatric causation, but will strictly enforce regulatory requirements about which diagnoses are categorically eligible.
- The treating psychiatrist’s opinion carries significant weight, particularly when informed by ongoing treatment relationship and corroborated by other medical records.
Why It Matters
This decision clarifies a critical distinction in West Virginia workers’ compensation law: while major depressive disorder can be compensable as a psychiatric injury arising from workplace trauma, generalized anxiety disorder faces a higher regulatory barrier. Insurers and claimants must distinguish between these diagnoses, as generalized anxiety disorder requires specific regulatory language tying it to an underlying medical condition caused by the injury. The case demonstrates that regulatory classifications trump case-by-case medical evidence when statutory language is explicit.
For practitioners, the decision reinforces that psychiatric diagnoses in workers’ compensation require careful attention to both medical causation and regulatory eligibility. Mental health treatment stemming from workplace injuries may be compensable, but only if the specific diagnosis fits within West Virginia’s statutory framework and is properly documented by treating physicians. The ruling also shows that courts will enforce technical regulatory requirements strictly, even when medical evidence of causation exists.