Brunell v. Wildwood Crest Police Department

The opinion of the Court was delivered by

These consolidated appeals present the issue of whether Post Traumatic Stress Disorder (PTSD) is an “accidental injury” or an “occupational disease” under the workers’ compensation statute. We conclude that the condition may qualify, depending on the circumstances, as either and that when the facts of a case straddle both categories, a worker is entitled to file both claims. Finally, we hold that in the narrow band of accident cases that result in latent or insidiously progressive injury, the accident statute of limitations does not begin to run until the worker knows or should know that he has sustained a compensable injury.

I

A.

Brunell v. Wildwood Crest Police Department

In 1995, Petitioner Diana Brunell was employed by respondent Wildwood Crest Police Department as a civilian police dispatcher. On June 2, she dispatched Officer Eugene Miglio to the scene of a vehicle stop. A scuffle ensued, during which the suspect struck Miglio on the chest. As a result, Miglio suffered a cardiac arrest *230 and died later that night. Although Brunell did not witness the incident directly, in addition to sending Miglio to the scene of his death, she called for medical assistance, informed and consoled other members of the police department, and arranged for notification of Officer Miglio’s widow. Immediately after the incident, Brunell suffered “symptoms of anxiety, depression, nightmares, irritability, fatigue, insomnia, and exaggerated startle response.” She became more tense as time passed.

In June 1999, Brunell began to experience difficulty at work, including disagreements with co-workers and other “emotional problems.” As a result, she was suspended for a week. The following month, a psychologist retained by the Department, Dr. Richard Cohen, diagnosed Brunell with a major depressive disorder. Brunell continued to see Dr. Cohen, who, on a subsequent visit, advised that Brunell “should not return to work.” Dr. Cohen also referred Brunell for further psychological evaluation. On August 20, 1999, Brunell was examined by Dr. William Miley and was diagnosed with PTSD as the direct result of Officer Miglio’s death in 1995.

On September 9, 1999, the Department’s insurer informed Brunell that her claim had been denied “for failure to report it in a timely fashion” and suggested that she pursue recovery through her private insurer. Dr. Miley then notified the insurer that

Ms. Diana Brunell is suffering from Post Traumatic Stress Disorder, with Delayed Onset (DSM IV-309.81). In this disorder, the symptoms do not occur until at least six months after the critical incident that initiated the condition. Ms. Brunell has noticed recently that she is experiencing symptoms of this disorder over which she has no control.

Dr. Miley reaffirmed that Brunell’s symptoms were the direct result of the 1995 incident.

On January 6, 2000, Brunell filed a claim petition seeking workers’ compensation. In the petition, she declared that the date of her accident or occupational exposure was June 2, 1995, and that she suffered from delayed onset PTSD as a result of Officer Miglio’s death. On April 3, 2000, the Department denied relief for *231 “failure to timely file a claim for an injury which occurred on June 2, 1995” and ultimately moved to dismiss the claim petition.

B.

Stango v. Lower Township Police Department

Petitioner Samuel Stango was a uniformed patrolman for the Lower Township Police Department for nine years, prior to his honorable resignation in 2000. On February 18,1994, Stango and a fellow officer, David Douglass, responded to the scene of a domestic dispute. When they arrived, the officers split up and took separate routes around the property. As Stango approached the backyard, he heard what sounded like gunshots. Stango found Douglass lying on the ground, the victim of a shooting in the throat. Stango held Douglass, who was bleeding from the mouth and ears, and watched him die. Following the incident, Stango noticed an increased anxiety level and began “having problems with awakening at night with panic feelings, anxiety and sweats, coupled with flashbacks and bad dreams.” He continued to work, however, without reporting his symptoms to the Lower Township Police Department because he felt that “it would just go away over time.”

In February 2000, Stango experienced what he called a “trigger incident” that led to a considerable increase in his anxiety level. He was carrying balloons into his house for his twin daughters’ birthday party when one of the balloons burst. The “pop” sound triggered a flashback that was “extremely intense and anxiety provoking.” That experience, in turn, set off a series of disturbing dreams involving snipers.

After the February incident, Stango sought help from several sources, including fellow officers, an FBI agent, and a “Stress Unit” on the Internet that referred him to a psychologist. On April 5, 2000, Stango discussed his troubles with his lieutenant who relieved him of his duties, requested the surrender of his *232 service weapon, and referred him to an Employee Assistance Program.

On April 13, 2000, Stango filed two claim petitions for Workers’ Compensation, one alleging that the date of his accident or occupational exposure was February 13, 2000 (the date of the balloon-popping flashback), and the other identifying the date as February 18, 1994 (the initial shooting incident). The Department’s insurer refused to cover Stango’s treatment.

On May 3, 2000, Stango was treated by Dr. Lawrence Clinton, a psychiatrist who concluded that he suffers from “an ongoing, chronic post traumatic stress disorder with anxiety reaction secondary to the work related incident when his partner was shot and Mr. Stango observed his death.” The doctor recommended psychotherapy, biofeedbaek, and medication.

On June 6, 2000, Stango filed a motion for medical and temporary disability benefits requesting payment for psychological/psychiatric treatment and payment for time lost due to his work-related injury. The Department filed an answer and a motion to dismiss for failure to comply with the time limitations set forth in N.J.S.A. 34:15-41 and -51.

C.

Although the facts of their cases are quite distinct, because Brunell and Stango raised many of the same legal issues, and because both the Wildwood Crest and Lower Township Police Departments were represented by the same lawyer, the two cases were consolidated and argued together before a single Judge of Compensation. The judge granted the motions to dismiss because neither petition was filed within two years of the “accident.”

The Appellate Division affirmed. Brunell v. Wildwood Crest Police Dep’t, 348 N.J.Super. 180, 791 A.2d 1030 (2002). In so doing, the panel focused on whether the claims for compensation based on PTSD should be adjudicated under the two-year “accident” statute of limitations, N.J.S.A. 34:15-41 and N.J.S.A. 34:15-51, or under the less onerous discovery-rule limitations period *233 prescribed for “occupational diseases.” N.J.S.A 34:15-34. Relying on Prettyman v. State, 298 N.J.Super. 580, 689 A.2d 1365 (App.Div.1997), and Schwarz v. Federal Shipbuilding & Dry Dock Co., 16 N.J. 243,108 A.2d 417 (1954), the court held that PTSD is compensable under the “accident” provision of the workers’ compensation statute when it arises from a single event. Id. at 189-92, 791 A.2d 1030. Citing Schwarz, the panel stated: “[0]urs is an ‘accident’ statute and not an ‘injury’ statute. Our courts have found no indication of a legislative purpose to suspend the running of the statute until the injury becomes manifest.” Brunell, supra, 348 N.J.Super. at 191, 791 A.2d 1030 (citing Schwarz, supra, 16 N.J. at 251, 108 A.2d 417). Because the “accidents” suffered by Brunell and Stango preceded the filings by more than two years, the court ruled that the claims were properly dismissed. We granted certification, Stango v. Lower Township Police Dep’t, 172 N.J. 359, 798 A.2d 1272 (2002) and Brunell v. Wildwood Crest Police Dep’t, 174 N.J. 40, 803 A.2d 635 (2002), and now reverse.

II

Brunell and Stango (collectively “claimants”) essentially maintain that PTSD is an occupational disease; that their time to file did not begin to run until they knew of their injuries; and that their claims are not barred by the two-year accident statute of limitations. The Departments acknowledge that PTSD can be characterized as either an accidental injury or an occupational disease, depending on the circumstances, but argue that when it arises out of a single unexpected or untoward event, it is classifiable only as an accidental injury, and thus is subject to the two-year accident statute of limitations. According to the Departments, therefore, both claimants are out of time. In order to evaluate the claimants’ contentions, both the relevant statutes and PTSD require explication.

Ill

With the passage of the New Jersey Workers’ Compensation Act in 1911, employees who previously had encountered great *234 difficulty in obtaining tort recompense for work-connected injuries became entitled to compensation for medical expenses and lost wages for such injuries, without proving fault. Monroe Berkowitz, Workmen’s Compensation: The New Jersey Experience 3-5 (1960); L. 1911, c. 95, § 7. The statute initially swept in only typical industrial accidents; however, “it rapidly became apparent that the new law failed to cover many of the developing hazards of industrial production, specifically the hazards of occupational disease resulting from exposure to toxic substances.” Suzanne Nussbaum & James Boskey, The Consumers League of New Jersey and the Development of Occupational Disease Legislation, 4 Seton Hall Legis. J. 101,110-11 (1979).

In 1924, the Legislature amended the compensation statutes to include toxic exposure cases. L. 1924, e. 124, § l(22b). Under the 1924 statute, a worker was covered for specifically delineated diseases 1 but only if the disability was reported within five months of the last exposure and the claim was filed within one year thereof. Ibid. Because “many of these diseases could manifest years after exposure, the limitations posed a serious problem.” Nussbaum & Boskey, supra, 4 Seton H. Legist. J. at 124. It was not until 1948 that the Legislature loosened the statute of limitations for occupational diseases by adding a two-year discovery rule, although maintaining an absolute five-year statute of repose. L. 1948, c. 468, § 2. A year later, the Legislature amended the section to cover all occupational diseases. L. 1949, c. 29, § 2. Eventually in 1974, in recognition of the insidious nature and delayed onset of many occupational diseases and the difficulty in pinpointing the exact date the disease process began, the five-year statute of repose was repealed, leaving only the discovery rule. L. *235 1974, c. 65, § l. 2

Because of the ameliorative effect that the Act was intended to achieve (swift recompense for injured employees), it has been characterized as important social legislation. Torres v. Trenton Times Newspaper, 64 N.J. 458, 461, 317 A.2d 361 (1974); Churukian v. Unarco Indus., Inc., 169 N.J.Super. 122, 125, 404 A.2d 343 (App.Div.), certif. denied 81 N.J. 352, 407 A.2d 1225 (1979). As a salutary remedial enactment, it is entitled to liberal construction in order to comport with its presumptive beneficence. See Fiore v. Consolidated Freightways, 140 N.J. 452, 465, 659 A.2d 436 (1995) (using liberal construction of workers’ compensation statute to find that heart disease arising from occupational exposure to carbon monoxide was compensable); Paul v. Baltimore Upholstering Co., 66 N.J. 111, 136, 328 A.2d 610 (1974) (“[O]ur courts have not hesitated in the past to construe the workmen’s compensation act so as to comport with its presumptive beneficent and remedial objectives.”). Overall, the statute is to be construed to bring as many cases as possible within its coverage. Lindquist v. City of Jersey City Fire Dept., 175 N.J. 244, 258, 814 A.2d 1069 (2003) (stating that social goal of Act to “implement legislative policy of affording coverage to as many workers as possible” applied “whether the claim involves an accidental injury or occupational disease, or whether the focus is on a well-established or a modern health condition”); see also Dawson v. Hatfield Wire & Cable Co., 59 N.J. 190, 197, 280 A.2d 173 (1971) (construing “wife” broadly so as to bestow death benefits to committed, non-married partner of deceased employee); Conley v. Oliver & *236 Co., 317 N.J.Super. 250, 257, 721 A.2d 1007 (App.Div.1998) (defining “employee” broadly to include claimant who was functional employee even though he bore official title of “independent contractor”). That is the backdrop against which the relevant statutory provisions are to be viewed.

IV

As indicated, our workers’ compensation scheme provides a remedy to an employee who suffers injury “arising out of and in the course of employment” either by accident, N.J.S.A. 34:15-7, or by contracting a compensable occupational disease, N.J.S.A. 34:15-34. The schedule of benefits is the same under both statutes, N.J.S.A 34:15-32, although different notice and claim provisions are applicable.

A.

Following the accidental injury format adopted by the vast majority of states, N.J.S.A. 34:15-7 provides in relevant part:

When employer and employee shall by agreement, either express or implied, as hereinafter provided, accept the provisions of this article, compensation for personal injuries to, or for the death of, such employee by accident arising out of and in the course of employment shall be made by the employer without regal’d to the negligence of the employer____

See 2 Arthur Larson, Larson’s Workers’ Compensation Law § 42.10 at 42-1 (2000) (summarizing “by accident” statutory provisions). The statute does not define “by accident”; however, it has been held that an accident “is an unlooked for mishap or an untoward event which is not expected or designed.” Klein v. New York Times Co., 317 N.J.Super. 41, 44, 721 A.2d 29 (App.Div.1998) (quoting duba v. Irvington Varnish & Insulator Co., 27 N.J. 127, 134, 141 A.2d 761 (1958)); see also Larson, supra, § 42.02 at 42-4 (“The basic and indispensable ingredient of ‘accident’ is unexpectedness.”). ' Obviously, it is not the mere mishap that triggers the compensation statute, but the mishap in combination with the statutory requirement of “personal injuries.” • N.J.S.A 34:15-7. To be an accident, what must be present is an “unintended or *237 unexpected occurrence which produces hurt or loss.” Spindler v. Universal Chain Corp., 11 N.J. 34, 38, 93 A.2d 171 (1952) (emphasis added) (quoting Ismay v. Williamson, [1908] AC. (Eng.) 437 (P.C.1908)).

Indeed, the entire workers’ compensation law is based on disability caused by injury. Cureton v. Joma Plumbing & Heating Co., 38 N.J. 326, 331, 184 A.2d 644 (1962). A worker simply has no claim unless he can demonstrate either temporary or permanent disability. N.J.S.A. 34:15-12 (providing schedule of payments for temporary disability, partial permanent disability, and total permanent disability). The former requires lost wages; the latter proof of a medical condition that materially “restricts the function of the body or of its members or organs” and the claimant’s ability to work. See N.J.S.A. 34:15-36 (defining permanent partial disability and permanent total disability); Perez v. Pantasote, Inc., 95 N.J. 105, 114-16, 469 A.2d 22 (1984) (holding permanent partial disability to be premised on showing of either “lessen[ing] of working ability” or “injury [that] substantially interferes with other, nonwork-related aspects of ... life”); Electronic Assocs., Inc. v. Heisinger, 111 N.J.Super. 15, 20-21, 266 A.2d 601 (App.Div.1970) (holding that claimant could not recover for temporary disability when she did not lose any wages). Obviously, none of those standards can be satisfied without injury.

That principle is underscored by the statute, which denominates “the occurrence of the injury” as the trigger for an employee to notify the employer. N.J.S.A. 34:15-17. That provision serves to insulate employers from having to investigate an onslaught of passing incidents that do not result in injury and therefore do not constitute accidents under the statute. Panchak v. Simmons Co., 15 N.J. 13, 22-23, 103 A.2d 884 (1954) (citing Hines v. Norwalk Lock Co., 100 Conn. 533, 124 A. 17 (1924)). Further, an accident claim cannot be filed unless the “injury” and its “extent and character” are described, thus obviating the possibility of filing a claim when injury is absent. N.J.S.A. 34:15-51.

*238 A “second ingredient” that has been added to the notion of injury by accident in most jurisdictions is that the injury must be traceable, within reasonable limits, to a definite time, place, occasion or cause. Larson, supra, § 42.02 at 42-4; Liondale Bleach, Dye & Paint Works v. Riker, 85 N.J.L. 426, 429, 89 A. 929 (Sup.Ct.1914) (adopting English definition of “accident” that “where no specific time or occasion can be fixed upon as the time when the alleged accident happened, there is no injury by accident within the meaning of the act”); Snoden v. Watchung Borough, 29 N.J.Super. 41, 46, 101 A.2d 583 (App.Div.1953) (defining accident as “an event happening at a specific time or occasion”), aff'd, 15 N.J. 376, 104 A.2d 841 (1954). When an untoward event occurring at a definite time causes a definite injury, Larson observes that “one has the clearest example of a typical industrial accident, in the colloquial sense: collisions, explosions, slips, falls, and the like, leading to obvious traumatic injuries.” Larson, supra, § 42.02 at 42-6.

B.

N.J.S.A. 34:15-31 defines “compensable occupational disease” as including

all diseases arising out of and in the course of employment, which are due in a material degree to causes and conditions which are or were characteristic of or peculiar- to a particular trade, occupation, process or place of employment.

By “characteristic of or peculiar to” is meant conditions that one engaged in that particular employment would view as creating a likely risk of injury. Those conditions must “cause” the disease as a natural incident of either the occupation in general or the place of employment. Walck v. Johns-Mansville Prods. Corp., 56 N.J. 533, 556, 267 A.2d 508 (1970) (stating that injury “must be due in some realistic sense and material degree to a risk reasonably incidental to the employment; [it] must issue from or be contributed to by conditions which bear some essential relation to the work or its nature”). In other words, there is attached to that job a hazard that distinguishes it from the usual run of occupations. See Lindquist, supra, 175 N.J. at 263, 274-75, 814 A.2d 1069 *239 (relying on medical epidemiological articles and expert testimony to conclude that firefighter claimant had demonstrated “by a preponderance of the evidence that his or her environmental exposure while fighting fires was a substantial contributing cause” of emphysema despite fact that claimant was also smoker); Magaw v. Middletown Bd. of Educ., 323 N.J.Super. 1, 731 A.2d 1196 (App.Div.), certif. denied 162 N.J. 485, 744 A.2d 1208 (1999) (granting compensation in case in which claimant developed lung cancer after twenty years of on-site exposure to co-worker’s secondhand smoke).

In differentiating between accidental injury and occupational disease, Larson observes that the basic “unexpectedness” ingredient of accident is absent in an occupational disease:

The cause is characteristic harmful conditions of the particular industry. The result is a kind of disability which is not unexpected if work under these conditions continues for a long time. And the development is usually gradual and imperceptible over an extended period.

[Larson, supra, § 42.02 at 42-6.]

c.

In most instances, when a worker is hurt on the job the claim is easily classifiable. For example, a worker who loses a finger due to a malfunctioning machine clearly has suffered an untoward or unexpected event resulting in hurt or loss. That is an accidental injury. Conversely, a worker who has developed emphysema, over time, due to continued toxic exposure in a chemical plant, plainly has experienced an occupational disease.

In a narrow band of cases, however, the denomination of exactly what the worker has suffered and when he has suffered it is less clear. According to Larson, those are the cases that fall somewhere between the two extremes and constitute a fruitful source of litigation. Larson, supra, § 42.02 at 42-6. This is one of them.

V

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, states:

*240 The essential feature of Posttraumatic Stress Disorder is the development of characteristic symptoms following exposure to an extreme traumatic stress or involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate.

[American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders 46S (4th ed. 2000) (“DSM-IV”).]

The development of a concise diagnosis for that set of psychological symptoms began in the late nineteenth century when the first forays into psychological treatment began to address the issue of “hysteria.” Symptoms of motor loss, convulsions, amnesia, and hyper-vigilance were examined and determined to be the result of a mental disorder peculiar to women. Judith Herman, Trauma and Recovery 10-12 (1997). Later, during and after the First World War, similar symptoms were discovered in men whose wartime experiences had left them “shell-shocked.”

Interest in the lasting mental effects of trauma remained strong through the Second World War, as psychologists struggled to treat soldiers who had witnessed, perpetrated, and been subject to the atrocities of war. Id. at 20, 26. But it was not until the Vietnam War that a broader political and psychological inquiry into the effects of combat trauma was undertaken. The experiences of Vietnam veterans who spoke out about the persistent mental difficulties that they had faced as a result of the traumatic incidents of combat led to a far-reaching rethinking of the ways in which trauma affects the individual psyche. Id. at 27. Post-traumatic stress disorder was recognized as a mental disorder and added to the DSM-IV in 1980, largely as a result of the grassroots efforts of Vietnam veterans and their allies to give credence to the symptomology that plagued so many soldiers who had returned from that conflict. Id. at 28.

Since its initial application to combat trauma, large-scale diagnoses of PTSD have been made in cases of survivors of domestic violence and childhood sexual abuse, asylum-seekers fleeing political violence and torture, survivors of natural disasters, and, most *241 recently, rescue workers and others involved in the September 11, 2001, terror attacks on the World Trade Center and the Pentagon. Karen E. Krinsley & Frank W. Weathers, The Assessment of Trauma in Adults, 6 PTSD Res. Q. 1, 1-2 (Summer 1995) (describing wide variety of traumas that can lead to PTSD); National Institute of Mental Health, Reliving Trauma: Post-Traumatic Stress Disorder, Publication No. 01-4597 (2001), available at http://www.nimh.nih.gov/publicat/reliving/efm (discussing widespread appearance of PTSD in aftermath of September 11th attacks).

The diagnostic criteria for PTSD are as follows:

A. The person has been exposed to a traumatic event in which both of the following have been present:

1. the person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.

2. the person’s response involved intense fear, helplessness, or horror. Note: in children, it may be expressed instead by disorganized or agitated behavior.

B. The traumatic event is persistently re-experienced in at least one of the following ways:

1. recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: in young children, repetitive play may occur in which themes or aspects of the trauma are expressed.

2. recurrent distressing dreams of the event. Note: in children, there may be frightening dreams without recognizable content.

3. acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: in children, trauma-specific reenactment may occur.

4. intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

5. physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

C. Persistent avoidance of stimuli associated with the ti’auma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:

1. efforts to avoid thoughts, feelings, or conversations associated with the trauma

2. efforts to avoid activities, places, or people that arouse recollections of the trauma

3. inability to recall an important aspect of the trauma

*242 4. markedly diminished interest or participation in significant activities

5. feeling of detachment or estrangement from others

6. restricted range of affect (e.g., unable to have loving feelings)

7. sense, of foreshortened future (e.g., does not expect to have a career,

marriage, children, or a normal life span)

D. Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least two of the following:

1. difficulty falling or staying asleep

2. Irritability or outbursts of anger

3. Difficulty concentrating

4. Hyper-vigilance

5. Exaggerated startle response

E. Duration of the disturbance (symptoms in B, C, and D) is more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

[DSM-IV, supra, at 467-68 (emphasis added).]

As can be seen from the foregoing, a diagnosis of PTSD can cover a broad variety of stressors and symptoms. It may result from a single traumatic event such as a fire or explosion that causes or threatens death or serious injury to the witness or others. Glenn R. Schiraldi, The Post-Trumatic Stress Disorder Sourcebook 1 (2000); Herbert Lasky, 1 Psychiatric Claims in Workers’ Compensation and Civil Litigation 16 (1993). It may also result from continued exposure to traumatic events such as occurs in combat, undercover police work, domestic abuse, or childhood sexual abuse. Jimmy P. Mann & John Neece, Workers’ Compensation for Law Enforcement Related Post Traumatic Stress Disorder, 8 Behav. Sci. & L. 447, 447-48 (1990) (describing wide variety of stressors that result in police officers suffering from PTSD and stating that officers experiencing cumulative traumas are much more likely to develop PTSD); Krinsley & Weathers, supra, 6 PTSD Res. Q., at 1 2 (suggesting that some cases of PTSD may result from culmination of traumatic events over span of time).

Symptoms may present quickly and last less than three months, in which case the PTSD is denominated as “acute.” If symptoms last more than three months, the condition is called “chronic.” *243 Schiraldi, supra, at 6; Mann & Neece, supra, 8 Behav. Sci. & L. at 49 (noting that after police officer witnesses traumatic event, PTSD symptoms may last days or several years). Although the symptoms may appear immediately after a traumatic event, they also may remain dormant until at least six months or more have passed, in which case the PTSD is specified as “with delayed onset.” Schiraldi, supra, at 6. In short, PTSD is a catchall phrase for an array of reactions to stress that can arise in various employment settings.

VI

There is no question but that PTSD is cognizable under the workers’ compensation statutes. With the passage of time, our courts have come to recognize legitimate mental stress claims as a compensable psychiatric disability. See Saunderlin v. E.I. DuPont Co., 102 N.J. 402, 410, 508 A.2d 1095 (1986); Margaritondo v. Stauffer Chem. Co., 217 N.J.Super. 565, 526 A.2d 711 (App.Div.) on remand from 104 N.J. 388, 517 A.2d 394 (1986). Indeed, Larson credits New Jersey with leading the way in recognizing the so-called mental-mental category of compensable injury — that is, cases in which a purely mental stimulus results in emotional or nervous injury. Larson, supra, § 56.04[1] at 56-16; see, e.g, Simon v. R.H.H. Steel Laundry, Inc., 25 N.J.Super. 50, 95 A.2d 446 (Hudson County Ct.), aff'd 26 N.J.Super. 598, 98 A.2d 604 (App.Div.), certif. denied 13 N.J. 392, 99 A.2d 859 (1953) (holding that purely mental injury suffered by railway worker following explosion in boiler room was compensable as accidental injury).

Moreover, PTSD already has been recognized in our case law. In Prettyman, supra, 298 N.J.Super. at 585-87, 689 A.2d 1365, the claimant, a clerk at the Attorney General’s Office, was traumatized and immediately suffered PTSD symptoms following a single incident of unduly harsh treatment at the hands of police who were investigating a crime within her office. The court declared Prettyman’s PTSD to constitute an accidental injury. Id. at 597,