By writ of certiorari, relator Marilyn Miels seeks review of the Workers’ Compensation Court of Appeals’ denial of her claim for death benefits following her husband’s suicide. The Court of Appeals overturned the compensation judge’s award of benefits to relator and her two minor children. We reverse and remand for further proceedings in accordance with this opinion.
I
The decedent Howard Miels was employed as a combination man by respondent Northwestern Bell Telephone Company (Bell) at Mora, Minnesota. His job required strenuous physical labor including cable splicing, trench digging, pulling in buried cables, and climbing telephone poles. On October 26,1972, when he was 29 years old, Howard sustained a disabling injury to his lower back arising out of and in the course of his employment. Howard twice underwent back surgery, but excruciating back pain and numbness forced him to stop working at Bell. Approximately 9 years after his injury, on July 2, 1981, Howard died of a self-inflicted gunshot wound.
Following his injury Howard’s life was dominated by mental suffering and despair. Shortly after the second back surgery Howard fell into a deep depression for which he was hospitalized. He was distraught by his inability to work and felt he was an inadequate husband and father. Howard’s relationships with his wife and children gradually deteriorated. He was extremely jealous of his wife and suspicious of her fidelity. He was also increasingly abusive of his son until in the spring of 1981 the 15 year old boy notified the welfare department. Howard was also dis *713 tressed by Bell’s surveillance of his activities since he believed they were indicative of the company ⅛ opinion that he was a malingerer. His problems were further exacerbated when early in 1980 he commenced drinking and thereafter developed an alcohol problem.
Expert testimony regarding the psychological effect of Howard’s back injury was provided by Dr. Robert Clark, a psychiatrist whom Howard began seeing in May 1973, shortly after he learned he was permanently disabled, and whom Howard continued to see on a monthly basis until his death. Dr. Clark diagnosed Howard as a paranoid-schizophrenic. He stated he was a man with very strong feelings of inadequacy and mistrust of others. Dr. Clark explained that while Howard was able to cope well with his psychological problems prior to his injury, his physical disability and the resultant blow to his self-esteem made his problems more pronounced. These psychological problems also contributed to Howard’s domestic difficulties which, according to Dr. Clark, were manifestations of his sense of lost power over the family. Dr. Clark testified that Howard’s work-related injury substantially contributed to his suicide, which Dr. Clark characterized as an impulsive act, and he stated that had the injury not occurred there was a “reasonable chance” that Howard would not have killed himself.
Dr. Loren F. Pilling, a psychiatrist who testified on behalf of Bell, never examined Howard and based his opinion on Dr. Clark’s records. Like Dr. Clark, Dr. Pilling testified that Howard’s injury and resulting physical disability were substantial contributing factors in his eventual suicide. He stated, however, that he could not identify the injury as the single event which caused Howard to commit suicide. Though chronologically first, according to Dr. Pilling, Howard’s injury was only one of several stressful events in his life which led to his suicide. In his opinion an altercation between Howard and his son precipitated an intentional suicide.
II
The primary issue presented is whether or not there is a sufficient causal relationship between Howard’s work-related injury and his death to allow compensation. Relying on
Hendrickson v. George Madsen Construction Co.,
The Hendrickson case, however, is inapposite. Hendrickson died of a myocardial infarct sustained shortly after testifying at a compensation hearing concerning his work-related shoulder injury. It was stipulated that the stress of his appearance at the hearing was a contributing cause of Mr. Hendrickson’s heart attack, but it was also conceded that neither the myocardial infarction nor Mr. Hendrickson’s underlying pulmonary emphysema and coronary insufficiency had any causal connection, either physical or mental, with the shoulder injury he had sustained five years earlier. We held that an injury which is medically unrelated to a compensable work-related injury does not become a compensable injury simply because it was sustained while the employee was pursuing a compensation claim. Since workers’ compensation is solely a creature of statute, policy decisions regarding the scope of the Workers’ Compensation Act are properly for the legislature; it would be an improper exercise of the judicial function to extend coverage to an event which does not arise out of and in the course of employment and is, therefore, beyond the compass of the Act.
Unlike Hendrickson, we are not here called upon to enlarge the scope of workers’ compensation coverage to include a suicide which does not arise out of and in *714 the course of employment. The issue now before us is whether or not the employee’s compensable work-related injury caused or was a contributing cause of his suicide in the medical or psychological sense. This is essentially a fact question which must be determined on a case by case basis — a process suited to the judicial function.
Minn.Stat. § 176.021, subd. 1 (1982), 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.,
Over the years courts have formulated two rules for determining whether or not a suicide arises out of and in the course of employment. Although not cited, the standard articulated in
Anderson v. Armour & Co., supra,
was derived from an early Massachusetts decision,
In re Sponatski,
[Wjhere there follows as the direct result
of a physical injury an insanity of such
violence as to cause the victim to take his own life through an uncontrollable impulse or in a delirium of frenzy “without conscious volition to produce death, having knowledge of the physical consequences of the act,” then there is a direct and unbroken causal connection between the physical injury and the death.
Id.
at
Once regarded as the majority rule, the
Sponatski
standard is couched in language long outmoded and is today seldom followed. The thrust of much of the criticism of
Sponatski
is directed to its failure to take into account the role pain and despair may play in the breakdown of the employee’s rational mental process.
See, e.g., Kahle v. Plochman, Inc.,
In recent years what is known as the chain of causation test has supplanted the
Sponatski
test as the majority rule. Under the chain of causation standard, 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.
In re Death of Stroer,
We conclude that the chain of causation standard is a realistic and reasonable criterion for determining whether or not a death by suicide is compensable under the Workers’ Compensation Act, and we adopt it as the standard henceforth applicable in Minnesota. The burden of proof is on the claimant to establish by substantial evidence that the employee’s work-related injury and its consequences directly caused a mental derangement of such severity that it overrode normal, rational thinking and judgment. The claimant must prove by substantial evidence an unbroken chain of causation between the work-related injury, the mental derangement, and the suicide. As in other subsequent injury situations, the work-related injury need not be the
sole
cause of the suicide, but it must be a substantial cause.
Roman v. Minneapolis Street Railway Co.,
Compensation will not be awarded if the suicide is caused primarily by non-work connected problems. The employer may attack the asserted causal chain with evidence that the decedent did not suffer from the claimed mental derangement or that stronger influences unrelated to the employment were the principal cause of the suicide. In those cases in which the employer presents evidence sufficient to rebut the claimed chain of causation, the statutory exclusion of self-inflicted injury is a complete defense. Minn.Stat. § 176.021, subd. 1 (1982).
Here the employee was hospitalized for depression shortly after learning that he was permanently disabled. He was diagnosed as a paranoid-schizophrenic. Although almost nine years elapsed between Howard’s work-related injury and his suicide, Howard was under the care of a psychiatrist, whom he visited monthly, during that entire period. Both psychiatrists agreed that Howard’s work-related back injury and its consequences were substantial contributing causes of Howard’s suicide. Although both regarded the altercation with the son as the event which precipitated Howard’s action, Howard’s treating psychiatrist testified that the breakdown of Howard’s relationship with his wife and children was itself the result of the injury. Inasmuch as the evidence is uncontroverted that Howard’s injury was a substantial contributing cause of the serious mental disturbance which ultimately resulted in his suicide, we hold that the employee’s death was compensable.
Ill
Because we have determined that Howard’s death is compensable, we address an issue which the Workers’ Compensation Court of Appeals did not reach: Does Minn.Stat. § 176.111, subd. 21 (1982), bar the payment to petitioner of weekly workers’ compensation benefits? Section 176.-111, subd. 21, provides that the combined total of weekly government survivor benefits and workers’ compensation benefits shall not exceed 100 percent of the de *716 ceased employee’s wage at the time of the injury which caused his death and that no workers’ compensation death benefit shall be paid for any week in which the survivor benefits paid under the federal program exceed 100 percent of such weekly wage.
In
Redland v. Nelson’s Quality Eggs, Inc.,
In calculating the amount of benefits to which the petitioner was entitled, the compensation judge correctly ruled that the claim for death benefits was governed by the Act in effect on the date of the employee’s death, July 2, 1981.
Borchardt v. Biddick,
The limitation imposed by section 176.111,subd. 21, shall first be applied to the combined total of weekly government survivor benefits, including mother’s insurance benefits and benefits for surviving dependent children, and workers’ compensation benefits. The allocation provisions of section 176.111, subd. 10, shall then be applied to such workers’ compensation benefits as are awarded after application of the limitation imposed by subdivision 21.
Relator is allowed attorney fees of $400.
Reversed and remanded for further proceedings in accordance with this opinion.
