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PSYCHOLOGICAL EVALUATION of MARITIME STRESS CLAIMS
part 1 of 5

Albert M. Drukteinis, M.D., J.D.

Occupational illnesses and injuries are rising dramatically in the United States. In particular, stress-related illness has reached epidemic proportions among both blue collar and white collar workers, costing the United States some $200 billion annually. The unique physical perils and stresses of maritime industries make them especially vulnerable. In 1990, shipbuilding and repairing was in the top three industries for injuries involving lost workdays. In addition, longshoring and other services incidental to water transportation had the highest number of lost workdays per injury. Although physical injuries are the most common type of claim, the rise of stress-related illness, either as an independent mental disorder or in combination with a physical disorder, is a growing concern. Indeed, stress and psychosocial factors have been shown to have a strong relationship to physical conditions such as low back pain and repetitive motion injury which are among the highest causes of industrial disability. Therefore, evaluation of maritime stress claims involves an assessment not only of purely psychological disorders, but also physical disorders which may have associated psychological factors. At times, those psychological factors are the primary source of the condition.

Workers in the maritime industries often face exceptional job stresses. Seamen, for example, may work under difficult physical conditions and have less than ideal personal health habits. Behavioral risk factors such as alcoholism, smoking, and lack of leisure time physical activity are prevalent. Studies have identified a number of other factors which may have an adverse effect on health and well being. These include: constraints due to safety regulations and procedures, unusual shift schedules and work/leave patterns, confined living and working space, lack of privacy, absence of windows and natural light, noise and vibration, and isolation from family and friends. In a group of offshore gas and oil extraction industry workers, who were exposed to a hazardous working environment that is acknowledged to be dangerous, arduous, and socially isolating, levels of job dissatisfaction and anxiety were noted to be high. Comparing onshore and offshore employees in the oil industries, offshore workers consistently showed higher levels of anxiety, even though rates of overt mental illness were not clearly different. Most importantly, socioeconomic trends affecting labor have not spared the maritime industries. For example, in the past thirty years, the United States' fleet of privately owned and operated merchant marine ships has shrunk from around 900 to fewer than 400, and U.S. shipboard jobs have dropped correspondingly to less than one quarter of their original numbers. Cargo carriers complain that it is difficult to compete with foreign vessels. Inevitably, this creates an atmosphere of job uncertainty and insecurity which compounds existing stress.

When a personal injury or illness has occurred, maritime remedies are typically provided under general maritime law and statutory law. In stress-related illness, recovery is more complicated. For example, while seamen have a right to medical care and treatment under the maintenance and cure remedy, there is no clear recognition of a right to recover damages for negligent infliction of emotional distress which is unaccompanied by physical injury. However, in common law a physical impact is not required in all jurisdictions for recovery, and the U. S. Supreme Court has acknowledged, at least in the case of railway workers under the Federal Employers' Liability Act (from which the Jones Act for seamen was an outgrowth), that recovery was possible if the plaintiff was merely in the zone of danger. Therefore, stress claims need to be examined in light of both physical and non-physical precipitants, the distinction between which may often be less useful than intended.

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