Vanderbilt Law Review


Arthur Larson

First Page



"[H]ow could it be real when. . .it was purely mental?" This poignant judicial cry out of the past, which I occasionally quote to put down my psychiatrist friends, contains the clue to almost all of the trouble that has attended the development of workmen's compensation law related to mental and nervous injuries. This equation of "mental" with "unreal," or imaginary, or phoney, is so ingrained that it has achieved a firm place in our idiomatic language. Who has not at some time, in dismissing a physical complaint of some suffering friend or relative, airily waved the complaint aside by saying, "Oh, it's all in his head?" The impact of this pervasive preconception on compensation decisions can be briefly stated. A high proportion of the cases display a search for something-anything-that can be called "physical" to supply the element of "reality" in the injury. If the courts find this element, they are quite happy to award compensation even though the injury viewed as a whole is preponderantly mental or nervous. But if no such "physical" component can be identified, even some of the more sophisticated appellate courts still find themselves unable to justify compensation for a work-connected mental or nervous disability.