The Forensic Minute December 2025 Issue: Psychological Injury & Emotional Distress in Civil Law

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How Civil Courts Handle Psychological Injury & Emotional Distress

Psychological injury and emotional distress claims sit at the intersection of psychology and U.S. civil law. Unlike physical injuries, harms such as PTSD, anxiety, or depression must be clearly defined and linked to the defendant’s conduct to be compensable. These injuries are generally stress‑related conditions arising from real or reasonably perceived threats significant enough to be recognized in litigation. A key recent case is Cummings v. Premier Rehab Keller, P.L.L.C. (2022), where the Supreme Court ruled that emotional distress damages are not recoverable under private actions enforcing the Rehabilitation Act or the Affordable Care Act. The Court reasoned that such damages are not traditionally available under the relevant Spending Clause analogues. The decision highlights that while psychological injuries are acknowledged, recovery for emotional distress depends on the statutory framework and type of claim. In personal injury or tort cases, damages may be available through claims like negligent or intentional infliction of emotional distress, though these require strong proof of severity and causation.

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The Difficulty of Proving Psychological Harm

A major challenge in civil litigation for psychological injury is proving reliable, admissible evidence of emotional harm. Unlike physical injuries, psychological conditions are subjective and vary widely, and courts require plaintiffs to show that emotional injuries—such as PTSD, depression, or severe anxiety—are clinically significant, causally linked to the defendant, and exceed ordinary stress reactions. Alleging such injuries reduces psychological privacy, as mental health records and treatment may be disclosed, making expert evaluation essential to assess onset, severity, causation, and prognosis. Once psychological injury is asserted, experts must provide clear, evidence-based conclusions admissible under the Federal Rules of Evidence. Practical approaches include structured forensic evaluations using validated interviews and standardized measures to assess symptoms, timing, and functional impairment; clear documentation linking symptoms to the defendant’s actions through longitudinal data and collateral evidence; and interdisciplinary collaboration with treating clinicians to clarify diagnosis, rule out preexisting conditions, and strengthen evidentiary support. Applying rigorous assessment standards and clearly articulating causal links helps courts evaluate psychological injury claims and make informed decisions on emotional distress.

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The Importance of Comprehensive Records and Evaluation in Psychological Injury Claims

Medical and mental health records are essential when a psychological injury is claimed. These records provide insight into what was occurring during the period in which the injury is said to have developed. They help the evaluator understand patterns in thoughts, emotions, and behavior over time. Reviewing these records supports a fair and accurate evaluation. High-quality evaluations also rely on objective psychological testing, which helps assess the accuracy of reported symptoms. Such testing can identify malingering, feigning, or symptom exaggeration. A thorough evaluation clearly explains the diagnosis, examines the level of impairment, and outlines the expected course of the condition. Finally, it provides appropriate treatment recommendations based on the findings.

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References:

Ambeau, K. (n.d.). The crucial role of causation in emotional damages assessments. Mountain Skye Psychology. https://www.mountainskyepsychology.com/thecourtroompsychologist/the-courtroom-psychologist

Baldinger, B. G., & Nelson, D. T. (1995). Crime victims and psychological injuries. Trial, 31(2), 56–58, 60, 62, 64.

Colorado Department of State v. Baca, 591 U.S. ___ (2020).

Dobbs, D. B., Hayden, P. T., & Bublick, E. M. (2011). Intentional infliction of emotional distress. In The law of torts (2d ed., Chapter 28). West Academic Publishing.

Foote, W. E., Goodman-Delahunty, J., & Young, G. (2020). Civil forensic evaluation in psychological injury and law: Legal, professional, and ethical considerations. Psychological Injury and Law, 13(4), 327–353. https://doi.org/10.1007/s12207-020-09398-3

New York City Bar Association. (n.d.). Infliction of emotional distress. https://www.nycbar.org/get-legal-help/article/personal-injury-and-accidents/infliction-emotional-distress/