The premise of the "thin skull" or "eggshell" plaintiff1 can be thought of as a carton of eggs.2 Looking at the carton itself, without opening it up to inspect the eggs for damage, one simply purchases the eggs "as they find them." Likewise, when a plaintiff is injured by the actions of a defendant, the universally accepted rule of American tort law that the defendant "takes the Plaintiff as he finds her" applies.3 According to the Restatement, "[t]he negligent actor is subject to liability for harm to another although a physical condition of the other which is neither known nor should be known to the actor makes the injury greater than that which the actor as a reasonable [person] should have foreseen as a probable result of his conduct."4
A condition that has received little attention in relation to the "thin skull" plaintiff rule and foreseeability of injury is posttraumatic stress disorder (PTSD). "The essential feature of Posttraumatic Stress Disorder is the development of characteristic symptoms following exposure to an extreme traumatic stressor 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 or learning about a similar event in relation to a closely connected person.5 Thus, PTSD is not congenital, but an injury caused by external events. Considered by many to be a mere emotional condition triggered by past traumatic events, recent studies have confirmed that PTSD is a condition where physical harm to the hippocampus and the medial prefrontal cortex results when a person experiences PTSD stimuli.6
PTSD is more widespread than the majority of the population realizes. Common types of psychological trauma that trigger the disorder are "car accidents, military combat, rape, and assault."7 In fact, approximately 7.7 million American adults (eighteen and older) have PTSD in a given year.8 When compared to adults who suffer from obsessive compulsive disorder (OCD) (2.2 million),9 panic disorder (6 million),10 or bipolar disorder (5.7 million),11 the number of people afflicted with PTSD is striking. For example, about 19% of Vietnam veterans experienced PTSD at some point post-war.12 In 2006, 89% of rape or sexual assault victims were women.13 Furthermore, nearly one-third of all rape victims develop Rape-Related Posttraumatic Stress Disorder (RR-PTSD) sometime during their life.14 Even more devastating is that roughly 16% of American women (40 million) are sexually abused before reaching eighteen years of age - the age of adulthood.15 Because of its staggering prevalence, childhood abuse may be the most common cause of PTSD in American women.16 Childhood abuse affects double the number of women (10%) as it does men(5%).17
Workplace sexual harassment results in so many cases of PTSD18 that this article will focus on women who have been physically violated due to sexual assault. "Traumatic events such as rape cause both short-term and long-term stress reactions."'9 This premise will form the foundation for applying the "thin skull" plaintiff rule in tort litigation.
Showing how abusive behavior in educational and work environments can cause physical harm to PTSD sufferers and open the negligent actors up to tort law liability under the universally accepted "thin skull" plaintiff rule is the focal point of this article. Part LI of this article explains PTSD as a medical condition. The law surrounding the "thin skull" plaintiff doctrine is evaluated in Part HI. Because there is evidence that PTSD is a physical injury, this section also addresses the possibility of moving it out of the realm of a mental injury and into the established and more accepted realm of a physical injury for the application of the "thin skull" plaintiff rule. Part LV examines workplace and educational scenarios where PTSD symptoms may be triggered. It also addresses the alternative notion that based on statistics, a reasonable person should have foreseen the injury as the probable result of his/her conduct. …