All over the United States, courts disagree about whether claims for negligent infliction of emotional distress should be recognized. Many states choose not to recognize this type of claim unless there was a physical injury as well, or at least an impact. Other states will allow a person to make this type of claim if they can show that their emotional distress resulted in a physical injury. The courts further disagree on what signs or symptoms qualify as a physical injury.
Maryland has quite a permissive rule on claims for negligent infliction of emotional distress. Years ago, Maryland courts used to require a strict physical injury to result from the emotional distress. Later, the modern rule was adopted which held that the “injury” resulting from the emotional distress could be a “mental state capable of objective determination.” To succeed in a negligent infliction of emotional distress claim in Maryland, typically you need to show that the effect on the individual’s functioning was extremely severe, or in the nature of posttraumatic stress syndrome.
Virginia, on the other hand, requires strict proof of a physical injury or actual physical manifestation of emotional distress. Virginia courts go further to require that the physical manifestation not be a typical or expected result of mental distress. This means that things like anxiety attacks and uncontrollable crying do not qualify.