Workers’ Compensation Insurance can cover mental conditions. However, for this to happen, you really need to be able to link the mental condition to a specific event – such as a traumatic event experienced on the job or the development of a physical problem which then lead to your mental problem. Mental health issues are rarely compensable in and of themselves; linking them to physical events is key to receiving workers’ comp benefits based on psychiatric issues.
The argument would go something like this: At such and such time, you were injured on the job, at which point in time you begin exhibiting the signs of depression. The depression is clearly related to your job injury, and thus you should be eligible for Workers’ Compensation. Another example would be an individual having a heart attack due to the stress of their job, and in the aftermath developing an anxiety disorder which has debilitating consequences.
In any event, to get workers’ comp benefits, the primary condition or injury should really be physical in nature; however, mental conditions of the person would definitely be taken into consideration. Just know that for the most part, it must be proven that the mental condition was a direct result of a work environment that was not normal or a specific triggering event/injury.
Which leads to a last point – you will need evidence to show that this is the case. Naturally, something like a psychiatric evaluation would be required in order to determine whether a mental condition exists and whether it resulted directly from performing one’s job responsibilities.
Mental Health Issues and Workers’ Comp Case Study: The case of “Ms. D”
Ms. D experienced a head injury while on the job and was treated for it. However, she has been plagued with recurring headaches since the injury and treatment occurred. According to Dr. X, Ms. D suffers from continual headaches, and medical reports show that the headaches appear to be a direct result of the original injury and the medications taken as part of treatment.
In addition to the above, though, Ms. D is also anxious, depressed, and having difficulties sleeping. Consequently, she was fired from her 25-year job and hasn’t worked since. To deal with her mental health issues, she needs psychiatric care for depression, and relaxation techniques as prescribed by Doctors X and Y. She has been placed on “no work” status, and the net result of all of this will require that she receive TTD payments.
As her lawyer, I looked at all this information and was able to argue for a clear connection between the initial traumatic injury and the ongoing headaches and psychiatric issues. Treatment for both of these ongoing issues was pricey (we reviewed the costs and quotes for ongoing care), and we calculated a settlement amount for our client based on future medical care, follow-up appointments, future medications, and TTD requirements. Based on all the above, we demanded settlement of “X” amount on behalf of Ms. D’s and were able to successfully settle.
In conclusion, this was a case where we were able to get compensation based partially on mental health issues, but the key was clearly tying those issues to a physical event – in this case an on the job head injury.
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