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.
Filed under Case studies, Depression by 
Workers’ Compensation Insurance and Occupational Disease/Injuries
As you may already know, Workers’ Compensation insurance is one of the most widely accessible entitlement programs in the US today. It is most commonly referred to as a series of paid benefits available to any employee who is injured on the job or becomes ill as a result of performing their jobs. Federal and state laws require all employers to provide Workers’ Compensation benefits to all employees, and it is usually available through a private carrier. Additionally, employees are paid these benefits regardless of whose fault the accident or injury is.
Workers’ Compensation insurance can cover occupational diseases and injuries like asbestosis/mesothelioma, repetitive motion injuries, and even injuries to the immune system due to exposure to any number of allergens or toxins. In the following workers’ comp case study, for example, my client sustained severe and debilitating injuries to her immune system due to work-related exposure to latex.
Latex allergy case involving hospital worker
A hospital employee, we’ll call her Jane, recently filed a Workers’ Compensation case with us due to how sick she has become because of an allergenic reaction to latex encountered on her job. Beginning in 1986, Jane began working for a hospital pediatric oncology/hematology unit as a staff member. She was well-liked by her fellow employees and was considered to be an excellent employee.
However, she began experiencing a variety of symptoms such as breathing difficulties, discomfort at work, and severe headaches. At that time, Jane was referred to the employee health department, where she would be diagnosed with a severe latex allergy after numerous tests. This allergy has impacted her life severely and resulted in ongoing health problems. She initially took a 6-month leave of absence from her job, receiving no TTD (Temporary Total Disability) while she was not working.
In order to avoid any contact with latex, when she returned to the job, she took a position in the hospital’s call center. Three months later, she encountered another allergenic reaction to latex while working the call center and left that department. Although her employer subsequently set her up to work from home with cables and wires attached to a computer modem, the cables were coated in latex and she had yet another flare-up. As a result, she can no longer work at all, as her latex allergy has severely damaged her immune system.
Today, Jane cannot work, and she is currently taking a number of medications as a result of her allergy to latex. These medications include Adavair, Albuterol, Nascort, Singulair, and Toanex. As if these weren’t enough, she has been forced to carry an Epinephrin pin with her at all times.
On a closing note, where the above case is concerned, we demanded “X” amount in order to settle the case once and for all, as well as see to it that Jane is compensated for what she has endured and how her financial earnings and future have been severely impacted by her work-related injuries. This is why it pays to have a workers’ compensation attorney on your side; we can help maximize your benefits and medical care and help settle your case to that you get the best outcome possible.
Filed under Case studies, Occupational Diseases/Injuries by
Recently I had a workers’ comp case where my client suffered from a very severe and complex ankle injury and had to undergo 2 surgeries over a period of several months. Even after the surgeries, she still required ongoing medical care and had limited range of movement, resulting in her inability to work certain jobs.
When her initial workers’ comp benefit was calculated, she was awarded a weekly TTD benefit that was a gross underpayment when you looked at all the care she needed and the specifics of her case. After a careful review of the case, it became obvious that her benefit was mis-calculated due to her position as a waitress – where a lot of the money she brought in was due to TIPS.
You see, many times servers and bartenders and other workers who bring in significant income from tips end up experiencing improper wage calculations and mis-calculations of benefits owed when in pursuit of workers’ comp cases. The same is true for workers who work off commissions or receive large bonuses.
In my client’s case, we were able to get her the benefits she deserved (we ended up securing higher TTD benefits, plus TPD and PPD as well), and we were also able to re-calculate her wages to reflect a more accurate picture of what she had been making at the time of the accident. This is why it pays to have a workers’ comp attorney helping you with your case – we see these situations often and can often help you maximize your benefits.
In any case, the tip of the day is this: To anyone bringing in significant income from tips, commissions, or bonuses, KEEP GOOD RECORDS in the event that you are one day injured and have to pursue a workers’ comp case!
Filed under Foot/crush injuries, Income benefits, Maximizing your settlement by
Recently I had to handle a situation for a client when the workers’ compensation insurance company denied treatment for migraine headaches caused by medication given to my client by an authorized physician.
In this case, my client hurt his back badly about a year previously when he was lifting HVAC equipment. For several months, the insurance company fought us in our attempt to get proper medical treatment but eventually I was able to get him to a good doctor who scheduled him for surgery to repair a large herniated disc in his lumbar spine.
Post surgery, my client developed complications when fluid began to build up in the spinal canal. The surgeon prescribed a strong medication to help drain the fluid and prevent an infection. Unfortunately this strong medication resulted in migraine headaches.
Although the migraine headaches were new, the law in Georgia is clear that medical treatment and medications necessary to treat a complication from a compensable injury is also compensable and must be paid for by the insurance company. And, in fact, the insurance adjustor originally assigned this case, authorized my client’s pharmacy to dispense his migraine medication
Several weeks into the treatment regimen, a new adjustor was assigned to this claim. The new adjustor decided that the migraine headaches were not related to the work injury and she canceled the pharmacy authorization. Suddenly, my client was left without medication to treat his frequent and painful migraine headaches.
As you might imagine, this development left my client in a great deal of pain. I immediately got on the phone with the adjustor but she would not change her position. I then wrote the treating doctor to request a statement from him that “connected the dots” and related the migraine headaches to the original work injury. I also got on the phone to the defense attorney representing the employer/insurer to demand that my client’s prescription be approved. It took about 5 phone calls until I finally got the defense attorney to call me back – he acknowledged that our position was correct and he was able to convince the adjustor to start the medication authorization again.
This type of arbitrary action by workers’ comp insurance adjustors is all too common. Adjustors come and go and a reasonable, knowledgeable insurance claims person can be replaced by someone new who is inexperienced, stubborn or even vindictive. As a claimant’s lawyer, I make every effort to stay on top of problems like the one my client experienced and to take whatever steps are necessary to solve these problems.
Although Georgia’s workers’ compensation system is supposed to foster an environment where legitimately injured workers can get needed treatment and then return to work, the reality is much different. It has been my experience that workers’ compensation practice is just about as adversarial as divorce practice. Often justice and fair play take a back seat to “winning” and efforts by employers insurance companies to avoid paying benefits.
Case in point. This week I received the following email from a young woman who works at a factory in north Georgia:
Where I work I have been told that carpel tunnel is not recognized as a workman’s comp injury if I wasn’t having problems with numbness before. Is this correct?
The short answer is “no, this is not correct.” Repetitive motion injury (often resulting in a diagnosis of carpel tunnel syndrome) is a very common work injury, especially for factory workers performing manual labor with their hands.
Any employer who tells an employee that “carpel tunnel is not recognized as a workers’ comp. injury” is either very misinformed or downright dishonest. More on Employee Gets Bad Information About Legitimate Job Injury
A front page story in the Sunday, May 24, 2009 edition of the Atlanta Journal-Constitution details the struggle of five catastrophically injured Atlanta police officers to obtain needed medical help from the City of Atlanta’s workers’ compensation office. Each of these police officers was injured in the line of duty – with injuries ranging from brain damage to paralysis arising from gunshot wounds to the spinal cord.
Like many city and county governments, the City of Atlanta “self-insures” against workers’ compensation claims, meaning that weekly wage benefits and funds for medical treatment come directly out of the City’s budget. The City does use a private claim’s administration service called NovaPro Risk Solutions out of San Diego.
The City is not denying responsibility for paying wage or medical claims, but it has been refusing to pay for various medical procedures and medical devices.
In one instance a police officer who had been rendered a parapalegic from a gunshot wound needed surgery on his Achilles tendon because his feet kept slipping off his wheelchair footrests. More on Injured Atlanta Cops Fight Workers Comp System
In our Georgia workers compensation law practice, we regularly see carpal tunnel cases. Carpel tunnel syndrome arises when the muscles in the wrist swell and compress the nerve running down the arm into the hand. When this median nerve gets squeezed, you will experience pain, numbness and tingling in the hands. In severe cases, a patient can suffer permanent nerve damage. Females are more likely than males to develop carpel tunnel syndrome.
If rest does not resolve the condition, the usual treatment for carpel tunnel injuries is surgery called a carpel tunnel release expands the space for the nerve and tendons and thereby relieves the pressure on the nerve.
Carpel tunnel injuries usually arise from repetitive motion type jobs. Examples of these types of jobs include:
- deboning chickens
- typing
- sewing
- meat packing
- small parts assemblers
At Ginsberg Law Offices, we represent many carpel tunnel claimants. An important part of our work is to get our clients to a doctor who specializes in wrist, hand and repetitive motion injuries and to see to it that our clients get appropriate rehabilitation care. More on Carpal Tunnel Diagnosis Need Not Arise from Repetitive Motion Job Tasks
Filed under Carpel Tunnel, Case studies by
