Mental health conditions can be covered by workers' comp if you can prove the mental or psychiatric problem was primarily caused by your work. In addition, many states require you to show that your mental health condition was related to a physical injury or illness that occurred at work, or that it was the result of an unusual and extreme stressor.
Each state has its own workers' comp eligibility rules. Check with your state's workers' comp agency for the rules that apply to mental health conditions.
Workers' comp eligibility rules vary by state, but in most states stress, anxiety, PTSD, and other psychological illnesses only qualify for workers' comp in special circumstances.
In most states, if your psychological or psychiatric condition is tied to a physical accident at work or an illness caused by work, you can qualify for workers' comp. For example, workers' comp benefits would be available for a worker who suffers a traumatic physical injury and later develops anxiety disorder or PTSD (post-traumatic stress disorder) as a result.
Many states allow workers' comp claims for mental conditions caused by a stressor that is extraordinary or unusual in nature, such as a shooting in the workplace. An increasing number of states are also implementing or considering laws that provide workers' comp coverage for PTSD claims by first responders.
The process of filing a workers' comp claim is the same whether you're filing for a mental or physical condition.
The first step is to report your injury or illness to your employer, preferably in writing. For mental conditions such as stress that don't have an obvious start date, report your condition as soon as it's limiting your ability to work. States place strict deadlines on how long employees have to report workplace injuries or illnesses—often 30 days—so don't delay.
Next, your employer will provide you with paperwork to fill out regarding your claim. The employer submits these forms to its insurance company and the state workers' compensation agency. If your employer is disputing your claim, which is more likely for claims based on mental or psychological conditions, it can usually state its objection in the initial paperwork that accompanies the claim.
If your claim is disputed, you'll have to attend a workers' comp hearing in front of judge. If you haven't hired a workers' comp lawyer already, you should do so well in advance of your hearing. The hearing is your opportunity to present evidence to persuade the judge that your claim is legitimate.
The judge will issue a written decision on your claim, usually within a few months. The decision is sent to you, your lawyer, and the insurance carrier.
If the judge rules against you, you can file an appeal. Each state has its own appeals process and filings deadlines vary, but they can be as short as a few weeks.
Workers' comp claims based on mental or psychological conditions, such as a claim for work-induced stress, can be hard to win, especially without a workers' comp lawyer. And it can be hard to find a workers' comp lawyer to take your case, since the chance of winning are poor, and the lawyer will get paid only if you win your case. (Learn about how workers' compensation lawyers are paid in our article.)
Furthermore, the chances of winning a permanent disability award is even more slim (since you would be expected to recover after you left the job), and workers' comp lawyers are paid through a percentage of your permanent disability benefits.
Those benefits are awarded based on your permanent disability rating, which can be difficult to assess for mental conditions. In general, the most you could reasonably hope for is to get compensated for your medical expenses and some temporary disability benefits to replace your wages while you take some time off work.
In some cases, if you have a severe mental impairment that prevents you from going back to work, your best bet would be to file for Social Security disability based on your mental condition.
If you've experienced a work-related psychological or mental health condition that limits your ability to work, you probably do have a valid workers' comp claim. The hard part is proving it.
As noted above, it can be difficult to find a workers' comp attorney that will take claims based solely on stress and anxiety. So be persistent. You might have to call several, or more, to find one that will work for you.
Ultimately, if no attorneys want to represent you, you can still file and appeal the claim on your own. But finding an experienced workers' comp attorney will give you the best chance of persuading the workers' comp carrier or judge of the merits of your claim.
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