One in five Americans lives with a mental illness, and mental health issues stemming from workplace events are becoming increasingly common. This is especially true for first responders. In fact, approximately 20% of firefighters and paramedics have post-traumatic stress disorder (PTSD)—a rate similar to that seen among combat veterans.
Some jobs are inherently more likely to lead to severe anxiety, but even jobs that don't require exposure to traumatic events can result in mental or emotional injury.
While all mental health issues deserve to be taken seriously, not all are covered by workers' compensation laws. Here's what you need to know about whether you can collect workers' comp benefits for a mental health condition.
Workers' compensation laws governing psychological conditions vary from state to state. The majority of states offer limited coverage for mental health conditions under specific circumstances, such as when the psychological injury arises out of a work-related physical injury, or is caused by a stressor that is extraordinary or unusual in nature. An increasing number of states are also implementing or considering laws that provide workers' comp coverage for PTSD claims by first responders.
Even if you are entitled to mental health coverage under your state's law, obtaining workers' comp benefits can be an uphill battle. Employers and insurers are often reluctant to compensate workers for psychological conditions because it can be hard to objectively measure these conditions or prove that they were caused by your job.
As a general rule, you're more likely to recover workers' comp benefits for mental health conditions in the following circumstances:
Your odds of recovering workers' comp benefits are higher if your psychological condition stems from a work-related physical injury. For example, if you sustain a back injury while on the job, and suffer a depressive disorder as a result, you'll likely be entitled to compensation for psychological injuries as well as for the original physical injury.
Many states don't allow any workers' comp recovery for mental health conditions unless they are tied to a physical injury. Even in states without such a law, it can be much easier to prove that mental health issues are work-related when they were caused by an on-the-job physical injury.
In an era of mass shootings, more and more states are instituting laws designed to protect the mental well-being of the firefighters, police officers, paramedics and other first responders who have to witness traumatic events as part of their job. At least a dozen states currently have laws allowing workers' comp coverage for PTSD claims by first responders, and many more states are considering passing such laws. These laws allow benefits for purely psychological injuries that aren't tied to any physical injury.
Some states, including Connecticut and New Mexico, have laws that apply only to certain types of first responders. Other states, such as Florida, allow recovery only when the first responders have witnessed a particularly horrific event. And a number of states have created a "rebuttable presumption" that a first responder's mental health issues are an occupational injury, which means that workers don't need to prove that their job caused their mental health issues. However, a workers' comp insurer can still contest that assumption by demonstrating that there is a non-work-related cause for an employee's psychological injury.
Some states provide workers' comp benefits for employees who have suffered purely psychological injuries like PTSD, even if they're not first responders.
In most of these states, however, the psychological injury must be the result of an extraordinary and unusual event or stressor. For example, in Colorado, mental health issues are compensable only if they are caused by a psychologically traumatic event that is generally outside of a worker's usual experience. And in New York, workers can recover benefits for psychological injuries only if the injuries arise from abnormal stress and unprotected employer actions.
There are a few states that don't impose this requirement. In California, for example, any employee may recover workers' comp benefits for a purely psychological injury even if it wasn't caused by an unusual, traumatic event, as long as the employee meets other requirements, such as being diagnosed with a mental disorder and proving that working conditions were at least 51% responsible for the disorder.
Just because you don't qualify for workers' comp benefits for a mental health issue doesn't mean you have no legal remedies. There are other laws that may help provide the time and resources you need to recover.
You may be able to receive unpaid leave and job protection under the Family and Medical Leave Act (FMLA). If you meet the definition of "disability" under the Americans with Disabilities Act (ADA), you are entitled to accommodations from your employer so you can do your job despite your disability. And if you have a severe mental impairment that prevents you from going back to work, you may be entitled to Social Security disability benefits.
Because workers' comp claims are often contested, they can be lengthy and complex. This is especially true for cases involving psychological injuries, as they are less straightforward than on-the-job physical injuries.
A workers' comp lawyer can help you evaluate your claim, navigate the various stages of the process, and recover the benefits to which you're entitled. Most workers' comp attorneys charge a fee only if you win your case, and don't require any money up-front.