Does Texas Allow Workers' Comp Claims for Depression, Anxiety, or PTSD?

The workers' compensation system allows Texas employees to obtain benefits for on-the-job injuries or illnesses that prevent them from working, regardless of who was at fault.

An employee making a claim must demonstrate that their injury occurred in the course of their employment and that they are unable to return to work either temporarily or permanently.

Some injuries have a clear connection to one's work, such as broken bones suffered in a fall at a construction site or injuries sustained by a delivery driver in an accident while out on a route.

The modern workplace can also cause people to suffer from mental health conditions like depression, anxiety, and post-traumatic stress disorder (PTSD).

Texas workers' comp law allows claims for certain types of mental health issues. Read on to learn more about what kinds of mental health conditions might qualify for workers' comp in Texas.

Does Texas Law Require Employers to Carry Workers' Comp Insurance?

Before you can claim workers' comp benefits for a mental health condition, you must determine whether your employer has workers' comp coverage. Workers' comp is a type of insurance. Every state except one requires most or all private employers to have workers' comp insurance policies. Texas is the lone exception.

Texas only requires public employers to have workers' comp insurance. Coverage is optional for most private employers. (Tex. Lab. Code § 406.002 (2024).) An employer that chooses not to carry workers' comp insurance must provide written notice to its employees and the state. (Tex. Lab. Code §§ 406.004, 406.005 (2024).)

Does Workers' Comp Cover Mental Health Conditions in Texas?

Workers' comp benefits are available for some mental health conditions in Texas. As a general rule, this applies to mental health conditions that arise from a specific incident in the workplace.

Example. Two window washers fall from a scaffold in windy conditions. The first man's fall is broken by a support cable and he suffers only minor injuries. However, he watches the other man fall eight stories to his death. If the first man suffers PTSD or depression as a result of the incident, he would likely have a claim for workers' comp benefits. (The other man's next of kin would receive workers' comp death benefits.)

In addition, some mental health conditions, such as stress or anxiety, can have significant physical effects. Workers' comp in Texas would cover a heart attack that results from "a specific event occurring in the course and scope of the employee's employment."

This does not apply to heart attacks that result from "emotional or mental stress factors" unless you can prove that a "sudden stimulus" was the cause. (Tex. Lab. Code § 408.008 (2024).)

When Mental Health Conditions Are Not Covered

Conditions that develop over time, such as depression resulting from workplace stress, are not covered by workers' comp, with an important exception for first responders discussed below.

Mental trauma injuries mainly resulting from "a legitimate personnel action" are likewise not covered by workers' comp. (Tex. Lab. Code § 408.006 (2024).) For example, if you've suffered depression or anxiety after being disciplined, demoted, or fired—assuming these actions were legitimate and not discriminatory or otherwise unlawful—your condition won't entitle you to workers' comp benefits.

Does Workers' Comp Cover First Responders with PTSD in Texas?

Workers comp benefits are typically not available for mental health conditions that develop over time, rather than in response to a single incident. A stressful or dangerous workplace can take a mental health toll over time, but this is not an "injury" for workers' comp purposes in Texas.

An important exception applies to first responders, whom most would agree have a uniquely difficult and stressful job. The term "first responder" includes:

• law enforcement officers, including sheriffs, constables, marshals, officers, rangers, investigators, and deputies
• emergency medical technicians; and
• firefighters.

A first responder must have a diagnosis of PTSD that meets the standards of the most recent edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, which is currently the DSM-5. The diagnosis must also state that:

• their PTSD resulted from "one or more events" that occurred in the course of their employment, and
• the evidence suggests that it is more likely than not that the event or events were "a producing cause of the disorder." (Tex. Lab. Code § 504.019 (2024).)

State law does not limit the availability of benefits to PTSD arising from certain types of incidents. Some states require evidence that a first responder developed PTSD because they witnessed a death while on the job or provided care to someone who suffered an injury that would prove fatal. Texas requires only proof that the condition developed because of the job.

Texas first responders are also not limited to PTSD that arises from a single traumatic incident. By specifying "one or more events," the statute makes it clear that they may claim benefits for a condition that develops over time.

Contact a Workers' Comp Attorney

If you're filing a claim for workers' comp benefits in Texas based on depression, anxiety, or PTSD, you likely face an uphill battle. Contact a workers' comp attorney to give yourself the best chance of receiving benefits.