Mental illness is a widespread issue in the United States, affecting a significant portion of the population. A 2005 study estimated that approximately half of Americans will meet the criteria for a DSM-IV disorder at some point in their lives. Stressful work environments often contribute to this problem.
Despite the prevalence of mental health issues, access to treatment remains challenging. According to the CDC, only 57% of employees reporting moderate depression and 40% reporting severe depression receive treatment to manage their symptoms. Efforts to improve mental health treatment accessibility have been made through federal regulations, aiming to align it with other medical and surgical treatments.
Many state workers compensation statutes fail to fully address these evolving needs. While workers compensation does offer coverage for mental health conditions in certain cases, it has not kept pace with the growing recognition of mental health challenges in the workplace. Nonetheless, workers’ compensation provides crucial support by covering medical treatment, lost wages, permanent partial disability, and rehabilitation benefits, serving as a vital safety net for injured workers.
Workers Compensation Generally
Employers in most states are required to insure for injuries that their employees sustain at work. Workers compensation insurance provides various benefits to injured workers:
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- Medical: Most workers compensation statutes require first dollar coverage for medical treatment necessary to treat a work-related injury.
- Rehabilitation: Many workers compensation statutes allow a vocational professional to assist with medical management and return to work efforts.
- Permanency: Permanent medical conditions are assigned a percentage rating, which corresponds to a monetary benefit payable to the employee.
- Wage loss: Workers compensation statutes cover wage loss during periods of disability caused by a work-related injury.
Psychological Injuries
Mandating coverage for injuries or illnesses arising during employment, the laws tend to address mental health conditions under specific circumstances but present limitations in coverage. Notably, workers’ compensation usually extends to PTSD stemming from employment-related incidents. However, coverage for other mental health issues is contingent upon their connection to a physical injury incurred at work. Typically, psychological conditions such as depression, anxiety disorders, adjustment disorder, and PTSD, arising from physical injuries, may be compensable.
The statutes tend to distinguish between physical and mental stimuli resulting in injuries, specifying that psychological injuries are compensable if caused by a physical stimulus. For instance, an employee experiencing depression or anxiety due to a workplace injury may qualify for benefits.
Moreover, the laws acknowledge mental stimuli leading to physical injuries, such as extreme workplace stress precipitating a heart attack. In such cases, where stress induces a physical ailment, workers’ compensation covers the resulting injury, although stress and anxiety alone are usually not compensable.
Establishing psychological claims poses challenges due to the subjective nature of mental health conditions. Unlike physical injuries, which leave tangible evidence, psychological injuries rely heavily on the testimony of mental health professionals to determine diagnosis and causation.
Post-Traumatic Stress Disorder
Many state workers compensation laws allow coverage for PTSD caused by a traumatic event at work. If PTSD arises from a work-related traumatic event, it generally will be covered akin to any physical injury. However, proof of diagnosis by a licensed psychiatrist or psychologist may be necessary.
In Minnesota, first responders diagnosed during their service are presumed to have work-related PTSD. Nevertheless, certain circumstances may lead to the denial of a first responder’s PTSD claim, including instances where PTSD results from disciplinary actions or job-related evaluations.
Conclusion
State workers’ compensation systems may offer avenues for addressing mental health concerns arising from employment, primarily through coverage for PTSD and psychological conditions resulting from physical injuries at work. However, improvements in coverage and support mechanisms may be necessary to ensure equitable treatment for workers facing mental health challenges in the workplace.