While OSHA reports that 83% of Americans suffer from workplace stress, this isn’t a problem to normalize. It’s a matter of life and death. Workplace stress causes about 120,000 fatalities across the US annually.
Mental health claims aren’t the most common workers’ compensation claims, but they can help you recover damages for a traumatic work situation or increased anxiety surrounding your job.
Read on to learn the ins and outs of California mental health benefits and navigating workplace claims.
The Basics of Mental Health Claims
In some states including California, employees can get workers’ compensation for injuries related to stress and anxiety. “Injuries” include:
- Depression
- Anxiety disorders
- Post-traumatic stress disorder
However, to make an effective claim, you need to be able to prove that the psychiatric issue stems from work. Proving that your job was the root cause is key. Because of this, you and an attorney will need to work together to show how the stress came from work rather than day-to-day life outside your workplace.
This can be challenging. Because of this, most mental health claims are for unique, sometimes extreme, situations.
An easy-to-prove case would be a workplace shooting. If someone fires a gun in your office building and it causes PTSD, the case wouldn’t just be solid – offering up workers’ comp would be expected of the company.
However, in less extreme cases, people still can get compensation.
If an aggressive colleague hits you and you get PTSD from the assault, you can file for psychiatric damages. You may have a valid claim if a coworker or employer verbally abuses or harasses you as well.
It might be more difficult to prove, but some people may also get compensation if their job causes the development of an anxiety disorder or depression. Lawyers will work with you to prove that your anxiety or panic attacks are caused by a toxic workplace.
Only a reputable attorney can accurately tell you what to expect.
Requirements for Mental Health Compensation
In California, there are four requirements that you must prove you meet to receive mental-health-related worker’s comp benefits.
The first is having a “mental disorder” that professional psychologists have diagnosed. PTSD and anxiety are common, but some people also deal with depression, bipolar disorder, or even schizophrenia.
Second, you need to have:
- Needed medical treatment for the “mental disorder,” such as therapy or medication
- Missed work as a result of the disorder
- Been unable to complete your normal work tasks because of the disorder
Only meeting one of these points is necessary, but if you meet more than one qualification, you may be entitled to further damages.
Third, if you haven’t been working for a company for six months or more, you usually cannot file a claim for psychiatric injury. The exception to this rule would be a sudden event like a natural disaster or shooting in the workplace.
Finally, you need to prove that your job is the main cause of the psychiatric injury. Your lawyer needs to help you take multiple possible causes into account and show that work is 51% or more responsible for the mental health problem. Sometimes, in cases of significant workplace violence, 35% to 40% may be a sufficient percentage of the cause.
Filing Workers’ Compensation Claims
Not everyone is eligible for damages due to the mental health impact of their job. Psychiatric stress injuries don’t qualify for compensation if they’re the result of “normal personnel action.” This includes usual routine parts of a job like:
- Daily activities in your job description
- Meetings
- Appointments
- Promotions
- Transfers
To determine whether your stress is a result of these routine actions, ask a workers comp attorney about the specifics of your situation. They can give you more in-depth information about what you can expect.
Report Your Injury
If you suspect that you have a mental work condition due to workplace events, seek out a psychiatrist immediately. Get a diagnosis and report that diagnosis within 30 days.
Formal reports are important, so sit down with a human resources representative and make sure to take all recommended actions.
Fill Out Required Forms
Filling out the DWC-1 workers’ compensation claim form requires you to write out:
- Your personal information
- Details about the psychological injury and how it came to be
- Your social security number for claims processing
The employer will then fill out their own information and add claim form details.
Submit your DWC-1 directly to your employer.
Talk With a Southern California Workers’ Comp Lawyer
At this point, it’s time to talk with your lawyer again. Consult with the workers’ compensation attorney about your mental health claims and how difficult it will be to prove your case.
Once you feel good about taking action, your attorney will help you gather evidence. Some of this evidence may include documentation of your mental health problem. Gather:
- Medical records
- Medical bills
- Reports from doctors and psychiatrists
- Camera footage (if there was a specific traumatic incident that caused the disorder)
Your lawyer will help you submit this evidence to your employer and workers’ comp insurance agent. If they want more information, a reputable attorney can help you gather that, too.
Once this happens, the insurer will decide whether to accept the claim or not. If it gets approved, you are entitled to access funds to cover treatments like therapy. You may also be able to recover lost wages if the mental health problem forces you to take time off work.
If your employer denies the claim, there’s still hope. An attorney can help guide you through the appeals process to increase the chances that you get your due.
Start Navigating Workplace Claims with an Workers’ Comp Attorney
Now that you know the impact of mental health claims on California workers’ compensation, it’s time to learn more about recovering damages after a psychiatric injury.
Solimon | Rodgers, P.C. is committed to helping California employees get assistance for mental-health-related issues in the workplace. Our team works on contingency, meaning that you pay nothing unless you win your case.
We have over two decades of experience and have handled thousands of cases successfully, so contact us to schedule a free consultation with top California worker’s comp attorneys.
Call us at (844) 774-3577 or visit www.KingsofWC.com to learn more.
