Workers’ Comp 101: Does Workers’ Compensation Cover Mental Illness?

In 2018, a staggering 2.8 million nonfatal workplace injuries occurred in the US. The previous year also had the same number of nonfatal occupational injuries.

Now, keep in mind that those figures above are only for the reported incidents. What’s more, they’re only for physical injuries and diseases. They don’t include mental illnesses that develop due to work-related factors.

This, however, doesn’t automatically mean that workers’ compensation coverage excludes mental disorders. In many states, a mental illness may still be compensable under workers’ comp.

We’ve outlined the key facts about workers’ comp and mental disorders below, so be sure to read on.

What Is Mental Illness?

Mental illness is a health condition that involves one’s emotions, thoughts, or behaviors. It causes a person to have poor health due to a disease of the body or the mind. It can also result in significant problems in a person’s functioning, be it at home, work, or society.

Note that there are at least 300 different types of established mental illnesses. The most common across all populations, however, is anxiety disorder (AD). Depression, post-traumatic stress disorder, and eating disorders are also prevalent.

As such, work-related mental illness is a mental illness that has to do with one’s occupation. For example, anxiety disorders, which affect 20% of all US adults, can take root in the workplace. In many cases, workers with anxiety disorders are those with high-stress or risky jobs.

Studies also found that almost a quarter of US workers have had a diagnosis of depression. Of these employees, 40% said they had to take an average of 10 days off of work due to their condition.

As with anxiety, depression can also arise from work-related factors, such as stress. It could also be a complication of work-induced anxiety disorder.

When Does Workers’ Compensation Cover Mental Illness Then?

Workers’ compensation may cover mental illnesses that develop due to work factors. In many cases, covered conditions include anxiety, depression, and even PTSD. In fact, several states have workers’ comp laws with specific clauses for PTSD.

In California, for instance, workers’ comp provides benefits to first responders with PTSD. This 2020, a new law took effect to include cops and firefighters.

What about non-first responders, cops, or firefighters? Do these workers get coverage for mental illness too?

This largely depends on the state, as state governments regulate workers’ compensation. Most states do have provisions for mental illness or injury coverage. However, most of these only apply to very few instances, such as a sudden incident.

What Do You Need to Have a Valid Mental Illness Claim?

In all workers’ comp cases, claimants must prove that their injury is work-related. In this way, incidents that result in physical injuries are not that difficult to prove. That’s because the injury itself can often serve as the actual evidence.

The thing is, documentation is still usually needed for filing a mental illness claim. Now, this is where it gets tricky, as mental disorders don’t really show up on X-rays or CT-scans.

Things can get even more complicated since a claimant needs to establish a causal link. This is to prove that the mental illness indeed arose from work-related factors.

Let’s use anxiety disorders as an example. For workers to have a valid claim, they have to demonstrate that their AD is due to their job. They also need to back this up with proof that personal reasons didn’t cause their condition.

State laws make the process even more burdensome because of specific limitations. For example, many states, like Idaho, require that a worker must have had a physical injury first. There should also be a direct relationship between the physical and mental harm.

In other states, coverage for mental illnesses only applies to first responders. In Kentucky, for instance, only first responders can get compensation for PTSD. Moreover, there’s no coverage for any other type of work-related mental injury.

There are a few states, though, that recognize pure mental illness as a compensable injury.

For example, workers in Oregon can feel a bit more at ease as the state covers any mental disorder. They can get compensation even if their work-related condition is purely psychological. They don’t need to tie their mental illness to a physical injury to get workers’ comp coverage.

Delaware, Illinois, and Iowa also cover mental illnesses without physical cause.

Tips For Filing a Mental Illness Worker’s Comp Claim

Do note that even physical injury workers’ comp claims get denied all the time. In 2017, for instance, insurance companies declined some 7% of claims. To make matters worse, most of these rejections were bona fide filings.

So, you can just imagine how denial can be even more likely for a mental illness claim.

It’s for this reason that you should consider hiring a local workers comp lawyer. These are attorneys who specialize in your state’s specific workers’ compensation laws. They can help you determine if you have a valid claim from the get-go.

From here, they can advise you if you have enough to go on and pursue a claim. They will study your case and see what you can do to prove that you have a work-related mental illness. They can help you gather evidence that can prove the causal link between your work and your illness.

Don’t Let the Stress of Filing a Claim Add to Your Illness

As you can see, workers’ compensation may or may not cover mental illness. It all depends on your state laws and what they consider a mental illness or injury. As such, if you are unsure, it’s best to get in touch with a workers’ comp lawyer.

With the help of a workers’ comp attorney, you may have better chances of getting your claim approved.

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Written by George K.

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