Why Mental Illnesses Are Covered Under Workers’ Compensation

Can Workers’ Compensation Cover Mental Illness?


The extreme conditions under which first responders work take a toll not only on their bodies, but also sometimes on their minds. Underlying mental health issues related to traumatic stress tends to be an issue in the first responder community, and many have lost their lives to suicide in the last few months as a result. Sadly, many also resist seeking healthcare due to a lack of understanding of the connection between mental health care and mental illness, as well as the significant stigmatization associated with seeking help.


Vermont fortunately took one of the very first steps towards helping first responders by recently passing legislation enabling first responders to receive workers’ compensation. Workers’ compensation is now available to first responders in the state suffering from issues such as Post Traumatic Stress Disorder (PTSD) as a result of traumatic stress experienced on the job (as of July 1). Before, any mental illness had to be linked to a physical injury in order to trigger benefits. Many feel that other states will now follow suit and, similarly to Vermont, automatically provide this to those who work in first responder professions, such as firefighters and emergency medical technicians.



“Hurt On the Job”


In order to trigger workers’ compensation, an injury, disease, disability, or illness needs to arise out of the course of employment. In other words, it covers employees hurt on the job.


However, it does not have to be an obvious injury, like an injured back or carpal-tunnel syndrome. Workers’ compensation also covers work-related illnesses, such as those that arise from exposure to toxic materials or unsafe working conditions.


While under other state laws (such as the Pennsylvania Workers’ Compensation Act), it is possible to apply for workers’ compensation for a mental health issue, it can, under some circumstances, be more difficult to provide sufficient medical evidence to trace the cause of that mental health issue to employment. What Vermont’s law does is help facilitate this process for first responders, making it easier to establish the causal link between the mental illness and the job. By drawing attention to the traumatic stress that first responders often experience as an inherent aspect of their everyday jobs, the legislation proves that presumption or burden of proof to help the claimant in those circumstances.



Pennsylvania Workers’ Compensation Facts: Mental Health


Pennsylvania law provides for three categories of psychological injuries:

  • Physical/mental (where a psychological stimulus causes physical injury) and mental/physical (where a physical stimulus causes a psychic injury): claimant must prove that injuries arose in the course of employment by a preponderance of the evidence. Example: an injury involving an amputation that leads to a psychological or psychiatric condition.


  • Mental/mental (a psychological stimulus causes a psychic injury): claimant must demonstrate abnormal working conditions and that any psychological injuries are not a subjective reaction to normal working conditions, making it more fact-specific and difficult to prove than the other two categories. One case example that arose in Pennsylvania involved harassment of a worker which triggered a pre-existing condition, whereby the employee was awarded workers’ compensation after comments made by a supervisor led to a mental health issue that triggered a pre-existing health issue.





While some types of mental injuries are already difficult to prove under the elevated standard to which they are held, there can be an additional challenge if and when these conditions take years on the job to develop, and even more challenging if the mental injury is linked to one particular incident that occurred.


PTSD, a condition that many suffer from, especially those who work in first responder professions, is a growing issue that still involves certain complexities when it comes to obtaining workers’ compensation. This condition is most commonly associated with soldiers and even those who witnessed the September 11 attacks, and involves a delayed psychological response after experiencing an extreme situation that interferes with one’s ability to cope. This can present challenges in drawing the causal link to the workplace, particularly since PTSD symptoms can take months or years after the event to show up.



Workers’ Compensation for Mental Health and Health Insurance


It is important to note that while all workers’ compensation claims are scrutinized, the psychological injury cases are arguably even more so, and health insurance companies often investigate every area of the claimant’s life. This includes any history of mental illness, criminal records, your family, financial issues, and more. This is yet another reason why working with an experienced workers’ compensation attorney is so very important—to ensure that you are as protected as possible.



An Attorney Can Help


Obtaining the assistance of a workers’ compensation lawyer can help provide you with the guidance you need to get through the application and/or appeals process. This is especially important if you are applying for workers’ compensation for a mental health-related issue because it can be more difficult. In addition, work injury attorneys can also advise you as to any other benefits for such you may qualify, such as social security disability.



Contact Our Team


At Krasno, Krasno & Onwudinjo, we believe it is important to have a workers’ compensation attorney by your side through the process to help your application and/or appeal be successful. Contact a dedicated member of our legal team today at (877) 299-0779 to find out more information or if you have questions regarding a case.

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