Is PTSD Covered By Workers Compensation?

When we think of workers’ compensation laws, what first comes to mind are often the protections and benefits given to employees who have sustained a physical injury at the workplace. However, workers’ compensation is not limited to physical injuries from the job. Workers’ compensation insurance includes benefits for a mental health injury that results from the workplace and negatively impacts an employee’s ability to work and their quality of life.

Workers’ compensation can cover mental health conditions like Post-Traumatic Stress Disorder (PTSD) and psychological injuries that result from workplace trauma or a harmful work environment. However, to receive benefits, workers must prove their mental health condition was directly caused by their job or workplace.

Defining Post-Traumatic Stress Disorder

When we think of workers’ compensation laws, what first comes to mind are often the protections and benefits given to employees who have sustained a physical injury at the workplace. However, workers’ compensation is not limited to physical injuries from the job. Workers’ compensation insurance includes benefits for a mental health injury that results from the workplace and negatively impacts an employee’s ability to work and their quality of life.

• Clinical Definition: the Social Security Administration defines Post-Traumatic Stress Disorder (PTSD) as a mental disorder that can develop after a person directly witnesses or experiences a traumatic event.
• Distinguishing PTSD from Acute Stress Disorder: Both Post-Traumatic Stress Disorder (PTSD) and acute stress disorder are responses to a traumatic event. Although the symptoms are similar, acute stress disorder usually begins immediately after the traumatic event. It can last for three days to one month, while PTSD may not present for up to six months after the traumatic incident and can last for longer than one month.
• Diagnostic Criteria: Diagnosis for PTSD is by clinical criteria such as exposure to a traumatic event and exhibiting clinical symptoms, including re-experiencing the event symptoms, avoiding certain situations, negative impact on mood or cognition, altered reactions, and dissociation.
• Neurological and Psychological Impacts: PTSD can cause neurological changes in regions of the brain, and psychological impacts include depression, anxiety, negative thoughts, avoidance, and difficulty maintaining relationships.

Recognize the serious nature of workplace-related psychological trauma and seek professional assistance.

Workplace Trauma and PTSD

Workplace trauma, whether it is psychological trauma or physical trauma, can lead to Post-Traumatic Stress Disorder, which can negatively impact a worker’s job performance, mental health, and wellness.

• High-Risk Profession Scenarios: Certain professions are considered high-risk professions when it comes to PTSD. This includes medical workers, military personnel, police officers, and firefighters, who are at a greater risk of developing occupational PTSD due to the nature of their work
• Specific Workplace Traumatic Events that can cause PTSD: Specific workplace traumatic events that can lead to work-related PTSD include sexual harassment, physical assault, workplace accidents, verbal abuse, and witnessing another employee’s traumatic incident or serious accident
• Cumulative Psychological Stress: when someone experiences cumulative psychological stress over a period of time, this can result in serious mental injury, physical symptoms, psychiatric injury, and mental health conditions if the extreme psychological stress is not properly managed
• Unexpected Workplace Trauma Sources: sources of unexpected workplace trauma include behaviors such as harassment from co-workers or management, toxic work environments, physical or mental intimidation, and bullying.

If you are experiencing PTSD from the workplace, it is critical that you document and report the workplace psychological distress immediately.

Symptoms and Diagnostic Considerations

Common symptoms of Post-Traumatic Stress Disorder (PTSD) and diagnostic considerations include exhibiting the symptoms for more than one month, leading to extraordinary stress or impairment of day-to-day functioning.

• Comprehensive Symptom Overview: symptoms of PTSD include re-experiencing the traumatic event through flashbacks or nightmares, displaying symptoms of avoidance, exhibiting negative cognition and mood changes, and increased arousal from extraordinary and unusual stimuli
• Workplace Performance Implications: PTSD has implications on workplace performance, including greater absenteeism, decreased productivity, and difficulty managing workplace relationships
• Psychological and Physical Manifestations: PTSD sufferers may experience extraordinary stress, anxiety, headaches, chest pain, flashbacks of the traumatic event, nightmares, and gastrointestinal distress
• Long-Term Health Consequences: PTSD has long-term health consequences, including a greater risk of depression, anxiety disorders, hypertension, substance abuse, chronic pain, mental health conditions, and gastrointestinal issues

Seek professional medical evaluation if you are experiencing persistent symptoms of PTSD or other mental health conditions.

Workers’ Compensation Claim Process

If you have suffered Post-Traumatic Stress Disorder (PTSD) from the workplace, you may ask “is PTSD covered by workers compensation?” The answer is yes, but filing PTSD claims is challenging. To file a claim, workers must:

• Eligibility Criteria: Workers must meet the eligibility requirements. Eligibility for workers’ compensation benefits requires that the Post-Traumatic Stress Disorder be directly tied to a work-related traumatic event, to repeated sources of stress tied to the employee’s job duties, or as a result of the workplace environment of intimidation and harassment
• Required Documentation: Filing a workers’ compensation claim for PTSD requires providing documentation to support the workers’ comp claim. This required documentation includes a clinical diagnosis of Post-Traumatic Stress Disorder from a licensed mental health professional, a report of the worker’s mental health history, evidence of the worker’s exposure to a work-related traumatic event, documentation of the mental injury caused at the workplace, or the continued, repeated psychological trauma from the workplace environment
• Claim Filing Procedures: Filing a workers’ compensation PTSD claim requires first reporting the traumatic event and the work-related PTSD to the employer. Then, the employee must obtain a clinical diagnosis of PTSD from a mental health specialist, collect evidence of the workplace injury, document medical costs, and then file a workers’ compensation claim to apply for benefits

Potential Compensation Types

There are several different types of compensation available to workers who are filing a workers’ comp claim for PTSD. These include the following:

• Medical Treatment Coverage: Workers’ compensation coverage for Post-Traumatic Stress Disorder includes compensation for medical costs stemming from the work-related trauma and resulting mental injury and physical trauma, such as coverage for mental health therapy.
• Partial Wage Replacement: Benefits for PTSD provide partial coverage of lost wages for employees who have experienced work-related physical injury or mental injury caused by a traumatic event at the job or the work environment itself.

Consult with a workers’ compensation attorney to understand your rights under workers compensation laws and receive the compensation you deserve.

Legal Protections and Advocacy

Workers’ compensation laws are designed to protect injured workers who develop Post-Traumatic Stress Disorder (PTSD) as a direct result of work-related traumatic events or trauma caused by the employee’s job responsibilities or the work environment.

• Workers’ Compensation Protections: workers’ compensation protections were developed to ensure that all workers have access to the appropriate medical treatment for PTSD and that workers’ compensation benefits cover the costs for such treatment
• Anti-Discrimination Provisions: The Americans with Disabilities Act (ADA) ensures that workers who are diagnosed with PTSD are protected from any workplace discrimination and are afforded reasonable accommodations for the mental health condition
• Employer Responsibilities: employers are required to maintain a safe work environment for workers and to respond promptly to any reports of work-related injury or illness, including a report of Post-Traumatic Stress Disorder. Any reports of physical injury or mental injury at the workplace must be reported to the company’s insurance provider promptly to ensure that the worker has access to proper medical treatment and related workers’ compensation benefits
• Legal Recourse Options: Injured workers have several legal recourse options. In addition to consulting with a workers compensation attorney regarding PTSD claims, the U.S. Department of Labor provides resources and guidance to assist workers in filing workers’ compensation PTSD claims

Protect your rights and seek professional legal guidance. If you are experiencing Post-Traumatic Stress Disorder (PTSD) from a traumatic incident at the workplace or from a toxic work environment, contact the workers’ compensation attorneys at Munley Law for a free initial consultation regarding your case and an evaluation of your eligibility to file a workers’ compensation claim to receive benefits.