Are Psychological Injuries Covered By Workers’ Compensation?

March 19, 2021
Stern & Cohen
Man having stress and headache migraine from work injury

The simple answer to this question is yes. However, it is important to understand how the Act works and what is needed to prove that you sustained a psychological injury. Psychological injuries fall into three discrete areas and are compensable if the elements needed to establish a claim are met. The three areas are:

  1. 1. Physical stimulus causing mental injury (physical/mental injury)
  2. 2. Psychological stimulus causing mental injury (mental/mental injury)
  3. 3. Psychological stimulus causing physical injury (mental/physical injury)

Physical/Mental Injury

This type of psychological injury is the most common. This is a physical injury that brings about a mental “disability” (remember, “disability” under the Act refers to a workers’ ability to work their pre-injury job). A common example of a physical/mental injury is someone who is involved in an accident and sustains a concussion. For example, if you are a truck driver and you are involved in a motor vehicle accident that involves you injuring your back and your head, in addition to whatever symptoms you have in your back, you may experience lasting, ongoing symptoms related to your concussion. This may include symptoms such as memory loss, headaches, light sensitivity, blurred vision, etc. Thus, in addition to needing medical treatment for your head, regardless of whether your back injury resolves, you may not feel capable of returning to work because of the symptoms associated with your concussion, or Post-Concussion Disorder. Or, even if you do feel capable of returning to work and do in fact return to work, you may require medical treatment or medication to help with your symptoms relating to your concussion. Either way, you are entitled to workers’ compensation benefits if the physical stimulus of being in the motor vehicle accident resulted in the mental injury, in this case, Post-Concussion Disorder.

Another example is, say you were assaulted by a random customer at work. The actual assault is the physical stimulus. Regardless of the extent of your physical injury – i.e., maybe you sustained just scratches and bruises – if you have suffered psychologically as a result of the attack, this constitutes a compensable injury under the Act. For example, you may have post-traumatic stress disorder as a result, and you are unable to return to work – the scene of the injury – because of it. If that is the case, you are entitled to seek medical treatment, such as seeing a psychologist, to help you treat as well as get wage loss benefits for the period of time you are out of work because of it. This is another example of what a physical/mental injury may look like.

Oftentimes, these types of claims are somewhat obvious because of the physical aspect of the injury. However, it is important to remember that an employee does not have to prove or show that they suffered a physical disability as well as a mental disability. All that matters is that a physical stimulus, i.e., a motor vehicle accident, an assault, a slip and fall, etc., resulted in a mental disability. A mental disability alone is enough to be entitled to workers’ compensation benefits.

Mental/Mental Injury

This type of injury is often harder to prove, but it is recognized under the Act. This type of injury is an employee claiming they have a psychiatric disability due to emotional, nonphysical stimuli at work. The work-related stress must be caused by “actual objective abnormal working conditions”. It cannot be caused by subjective, perceived, or imagined employment events. The abnormal working condition can be a single, isolated event. On the flip side, a long-term process of mental or emotional deterioration can also be compensable.

The criteria for determining if a mental/mental injury is compensable is three-fold: (1) the claimant’s disability has been objectively verified, (2) it has been traced to an identifiable source, and (3) that incident alone, and not any purported comparable set of incidents, was abnormal.

The determination of an abnormal working condition is highly fact-sensitive. For objective employment events to be considered “abnormal”, they must be considered in relation to the specific employment. For example, if you are a police officer, the comparison will be made to other police officers. However, the conditions of employment or inherent risk related thereto are not a controlling factor in the determination of an abnormal working condition. This means that just because you are a police officer, which is, of course, a stressful job, does not mean you are not entitled to workers’ compensation for a mental/mental injury. There have been several cases finding that employees with inherently stressful jobs, such as police officers, firemen, rescue workers, etc., are entitled to benefits under the Act because of certain events they have seen or been a part of.

Some examples of types of events/circumstances that have been found to cause a mental/mental injury is verbal harassment, including sexual harassment at work, being robbed at gunpoint while working, having a near encounter with death at work, being wrongfully accused of a crime by a supervisor, and witnessing someone be killed at work. Of course, there are many more examples. Contact us to find out if the circumstances surrounding your mental/mental injury entitle you to workers’ compensation benefits.

After showing that an abnormal working condition exists, unequivocal medical evidence is required to establish that the resulting psychological disability is causally related to the abnormal working condition. This medical evidence is often established by the testimony of your treating physician, likely a psychologist or psychiatrist, and is something your attorney can handle.

Because of the high burden placed on employees trying to prove this type of claim and the highly fact-specific nature of the claim, for this type of injury, it is particularly important to hire an attorney. Our attorneys are experienced and understand how to handle these types of claims. Further, if you have not been able to obtain medical treatment yet for your psychological injury and feel as though you need to see a medical professional about it, our attorneys can refer you to a doctor to get the treatment you require and deserve.

Mental/Physical Injury

A work-related psychological stimulus, such as stress, that results in a “purely physical injury” falls into the mental/physical category. Proof of an abnormal working condition is NOT required for this type of claim. For these types of injuries, there are two common elements: (1) psychological stimulus that causes a physical injury, which continues even after the stimulus is removed; and (2) a disability or loss of earning power which is caused by the physical condition rather than by the psychological stimulus. This is another type of injury that is fact-intensive and requires an attorney to analyze the facts giving rise to the alleged claim.

If an employee can show a work-related psychological stimulus, such as work-related stress or anxiety, caused physical injuries, it is covered under the Act. Examples of these types of injuries may include high blood pressure, gastrointestinal (stomach) issues, or even heart attack that is caused by something at work. If you are experiencing a physical injury from a work-related psychological stimulus and it has caused you to miss work, or, even if you have continued working it has caused you to require medical treatment, your mental/physical injury should be covered by workers’ compensation. To prove that there is a physical injury resulting from a psychological stimulus, there needs to be medical evidence. Again, typically this would involve medial testimony of the doctor you treat with for the physical condition, and your attorney would handle the testimony.

What should you do if you think you have suffered a psychological injury?

Contact us. The consultation is always free. We will be able to properly assess your claim and determine if your work-injury entitles you to benefits under the Act.