Each job has its own challenges. So it’s no surprise that almost all of us, at some point in our careers, have become stressed out at work. But sometimes, it goes way beyond the usual work fatigue. There are times that work-related stress evolves into a debilitating anxiety that affects your work and your life in general.
In these instances, you can’t help but ask: can I claim workers compensation for stress?
Stress alone will not qualify you for workers compensation benefits. You can only claim workers comp for stress and anxiety if they give rise to disabling mental conditions.
Mental illnesses, however, are harder to prove than physical injuries. So if you’re planning to claim workers comp for stress, expect to have your work cut out for you. In fact, only very few stress-related compensation claims get approved every year.
Remember that workers’ compensation only pays for disabilities caused by work-related injuries. And stress, per se, cannot really be considered an injury unless it leads to a mental health issue. Some states also do not consider mental issues arising from stress as a compensable injury. While others will only give out workers comp if the psychiatric injury is substantiated by clear and convincing medical evidence.
In California, for example, you can claim workers comp if the stress at work leads to or worsened a mental illness. However, states like Florida will only compensate for a psychological disorder if it comes with a physical injury.
To know if your work-related stress will qualify you for workers comp, consult an experienced workers comp lawyer like Victor Malca. He has already helped thousands of injured workers in Florida fight for their workers comp benefits. He can help you get the benefits you deserve too.
Workers Comp for Mental Health Issues
As they say, not all injuries can be seen by the naked eye. Sometimes, a psychiatric injury can be more disabling than a physical one. But, as mentioned, due to the very subjective nature of mental illnesses, getting workers comp benefits for it can be extremely difficult – especially if it’s caused by work-related stress and fatigue.
In Florida, the statutes state that:
A mental or nervous injury due to stress, fright, or excitement only is not an injury by accident arising out of the employment.
It further specifies that:
Mental or nervous injuries occurring as a manifestation of an injury shall be demonstrated by clear and convincing medical evidence by a licensed psychiatrist meeting criteria established in the most recent edition of the diagnostic and statistical manual of mental health issues published by the American Psychiatric Association.
The above provisions aren’t unique to Florida. Most states have strict requirements when it comes to compensating work-related psychological disorders. Some states have even gone so far as to establish specific parameters for claims involving job-related stress.
In general, you can only claim workers comp for mental health issues if it’s severe enough to interfere with your ability to work. Though stress and anxiety are typical in the workplace, rarely do they ever reach such severity.
But if you can prove that you have a severe mental disorder because of extreme stress at work, you may be able to claim workers’ compensation.
Proving Your Mental Condition
It’s easy to claim that you have a debilitating mental disorder. But proving it is another story.
Unlike physical disabilities, mental conditions don’t have very obvious symptoms. For example, you can usually tell by just one look if someone broke their legs or hurt their arms. But it’s pretty difficult to tell if someone is suffering from depression or generalized anxiety disorder. Having psychosocial issues doesn’t necessarily mean one has a psychiatric disorder. And some people who are suffering from severe anxiety or depression may appear completely normal.
This is why proving that you have a mental disorder isn’t easy. It’s mostly subjective. You cannot submit a blood test or x-ray result as evidence. Everything depends on what you tell or how you behave in front of your psychiatrist.
As if proving that you have a disabling mental condition isn’t challenging enough, you also have to prove that it’s because of your work. Moreover, you need to prove that it’s disabling enough to disrupt your work too.
Obviously, the most important evidence to prove your claim is the psychiatrist’s report. But you may also have to submit other documentary evidence such as:
- job history
- performance reviews
- personal history
- sworn testimonies by the people who know you
Because it’s so hard to prove, workers compensation claims for stress and anxiety often get denied. If this happens to you and you believe you have a strong claim, you can always take your case to court.
How Much Can You Get?
Workers compensation is implemented on a state level. So the rules and regulations tend to vary across the country. In general, however, workers comp includes both medical benefits and lost wages compensation. As such, the amount of your workers comp settlement will depend on the severity of your mental and physical injuries as well as how many days you’ll miss work.
Medical Benefits
In most states, workers comp medical benefits will cover all medical expenses necessary for the injured worker’s recovery. This includes:
- medications
- medical supplies
- doctor’s fee
- surgery (if necessary)
- orthopedic devices (if necessary)
With mental illnesses, workers comp may also cover the cost for psychiatric treatment or any required therapy. If your condition requires long-term treatment, workers comp will pay for that too.
Wage Loss Replacement
If your condition requires you to take some time off from work, you’ll receive compensation for lost wages. The rate varies per state but in Florida, you’ll get 66 ⅔% of your average weekly wage from before you got injured paid out every two weeks. However, you’ll only be paid for the first seven days if your injury extends to over 21 days.
Your wage loss benefits will continue until you reach maximum medical improvement (MMI) but shall not exceed 104 weeks.
How to File a Workers Compensation Claim
If you believe your mental illness will qualify for workers comp, here’s a quick guide on filing workers comp claim:
1. Report your injury
The entire workers compensation process starts when the injured worker reports their injury to their employer.
Most states have a time limit for reporting injuries. In Florida, you should report your injury to your employer within 30 days after the accident or after you’ve known of it. Otherwise, your claim can get denied.
After reporting your injury, your employer should inform your insurance provider about it within 7 days. They should also give you workers comp claim forms to fill-up and explain the workers comp process to you.
2. Gather evidence
Once you’ve filed a claim, your insurance provider will began evaluating it. They’ll examine your evidence to ascertain if you’re eligible for benefits. They may also ask for additional evidence or even send a workers comp investigator after you.
As I’ve said, it’s more difficult to prove a psychiatric injury than a physical one. So in addition to your psychiatrist report, your insurance company may ask for more evidence. They may require a separate psychiatric exam from a psychiatrist of their choosing. Depending on your condition, they may also require testimonies from your coworkers or the people you interact with everyday.
The crucial thing to remember here is to be proactive. Gather all the evidence you can get to prove that your mental condition is disabling enough and that it’s work-related.
If the insurance company finds your evidence satisfactory, they’ll approve your claim. But if they deny your claim, you can still file an appeal and defend your claim before a judge.
(Related: WHAT IS THE AVERAGE SETTLEMENT FOR WHIPLASH?)
VICTOR MALCA – Florida Workers Compensation & Social Security Disability Attorney
Victor Malca P.A. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. His experience and continued success when fighting for his clients puts him among the most trusted workers’ compensation attorney’s in Florida. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits.
Book a free consultation today. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida.
About The Author
Judy Ponio is a writer and editor for the Victor Malca Law P.A. website and blog. She enjoys helping people in need with questions about social security disability and workers compensation law. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives.