Can my workers’ comp claim cover my mental health needs?

On Behalf of | May 15, 2024 | Psychological Injury

Recovering from a workplace injury requires more than just healing physical injuries. These accidents can also impact the workers’ mental health. It is not uncommon for physical injuries at work to lead to psychological conditions such as depression, anxiety, or post-traumatic stress disorder (PTSD). If a healthcare professional deems psychological care necessary due to a work-related physical injury, Wisconsin’s workers’ compensation system may cover the costs for such treatment.

How does an injured worker claim psychological care benefits?

After sustaining a physical workplace injury, employees should report the incident to their employer as soon as possible and seek professional medical attention. When recovering from the effects of the injury, if the employee is experiencing mental stress, psychological care may be necessary.  The employee may need to undergo an evaluation by a licensed psychologist or psychiatrist to support the claim for workers’ compensation benefits if the treating physician recommends psychological care.  While occasionally difficult to get timely appointments with mental health professionals in Wisconsin, a worker suffering mental stress from the effects of a physical work injury needs to push to obtain the appropriate and needed mental health care.

It is helpful to have copies of medical records and other paperwork to support the claim.

Is care for mental health worth it?

Psychological care is an important part of recovery from workplace injuries. Taking this step is not only good for the victim, but also the employer. Recent research shows that addressing mental health needs after a workplace accident can decrease recovery time. This can mean a quicker recovery for the worker, which is best for all involved.

In Wisconsin, workers’ compensation laws are in place to support employees on this journey. Remember, psychological well-being is just as important as physical health, and the law is there to protect your rights. If you are dealing with a workplace injury that has impacted your psychological health, do not hesitate to seek professional advice to guide you through the process.

Permanent psychological injury

Following a physical work injury, if a worker has a permanent psychological condition (like severe PTSD) that results in permanent work restrictions, the worker may pursue a loss of earning capacity claim. For example, if a worker suffered a traumatic hand amputation at work or a chemical burn, they may have a permanent psychological limitation that does not allow them to return to certain types of employments (like a factory or machine setting). In these circumstances, a worker can pursue a loss of earning capacity claim due to the impact of the psychological injury on their long-term career.

Non-traumatic mental injury claims

In huge contrast to psychological conditions stemming from a physical workplace injury, a very different (and much more difficult) standard applies if a worker is claiming a mental stress claim due to their job duties or experiences at work. For example, many workers experience mental stress due to harassing bosses, excessive workloads, or bullying co-workers. Police officers and firefighters also experience incredibly stressful situations in their line of duty. These claims, unfortunately, are very difficult to win in Wisconsin worker’s compensation.

To prevail on a mental stress claim in Wisconsin, a worker has to prove they were exposed to extraordinary stress beyond what similarly situated co-workers experience. (This is known as the School Dist No. 1 standard–stemming from a 1974 Wisconsin Supreme Court decision). This is an objective standard, judged not by what the specific worker experienced, but based on what other workers in that same field would normally have to experience. For example, dealing with harassing supervisors and extreme workloads generally does not meet the standard. Workers should still consult with an experienced worker’s compensation attorney, but candid advice is needed when discussing the chances for success in a mental stress only claim.

For a small slice of workers (police officer and firefighters), the law was changed in 2021 to provide work comp benefits if suffering from PTSD from their job duties. The law eased the legal standard and allowed public safety officers greater opportunities to receive needed mental health care under the work comp law.



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