Legal Dilemma: Does workers' comp cover mental health?

Does workers comp cover mental health?

Workers' comp rules murky around mental health

I know that workers’ compensation will cover physical injuries sustained while on the job, but will it also cover mental illness stemming from my workplace? I’ve been so stressed about work that I’ve developed an anxiety disorder.

The rules about workers’ compensation are often clear cut when it comes to physical injury, according to employment lawyer Joe Veenstra, but it’s far more murky when it comes to mental illness.

“Workers’ compensation will cover mental health claims that arise from your workplace, but the challenge is to demonstrate the illness stemmed specifically from your work environment,” says Veenstra.

Wisconsin recognizes certain psychological injuries

Wisconsin workers’ compensation acknowledges three types of psychological injuries:

  • Physical-Mental—where a physical injury leads to a mental injury such as PTSD or depression
  • Mental-Physical—where mental stress leads to physical injury, such as a heart attack
  • Mental-Mental—where “extraordinary” stress leads to mental injury, such as sexual harassment or witnessing a traumatic event

Under these definitions, a person who suffers a major injury in the workplace and later develops PTSD may be able to make a pretty straightforward case, but it’s more complicated with mental-physical or mental-mental claims.

The "Extraordinary Stress Standard"

“While Wisconsin is among a few states where workers’ compensation recognizes mental-physical and mental-mental injuries, you still face the challenge of proving that your condition is primarily work-related,” says Veenstra. “But it can be done.”

Wisconsin applies what’s called the Extraordinary Stress Standard to determine if the mental injury “resulted from a situation of greater dimensions than the day-to-day emotional strain and tension which all employees must experience.” If so, then a claim may be compensable.

Best advice: Contact a workers' comp attorney

Veenstra says your best bet is to consult with an attorney experienced in workers’ compensation who can review your case.

“Either way," says Veenstra, "if your mental condition prevents you from working, you may also qualify for Social Security disability benefits, so it may be a good idea to contact an attorney anyway.”

Does workers comp cover mental health?Information provided by employment law attorney Joe Veenstra at Johns, Flaherty & Collins, SC. For more information about workers' compensation in Wisconsin, contact him at 608-784-5678.

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