Workers’ Compensation: Are Mental Health Issues Included?

You can now claim workers' compensation based on a mental health condition that arises from doing your job. Here’s what you should know and how to navigate the process

In recent years, our security has increasingly recognized the significant impact of mental health issues in the workplace. As a result, Sacramento County, like many other jurisdictions, has brought mental health conditions into the scope of workers’ compensation coverage. If you’re preparing to make a workers’ compensation claim based on a mental health condition in Sacramento County, it’s advisable to know how mental health issues are included in workers’ compensation, which specific conditions are covered, and how to navigate the claims process.

Mental Health Coverage in Workers’ Compensation

Although in the past workers’ compensation has focused primarily on physical injuries, it’s evolved to encompass mental health conditions that arise from employment-related factors. In Sacramento County, mental health issues can be covered under workers’ compensation if they meet specific criteria.

  • Work-related factors and causation: To be eligible for workers’ compensation benefits for a mental health condition, your condition must be primarily caused or significantly aggravated by job-related factors. Common workplace factors that can contribute to your mental health issues include excessive stress, traumatic events, harassment, or bullying. You need to establish a clear link between your work environment and the development or worsening of your mental health condition. This often requires gathering evidence such as witness testimonies, medical records, incident reports, or documentation of the work-related factors that contributed to your mental health issue.
  • Presumption for certain professions: If you work in a high-risk occupation, Sacramento County has specific provisions or presumptions in place that can make it easier to prove that your mental health condition is work-related. These occupations often involve high levels of stress, trauma, or exposure to challenging environments, and may include first responders (police officers, firefighters, paramedics), healthcare workers, and law enforcement personnel.

Mental Health Conditions Covered by Workers’

Sacramento County recognizes a range of mental health conditions as eligible for workers’ compensation benefits. While the specific covered conditions can vary, the following are common examples:

  • Post-Traumatic Stress Disorder (PTSD): PTSD is a mental health condition that often affects individuals who have experienced or witnessed traumatic events. In the workplace, this condition may be prevalent among first responders, military personnel, and victims of workplace accidents. Symptoms of PTSD can include persistent distress, intrusive memories, nightmares, flashbacks, avoidance behaviors, and anxiety.
  • Anxiety and depression: Occupational stress, hostile work environments, or chronic job dissatisfaction can contribute to the development or exacerbation of anxiety and depression in your daily life. These conditions can significantly impact your ability to function effectively at work and in your personal life. Symptoms may include persistent feelings of sadness, hopelessness, loss of interest, changes in appetite or sleep patterns, and difficulty concentrating.
  • Work-related stress: Excessive workload, unrealistic deadlines, lack of support, or unreasonable job demands can lead to work-related stress. Prolonged exposure to high levels of stress can have detrimental effects on your mental health, leading you to suffer from burnout, anxiety, and depression. Symptoms of work-related stress may include irritability, difficulty relaxing, fatigue, headaches, and difficulty concentrating.
  • Occupational burnout: Occupational burnout is when you suffer chronic physical and emotional exhaustion caused by prolonged exposure to high levels of stress and frustration in the workplace. It often results from a mismatch between your expectations and the realities of your job. Symptoms of burnout can include exhaustion, detachment from work, reduced work performance, cynicism, and feelings of ineffectiveness or lack of accomplishment.
  • Psychological injuries from workplace violence: If you’re a victim of workplace violence, harassment, or bullying, you may experience significant psychological trauma, leading to mental health conditions like anxiety, depression, or post-traumatic stress disorder. Sacramento County recognizes the impact of workplace violence on your well-being and includes these psychological injuries within the scope of workers’ compensation coverage.

Navigating the Workers’ Compensation Claims Process

Navigating the claims process for mental health issues requires attention to detail. The following steps provide a way for you to seek compensation:

  • Report the injury. When you realize that your mental health has been affected by work-related factors, it’s important that you promptly notify your employer or supervisor. Inform them about the situation and the impact it’s had on your mental well-being. Make sure to document the incident or circumstances that contributed to the development or worsening of your condition. This can include writing down the details of the incident, keeping records of any conversations or interactions that caused distress, or preserving any relevant emails or messages.
  • Seek medical attention. Consult with a mental health professional who has experience with workplace-related issues. This provider should understand the connection between your mental health issues and work-related factors. During the appointment, discuss your symptoms, explain the work-related factors that have affected your mental health, and how they have impacted your ability to function at work or in other areas of your life. The mental health professional will assess your condition, provide a diagnosis if applicable, and offer treatment recommendations. It’s crucial that you obtain documentation from the provider, including medical records and diagnostic reports—these will serve as important evidence for your claim.
  • File the claim. Submit a workers’ compensation claim to your employer or the insurance carrier within the designated timeframe. Follow the instructions provided by your employer, or consult the relevant workers’ compensation agency for the necessary forms and procedures. Include all relevant documentation, such as medical records, diagnostic reports, and any supporting evidence that helps link your mental health condition and the workplace. You may want to consult with a workers’ compensation attorney to make sure you complete your paperwork accurately.
  • Get your case investigated. After filing the claim, the workers’ compensation carrier will investigate your case. This will include reviewing your medical records, consulting with experts, or conducting interviews with you, your employer, or other relevant parties. Insurance companies often ask for more information than they are entitled to so you will want to retain an attorney to determine the extent of information you share during the investigation.
  • Engage in dispute resolution and litigation. If your claim is initially denied or disputed by the workers’ compensation carrier, you may need to engage in dispute resolution and litigation. This can take various forms, including mediation, negotiation, and/or filing a case with the Workers’ Compensation Appeals Board. It’s advisable to consult with an experienced workers’ compensation attorney who can guide you through this process. An attorney can help you understand your rights, provide advice on the best course of action, and advocate for your interests.

Contacting Tichy Law Inc.

If you’re seeking to claim workers’ compensation for a mental health condition, then contact a workers’ compensation attorney at Tichy Law Inc. at (916) 444-0321 for a free consultation. We look forward to assisting you.

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