Are Psychological Conditions Like PTSD Covered by Workers’ Compensation?

When we think of workers’ compensation, we usually only think of physical injuries – things like physical trauma, broken bones, slipped discs, and torn muscles. However, there are injuries that occur at work that are not primarily physical.

Workplace traumas that affect a worker’s mental health are just as debilitating as any physical injury, sometimes even more so because they cannot be outwardly seen. However, because these injuries are psychological in nature, they may be treated as being less severe or not as important as their physical counterparts. Nothing could be further from the truth.

Psychological conditions, like PTSD (post-traumatic stress disorder), are very real and they inflict just as much pain and suffering on their victims as any broken bone or soft tissue injury. However, psychological conditions can often be harder to diagnose and treat than a physical injury. Because of this, the victims of psychological trauma are still often marginalized.

Unlike individuals who suffer from physical trauma, people whose mental health is affected by workplace injuries often find themselves fighting an uphill battle to obtain compensation. That being said, mental health and psychological conditions, like PTSD, are covered under California’s workers’ compensation statutes, albeit in a way that makes them much more difficult to prove than any physical workplace injury.

The “Stress” of Stress

Stress is pervasive in everyday life, especially in the workplace. In an effort to remain competitive, an employer may expect you to do more, perform faster, and maintain performance for longer periods of time. This pressure causes the body to experience stress and too much stress can be very detrimental to physical and mental health.

Small amounts of stress aren’t bad. In fact, they help to keep us alive. When we are confronted with what appears to be a life threatening situation, our bodies produce several chemicals that physically prepare us to survive. These chemicals, which include adrenaline and dopamine, induce what is known as the “fight-or-flee” response. Our heart rate increases. Our breathing becomes quicker. Our major muscle groups tighten. We are ready to do what it takes to stay alive. This is a good thing in small doses.

When stress is constant, it constantly triggers the fight-or-flee response. Our bodies are always in a state of enhanced readiness. We are always trying to survive. The chemicals that produce this reaction begin to build up in our systems. We start to experience physical and mental symptoms that are debilitating and impede the ability to function normally. For some, the constant stress produced by their employment situation manifests itself as a condition known as post-traumatic stress disorder, or PTSD.

Some professions are far more stressful than others. Police, firefighters, and other first responders are constantly exposed to highly stressful situations that produce the fight-or-flee reaction. Healthcare professionals such as emergency room doctors and nurses are also susceptible to this phenomenon. However, PTSD can occur in any profession. A worker who suffers a traumatic on-the-job injury can develop PTSD as a result of the accident. So can a worker who witnesses an accident that occurs to a fellow worker.

The Effects of PTSD

Post-traumatic stress disorder can produce a wide-ranging variety of physical and psychological symptoms. Sometimes, these symptoms are mild and can be easily treated and controlled. However, there are times when the symptoms of PTSD can be severe, deeply affecting the person involved, and may take years of treatment to resolve.

The most common emotional symptoms of PTSD are depression and anxiety. These can be accompanied by insomnia, irritability, impaired memory and cognitive abilities, and more. These symptoms can vary in appearance and severity from individual to individual and also within a single individual.

The physical symptoms of PTSD can include fatigue, reoccurring headaches, ulcers, and high blood pressure. Again, each individual’s physical symptoms can be variable. The one thing that ties them together is that they tend to manifest after an acute or long-term stress event.

Psychological Conditions and Workers’ Compensation

As stated above, California’s workers’ compensation laws allow a worker who has suffered an employment-related psychological condition, like PTSD, to receive benefits. However, the burden on the worker to obtain those benefits is greater than if they had suffered a purely physical injury.

First, the worker has to have a specifically diagnosed psychological condition that caused disability or the need for medical treatment. More importantly, the employee also has to prove that events at work were, more likely than not, the predominate cause of the condition at issue. Compare this to a workers’ compensation case involving a physical injury. There the worker only has to show that he or she was injured while working. There is absolutely no requirement that the physically injured worker must show that events or conditions at work caused the injury. Simply being on the clock is enough to obtain compensation.

Additionally, a worker bringing a workers’ compensation claim based on a psychological condition must submit a detailed physician’s report that supports the assertion that the condition was caused by the worker’s employment. This report must contain detailed information on the worker’s past medical/psychological history, developmental history, personal records, performance reviews, and history of personal or familial problems, if any.

In other words, a worker who brings a compensation claim for a psychological condition must be prepared to face a thorough examination of everything in their background that may be relevant to the claim. They must be prepared to answer very personal questions about some of the most private areas of their life. In short, they must be prepared to vulnerably expose themselves fully at a time when that exposure may be extremely difficult.

Psychological injuries can most certainly be attributed to working conditions and working accidents. Unfortunately, our society treats mental health issues differently than physical health issues. This double standard is still apparent in the State of California’s workers’ compensation laws.