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Does workers’ compensation cover mental conditions, like PTSD?

On Behalf of | Feb 22, 2024 | Workers' Compensation |

The average worker expects to be eligible for workers’ compensation coverage if they suffer a physical injury on the job. If someone breaks their arm because of a machinery malfunction or develops a brain injury when they fall, they know that California workers’ compensation can potentially help them.

The benefits available include medical coverage to pay for someone’s treatment expenses and disability benefits to cover some of their lost wages. Benefits are available for both injuries and acquired medical conditions. Someone sickened due to chemical exposure or struggling to work because of a repetitive stress injury could potentially apply for workers’ compensation coverage.

Workers may feel less certain about their rights if they have a mental health issue related to their employment. Can an employee request workers’ compensation coverage for mental health challenges directly related to their employment?

Mental health challenges can be very expensive

Contrary to what many people sometimes assume, workers’ compensation does not automatically decline benefit requests related to mental health issues. In fact, the state has historically approved benefit requests in cases where workers can clearly show that their diagnosis directly relates to their employment.

For example, someone who develops post traumatic stress disorder (PTSD) after witnessing a tragic incident or being a victim of a crime on the job could potentially qualify for benefits. The state could replace their wages while they are unable to work because of their trauma and might also help pay for their treatments.

Recently, lawmakers expanded on those protections by specifically passing a law to protect first responders. Research into mental health claims for PTSD in particular show that first responders actually had a lower rate of approval for benefits than those in many other professions. The new law in California now clarifies that a first responder who can show their condition is at least 51% the result of their employment can potentially qualify for benefits.

Establishing the severity of a mental health disorder and connecting it to someone’s employment can be a challenge. However, those who put in the effort to gather adequate documentation of the incident that caused their trauma and the symptoms that they currently experience could theoretically secure benefits that could help them overcome their mental health challenges and replace the wages they were unable to earn while obtaining treatment.

Reviewing the rules that govern workers’ compensation claims with a skilled legal team may benefit those currently struggling with a work-related health condition and who are uncertain about whether they might qualify for benefits.