Everyone has a stressful day at work now and then. For some workers, the stress can become so debilitating that it interferes with routine tasks. At that point, many workers ask if stress falls under the auspices of a workplace illness that could be covered by workers’ compensation.
Not all stress or anxiety responses meet stringent parameters warranting workers’ compensation benefits. On the other hand, some mental health injuries have been approved by workers’ compensation providers and employers, rather than being denied or challenged. Employees must first understand what workers’ compensation benefits are, how they work, and how to prove that a mental health issue is linked to a workplace or job. They should also be open to speaking with an experienced workers’ compensation lawyer, especially if they have no accompanying physical injuries with their stress or anxiety diagnosis.
What are the Parameters of Workers’ Compensation?
Workers’ compensation provides a series of benefits to employees who have been injured on the job. Every state requires that companies carry different types of benefits. For instance, in New Jersey, employees who are approved for workers’ compensation are entitled health care treatment, a percentage of their salary up to a maximum per-week amount, and other benefits.
The workers’ compensation system can be practical and fair for both the employer and the employee. In exchange for receiving workers’ compensation benefits, the worker gives up the right to file a workplace injury-related lawsuit against the company.
The majority of workers’ compensation claims involve physical injuries. For instance, a construction worker who breaks a leg because of a fall from a ladder can collect workers’ compensation benefits. However, more people are starting to submit workers’ compensation claims for mental health injuries and illnesses directly related to their occupations, such as stress, anxiety, and post-traumatic stress disorder (PTSD.) In 2020, some workers began submitting claims related to the Coronavirus (COVID-19).
What Types of Workplace Stress Might be Eligible for Workers’ Compensation?
Ordinary stressors and frustrations are not eligible for workers’ compensation, for understandable reasons. Neither eligible are stress and anxiety that start at home and are brought into the workplace. For stress to be eligible for workers’ compensation, it must have begun at the office or worksite. Additionally, the stress must be severe rather than easy to manage.
These parameters can make it difficult for employees to prove that stress is overwhelming in some circumstances. The exception would be something catastrophic and out of the ordinary, such as a workplace shooting or robbery that leaves employees unable to come back to work.
Because every worker experiences stress differently, each workers’ compensation claim for mental health will look different. One individual might have no trouble standing up to harassment from a boss or coworker, whereas another worker may suffer needlessly because of expectations to work around the clock without relief or face conflicts with superiors.
For this reason, workers need to be specific when filing workers’ compensation claims. Not only should they document their stress and anxiety, but they should also be able to support their assertions in the event of pushback from a workers’ compensation provider or employer. An important way to establish a mental health workers’ compensation claim would be to recognize signs of job-related stress and anxiety, and act on them sooner rather than later.
What are Some Indicators of Workplace Stress or Anxiety?
Workplace stressors can lead to a myriad of mental and physical symptoms. Employees under tremendous pressure should be on the lookout for telltale signs that they might be reaching a critical point from a mental health perspective. For example, many workers experiencing on-the-job stress spend days dealing with worsening depression, mood swings, panic attacks, focus problems, and an inability to make important or wise decisions. From a physical aspect, they may encounter stomach ailments, think they are having heart attacks because of chest pain, not be able to sleep, and lack the energy to do anything extracurricular. Overwhelmed workers may be unable to meet timelines, become aggressive, have problems dealing with others, or lack any interest in their family or friends.
Any major, long-term mental health changes deserve to be noted, diagnosed, and treated to avoid becoming so severe that the employee requires in-patient treatment or becomes permanently disabled. This can happen only by seeking medical care immediately.
What are the Challenges of Proving a Mental Health Claim?
As indicated previously, many insurers and employers hesitate to accept workers’ compensation claims pertaining to employees’ mental health states. The reason is that mental health is an invisible problem or disability. It is easy to see when someone has a cut, bleeding arm. It is much harder to tell that someone feels anxious and stressed out.
Another reason many mental health claims are initially denied is that insurance companies may argue that the stress, depression, or anxiety might be clinically accurate but is not due to the worker’s occupation. Instead, the insurance provider could suggest that the mental health problems stem from the worker’s personal life or even genetic make-up. The provider might even go so far as to assert that since the worker clocked in regularly, the mental illness could not be too debilitating.
It can be disheartening and scary for a worker to receive a claim denial. However, the worker does not have to take the initial denial at face value. Employees have the right to appeal denials.
How can Workers with Mental Health Claims Improve Their Chance of Approval?
A legal professional who works in this line of employment law can help an employee present a more compelling case. One of the problems with an initial workers’ compensation claim is that it lacks enough evidence to support the idea that the mental illness was the product of work. Lawyers are trained to help clients gather evidence and supporting documentation. Such evidence could be anything from well-documented visits to a psychiatric office to written correspondence between the worker and a supervisor or human resources team member. Being able to pinpoint when and why occupational stress or anxiety occurred can go a long way toward reversing an original claim denial.
A workers’ compensation lawyer can also lessen a client’s overall stress level at a time when stress seems too heavy. Trying to negotiate with a resistant insurance adjuster or hostile employer can make a mental health problem worse for an employee already overcome with emotions. Lawyers are accustomed to handling difficult situations and carrying out tough negotiations, so they can take on the brunt of the burden of proving a client’s claim.
Should I File for Workers’ Compensation Benefits for My Mental Illness?
Employees experiencing mental illnesses directly related to their careers should not allow themselves to believe that they will never win a workers’ compensation claim. Every worker deserves the right to be mentally and physically healthy. If an employee is hurt on the job, including from a psychological perspective, the employee deserves to receive adequate compensation.
Cherry Hill Workers’ Compensation Lawyers at Pietras Saracino Smith & Meeks, LLP Help Employees with Work-Related Mental Illnesses
If you have been diagnosed with stress, PTSD, or anxiety that is related to your job and you are denied workers’ compensation, the Cherry Hill workers’ compensation lawyers at Pietras Saracino Smith & Meeks, LLP are available to help. Our legal team will help you recover the compensation you deserve, including medical expenses and wage loss compensation. Call us today at 856-761-3773 or contact us online for a free consultation. Located in Cherry Hill, New Jersey, we proudly represent workers throughout South Jersey, including Camden, Cinnaminson, Delran, Maple Shade, and Pennsauken.