At The Law Office of William L. Phalen, the most common questions we receive about workers’ compensation are in reference to benefits. Workers’ compensation exists to assist injured workers by providing either temporary relief or long-term benefits.
Workers’ compensation can cover medical expenses, wage loss, rehabilitation and death. But what injuries and illnesses are covered by workers’ compensation? Are mental illnesses like depression covered by workers’ compensation?
If you become injured or ill due to your work, you have a right to workers’ compensation benefits that can cover your wages, medical expenses and prescriptions.
What Is Workers’ Compensation?
Under state law, workers’ compensation is a system that instructs employers to provide injured workers with benefits. Whether an injured employee qualifies for workers’ compensation benefits varies from state to state. In Pennsylvania, for example, every employer that has at least one employee is required to provide workers’ compensation benefits. Other states require that employers that have at least five employees provide workers’ compensation benefits.
Workers’ compensation laws came to the U.S. during the early years of the 20th century. Many states tried passing workers’ compensation laws but failed due to opposition from employers. However, the conditions that workers were facing were later brought to the public’s attention.
In 1911, Wisconsin became the first state to institute a workers’ compensation system. In 1948, Mississippi became the final state to institute a workers’ compensation system. The laws are somewhat similar today as they were when they were first instituted, requiring employers to provide workers’ comp for full-time or part-time injured employees.
Workers’ compensation provides protection for both the employee and the employer. If an employee is injured while on the job, they cannot sue the employer. Prior to workers’ compensation laws, injured workers could sue their employers and cost their employers significant amounts of money if the employee won the lawsuit. If the employer won the lawsuit, the employee would not receive anything.
Workers’ compensation laws offer a compromise. These are no-fault laws, which means workers can get compensation no matter who is responsible and employers cannot be sued. However, this can vary from state to state. In Kansas, for example, an employer may be able to deny an injured employee workers’ compensation benefits if the employee showed a willful failure to protect against the injury.
Since laws can vary by state and the burden of proof often falls to the employee, you may want to hire a workers’ compensation lawyer if you have become physically or mentally injured at work or because of your work conditions.
Does Workers’ Compensation Cover Mental Illness?
You may believe that you can only receive workers’ compensation if you have been physically injured while at work. However, mental illness like depression is frequently a viable way to get benefits. Generally, workers’ compensation covers injury or illnesses that arise out of the course of employment, and mental illness can be included.
General Provisions of Workers’ Compensation
The following are the general provisions of workers’ compensation:
- To receive workers’ compensation, the illness must arise from the worker’s employment.
- The employer may mandate that the employee confirms the workplace illness or injury by being subjected to a physical exam.
- Work-related illnesses are typically covered, including illnesses that arise due to continuous exposure to unsafe pollutants.
- The injury needs to be severe to be covered by workers’ compensation, which means this injury typically requires more than first aid.
- Repetitive motion injuries, which occur as a result of continued events or movements at work, can also be covered.
Depression Can Get You Workers’ Compensation Benefits
Depression is a mental state with real mental and physical consequences. For this reason, depression is considered to be as serious as nerve damage or a broken bone. As such, sufferers of depression may be eligible for workers’ compensation if the depression is aggravated or caused by work-related activity.
If you are an eligible depression sufferer, you may be able to claim that your employment has caused your depressive state or aggravated a pre-existing condition.
Factors That Contribute to Work-Related Depression
Factors that may lead to work-related depression include the team environment, individual factors, a previous work-related injury and work factors and conditions that cause stress.
1. A Previous Work-Related Injury
Depression can frequently follow a physical injury. If you have sustained a physical injury as a result of your job, this may help you with your depression workers’ compensation claim.
While the treatment of claims for physical injuries may be similar, depression can continue long after a physical injury has healed. You may be able to continue receiving workers’ compensation benefits even after your physical injury has healed if you have been suffering from depression following your work-related physical injury.
2. Work Factors and Conditions That Cause Stress
Blue-collar workers, workers in male-dominated industries and those in lower-skilled occupations are associated with more depression and anxiety. Higher-level managers have significantly fewer depression symptoms than other occupation levels, including labor and trade.
High job demand and job overload are also associated with poorer mental health. This can include a job that requires increased levels of mental or physical effort or repetitive and fast-paced work. Growth in job demand increases the risk of depression among blue-collar workers, such as excessive overtime and a requirement to work fast. If pay is too low, this can also lead to stress, worry and depression.
Feeling like a job is the wrong fit could lead to a worker feeling trapped and becoming depressed. You may feel trapped if you dislike your job, but feel like you cannot leave. Maybe you need to continue working to pay your bills and cannot quit until you find another job. This can cause you mental harm.
3. Team Environment
A team environment with interpersonal conflict, poor cooperation and lack of support are all workplace risk factors for depression. Additionally, if your hard work is not being recognized, this low morale can contribute to workplace depression.
Workplace bullying can create a negative team environment and make employees dread coming to work. Men and women who been bullied or witnessed bullying in the past are much more likely to become depressed than other workers who have not experienced or been exposed to bullying.
4. Individual Factors
Age, gender, health, life events and marital status are all individual factors that can contribute to work-related depression:
- Age: Younger and middle-aged individuals are more likely to become depressed than individuals over the age of 51.
- Gender: Women are more likely to suffer from depression than men.
- Health: Health issues can contribute to work-related depression, such as not getting enough sleep.
- Marital status: Being unmarried is an individual factor that can contribute to work-related depression.
- Life events: Stressful personal events that have occurred in the past year can contribute to work-related depression. These can include sentimental loss, legal problems, a significant decrease in income or having a new baby. For example, you may feel working parent guilt if you want to be spending time with your child, but you need to work to pay rent and keep food on the table.
Receiving Workers’ Compensation for Depression
Some workers may suffer mental illnesses as a result of work factors or conditions. These mental health illnesses include:
- Post-traumatic stress disorder
These mental health illnesses can arise from work conditions over time or from a singular event, and these illnesses may be covered by workers’ compensation.
Proving these illnesses is frequently more complex than proving physical injuries. One of the difficulties in pursuing a workers’ compensation mental illness claim lies in tracing the illness to the job. You must be able to establish a causal link between your mental illness and your work. For instance, if you have a stress-related claim, you would need to show that you suffered stress due to workplace factors instead of personal factors.
For a mental injury without physical injury, like depression, you need to prove that the illness is work-related for your workers’ compensation claim. When seeking workers’ compensation for mental illness, you may have to prove both medical causation and legal causation:
- Legal causation: A burden of proof that shows work was the legal cause of the mental illness.
- Medical causation: An evaluation from a psychiatrist or doctor that states the depression has been aggravated or caused by work events.
The burden of proof for legal causation varies by state. Many states will allow workers’ compensation benefits for depression only when the depression is a major or substantial contributing cause. Other states only require the depression to be a material contributing factor. In New Jersey, for example, a claimant must establish that they were a worker, and their injury occurred while at work. In other instances, a claimant may need to establish that they sustained a permanent condition that caused the loss of a body part’s use or function.
The court may mandate that the claimant shows how the mental illness was related to work from an objective standpoint. As a claimant, you may even need to provide a determination that your work conditions would have led to a mental health problem, such as by noting a work condition that is objectively stressful. You may also need to prove that the stress of your position was greater than the stress that is inherent in any position.
For example, in California, an employee can get workers’ compensation benefits if they provide proof that they have been diagnosed with a mental disorder that resulted in a need for treatment or caused a disability. The claimant should be able to establish that the conditions or events of the job were the primary cause of the mental illness.
To receive workers’ compensation benefits for a psychological injury, claims may be primarily supported by the treating doctor’s testimony. Medical records should contain information about a worker’s background, performance reviews, job satisfaction and personal problems. A physician’s report should substantiate your claim.
How to Get FMLA for Depression
The Family and Medical Leave Act is a law that helps protect your job position when you need to take leave due to medical reasons. You can use FMLA to care for a child, spouse or parent as well. While FMLA applies to mental health, there are some limitations.
Under FMLA, you may be able to receive unpaid leave for as many as 12 weeks. After these 12 weeks, your employer must let you return to the same position or an equivalent job, which entails similar job duties and pay.
To get FMLA for depression, you may need to follow these steps:
- Determine whether your employer follows FMLA. Not every employer must follow FMLA, so you should double-check to determine if this may be an option for you.
- Provide documentation of your depression if requested by your employer.
- Obtain the needed documentation from a qualified professional, which is typically a therapist or doctor.
- Work for the company for a minimum of 12 months. If you have not worked for the employer 12 months, you may not be able to use FMLA.
- Provide a 30-day notice to your employer, if possible.
Why Legal Consultation Matters
Proving depression as a result of workplace conditions can be tricky. As such, seeking legal help is key in these scenarios. Individuals who want to pursue a workers’ compensation claim frequently decide to consult a workers’ compensation attorney who can offer guidance and advice during the claims process.
With a mental health injury, legal support is vital due to the difficulty in establishing a causal link and the complexity of the situation. A workers’ compensation attorney can review the evidence to see if your claim is viable. A lawyer can also make a recommendation about how to proceed with your case, along with providing information about whether additional benefits may be available to you, like Social Security benefits.
If you want to know more about depression and work rights, you can consult a workers’ compensation attorney.
Seek Legal Advice From The Law Office of William L. Phalen
At Phalen Law Firm, we will fight for justice on your behalf. We know how difficult it is for an individual to get justice from an insurance company or massive corporation, as they have vast resources and high-profile legal teams.
We can provide you with the legal support you need to receive workers’ compensation benefits for your work-related depression. No case is too small or too big for our passionate team of lawyers. Are you an employee in Missouri or Kansas dealing with depression that may have resulted from your working arrangement? Contact us at Phalen Law Firm for a free consultation about your depression workers’ compensation claim.