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Mental Injury
Rising Workplace Stress Has Big Impact on Comp
Eight out of every ten American workers report being stressed by at least one thing at work, according to a study by Nieslen, a market research firm. Long commutes, too-heavy workloads coupled with stagnant pay, and poor work-life balance account for the top stress-inducers.
The impact of poor mental health on physical recovery is well-known in the workers’ comp world, but as stress and anxiety become bigger issues in the workforce, it’s worth taking a longer look at how high levels of stress affect claims, and what employers can do to mitigate those effects.
States vary in how they approach claims of mental or psychological injuries at work, but by and large they are not compensable.
The employee bears the burden of proving that their mental condition — usually anxiety or depression — rose directly out of some extraordinary circumstance of their employment; normal workplace demands are not deemed sufficient reasons for a claim.
“Stress has a negative impact on overall health and return to work outcomes, and a growing body of evidence supports that.” — Trey Gillespie, senior director, workers’ compensation, Property Casualty Insurers Association of America
“There’s a lot of variance, but most states don’t recognize any form of mental-mental dynamic in terms of a compensable workers’ comp claim,” said Trey Gillespie, senior director, workers’ compensation at the Property Casualty Insurers Association of America.
“Typical work-related stresses, in terms of getting work done and dealing with bosses and co-workers, are generally not a basis for a claim.”
“There are circumstances in which an employee can be compensated for workplace stress, but there are a lot of ‘buts’,” said Bruce Wood, vice president and associate general counsel, American Insurance Association. “States have erected speed bumps or barriers that a claimant would have to pass to be compensated.”
Those speed bumps include higher evidentiary standards for compensability.
Employees must present a preponderance of evidence that clearly and convincingly establishes their work environment as the primary cause for their psychiatric condition — a tall order when other stress-inducing factors like personal finances or troubles at home come into play.
In most states, in order for a mental condition to be compensable, it must be accompanied by some sort of physical injury.
But again, proving that mental stress led to a physical disorder — such as a heart attack, high blood pressure, or other cardiovascular condition — can be difficult.
That’s why these types ‘mental-physical’ claims are not common, but could see an uptick if U.S. workers continue to report high levels of stress connected to unreasonable workloads or long hours.
Specific Exceptions
Some states make exceptions for causes involving PTSD or depression stemming from either experiencing or witnessing a traumatic injury. Connecticut, for example, strictly prohibits mental-mental claims with no physical component, but is seeking legislative amendments to its workers’ compensation act after the Sandy Hook school shootings in 2012.
“Teachers and first responders came upon a horrific scene, and may face PTSD or other emotional distress,” Wood said.
“There’s an attempt to change the law to eliminate the prohibition on mental-mental, or to specifically state that where a trauma is witnessed, that trauma constitutes a physical component of a valid claim.”
Even where mental stress does not constitute a compensable claim, everyday pressures and anxiety nonetheless worsen the outlook of a purely physical claim.
“If a worker has an injury and is trying to get back to their norm, meaning getting back to work in some capacity and back to their usual routine, anything that delays that recovery can trigger some psychological conditions,” said Deirdre Doyle, vice president of quality and continuing education at Procura, a Healthcare Solutions company. “That could be stress, anxiety, depression or all three.”
Doyle also said she believes workers’ comp payers will see more mental health issues as secondary diagnoses on claims going forward.
“Stress has a negative impact on overall health and return to work outcomes, and a growing body of evidence supports that,” Gillespie said.
The good news is that, while stress-free work environments may never be the norm, employers are becoming more receptive to employees’ mental health needs.
“There’s been a trend for the past 20 years or so in which employers fully understand how day-to-day work environment affects performance and also length of time off due to injury,” Gillespie said.
“There are proactive movements in human resources departments to create environments where employees feel valued, and to not set an adversarial tone if a worker becomes injured.”
However stress comes into play during a claim, whether as a contributing factor to or result of a physical condition, it’s clear that employers and their workers’ comp providers can improve outcomes and save dollars by recognizing the mental component of an injury early and attentively.
