Which states offer workers’ comp benefits for post-traumatic stress disorder and mental-only injuries?
The darkest states show where mental-only injuries like PTSD are generally covered, meaning compensation can be granted even if there was no physical injury.
Lighter colored states show where mental/mental injuries are covered only in limited circumstances (such as a sudden or unusual incident, or just for first responders).
States not highlighted show where mental-only injuries are not covered at all.
“What’s past is past. Let go of the past.
Your past does not define you. Don’t lose your present to your past.”
Despite these and other common sayings, the difficult reality is that catchy clichés do little to ease the pain of the approximately 8 million Americans who suffer from PTSD and who relive past trauma every day.
What is PTSD?
Posttraumatic stress disorder, or PTSD, is a serious potentially debilitating condition that can occur in people who have experienced or witnessed a natural disaster, serious accident, terrorist incident, sudden death of a loved one, war, violent personal assault such as rape, or other life-threatening events.
Definition provided by the Anxiety and Depression Association of America (ADAA)
Post-traumatic stress disorder is a mental health condition in which a person has difficulty recovering after experiencing or witnessing a terrifying event. Though the term “PTSD” wasn’t accepted as a clinical diagnosis until 1980, the condition has long been associated with military activities for as long as wars have been waged — previously going by terms like “shell shock,” “soldier’s heart,” “combat fatigue” or “war neurosis.”
As Adam Chekroud, PhD, Assistant Professor of Psychiatry at Yale University said after combing through 14 million newspaper articles between 1900-2016 for mentions of trauma-related symptoms:
PTSD has existed forever. It’s just a question of what we’ve been calling it. Tweet this
However, in recent years, the issue of PTSD and how it affects people has expanded beyond the battlefield. In particular, firefighters and EMTs, police officers, paramedics, health care workers and other first responders report higher than average instances of work-related PTSD due to the serious accidents and scenes of devastation they witness on a frequent basis.
In response to this crisis, a growing number of states are codifying new laws, statutes and provisions that allow first responders and the general workforce to receive workers’ compensation benefits for mental health conditions caused by a person’s job, including PTSD. Some states already allow for full coverage of “mental-only” injuries, while others offer limited benefits in certain circumstances. Many states have yet to address the issue at all though, forcing first responders and injured workers to face the long-term physical, emotional and financial damages of PTSD on their own.
While there has been significant progress in recent years, much work remains to be done. Unfortunately, workers often face an uphill battle when filing for their PTSD workers’ compensation benefits—though some first responders may find it easier to obtain benefits in certain states thanks to recent legislation.
Work-related PTSD statistics
Some 7-8% of the American population will develop PTSD at some point in their lives. About 8 million adults have PTSD during a given year.
PTSD has been estimated to occur in 32% of first responders, including 19% of police officers.
Almost 20% of firefighters and paramedics had PTSD, compared with the general population’s rate of 3.5 percent. These rates are similar to what’s seen among combat veterans.
Approximately 100,000 active police officers in the United States suffer from PTSD, and many also live with the comorbidities of depression, anxiety, and suicidal ideation.
In 80-90% of cases, PTSD is accompanied by another mental disorder (most commonly major depressive disorder, anxiety disorders, borderline personality disorder, and alcohol use disorder).
Women are more likely to experience PTSD as a result of sexual assault and child sexual abuse. Men are more likely to experience trauma caused by accidents, physical assault, combat, disaster, or to witness death or injury.
Work-related PTSD becoming a nationwide topic
As the map above shows, as of October 2019, 9 states so far have passed workers’ compensation laws to generally cover “mental/mental” injuries like work-related PTSD. Twenty-eight states currently offer limited coverage for psychological injuries in certain circumstances (such as in sudden or unusual circumstances, or just for first responders). Thirteen states offer no such coverage whatsoever.
A number of states are currently researching whether mental injury claims like occupational PTSD should be covered under workers’ compensation. Utah, for instance, has passed legislation establishing a commission to study the compensability of mental stress claims from first responders with PTSD. Other states, including Arizona, Kentucky, Missouri, Ohio, South Carolina, and West Virginia, have considered such legislation in the past, but chose not to move forward or failed to pass the law.
In 2019, at least 26 states considered new legislation addressing workers’ compensation coverage for PTSD and other “mental-only” injuries for first responders. A total of 122 related bills were considered in 2019. (source)
Nine states (California, Connecticut, Idaho, Louisiana, Nevada, New Hampshire, New Mexico, Oregon, and Texas) have passed legislation addressing benefits for first responders with PTSD in 2019. In 2018, 2 states (Florida and Washington) passed legislation expanding benefits for first responders with PTSD.
For instance, Florida Senate Bill 376, which was at least partly written in response to the 2018 school shooting in Parkland, expanded workers’ compensation benefits for first responders by allowing benefits for mental-only injuries. Before this law, only medical benefits were paid to first responders suffering from a mental-only injury like PTSD (a mental injury with no accompanying physical injury). Now, thanks to Senate Bill 376, first responders can also receive indemnity (wage loss) benefits for PTSD and other mental-only injuries, regardless of whether or not there was a physical injury, in certain circumstances. This law went into effect on October 1, 2018.
Colorado also expanded workers’ comp benefits to PTSD sufferers in 2018, but not just for first responders. Now, any worker who experiences certain kinds of traumatic events, even when they’re part of the employee’s usual work experience, can qualify for workers’ compensation benefits.
More recently, California governor Gavin Newsom signed Senate Bill 592 on October 1, 2019, which provides workers’ compensation for firefighters and law enforcement personnel who sustain occupational PTSD. According to the Sacramento Bee, this new law creates “a rebuttable presumption that a worker’s mental health struggles are an occupational injury, which could qualify them for paid time off to recover.” The law applies to injuries on or after Jan. 1, 2020.
Aside from state legislatures, first responders suffering from work-related PTSD can also look to the courts. There have been a number of cases around the country that have involved courts siding with employees and setting a legal precedent in workers’ compensation disputes.
Here are 4 examples:
Connecticut. In 2016, the Connecticut Supreme Court set a legal precedent for employees to receive workers’ compensation for PTSD caused by the worker being overworked. In William D. Hart v. Federal Express Corp, the Court ruled in favor of a FedEx Corp. driver who had been diagnosed with PTSD as a result of a new manager’s high-pressure demands. The driver was granted workers’ comp benefits.
Tennessee. In 2012, the Tennessee Supreme Court ruled in Gerdau Ameristeel, Inc. v. Steven Ratliff that a worker who had witnessed the deaths of 2 co-workers (in separate work accidents) was entitled to workers’ compensation benefits, even though he hadn’t filed a PTSD claim until over a year after the second death.
Oregon. In 2016, the Oregon Court of Appeals ruled in favor of a “911” dispatcher who said she developed PTSD from sending police officers to the scene of a shooting (Sheila L. Minor v. Saif Corp. and Coos County). She was awarded workers’ compensation benefits.
Michigan. In 2018, the Michigan Compensation Appellate Commission upheld the ruling in Dickey v. Delphi Automotive Systems LLC by a lower court awarding benefits to a worker who suffered PTSD after a restaurant shooting. The man was on a business trip in Mexico when he witnessed a gunman kill several people in the restaurant where he was eating with clients and co-workers. He and his party hid underneath their table and then fled the restaurant. He was diagnosed with PTSD upon returning to Detroit, and subsequently filed a workers’ comp claim.
Workers’ compensation laws for workplace PTSD
(a state-by-state breakdown)
How much compensation can I get for work-related post traumatic stress disorder?
The question of whether or not workplace PTSD is covered under workers’ compensation is a difficult one to answer, as it varies by occupation and location. First, you need to know if PTSD is considered an occupational illness or disease where you work. Then, it’s important to understand whether existing statutes apply only to first responders (firefighters, police, EMTs, paramedics, etc.) or if it has broader implications.
In most states, PTSD benefits fall under “mental/mental,” “mental-only” or “psychological” injuries. While a majority of states allow some form of compensation for mental injuries arising out of a physical injury at work (mental/physical injuries), far fewer states allow workers’ compensation for mental harm, suffering, damage, impairment, or dysfunction resulting from some action or failure to act by some individual.
Review the following chart to see a breakdown of relevant state laws and statutes regarding occupational mental/mental injuries like PTSD:
State Workers’ Compensation Laws for Mental-Only Injuries
| State | Statute | Description |
|---|---|---|
| Alabama | Title 25 | If your injury is mental, such as post-traumatic stress disorder or chronic anxiety disorder, your claim may be denied. Only mental injuries and mental disorders which were produced or proximately caused by a physical injury are compensable in Alabama. |
| Alaska | https://labor.alaska.gov/ | Alaska law only allows claims for mental-stress injury as long as it is “extraordinary and unusual.” Mental injuries are covered in specific circumstances, but not if the mental injury results from a disciplinary action, work evaluation, job transfer, layoff, demotion, termination, or similar action taken in good faith by the employer. |
| Arizona | 23-901 | By special statute, a “mental injury, illness or condition” is not covered “unless some unexpected, unusual or extraordinary stress related to the employment or some physical injury related to the employment was a substantial contributing cause of the injury, illness or condition,” A.R.S. § 23-1043.01(B). |
| Arkansas | 11-9-113 | In Arkansas, to successfully claim a mental injury or illness for workers’ compensation benefits, you must prove that the injury was the result of a work-related physical injury. Employees cannot claim a mental illness for observing another person being seriously or fatally injured while working – they must face a physical injury themselves. Arkansas also mandates that an employee cannot receive compensation for their mental illness unless they are examined and diagnosed by a licensed psychiatrist or psychologist. Additionally, if you want to prove that your stress or anxiety qualifies you for workers’ compensation benefits, those conditions must meet requirements set in the latest issue of Diagnostic and Statistical Manual of Mental Disorders (DSM). |
| California | Cal. Labor Code § 3208.3 (2018) | In workers compensation cases, a psychiatric injury is a mental disorder that is determined to be at least 50% caused by work. It requires medical treatment or causes disability. Generally, an employee with a psychiatric injury must: have worked for the employer for six months or longer. In addition, first responders in California were granted further rights when Gov. Gavin Newsom signed Senate Bill 542 in October 2019. This law creates a rebuttable presumption that a worker’s mental health struggles are an occupational injury, which could qualify them for paid time off to recover. |
| Colorado | 2018 Colorado Worker’s Comp Act | There is specific law in Colorado governing when a mental claim, i.e. anxiety, depression, etc., without a physical injury constitutes a compensable injury. For a stand-alone mental injury to exist, there must be “a psychologically traumatic event that is generally outside of a worker’s usual experience and would evoke significant symptoms of distress in a worker in similar circumstances.” C.R.S 8-41-301(2)(a). Colorado law further clarifies that a workers’ usual experience includes disciplinary action, work evaluations, job transfers, lay-off, demotion, promotion, termination, or retirement. A claim for a mental injury cannot be based in part on facts that are common to all fields of employment. |
| Connecticut | CT Workers’ Compensation Act 2019 | While Connecticut’s workers’ compensation law provides benefits for mental or emotional impairments that stem from a work-related physical injury, it limits benefits for those arising from a mental or emotional injury (“mental-mental”) injuries to: 1) police officers who use, or are the target of, deadly force in the line of duty, and 2) firefighters who are diagnosed with posttraumatic stress disorder (PTSD) caused by witnessing another firefighter die in the line of duty. |
| Delaware | House Bill 313 | Delaware recognizes a compensable mental injury absent any physical trauma. PTSD is covered as a personal injury as long as it is related to the occupation that the employee was engaged in, or if the person was deployed in a combat zone in the National Guard or the military or its reserves during the appropriate time period. |
| Florida | Section 112.1815(5)(a), Florida Statutes | Florida law states that a mental or nervous injury caused by stress, fright, or excitement is not considered a workplace injury. The only exception is when a physical injury also accompanies a mental injury. A special provision in Florida workers’ compensation law allows first responders to be compensated for a mental or nervous injury “occurring as a manifestation of a compensable injury” so long as they demonstrate their injury through clear and convincing evidence. For a mental or nervous injury arising out of the employment that is not accompanied by any physical injury, only medical benefits are available. Payment for lost wages may not be made unless a physical injury accompanies the mental or nervous injury. Benefits for a first responder are not subject to any limitation on temporary benefits or the 1-percent limitation on permanent psychiatric impairment benefits. In addition, Senate Bill 376 now allows first responders to receive indemnity (wage loss) benefits for PTSD and other mental-only injuries, regardless of whether or not there was a physical injury, in certain circumstances. This law went into effect on October 1, 2018. |
| Georgia | Georgia Code § 34-9-280 | In Georgia, it is required by law that workers first have a physical injury before they are eligible to receive benefits for a psychological injury, as psychological symptoms without bodily injury are not compensable under Georgia workers’ compensation laws. |
| Hawaii | Hawaii Code 386 | Mental injuries are only covered in very specific circumstances. If the mental stress results solely from disciplinary action taken in good faith by your employer, your claim will be denied. If an employee suffers personal injury either by accident arising out of and in the course of the employment or by disease proximately caused by or resulting from the nature of the employment, the employee’s employer or the special compensation fund shall pay compensation to the employee or the employee’s dependents. Accident arising out of and in the course of the employment includes the willful act of a third person directed against an employee because of the employee’s employment. No compensation shall be allowed for an injury incurred by an employee by the employee’s willful intention to injure oneself or another by actively engaging in any unprovoked non-work related physical altercation other than in self-defense, or by the employee’s intoxication. A claim for mental stress resulting solely from disciplinary action taken in good faith by the employer shall not be allowed. |
| Idaho | TITLE 72 | An injured worker in Idaho must suffer a physical injury for a psychological condition like PTSD, depression, or anxiety to be compensable under a workers’ compensation claim. Idaho Code Section 72-451 reads: “Psychological injuries, disorders or conditions shall not be compensated under this title, unless… caused by accident and physical injury…” However, this is an exception for first responders. In the 2019 Idaho legislative session, lawmakers passed a bill making PTSD in first responders coverable by workman’s compensation. They only need to show “clear and convincing” evidence of a psychological injury for worker’s compensation to cover their treatment. |
| Illinois | 820 ILCS 305 | Under certain circumstances, an injured worker can obtain Illinois workers’ compensation benefits for purely psychological injuries. These “mental-mental” cases occur when an injured worker sustains psychological injuries as a result of non-physical work-related factors. There are two types of these cases: 1) where the employee suffers a sudden, severe emotional shock traceable to a specific incident, or 2) where the employee develops a psychological injury after a series of work-related events. |
| Indiana | Indiana General Assembly Code | Psychological injuries/mental stress Injuries are potentially compensable in Indiana if: 1) A physical injury caused by psychological trauma is potentially compensable assuming that the stimulus or stress arises out of and in the course of employment. 2) Where there has been a physical worker’s compensation injury and the injured worker’s disability is prolonged or impairment is increased by accompanying psychological dysfunction, the full extent of disability and impairment may be compensable. 3) Preexisting psychological shortcomings and weaknesses of the injured worker which are aggravated or precipitated by physical injury and trauma may be found to be compensable to the full extent of the aggravation of the pre-existing psychological dysfunction. |
| Iowa | 2018 Brochure | Mental/mental injuries are recognized. But in order to be compensable under Iowa law, the work condition and circumstances leading to the mental condition must exceed that which is typically experienced by peers in that same profession. PTSD may be compensable without any physical injury to the body under these circumstances. |
| Kansas | 2018 Practice Guide | In Kansas, psychological injuries must be associated with a physical injury. In other words, you can claim injuries like stress, anxiety, and/or depression from a physical injury or a physical change caused by factors at work. Depression, stress, and anxiety alone are not covered by workers’ compensation. |
| Kentucky | KRS Chapter 342 | PTSD workers comp claims are available for first responders only. |
| Louisiana | Title 23 of the L.S.A.-R.S. §1307 | The law covers both mental and physical injuries from either accidents or occupational diseases. However, a mental injury must be the result of a physical injury or of a sudden, unexpected and extraordinary stress related to the employment—and, in either case, must be proved by clear and convincing evidence. As in other states though, there is an exception for first responders. Senator Gatti’s bill SB107 was signed by Governor John Bel Edwards and went into effect on August 1st, 2019. The bill adds PTSD to the list of compensable presumptions under workers’ comp for first responders (state police, emergency medical personnel, volunteer firefighters, sheriff and sheriff’s deputies). The presumption may only be rebutted by clear and convincing evidence. |
| Maine | Title 39-A | Mental injuries caused by mental stress may be covered so long as it can be proven that it was work-related. A mental injury resulting from work-related stress does not arise out of and in the course of employment unless it is demonstrated by clear and convincing evidence that: (1) The work stress was extraordinary and unusual in comparison to pressures and tensions experienced by the average employee; and (2) The work stress, and not some other source of stress, was the predominant cause of the mental injury. |
| Maryland | Title 14 | Maryland law does not explicitly cover mental injuries, but there have been cases where the Maryland Court of Appeals determined that PTSD was a compensable occupational disease. |
| Massachusetts | Chapter 152 | Under Massachusetts law, workers are eligible for compensation for mental or emotional disabilities such as PTSD if the workplace incident or a work-related physical injury was the contributing cause. |
| Michigan | Section 418.101 | In Michigan, a psychological injury caused by events that occurred while on the job may be considered a valid work injury, compensable by workers’ compensation benefits if proven to be as a result of an injury occured. |
| Minnesota | MN Dept of Labor | PTSD is specifically addressed in the statute. If an employee is diagnosed with PTSD by a licensed physician or psychologist and the employee meets the Diagnostic and Statistical Manual of Mental Disorders criteria, the claim is covered by workers’ compensation benefits. This is the only type of mental/mental claim recognized in Minnesota. If PTSD is diagnosed as arising from a physical injury, that would be compensable in Minnesota as a physical/mental claim. For injuries occurring after January 1, 2019, it will be a presumption that PTSD in first responders is compensable under workers’ compensation, absent preexisting history and limited statutory exceptions. PTSD claimed due to job performance issues, such as demotions and layoffs, is not compensable. |
| Mississippi | 71-3-3 | For purposes of a mental or psychological injury, the employee must prove by clear and convincing evidence that the mental injury resulted from something “more than the ordinary incidents of employment.” A direct physical impact is not required so long as the mental injury is directly linked to an untoward event or unusual occurrence which is incident to employment. |
| Missouri | Title XVIII | Under Missouri law, a mental injury is compensable only if it is demonstrated by the employee that the stress causing the mental injury is work related and was “extraordinary and unusual.” |
| Montana | TITLE 39 | Montana Code Annotated (MCA) 39-71-105 states that stress claims, often referred to as “mental-mental claims” and “mental-physical claims”, are not compensable under Montana’s workers’ compensation and occupational disease laws. |
| Nebraska | Chapter 48 | Mental/mental injuries are not compensable in Nebraska, so a diagnosis of PTSD without any physical injury would typically not be covered. If there is a physical injury to the body and PTSD is a condition that is a result of that injury, it could be compensable as a physical/mental injury. However, first responders are an exception. PTSD could be compensable as a mental/mental injury for first responders who are exposed to extraordinary and unusual stimuli in comparison to normal conditions of their employment. |
| Nevada | NRS 616C.180 | NRS 616C.180 governs workers’ compensation for injury or disease caused by stress, including PTSD. There are two important features of this statute. First, it explicitly exempts from coverage any condition “caused by any gradual mental stimulus.” This precludes workers’ comp claims for certain types of anxiety-related conditions. Second, the statute defines when a stress-related claim is compensable. To qualify for benefits, the condition must meet these factors: 1)The employee has a mental injury caused by extreme stress in time of danger; 2) The primary cause of the injury was an event that arose out of and during the course of employment; 3) The stress was not caused by a layoff, termination, or any disciplinary action. In June 2019, Governor Steve Sisolak signed Assembly Bill 492 into law which expanded protections for first responders. |
| New Hampshire | CHAPTER 281-A | “Injury” or “personal injury” shall not include diseases or death resulting from stress without physical manifestation. “Injury” or “personal injury” shall not include a mental injury if it results from any disciplinary action, work evaluation, job transfer, layoff, demotion, termination, or any similar action, taken in good faith by an employer. The exception is for first responders. On July 17, 2019, Governor Sununu signed into law Senate Bill 59. The definitional section of the statute, 281-A:2,XI was amended to state that “‘Injury’ or ‘personal injury’ shall not include diseases or death resulting from stress without physical manifestation, except that, if an employee meets the definition of an ‘emergency response/public safety worker’ under RSA 281-A:2, V-c, the terms ‘injury’ or ‘personal injury’ shall also include acute stress disorder and post-traumatic stress disorder.” |
| New Jersey | Title 34, Chapter 15, Articles 1 to 10 | In the psychiatric claim that arises from a traumatic incident to the petitioner (physical-mental) there must be objective evidence to support an expert opinion of psychiatric disability. The mere “parroting” of the petitioner’s subjective statement of disability by the psychiatric expert cannot support an award of disability. However, there need not be a physical manifestation “observable” and “measurable” to support such a claim. “A professional psychiatric judgment might rest upon (1) analysis of the subjective statement of the patient; (2) observations of physical manifestations of the symptoms related to the subjective statement of the patient and/or (3) observations of manifestations of physical symptoms and analyses of descriptions of states of mind beyond those related in a patient’s subject treatment.” When a psychiatric claim is alleged to have occurred as the result of gradual stressful work-related stimuli (mental-mental) there must be objective verifiable evidence. The proffered evidence must show that the employer created stressful conditions peculiar to the work place which justifies the medical opinion that there were material causes to the alleged disability. The perception of the petitioner is not sufficient. |
| New Mexico | Title 11 – Chapter 4 | Some mental injuries are covered, but not where the injury arises from an event in connection with disciplinary, corrective or job evaluation action, or employment termination. In April 2019, Gov. Michelle Lujan Grisham signed a bill to extend the rights of New Mexico first responders. House Bill 324 recognizes PTSD as a health condition firefighters may get in the course of their duty. Under the old law, PTSD was not recognized as a job-related illness. Now, firefighters diagnosed with PTSD qualify for benefits like workers compensation. |
| New York | 329.3 | While it is generally accepted that a mental injury precipitated solely by psychic trauma may be compensable in workers’ compensation, psychological injuries only qualify for workers’ compensation benefits in New York if they arise from abnormal stress and unprotected employer actions. |
| North Carolina | CHAPTER 97 | State law does not currently cover PTSD. However, a newly filed bill looks to provide workers’ compensation benefits for first responders suffering post-traumatic stress disorder. |
| North Dakota | 65-01-02 | A mental or psychological condition caused by a physical injury may be covered, but only when the physical injury is determined with reasonable medical certainty to be at least fifty percent of the cause of the condition as compared with all other contributing causes combined, and only when the condition did not pre-exist the work injury. This does not include a mental injury arising from mental stimulus. |
| Ohio | House Bill 80 | The Bureau of Workers’ Compensation (BWC) has introduced House Bill 80. If passed, the measure would make several changes to Ohio’s BWC law that would expand workers’ comp benefits for mental or emotional impairment caused by PTSD for first responders, even when there is no physical injury. Currently, however, Ohio doesn’t recognize workers’ compensation claims for mental injury or mental disease caused solely by job-related stress unaccompanied by physical injury or occupational disease. |
| Oklahoma | Title 85 | “Compensable injury” shall not include mental injury that does not arise directly as a result of a compensable physical injury, except in the case of rape or other crime of violence which arises out of and in the course of employment. |
| Oregon | 656.802 | Any mental disorder, whether sudden or gradual in onset, which requires medical services or results in physical or mental disability or death is covered under state workers’ compensation law, as is any series of traumatic events or occurrences which requires medical services or results in physical disability or death. “Mental disorder” includes any physical disorder caused or worsened by mental stress. The worker must prove that employment conditions were the major contributing cause of the disease. In 2019, the Oregon Legislature and Governor also passed a bill that made presumptions on the compensability of post-traumatic stress disorder suffered by first responders. |
| Pennsylvania | House Bill 432 | Under Pennsylvania law, when PTSD occurs unaccompanied by a physical injury, it is considered as a “mental injury.” To obtain compensation, the worker in Pennsylvania will be required to prove that they sustained their “mental injury” due to an abnormal condition at the workplace. House Bill 452 hopes to allow PTSD claims for first responders. |
| Rhode Island | TITLE 28-34 | The disablement of an employee resulting from mental injury caused or accompanied by identifiable physical trauma or from a mental injury caused by emotional stress resulting from a situation of greater dimensions than the day-to-day emotional strain and tension which all employees encounter daily without serious mental injury shall be treated as an injury as defined in § 28-29-2(7). |
| South Carolina | Bill 164 | Employees in SC are required to prove that the stress or mental health injury is extraordinary and the result of abnormal working conditions in order to qualify for workers’ compensation benefits. |
| South Dakota | — | South Dakota does not cover mental/mental injuries. There must be a physical injury to the body. If an employee sustains a physical injury and claims PTSD as a consequential injury, then it could be compensable. |
| Tennessee | TN Work Comp Law | In 2011, the state legislature passed sweeping workers compensation reform deemed more favorable to employers and insurance companies. Gradual onset resulting in cumulative stress, emotional, or mental or injury is no longer covered under the Workers Compensation Act. However, some court rulings have come down in facor of workers. “Mental injury” means a loss of mental faculties or a mental or behavioral disorder where the proximate cause is a compensable physical injury resulting in a permanent disability, or an identifiable work-related event resulting in a sudden or unusual mental stimulus. A mental injury shall not include a psychological or psychiatric response due to the loss of employment or employment opportunities. |
| Texas | Chapter 408 | Texas does not require businesses to provide workers comp insurance. Sec. 408.006. MENTAL TRAUMA INJURIES. (a) It is the express intent of the legislature that nothing in this subtitle shall be construed to limit or expand recovery in cases of mental trauma injuries. Notwithstanding Section 504.019, a mental or emotional injury that arises principally from a legitimate personnel action, including a transfer, promotion, demotion, or termination, is not a compensable injury under this subtitle. For first responders, however, some compensation for work-related PTSD may be available. Post-traumatic stress disorder suffered by a first responder is a compensable injury in Texas only if it is based on a diagnosis that: 1) the disorder is caused by an event occurring in the course and scope of the first responder’s employment; and 2) the preponderance of the evidence indicates that the event was a substantial contributing factor of the disorder. |
| Utah | Title 34A | Mental stress claims are allowed without a physical injury only when there is extraordinary mental stress from a sudden stimulus arising out of and in the course and scope of employment. Mental stress claims are not allowed if the basis for the claim is good faith employer personnel actions. |
| Vermont | Title 21 Chapter 9 | Vermont workers’ compensation law is clear that psychological injuries that arise out of and in the course of employment are just as compensable as physical injuries. In the case of police officers, rescue or ambulance workers, or firefighters, post-traumatic stress disorder that is diagnosed by a mental health professional shall be presumed to have been incurred during service in the line of duty and shall be compensable, unless it is shown by a preponderance of the evidence that the post-traumatic stress disorder was caused by nonservice-connected risk factors or nonservice-connected exposure. |
| Virginia | 65.2-101 | Workers’ compensation doesn’t just apply to physical injuries. Workers who can’t emotionally do their job are also entitled to Virginia worker’s compensation benefits. This includes PTSD cases. |
| Washington | 51.08.142 | Workers’ compensation claims for mental stress are only allowed in Washington State if the stress resulted from a single, traumatic event. Washington State law excludes mental health conditions or disabilities that are caused by stress from coverage as occupational diseases. A 2019 law passed in Washington State now means that first responders can file a successful PTSD claim for the effects of cumulative trauma. The old law did not allow PTSD claims which were based on cumulative psychological trauma that occured over time and combine to cause severe mental problems. The old law is still in effect for all occupations in Washington State, except first responders. |
| West Virginia | Title 85 | As a general principal in West Virginia, a claimant is precluded from receiving workers’ compensation benefits for a mental injury with no physical cause. |
| Wisconsin | Chapter 102 | Mental claims are specifically included in Wis. Stats. Sec. 102.01(2)(c), but mental-mental claims are difficult to establish in Wisconsin. The applicant must prove that his or her job produced “extraordinary stress” as compared to similarly situated persons. |
| Wyoming | 27-14-102 | Mental injuries are generally not covered unless it is caused by a compensable physical injury. In no event shall benefits for a compensable mental injury be paid for more than 6 months after an injured employee’s physical injury has healed to the point that it is not reasonably expected to substantially improve. |
Overcoming the challenges of work-related PTSD
While legal jargon and workers’ compensation laws commonly categorize PTSD as a “mental-mental” claim (because it’s a mental health problem caused by a mental or psychological condition at work), the real-world consequences of this condition extend well beyond the mind.
According to the Center for Workplace Health:
Compared to workers without the disorder, those with PTSD have higher rates of work absenteeism, a higher number of medical visits, an increased likelihood of unemployment or underemployment, lower hourly pay, and increased difficulty meeting work-related demands. PTSD is also associated with an increased risk of suicide attempts.
In addition, people suffering from PTSD may experience the following debilitating symptoms and mental health conditions connected to the traumatic event:
- Fear
- Stress and anxiety
- Flashbacks and nightmares
- Social isolation
- Increased sensitivity and reactive responses
- Hostility
- Difficulty sleeping (insomnia)
- Agitation and irritability
- Self-destruction behavior (i.e., substance abuse)
- Emotional detachment
Most people who experience such events recover from them, but people with PTSD continue to be severely depressed and anxious for months or even years following the event.
One of the most difficult aspects of workplace PTSD is that the signs may not be obvious or visible at first, unlike a physical injury. The side effects of PTSD and other mental conditions caused by witnessing a traumatic event often take months or years to fully develop, during which time the statute of limitations for filing a workers’ compensation claim may have run out.
Another challenge facing workers experiencing occupational PTSD is the insurance companies. Because the laws pertaining to compensation for mental health conditions like post-traumatic stress disorder are relatively new, workers’ compensation insurance companies are often wary of awarding benefits for these types of claims and investigate them very closely.
Insurance companies frequently question whether mental health treatment is necessary or related to the accident. Some insurers claim that a PTSD diagnosis is “subjective evidence” since it cannot be proved by traditional medical practices such as an MRI or X-ray. Others wrongfully argue that there’s nothing wrong with the employee because they were able to work for months or years after the traumatic event “just fine.”
A third obstacle facing individuals experiencing PTSD is the high cost of treatment. As a mental disorder, PTSD is treatable through a combination of medications, psychotherapy and counseling. Some popular approaches for treating post-traumatic stress include trauma-focused cognitive behavioral therapy, Eye Movement Desensitization and Reprocessing (EMDR), and family therapy. Many of these treatments are long-term and costly, which presents a major financial barrier for injured workers.
By obtaining a referral from an authorized treating physician, an injured employee has a stronger basis to request mental health treatment from a psychologist or therapist. However, obtaining the referral can be difficult for many injured workers, and the insurance company may still refuse mental health treatment even after they receive a direct referral.
What to do if you or a loved one are experiencing work-related PTSD
If you believe you may be suffering from work-related PTSD, or you suspect a loved one is experiencing PTSD after witnessing a traumatic event, it’s imperative that you talk to your doctor and get an evaluation from a mental health professional. Recognize that you need help is one of the most important steps—and one that first responders, in particular, often struggle with.
“A challenge among uniformed personnel is their unwillingness to seek help for psychological problems. This may be due to a ‘macho culture’, which includes having difficulties admitting weakness, denial and/or a constant pressure to control emotions and a desire to appear efficient.” (source)
It’s okay to ask for help—and that starts with talking to a professional, preferably a mental health specialist such as a psychiatrist or psychologist. Not only is this a positive step for your personal health and well-being, but it also creates a trail of documents to support a future workers’ compensation claim.
Next, if you or a loved one have been diagnosed with PTSD, we strongly recommend you speak with a workers’ compensation attorney near you about your legal rights. An experienced lawyer will fully understand your state’s workers’ compensation laws and whether or not your injury is covered. Then, they can advise you on the next best steps on how to file a claim with your employer and secure the maximum benefits you’re owed. Most attorneys offer a free initial consultation, so it’ll cost you nothing but your time to learn about your rights.
About Gerber & Holder
Benjamin Gerber and Tom Holder are trusted, nationally recognized Atlanta attorneys specializing in workers’ compensation litigation for Georgia workers who suffer back and neck injuries, catastrophic injuries and other common workplace accidents—including PTSD and other mental health conditions.
We have over 75 years of combined experience in workers’ compensation litigation.At Gerber & Holder Attorney At Law, we see every client as an individual with a unique story and important concerns. Our law firm has served our clients faithfully in every case. By doing so, we have been able to build a history of success stories by securing large workers’ compensation settlements and payouts. Most importantly, we’ve been able to change the lives of our clients, helping them recover physically, emotionally and financially.
“I’ve seen first-hand how work-related trauma can devastate an entire family and derail a person’s life. This doesn’t have to be your story. We can help you obtain the compensation you need to pay for PTSD treatment and recovery. The path to recovery is a long and difficult journey, but it is possible. Let us help you take the first step.”
If you or a loved one have been seriously injured on the job, or suffered an occupational injury, you should know that you have legal rights under the Georgia workers’ compensation law. Our Atlanta attorneys can tell you what those rights are and we’ll fight aggressively on your behalf to negotiate a fair settlement—and even take your case to the highest court in the land if necessary.
