PTSD & Workers’ Comp

December 12, 2024

Post-Traumatic Stress Disorder (PTSD) is a serious mental injury that can stem from a traumatic event while on the job.

Whether it’s because of a physical injury like being attacked or shot or simply witnessing these terrible events, workers’ comp benefits can cover the medical treatment needed to help workers heal from their PTSD. Other common causes of psychiatric injury include:

Serious accidents
Extraordinary stress
Physical trauma
Natural disasters

Since PTSD is a mental health condition, it’s more challenging to prove when applying for workers’ compensation benefits. Understanding how to go about securing these benefits when dealing with a mental injury is crucial to ensure you get the financial support you need.

Post-Traumatic Stress Disorder and workers compensation

How Work Can Cause Post-Traumatic Stress Disorder

Workplace trauma has many faces and can affect workers in any industry. However, there are specific careers that tend to see a higher rate of Post-Traumatic Stress Disorder. First responders, police officers, healthcare workers, and military personnel, such as combat veterans, often face Acute Stress Disorder (ASD) from traumatic events that develop into PTSD.

Many things can happen on the job that might cause someone to develop a mental injury, like PTSD, and seek workers’ compensation. Some of the most common causes of mental injury in the workplace are:

Witnessing fatal or severe accidents
Being trapped in a dangerous situation
Extraordinary and unusual stimuli
Experiencing workplace violence
Exposure to gruesome scenes or death
Experiencing repeated exposure to traumatic events or disturbing situations
If you witness death
Extreme stress

Some examples of the most common causes are:

Police officers watching their partner get shot or being shot themselves
Being at work during an active shooter situation
A healthcare worker constantly sees patients suffer or pass away

PTSD claims can be from any event that a worker has a significant reaction to that causes them to develop ASD. Remember, just because there are some industries and professions more likely to develop PTSD, any worker can if something happens on the job.

The Impact of a Traumatic Event on Workers

Workers who want to file a workers comp PTSD claim will need to elaborate on the impact that the psychologically traumatic event or events have had on their lives. PTSD can have a profound effect on someone’s professional and personal life, which can create unique challenges for them.

While everyone experiences PTSD differently, there are some common symptoms of this mental or psychological condition:

Difficulty concentrating on job duties, leading to job performance issues
Flashbacks and intrusive memories of the traumatic event that caused a physical injury or mental injury are common PTSD symptoms
PTSD sufferers often have poor coping skills
Severe anxiety when it’s time to return to work or be in similar environments
Sleep issues like insomnia and nightmares affect job performance
Depression and emotional numbness affection work motivation
Physical symptoms like fatigue, muscle tension, increased heart rate, and headaches
Strained relationships with coworkers and supervisors

PTSD and Workers’ Compensation Eligibility

Understanding your eligibility for workers comp benefits because of Post Traumatic Stress Disorder is essential for getting the support you need. The rules and requirements for PTSD claims might vary per state, but there are common factors that will determine your eligibility.

Mental Claims vs. Physical-Mental Claims

There are two categories that PTSD can fall under in workers’ compensation claims. Each one has to establish the connection between work and PTSD, but they’re slightly different in how they happen.

Mental claims involve a mental injury caused by psychological trauma. This means there was no physical injury that led to the PTSD. This could be witnessing the death of a coworker or someone else on the employer’s premises.

Some states have strict requirements for proving mental claims and might require you to establish the trauma was extraordinary or unusual for your occupation.

Physical-mental claims are when PTSD develops after a physical work-related injury. These are generally easier to prove since there’s a physical injury in play. These claims are far more accepted across jurisdictions than mental claims.

With physical-mental claims, there has to be proof of the correlation between the physical injury and the psychological impact. Working with mental health professionals and other healthcare experts to obtain medical evidence and get PTSD diagnosed is the best way to prove PTSD claims.

Requirements for Proving Work-Related PTSD

If you want to claim workers’ compensation benefits for PTSD successfully, you need to establish:

Clear evidence of a work-related traumatic event or series of events
A formal PTSD diagnosis from a qualified mental health professional (a mental health specialist will use a diagnostic and statistical manual to determine whether you have PTSD.)
Documentation showing the direct correlation between work events and PTSD symptoms
Evidence that the condition impacts your ability to work in any capacity
Proof that the trauma happened during your employment

Challenges in Obtaining Workers Comp for PTSD

Even though workers’ comp can cover mental disorders related to traumatic events at work, there can be complications or challenges when applying for it:

Varying state laws regarding mental health coverage
The stigma surrounding mental health conditions in the workplace and in general
Insurance companies’ tendency to dispute mental health claims
Difficulty proving invisible psychological injuries
Limited understanding of PTSD by some insurance claims adjusters and employers
Challenges in documenting the exact cause and onset of PTSD
The presence of other mental health conditions with similar symptoms to PTSD

However, working with a mental health expert who utilizes a diagnostic and statistical manual and a professional lawyer who understands mental disorders criteria can increase your chances of success.

Types of Workers’ Compensation Benefits for PTSD

Workers comp helps provide injured workers with compensation for those suffering physical injuries as well as work-related PTSD. Since PTSD is a mental health problem, the benefits you can receive from workers’ compensation coverage will differ slightly from the benefits you can receive for a physical injury.

Medical Benefits

Workers’ compensation should cover medical expenses that are reasonable and necessary for medical treatment for a mental disorder. This can include medical costs for things like:

Psychiatric evaluation and ongoing care
Prescribed medications
Individual therapy sessions
Group therapy sessions
Hospital stays
Specialized trauma treatments
Travel expenses to medical appointments
Alternative therapies, when prescribed

PTSD can last for months to someone’s whole life. That’s why getting financial help from workers’ compensation is essential. Participating in therapies and other treatments is the best way to cope with the mental health condition and hopefully heal enough that they can move past it.

Disability Benefits

Mental disorders can affect workers just as much as physical injuries. How the traumatic event that led to your PTSD affects your ability to work will vary based on your circumstances. Depending on its impact, you might qualify for different types of disability benefits::

Temporary Total Disability (TTD): Available when PTSD completely prevents you from working. It usually pays two-thirds of your average weekly pay and continues until you can return to work or reach maximum medical improvement.
Temporary Partial Disability (TPD): This applies when you can work with PTSD with limitations. It helps compensate for reduced earnings during recovery and bridges the gap when you’re working fewer hours or on light duty.
Permanent Disability: Available if PTSD causes lasting impairment and can be partial or total depending on the severity. It helps provide long-term support, and compensation is based on the impact on earning capacity.

Many people will start on permanent disability, where they can’t work at all, and then transition to partial disability if their condition improves enough that they can work in any capacity. If you’re unsure which you qualify for, your attorney can help you determine the best option for filing your workers’ compensation claim.

Vocational Rehabilitation

When PTSD impacts your ability to return to your previous employer or position, you can utilize vocational rehabilitation programs. These services offer:

Career counseling and guidance
Skills assessment and training
Job search assistance
Job placement services
Education programs
Return-to-work programs
Workplace accommodations
Career transition support

The Role of a Workers’ Comp Attorney

Having a Chicago workers’ compensation attorney from Rosenfeld Injury Lawyers on your side is the best way to increase your chances of getting approved for benefits for PTSD. While you might think you can handle it alone, we can help reduce the risk of denial and help you understand workers’ compensation laws and claims processes.

Navigating the Claims Process

Our Chicago personal injury lawyers are skilled at working on workers’ compensation cases. We will help you navigate the claims process and will:

Explain your rights and options under workers’ compensation laws
Handle paperwork filing
Communicate with the insurance companies
Ensure that there’s proper documentation of your mental health condition
Guide you through every step of the process
Continue to protect your interests throughout the claims process

Gathering and Presenting Evidence

You’ll need strong evidence of your emotional distress to include PTSD in your workers’ comp claim. Our lawyers will help build a strong case by:

Collecting detailed medical records
Securing expert testimony from qualified mental health professionals
Documenting workplace incidents and conditions that have contributed to your PTSD
Gathering statements from witnesses
Demonstrating the correlation between your job or work environment and PTSD
Presenting all the evidence to claims adjusters or judges

Negotiating with Insurance Companies

Your workers’ comp lawyer will:

Deal with all the communications with insurance adjusters
Counter any lowball offers you receive
Calculate the full value of your claim so you can maximize your benefits
Negotiate with insurance companies
Protect you from unfair tactics utilized by insurance companies
Ensure that your settlement also covers future medical expenses

Appealing Denied Claims

If your claim is denied, your attorney will:

Look into the denial reasons
Identify any additional evidence to support your case
File necessary appeal paperwork promptly
Represent you at appeal hearings
Present a strong argument for approval
Fight for your rights
Navigate the appeals process

Secure Expert Legal Representation!

If you’re struggling with PTSD after an accident or injury at work, you don’t have to face things alone. The experienced team of workers’ compensation attorneys at Rosenfeld Injury Lawyers has helped other injured workers seek compensation for their physical injuries as well as the PTSD they often experience afterward.

PTSD can have significant impacts on your life, and you deserve to be compensated for what you’ve been through. We’re here to help fight for your rights so you can focus on healing physically and emotionally. Don’t let insurance companies minimize your PTSD.