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What Kind Of Mental Claim Do You Have Under The Workers' Comp System (And Does It Matter)?

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Can you get worker's compensation benefits based on a mental injury? Possibly. For the purposes of workers' comp determinations, all claims based on mental disorders fall into one of three categories. Your odds of approval change depending on which category you're in:

1.) Physical-Mental: These claims involve a physical injury that ultimately leads to a mental condition, like depression or anxiety. For example, if you injured your back at work one day and the injury led to debilitating pain and spinal surgeries, you could develop depression as a result. The physical disability eventually led to a mental disability.

These are probably the easiest mental disabilities to get through the courts, as long as you can show a clear connection between your physical injury and your mental disability. Usually, it requires evidence from your doctors that you weren't suffering from the mental condition until after you suffered the physical injury.

Even if other factors aggravate the mental condition later, as long as it started with the physical injury you suffered and the physical injury continues to be at least partially at fault, you can win your case. For example, if your back injury and pain led to ongoing depression, your employer can't stop paying your claim just because some new problem in your life (such as a looming divorce) is aggravating the depression that started with your back injury.

2.) Mental-Physical: These claims start with a mental problem that's caused by work and evolve into a physical problem. For example, if you work in a stressful environment, have long hours, aren't given enough help on the job, and your stress levels eventually lead to a heart attack, that's a mental-physical injury.

These claims can only be successful when the psychiatric injury is directly related to something that occurred on the job (whether it was a long-term situation or a single, traumatic event). You're only barred from collecting workers' comp for these types of claims if your mental injury is the result of management's legitimate personnel actions toward you. For example, if you allege that the stress that led to your heart attack was caused by your boss reprimanding you for poor job performance, you won't be able to get workers' comp over it (unless you can prove that your boss was purposefully causing you stress for some reason and not acting in good faith).

3.) Mental-Mental: These claims arise solely based on some traumatic event or stressful condition on the job. No physical injury is involved. For example, if you are robbed at gunpoint and develop post-traumatic stress disorder as a result, that's a mental-mental type claim. These can be difficult cases to win, and employers will often dispute them.

In order to win your case, you will have to prove that your mental injury was more than just your personal reaction to normal working conditions. The type of job that you do may be a factor in any case. For example, a liquor store manager who developed a mental condition after he was robbed at gunpoint was initially denied workers' comp because his employer maintained that getting robbed was just part of his job. The court overturned the initial ruling, noting that he'd never been robbed in 30 years of employment and that having a gun held to his head wasn't a normal part of his working conditions.

Your employer may be reluctant to pay a claim based on mental injury. If you need to overcome your employer's objections, your chances at success will depend largely on the unique circumstances of your claim. Talk to a workers compensation lawyer today to discuss the situation.