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Workers’ Compensation for PTSD

September 29, 2023 Legal Team

In the realm of workers’ compensation, the focus is predominantly on physical injuries or illnesses sustained in the workplace. However, as society’s understanding of mental health deepens, a crucial concern is whether workers’ compensation will also cover Post-Traumatic Stress Disorder (PTSD).

Fortunately, California workers can file for workers’ compensation benefits for PTSD as long as the work-related incident they experienced was at least 51% responsible for their condition.

Workers' Compensation for PTSD

The Emergence of PTSD as an Occupational Hazard

PTSD can develop after a person is exposed to a traumatic event. In the workplace, this can include incidents such as severe accidents, violence, sexual harassment or assault, bullying, natural disasters, terrorist attacks, and other high-stress or shocking experiences.

Recent years have witnessed a paradigm shift in recognizing mental health conditions, particularly PTSD, as a legitimate occupational hazard. Professions like first responders, military personnel, and healthcare workers, who routinely encounter traumatic situations, are at heightened risk for developing PTSD. The profound impact of this condition on an individual’s mental well-being and job performance cannot be overstated.

What is PTSD?

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can occur after experiencing or witnessing a traumatic event. Symptoms of PTSD can include:

  • Intrusive thoughts or memories
  • Nightmares
  • Flashbacks
  • Avoidance of triggers
  • Emotional distress
  • Difficulty concentrating
  • Sleep disturbances
  • Changes in mood or behavior

Victims may also experience anxiety, depression, and other conditions that compound it.

Eligibility for Workers’ Compensation Related to PTSD in California

California law recognizes that mental health conditions, including PTSD, can result from work-related conditions or incidents. However, there are specific criteria that must be met for a PTSD claim to be valid:

The Traumatic Event

The event that led to the PTSD must be work-related. It could be a single traumatic incident or a series of events over time.

Direct Cause

The work-related event must be at least 51% responsible for causing your PTSD. This means that you must be able to demonstrate a clear link between the event and the development of the condition.

Medical Evidence

A diagnosis of PTSD from a licensed medical professional is crucial. This provides the necessary medical evidence to support the claim.

First responders such as firefighters, police officers, healthcare workers, or public safety agency dispatchers do not have to cite specific on-the-job incidents or experiences to file a claim for PTSD. California passed legislation allowing the presumption that a first responder’s PTSD is related to their employment if they are filing a claim.

How to Prove PTSD is Work-Related

If you wish to file a workers’ compensation claim for your PTSD, consider taking the following steps to help support your case:

Follow Proper Reporting Procedures

Report any incidents that contributed to your PTSD to your employer as soon as possible. This helps establish a documented timeline.

Seek Professional Help

Consult a mental health professional who can diagnose and document your PTSD. Their notes and records are crucial for your claim.

Document the Incidents

Write down the incidents or situations at work that you believe contributed to your PTSD. Include dates, times, locations, and any individuals involved.

Review Workplace Policies

Familiarize yourself with your workplace’s policies regarding traumatic incidents and mental health. This can help you understand if there were any breaches that contributed to your condition.

Obtain Witness Statements

If there were witnesses to any of the traumatic events that took place at work, try to get statements from them. Their accounts can provide additional evidence for your claim.

Document Medical Treatment

Keep records of all medical appointments and medications related to your PTSD. This can serve as evidence of the impact on your health and your need for treatment.

Consult an Attorney

Consider speaking with a trusted Orange County workers’ compensation lawyer with experience in mental health cases. They can provide legal advice and help you navigate the process.

Expert Opinions

Your attorney may obtain expert opinions from mental health professionals or medical experts who can attest to the work-related nature of your PTSD.

File a Formal Claim

Work with your attorney to file a formal workers’ compensation claim within applicable deadlines.

Cooperate with Evaluations

Be prepared to undergo evaluations as part of the workers’ compensation process. These may be conducted by independent medical examiners.

In California, you have the right to appeal a denied workers’ compensation claim. You must file an Application for Adjudication of Claim with the Workers’ Compensation Appeals Board (WCAB) to initiate the formal legal process. If your appeal moves forward, be prepared to present your case at a hearing. This may involve providing testimony and presenting additional evidence to support your claim. In some cases, resolving the dispute through mediation or settlement discussions may be possible. Your Orange County employment attorney can advise you on the best approach.

Types of Compensation Available

In workers’ compensation claims related to PTSD, the following types of compensation may be available to help cover expenses and support you as you recover:

  • Medical Treatment: This includes coverage for all reasonable medical treatment related to your PTSD, such as therapy, counseling, medication, and any other prescribed treatments.
  • Temporary Disability Benefits: If your PTSD prevents you from working temporarily, you may be eligible for temporary disability benefits. These provide partial wage replacement during your recovery.
  • Permanent Disability Benefits: If your PTSD results in a permanent impairment or disability, you may be entitled to permanent disability benefits. The amount depends on factors like the severity of your condition and its impact on your ability to work.
  • Vocational Rehabilitation: If your PTSD prevents you from returning to your previous job, vocational rehabilitation benefits may be available. This can include job training or assistance in finding suitable employment.
  • Mileage and Travel Expenses: Reimbursement for travel expenses related to medical appointments and treatments may be provided.

An attorney can provide specific guidance on the types of compensation you can recover based on your individual circumstances.

Speak to a Lawyer Today

If you or someone you know is struggling with PTSD related to an incident in the workplace, a trusted attorney can help. They will ensure you receive the compensation and support you are entitled to.