Stress Claims
Stress itself is not eligible for workers’ compensation benefits. However, stress claims resulting from certain psychiatric injuries are eligible for workers’ compensation benefits in California. Determining what specific injuries resulting in stress may qualify for workers’ compensation benefits is complex. Our work injury lawyers can walk you through the complicated claims process.
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Stress Claims Require an Underlying Psychiatric Injury
Workers’ compensation law makes no specific reference to stress. The phrase “stress claim” is kind of a misnomer. Nearly every worker has at some point experienced stress associated with difficult workloads, unexpected workplace changes, or overbearing supervisors. Normal workplace stress is not a sufficient reason to open a workers’ compensation claim. Only stress resulting from a qualified psychiatric injury suffered on the job is eligible for workers’ compensation benefits.
The main requirement for a valid stress claim is the diagnosis of a mental disorder that requires medical treatment or causes disability. There are several other prerequisites as well. Among them,
- The mental disorder must be at least 35 to 40 percent caused by events of employment
- The worker must have been employed for at least six months, unless the injury was caused by a sudden and extraordinary event
- The mental injury must not be related to a physical injury
- The injury cannot be caused by lawful, nondiscriminatory good faith personnel actions, such as disciplinary actions, demotions, or transfers
It’s pretty apparent that many of the requirements seem incredibly subjective. If you believe you should qualify for a stress claim because of an underlying psychiatric injury, it’s important to hire an experienced work injury attorney who can argue your case to the insurance companies.
Reporting a Psychiatric Injury to Pursue a Stress Claim
Psychiatric injuries should be reported as soon as they become apparent. Any delay in reporting can increase the risk of a stress claim being denied by insurance company. Different workplaces may have different reporting procedures. In most workplaces, you’ll need to report your psychiatric injury to your supervisor or manager, who will provide a form to fill out. After completing the form, be sure to make a copy and keep it for your own records.
Opening a Stress Claim
The claims process for stress resulting from a psychiatric injury is the same as for any other type of work injury. Workers need to complete the appropriate section of the Workers’ Compensation Claim Form (DWC-1) & Notice of Potential Eligibility form and submit it to their employers. The DWC-1 must be filled out completely and as accurately as possible. Workers should keep a copy of the form for their own records.
Upon receiving a submitted DWC-1, employers will complete the remainder of the form and submit the completed form to the workers’ compensation insurance company. Workers should request a copy of the completed DWC-1 if they do not automatically receive one. As soon as the form is submitted, workers can seek appropriate medical treatment for their stress and underlying psychiatric injuries, up to $10,000. They will be notified whether or not their claim has been accepted or denied. If accepted, workers will treat their injuries until they have recovered or until treatment is no longer beneficial. If their claim is rejected, they will need to appeal the workers’ compensation claim denial.
A Workers’ Compensation Lawyer Can Help
Opening a workers’ compensation claim for a psychiatric injury resulting in stress can be incredibly difficult to do by yourself. Any improper actions, delays, or wrong statements can ultimately lead to a claims denial. An experienced workers’ compensation attorney can help you file your claim and fight a claim denial. The Law Offices of Scott Warmuth helps its clients receive the treatment and financial compensation they deserve.
Schedule a free consultation today – Call 888-517-9888!
