When most people think of workplace injury, they think of physical or personal injuries, like a broken leg or a strained back. However, Washington State recognizes that job-related injuries can also include a psychiatric injury, like experiencing emotional distress or other mental health issues due to a traumatic event that happens on the job.
What qualifies as a traumatic workplace event in Washington can be limited, and you have to prove your mental health has been negatively impacted, which requires the input of doctors and other mental health professionals. Here’s what you need to know about claiming emotional distress as part of a workers’ compensation case.
Who Can Seek Compensation for Emotional Distress in the Workplace?
Washington State’s Department of Labor and Industries (L&I) allows any injured worker to cite emotional distress when filing for workers’ compensation benefits. However, whether L&I approves your claim depends on what your job is and what caused your emotional distress or other mental health condition.
Normal Job-Related Stress vs. Stress From a Traumatic Event
One of the key distinctions in a workers’ compensation case is whether the emotional distress was caused by normal work stress or from exposure to a traumatic event.
Normal stress is generally a part of any job and not considered enough to qualify for workers’ comp benefits. For example, feeling overwhelmed because of your workload or looming deadlines is normal and (in some industries) expected, not something unusual or extreme.
Ongoing or cumulative stress is also a normal part of most jobs that won’t qualify for mental health benefits. For example, when you feel stress and anxiety because of a looming deadline, that feeling generally resolves once the deadline passes. Facing deadline after deadline is ongoing stress, but that’s also considered a normal part of having a job — even if it’s harming your mental health.
Stress and emotional conditions that qualify for workers’ comp are different. Unlike normal job stress and anxiety, exposure to traumatic events, like violence, serious accidents, or death, may cause emotional distress. What makes this stress different is that it stems from a single traumatic event and can be treated as an industrial injury under workers’ comp.
How Most Workers Can Claim Emotional Distress in a Workers’ Compensation Case
For most workers, mental health conditions caused by stress or even emotional distress aren’t enough to support a workers’ comp claim. However, if your emotional distress develops into a diagnosable mental health condition, such as post-traumatic stress disorder (PTSD) or anxiety, you may have a valid workers’ comp claim if the condition stems from a traumatic work event.
You must prove your mental health condition was caused by a single traumatic event that you either directly experienced or witnessed while on the job. For example, if a workplace incident involves:
- Threatened or actual physical injuries
- Threatened or actual sexual assault
- Suffering a life-threatening personal injury
- Threatened or actual death
and you develop a mental health condition, like PTSD, you may be able to receive workers’ compensation benefits while you undergo mental health treatment. However, you must demonstrate that your psychological injuries developed due to this singular event.
How First Responders Claim Emotional Distress in a Worker’s Compensation Case
Due to the nature of the work, Washington’s workers’ comp laws recognize that ongoing stress in the form of PTSD is an occupational hazard for first responders. As a result, first responders diagnosed with PTSD can file a workers’ comp claim, and the law assumes the condition is work-related. An employer can try to challenge that assumption, but workers’ comp treats the PTSD as job-related unless there’s clear evidence showing otherwise. So, most people who work as a:
- Firefighter
- EMT
- Law enforcement officer
- Public safety telecommunicator (911 operator)
- Direct care nurse
can file for workers’ compensation benefits if they experience PTSD.
Though Washington State recognizes that mental health injuries are an occupational hazard for first responders, they still need to provide medical evidence to support their emotional distress claim.
What Evidence Supports an Emotional Distress Claim in a Workers’ Comp Case?
Saying an incident at work caused your emotional distress isn’t enough to have your claim approved. You have to prove your symptoms are connected to a traumatic incident that happened at work with a combination of your medical records and mental health evaluations.
Diagnosis
Labor and Industries requires a licensed mental health specialist to evaluate and diagnose your condition using established criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
The mental health specialist must make a clear connection between your diagnosis and the traumatic event, and work injury or ongoing traumatic exposure (for first responders). Without a diagnosis, you won’t be able to obtain benefits for emotional distress.
Medical Records
Your medical records must clearly document that your symptoms began after experiencing trauma at work or that the traumatic event made an existing mental illness or mental health condition worse.
Your claims manager will look at when your symptoms began and how they’ve impacted your ability to work and function in everyday life. Your claims manager may also investigate any mental health treatment you’ve participated in or medications you’ve taken.
Causation Statement
Easily one of the most important pieces of medical evidence is the causation statement. Your mental health specialist writes a note or report that explains your current mental health condition was caused by the traumatic work injury or event, or the ongoing trauma of your first responder job.
Additional Documentation
You may also be asked for additional documentation that proves a traumatic event occurred. Depending on the job, you could provide:
- A witness statement
- An accident or incident report
- Employer records
What Workers’ Comp Benefits Are You Eligible For?
If L&I approves your claim, you’ll receive workers’ compensation benefits at the same level and rate as someone who suffered physical injuries on the job. Those benefits can include:
- Mental health therapy or counseling
- Medication management services
- Hospitalization and inpatient care
- Referrals to and treatment by specialists
- Time loss compensation (lost wage replacement)
- Permanent partial disability
- Vocation rehabilitation (job retraining)
- Permanent disability (pension)
Reasons a Workers’ Compensation Claim for Emotional Distress Is Denied
Because the rules defining traumatic workplace events are narrow, it’s easy to miss the details that could result in your claim being denied. Here are some of the common reasons a workers’ compensation claim for mental health issues and emotional distress is denied in Washington.
It’s Not the Right Kind of Stress
Most workers can only claim they’ve suffered mental stress injuries when such stress is related to a single traumatic event. Unless you’re a first responder, emotional distress that’s the result of normal workplace concerns doesn’t qualify for workers’ compensation. The same is true for emotional distress that accumulates over time, unless you’re a first responder.
Lack of Clear Documentation
Whether it’s the lack of a proper diagnosis based on DSM-5 criteria, failure to provide a causation report, or not providing additional evidence to support your claim, not including all of the proper and required documentation is likely to result in L&I denying your workers’ compensation request.
Preexisting Mental Health Issues
Having a preexisting mental health issue alone doesn’t disqualify you from receiving workers’ compensation for emotional distress due to a workplace injury. However, if you have a preexisting condition, failing to document how the traumatic event made your current mental health condition worse may mean your claim is denied.
Walthew Law Firm Is On Your Side
Suffering a traumatic event at work can negatively impact your mental health. You may develop an anxiety disorder, PTSD, or other form of stress. Fortunately, Washington State recognizes that a person’s ability to work can suffer and allows these and other forms of emotional distress to be covered by workers’ compensation.
While you can choose to file a claim with L&I on your own, navigating the system is complex, and submitting all the right paperwork to ensure your claim is approved can be overwhelming. The compassionate and knowledgeable team of workers’ compensation lawyers at Walthew Law Firm understands the L&I system and can help you with your claim or appeal a denial. Their expertise will guide you throughout the claims process and ensure you receive the fair and just compensation you deserve.
Contact us today for your free consultation and learn more about our services. There’s no obligation and no fee unless you win.