Think you have a workers comp stress claim?

In the legal system, there are three different kinds of stress claims that can arise at work:

1.  Physical-mental

2.  Mental-physical

3.  Mental-mental

Physical-mental injury are conditions like depression, post traumatic stress, or other psychological injuries that are caused by the trauma of a physical injury, the stress of prolonged treatment, or the stress from severe disability.

Mental-physical injury refers to the need for medical treatment due to severe mental trauma. For example, dental treatment needed due to grinding teeth induced by stress, ulcers or high blood pressure caused by workplace stress, or stress induced heart attack. These are medical claims, and not psychiatric stress claims.

Mental-mental injury is the psychological stress or psychiatric condition diagnosed when emotional distress is due to the events of employment.

Physical-mental and mental-mental claims are a special type of workers’ compensation claim.  They are almost always investigated by a defendant (e.g. your employer) and considered to be questionable claims. Even when it is clear that stress on the job has caused the need for time off work, the need for treatment, or that stress on the job has caused permanent disability, the workers’ compensation insurer will not have to pay for these workers’ compensation benefits unless certain requirements have been met.

Current Workers' Compensation laws in California require that actual events of employment must be the “predominant cause” (more than 50% of all causes) of a claimed psychiatric injury in order for that injury to be compensable. This means that personal and work-related issues that cause stress will be considered in the claim.  Thus, the defendant’s liability will be determined on the basis of whether work-related events, and not personal factors, have contributed the most to the claimed stress injury.

The law also provides that the work related stress can not include “good faith personnel actions”. A stress claim based on decisions regarding wages, hours, benefits, promotion, demotion, discipline or termination cannot be the basis for a claim for stress unless these actions were not done in good faith. In order to prove a claim for stress where a manager’s or employer’s personnel decisions play a significant role in causing stress, the injured worker is required to show (“burden of proof”) that such actions were not done in “good faith”.

In addition, even if your claim meets the predominant cause requirement, you must have been an employee for six months or more in order to establish your employer’s liability for a stress claim, unless your claim arises from a “sudden and extraordinary” event.

Due to a change in the law in 2014, stress claims for disability can only arise from a physical injury that is classified as “catastrophic.”

Also, unless the cause stress on the job was clearly a “sudden and extraordinary” event (e.g. a traumatic work event, such a being a victim of a violent act, or from direct exposure to a significant violent act), a claim for stress due to events of employment will be investigated and likely denied.

In summary, not all stress claims on the job are created equal, and you should always evaluate the nature of your injury and how it occurred to determine how strong your claim is.