Is My Psychiatric Condition Covered Under Workers Compensation?

The quick answer is yes.  However, there are very strict criteria that must be met and limitations that exist.  Such criteria and limitations are discussed in greater detail below.

Workplace accidents can result in an employee suffering from various mental health conditions.   Depending on the nature of the injury and the circumstances in which it occurred, some mental health conditions the employee may display symptoms of include, but are not limited to, depression, post traumatic stress disorder, and anxiety.   Most people consider the causal connection between a decline in their mental health and their work related injury as one that is both direct obvious.  The rationale most often applied is, “but for my work accident, I wouldn’t be suffering from the mental heath condition I have now.”   Unfortunately, workers compensation insurance companies are not inclined to consider any injury as directly causally related to any work accident 100% of the time.  If workers compensation carriers operated in such a manner, people injured on the job wouldn’t need representation to obtain benefits being denied by a workers compensation carrier, or otherwise ensure they’re receiving the benefits they’re entitled to.  If you’ve been injured on the job or know someone who has, consultations with our office are free.

Fortunately, Florida workers compensation law does provide coverage for psychiatric injuries.  However, the coverage is limited and certain criteria must be met.  Without an accompanying physical injury, a psychiatric injury alone will not be covered.  The physical injury or injuries must be underlying causative factor.  The physical injury does not need to be particularly serious or disabling, but it must be present as the underlying causative factor.  Fla. Stat.  440.093(1). In some cases, a mental or nervous injury will not become apparent until some time has passed from the initial physical injury.   The law provides that mental or nervous injuries occurring as a manifestation of a work related injury are covered under this chapter.  Proving such injuries are causally related to a work accident must be accomplished by providing clear and convincing medical evidence from a licensed psychiatrist, meeting criteria established in the most recent edition of the diagnostic and statistical manual of mental disorders published by the American Psychiatric Association. The work related physical injury must be, and remain, the major contributing cause of the mental or nervous condition.  Moreover, the compensable physical injury must be at least 50 percent responsible for the mental or nervous condition; as compared to all other contributing causes combined. Compensation is not payable for the mental, psychological, or emotional injury arising out of depression resulting from a preexisting mental, psychological, or emotional condition, or due to pain or other subjective complaints that cannot be substantiated by objective, relevant medical findings.  Essentially, your mental or nervous injury is one that can be covered through workers compensation, but proving the relation of your condition to your work accident is a process that you would be wise to obtain representation for.

The two most commonly seen psychiatric injuries are depression and anxiety.   Depression is commonly associated with work injuries that impact an individual’s functional capacity.  If the injury is one that leaves the employee without the same physical abilities they had before the accident, depression can result from the employee not feeling as though they’re capable of contributing to their family’s needs.  Daily household chores can become an issue.  Symptoms of depression resulting from a loss in physical abilities are commonly seen in males, but females are far from immune.  Women are involved in all aspects of today’s work force; rendering them prone to symptoms of depression based on a substantial change in circumstances.

Anxiety is most often associated with workplace accidents that occur in a traumatic or violent manner. Some examples would include injuries resulting from a robbery, injuries involving an amputation, or injuries involving serious disfigurement.  If an employee is using heavy machinery in the course and scope of their employment and such machinery results in the loss of a finger, hand, arm, or otherwise, that employee is likely to have anxiety concerning returning to work for the employer they were working for when the accident occurred.  Symptoms of anxiety can also occur in circumstances where the accident involved a robbery, or where the injury left the employee with physical disfigurement.  The biggest issue such anxiety presents in connection with a worker’s compensation case is when the employee is released to return to work.  Fear of returning to work for an employer where such an accident and resulting injury occurred is not sufficient to entitle the injured worker to lost wages paid by the worker’s compensation insurance company.   Though such fears are entirely understandable, fear alone is not enough justify entitlement.  We have worked to successfully obtain the continuation of wage loss benefits for individuals in various circumstances.   If you’re not certain whether you are being paid the correct amount of lost wages, or if your wages have been denied, contact our office for a free consultation.

Consultations with our office regarding any question you have are free.  Furthermore, representation in workers compensation claims is on a contingency fee basis. Representation on a contingency basis means that you will not have to pay attorney fees or costs in order for us to undertake representation. For all intents and purposes, you have nothing to lose, and everything to gain, through contacting our office for a consultation.  Call the Dolman Law Group today at (727) 853-6275.

Dolman Law Group
5435 Main Street
New Port Richey, FL 34652
(727) 853-6275