Can I Collect Workers’ Compensation Benefits for Post-Traumatic Stress Disorder (PTSD)?
“Workers’ compensation” brings up images of someone hurt while performing hard physical labor, but that’s only the beginning. Anyone injured in the course of their work may qualify, and that injury could be mental or psychological stress, with or without a physical disorder. That includes those dealing with PTSD due to events at work.
If you’re emotionally or psychologically impacted by what you experience or observe at work, you may qualify for workers’ compensation benefits. If you have questions or want legal representation in a workers’ compensation matter, call Castillo & Associates at 800-497-9774 today.
What is PTSD?
PTSD is a mental health condition triggered by witnessing or experiencing a traumatic event. Symptoms can include nightmares, flashbacks, severe anxiety, and uncontrollable thoughts about the event. A California law passed in 2019 classifies this condition as an “injury” that’s compensable, like a broken bone or concussion.
What Causes PTSD?
An individual experiencing a traumatic and or life-threatening event may develop PTSD. This could include surviving a natural disaster, workplace violence, or severe bullying in a work environment. One might witness a shocking event or deal with its consequences and be traumatized. Law enforcement, firefighters, and those working in emergency medicine are in jobs with a higher PTSD risk.
What are PTSD Symptoms?
Symptoms can include:
- Feeling high stress levels
- Hyper-vigilance
- Increased heart palpitations
- Reduced self-esteem
- Angry outbursts
- Avoiding reminders of an event
- Sleep disturbances
- Depression and self-blame
- Feeling cut off from friends and family
- Increased blood pressure and heart rate
- Fatigue
- Muscle tension
- Nausea
- Headaches
PTSD can also show itself at work:
- You don’t meet goals or deadlines
- Increased absences
- Panic attacks
- Memory problems
- Inability to stay on task
- Poor reactions with coworkers
Severe PTSD cases can result in suicidal thoughts.
How Do I Qualify for Workers’ Compensation Benefits?
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association. It lists recognized disorders, criteria for diagnosis, and their accepted treatments. The state’s Division of Workers’ Compensation relies on it when making coverage decisions. The DSM states symptoms must last for at least a month before PTSD can be diagnosed.
To qualify for benefits, you must be diagnosed with the condition, and there must be a finding that workplace conditions are at least 51% of the cause. You may receive benefits even if your symptoms are psychological and there are no physical injuries.
California has a rebuttable presumption that PTSD in firefighters and peace officers is a work-related injury and compensable, though their employers can still deny their benefit request.
What Should I Expect if I Seek Benefits?
Your employer’s insurance company will probably scrutinize your claim closely. Investigators may follow you if you have a physical injury to see if you’re doing anything that may show you’re not injured, or it’s not as bad as you claim.
You must be prepared to lose your privacy and build evidence supporting your claim. If you seek benefits due to a psychological condition:
- The insurance company will look into your family and personal life to see if something else is causing the problem
- They may try to see if you have a criminal history or financial problems
- Investigators may try to talk to your family members, neighbors, coworkers, and supervisors
- Your medical and psychiatric history will be examined
- If you cite a specific event, or multiple events, as leading to your PTSD, the insurance company will try to determine whether the event took place and what happened.
You must consistently get treatment and follow the suggestions of your treating professional. The insurance company will look at your sessions’ records, including notes. You must speak honestly and clearly about your situation so your records can accurately tell your story. Minimizing what you’re going through may lead the insurance company to think you’re not as affected as much as you claim.
Speak With an Experienced Workers’ Compensation Lawyer Today
If you’re considering filing a workers’ compensation claim due to PTSD or have already started the process and received a denied or delayed claim, seek legal counsel as soon as possible.
With more than three decades of experience, Castillo & Associates workers’ compensation attorneys have the skills to handle the complex legal and insurance challenges that come with California workers’ compensation claims. With our legal team on your side, you can focus on making a full recovery. If you are an injured worker, contact our firm today for more information about your rights and legal options.
Attorney Domingo Castillo handles workers’ compensation, personal injury, family law & immigration throughout Southern California from our 5 offices: Indio, Pomona, Riverside, San Diego & Cathedral City. We help clients file injury claims, obtain residency & citizenship, and we assist families through divorce, child custody and all family law matters.
