Things To Know About Filing A Workers Comp Claim For PTSD

It can be difficult to convince an insurer that you deserve workers compensation for psychological trauma, but some employees are successful in these claims. You must learn whether your state allows benefits for post-traumatic stress disorder related to an incident at work and the qualifying requirements for your claim. 

Requirements for Workers Comp for PTSD

You may be experiencing debilitating emotions after a traumatizing episode at work. The insurer that covers workers comp for your employer needs verification that:

  • you have a combination of symptoms for a PTSD diagnosis, such as anxiety, panic, depression, flashbacks and nightmares
  • your problem prevents you from working full-time at your current position
  • the issue is directly related to what happened at your job 

This verification must come from a psychologist or a psychiatrist. 

Some states require that the incident that caused PTSD is unusual for this type of job. For instance, a police officer may not be able to claim workers comp if he was compelled to shoot a person committing a violent crime.

However, an office or retail employee witnessing a fatal shooting at work is an example of an unusual situation. Seeing a co-worker killed by machinery in a factory is another one. 

What to Expect From the Insurer

The insurance carrier may conduct an investigation to make sure you're being truthful. That investigation may look at your relationships, your home life and your prior mental health history. The investigator may try to interview people you know. Any information the insurer finds out might be used to deny your claim.

For example, if you've ever taken prescription anti-anxiety medication, that could be viewed as evidence of a pre-existing mental health disorder. 

Appealing a Denied Claim 

If your claim is denied, you have the right to appeal. It's important not to simply give up. 

Even a person who works in a profession with significant risk of danger may be awarded workers comp for mental health issues. The Pennsylvania Supreme Court in 2013 awarded benefits for a police officer after previous denials. The officer had struck a mentally ill woman with his vehicle after she ran in front of it on a highway. He tried to save her, but the collision was fatal. 

What You Can Do Now

If you haven't yet talked with your supervisor about your symptoms, do so now. You'll likely be referred to a person in the human resources department who handles workers compensation claims. 

You may want to have a free consultation with a lawyer before you even file a claim. An attorney who assists clients with these claims will know if your state allows workers comp benefits for PTSD and the documentation you need to proceed. Contact a firm like Robinson & Kole for more information.