How does the workers’ compensation system handle mental health claims?

How does the workers’ compensation system handle mental health claims?

CAN I QUALIFY FOR WORKERS COMP FOR A WORK-RELATED MENTAL HEALTH ISSUE?

Many things can happen to you at work, and sometimes even if you’re in a non-physical job. Mental trauma from constant deadlines, forms of harassment, and much more can (over time) affect your mental and psychological health.

The good news is that in South Carolina, your employers’ workers’ comp program can cover mental health issues if aspects of your job or work environment cause your psychological or mental health condition.

However, there are legal caveats proving that your mental health condition arose from your job may not be as easy to do as a back, leg, or head injury.

Essentially, there are two main ways your experienced Greenville workers comp lawyer may qualify for your psychological injury benefits. They are going to have to prove either caused your mental injury:

  • Physical injury – That may have caused significant changes in your life, thus possibly followed by depression, etc. This is commonly referred to as a “physical—mental injury” in workers’ comp jargon.
  • Or an unusual or extraordinary job condition or environment compared to what would be considered normal in your job. Workers comp considers this  a “mental-mental injury.”

This becomes a challenging legal issue due to its complexity, and you must work with a workers comp law team that’s experienced and has a winning history in workers comp mental health cases.  Proving mental health cases to the Workers’ Comp Commission requires detailed and valid medical evidence. If your disorder, such as depression, PTSD, etc., is not presented in precisely the right way, you can, and usually will, lose your right to all workers’ comp benefits. This, again, is the critical reason you need a skilled workers’ compensation attorney to do it right.

WHAT “UNIQUE CHALLENGES” MAY BE INVOLVED IN GETTING WORKERS COMP PSYCHOLOGICAL TRAUMA?

If you are hit by a falling object, hurt by malfunctioning equipment, etc., it’s relatively easy (at times) to prove your injury and obtain your due workers’ comp benefits. However, mental issues usually take time to develop and are “hidden” ailments that you may feel but are not easily noticed or visible to others.

Mental–mental injuries require significant proof of the dire, stressful, or disturbing conditions you endured compared to others with your same job. For example, let’s say a deputy sheriff shoots and kills a suspect that attacked him. He may be denied (and some have) because using deadly force is within the normal scope of a deputy sheriff. So, in cases like these, it’s up to your lawyer to prove that whatever occurred was not in the normal scope of the job and caused you significant mental damage.

Also, there’s usually no coverage for your mental suffering from specific personnel actions unless they’re done in a combative, unusual, or extraordinary way.

Some examples of routine personnel actions that may not qualify for workers’ comp benefits may include:

  • Disciplinary actions, reprimands, or write-ups.
  • Job evaluations or transfers.
  • Promotions or demotions.
  • Salary reviews or firings.

However, if done in a severe, unusual, or malicious manner, any of the above-mentioned personnel issues may qualify, and it’s up to your experienced, aggressive workers comp lawyer to prove it. So, many times when benefits for mental issues are granted, it’s not always the occurrence that caused your injury that’s judged, but the severity, hateful, or harassing manner in the way it’s done.

WHAT TYPES OF EMOTIONAL INJURIES ARE COVERED BY WORKERS COMP IN S.C.?

There are many mental conditions, but PTSD ( post-traumatic stress disorder) is a common mental health condition; let’s use that as our example. PTSD may result from witnessing or being involved in a specific event that causes intense feelings of horror, helplessness, or fear.

South Carolina workers’ comp law currently restricts the availability of workers comp benefits for PTSD, but it does allow them to be paid under specific instances. However, these laws are changing, as referenced by the amended section 42-1-160 of the 1976 Code related to such matters.

Let’s say your mental health condition results from a workplace injury or an extraordinarily stressful or horrific situation; compensation may be available.

Examples of some extraordinary situations could include:

  • Witnessing the death of a fellow worker in the workplace.
  • Sexual assault that another co-worker committed during your employment.
  • Consistent and persistent abuse from another employee, co-workers, or management.
  • Criminal activity that victimized you in your workplace, such as an active shooter situation or armed robbery.

As a result of these extreme situations, you could suffer PTSD and could receive workers’ compensation coverage for treatments, lost wages, and more.

WHAT MUST I PROVE TO OBTAIN WORKERS COMP FOR MENTAL TRAUMA IN S.C.

As they say, “herein lies the rub, ” which is a critical reason if you want to obtain workers comp benefits for a mental health issue, you must work with a Greenville workers comp law team versed and wholly experienced in these cases.

Simply put, your mental injury or illness (such as PTSD) must have occurred within your workplace or during your employment. Also, a resulting physical injury usually must be diagnosed by a medical professional to be causally connected or related to that diagnosed stress with a work-related cause. It’s again vital to note that workers’ comp claims for mental illness are often contested by employers whose main rebuttal is that something in your personal life caused your emotional or mental health issue.

Proving mental health workers comp claims often involve in-depth medical diagnosis, deposing co-workers as possible witnesses, psychiatric evaluations, and much more. In summary, it’s always a legally challenging case to win, but with the help of your detail-oriented, aggressive, and diligent Greenville workers comp law team, it often can be done.

I’VE SUFFERED MENTAL TRAUMA AT WORK AND NEED WORKERS COMP; WHAT SHOULD I DO?

Remember that you have rights under South Carolina workers’ comp laws. Still, you must have a workers comp law team that will tirelessly fight for you and the benefits you deserve for mental health injuries or illnesses suffered in the workplace.

If you seek a law firm to assist you in claiming these types of benefits, the workers’ comp lawyers at the Eller Frye Law Firm have the knowledge, persistence, and winning history you and your family must have. Call them today at (864) 686-4827, and they will provide you with the information, empathy, and legal advice you need.

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