Does Workers’ Compensation Cover Emotional Distress in California?
As is usually the case in legal actions, the answer to this question is yes with an if. Workers’ compensation covers emotional distress as a standalone injury if the victim meets all requirements set forth below. Workers’ Compensation in California also covers emotional distress related to a physical injury, such as anxiety, depression, or Post Traumatic Stress Disorder. Our experienced California Workers’ Compensation Lawyers can guide you through the complex legal processes. We can help you secure the compensation you deserve for workplace injuries.
If you’re new to California, this coverage might seem shocking. These injured workers usually aren’t so lucky in other states. Claims Examiners in most states either deny these claims outright or approve so little compensation that it’s hardly worth filing a claim. The outcome in California is usually different, but the process is very much the same. More on that below.
Significant benefits are available, but they aren’t there for the asking. Stingy insurance companies look for ways to reduce or deny compensation to injured workers, regardless of their needs. A Los Angeles construction accident lawyer is equally determined to obtain maximum compensation for these victims. A combination of grim determination and diligent planning usually wins the day.
The Process of Workers’ Compensation in California
Simply filing a claim is a complex process in California. Strict time deadlines apply. These deadlines are problematic in emotional distress claims. Burnout is one of the leading causes of work-related stress. Workers aren’t energetic on Wednesday and burned out on Thursday. Instead, burnout is a slow, roller-coaster process. So, it’s very difficult to pinpoint when the burnout moved from a challenge to an injury (more on that below).
If the claim moves forward, and that’s another pretty big “if,” a Claims Examiner approves or denies coverage, largely based on the medical bills. Workers’ compensation Claims Examiners are little more than insurance company claims adjusters. Technically, Claims Examiners are independent. But insurance company premiums pay their salaries.
After several months, the claim moves to the Administrative Law Judge review level. Since ALJ reviews resemble trials in most ways, the chances of obtaining maximum benefits increase. These benefits usually include lost wage replacement and medical bill payment. The long workers’ compensation process is very frustrating for job injury victims and Los Angeles construction accident lawyers. Clients and lawyers need to keep their eyes on the prize and keep moving forward.
Emotional Distress Rules
Workplace challenges are inevitable. Everyone has bad days. Sometimes, the bad days outweigh the good days. If construction-related emotional distress becomes an injury, the aforementioned benefits are available. So, job-related emotional distress is compensable if:
- A doctor treated the worker’s emotional distress,
- The emotional distress was disabling (the victim missed work because of the emotional distress),
- The stress was “predominantly” work-related (the standard of proof is lower if workplace violence caused the emotional distress),
- Good-faith personnel decisions (raises, promotions, discipline, etc.) didn’t cause the emotional distress, and
- The worker’s mental condition is listed in the state’s Diagnostic and Statistical Manual of Mental Disorders.
Additionally, the job injury victim must have worked for the employer for at least six months prior to filing a claim.
A medical diagnosis is key. The diagnosis must be supported by the victim’s prior job satisfaction level, health history, and job history. Workplace conditions and other factors come into play as well. Furthermore, doctors must cite medical records, test data, statements from co-workers, family, friends, and other evidence.
Secondary Emotional Conditions
Similar rules apply to Post Traumatic Stress Disorder and other mental conditions caused by a physical workplace injury.
“Predominantly” is a rather low standard, and PTSD, specifically complex PTSD, is a good example. The cumulative effect of multiple stressful situations causes complex PTSD. Usually, the victim’s symptoms draw the line between a normal stress response and PTSD. These symptoms include nightmares, depression, hypervigilance, and anger.
So, in this context, stress at home combined with stress at work could cause complex PTSD. Compensation is available if a doctor convincingly testifies that the work-related stress was the straw that broke the camel’s back.
A Los Angeles construction accident lawyer must mix medical evidence with non-medical evidence. Friends and family members cannot testify about medical conditions, like PTSD. They certainly can’t testify about the cause of the medical condition. However, these witnesses can describe what they see, which is how PTSD affects the victim on a day-to-day basis.
Contact Our California Workers’ Compensation Lawyers
Stressed-out construction workers may be eligible for workers’ compensation benefits. For a free consultation with California Workers’ Compensation Lawyers Near Me, contact the Law Offices of Eslamboly Hakim. We routinely handle matters throughout California.
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