Injuries at work can come in all shapes and sizes. Often we think of work-related injury as being physical injury, such as a broken foot or carpel tunnel syndrome. Not all work-related injury is physical, though, as California law does recognize some mental illnesses as being potentially work-related injuries, subject to workers’ compensation rules and regulations. California law treats psychiatric injury claims in workers’ compensation differently than physical injury. This is logical, as a mental illness is much more subjective than a physical one, and focuses on the employee’s internal thoughts and feelings. Unlike a physical injury, it is not possible to diagnose mental illness with scans, x-rays, or other objective tests.
Under California statutes, a work-related psychiatric injury is compensable if a worker sustains a diagnosed mental illness that is the cause of the injury or need for treatment. Moreover, the employee claiming injury must prove that the work environment is the “predominant cause” of the psychiatric injury. This means that the employee must prove that the work environment was at least 51% of the cause of the injury. By inference, then, the work environment need not be the only cause of the psychiatric injury, just the main cause. An employee will have the burden of showing that it was the work environment that injured him or her. The employee’s background including family life, psychiatric history, medical history, or other relevant details are all relevant and will need to be reviewed to determine if another source is the main cause of the psychiatric illness. The employee will also be required to demonstrate that he or she has worked for the employer for at least six months, although those six months need not be continuous.
A common type of psychiatric claim in the context of workers’ compensation would be a stress-related psychiatric injury. In California, an employee will need to support his or her claim that “actual events” within the work environment resulted in the stress-related psychiatric injury with medical evidence from a doctor. It is necessary that the doctor review the employee’s history before being permitted to provide evidence to the effect that the work environment is the predominant cause of the employee’s claimed work-related mental illness. If the Employer demonstrates that a substantial cause (30-35%) of the worker’s stress is caused by “lawful, nondiscriminatory, good faith personnel action,” the worker may not recover for the injury. This is an affirmative defense that must be proved by the Employer, AFTER the worker proves up emotional disability, six months of employment, and that more than 51% of the emotional disharmony is related to work.
If you have questions about workers’ compensation claims involving mental illness or stress, we can provide you with answers. Contact us today at 714-516-8188 to discuss how mental illness and workers’ compensation can impact your business.