Obtaining Workers’ Compensation for PTSD from Work

After witnessing a traumatic event at work, obtaining workers’ compensation for PTSD from work is possible. In the United States, in any given year, one in four people suffer from mental illness, some of which can be caused by workplace events. Among paramedics and firefighters, roughly 20% suffer from PTSD.  Among non-federal healthcare workers, PTSD is especially prevalent, with one study suggesting approximately 28% of workers suffer from PTSD.

While some jobs are more likely to lead to emotional distress and PTSD by their nature, even jobs that don’t expose workers to traumatic events can lead to mental or emotional hardship.

What Is PTSD?

PTSD is a mental health condition that is suffered after either experiencing or witnessing a traumatic event. While it is normal for a person to have temporary difficulty adjusting after a traumatic event, there is a difference between temporary difficulty overcoming the event and PTSD.

Usually, a person will be able to cope and emotionally recover, given time and good care. With PTSD, the symptoms last for months or years, get worse rather than improve, and interfere with a person’s day-to-day functioning. People suffering from PTSD may have intense and disturbing thoughts and feelings long after the experience, and can have intense negative reactions to ordinary day-to-day experiences such as loud noises or an accidental touch.

In the United States, each year approximately 3.5% of adults are affected by PTSD, and it is estimated that at some time during their lifetime, 1 in 11 people will be diagnosed with it.

Symptoms are grouped into four types:

Intrusive Memories and Thoughts

These can be unwanted, recurring memories of the event, distressing dreams, or flashbacks of the event, causing distress. There can also be severe physical reactions or emotional distress in response to something that reminds the person of the event.

Avoidance

A person may avoid people, places, objects, or situations that remind him or her of the event, triggering distressing memories. He or she may avoid talking about the event, or resist remembering or thinking about it.

Negative Thinking and Mood

PTSD can lead to a person having negative emotions and thoughts, causing distorted feelings about him or herself and others, the cause of the event, and incorrectly blaming him or herself, or others. This can lead to difficulty in forming and keeping close relationships, feelings of detachment, and estrangement from family members and friends. A person may face a lack of interest in activities that he or she used to enjoy, feel emotionally numb, or hopeless about the future.

There may also be memory problems, with an inability to remember important aspects of the event causing the PTSD, and ongoing feelings of fear, anger guilt, or shame associated with it.

Negative Arousal Symptoms

Arousal symptoms are changes in the way a person reacts physically and emotionally. A person may be startled or frightened easily, be irritable and have angry outbursts, always be on guard and suspicious, or engage in reckless and self-destructive behaviors.

Worker’s Compensation for Mental Health

Workers’ compensation is a form of insurance that compensates employees for losses, such as medical expenses, lost income, and rehabilitation costs, if they are injured while fulfilling their employment.

In Illinois, employees may be entitled to compensation for both physical and mental injuries. The supreme court has decided that a mental injury does not have to be associated with a physical injury. PTSD can occur without physical injury if it results from a sudden, severe emotional shock that had a definite cause and happened at a specific time and place. While PTSD can occur months or even years after the incident, reopening a closed workers’ compensation claim may be possible.

While there are any number of workplace incidents that can cause PTSD, there are some types of jobs where it is more prevalent. These can include a teacher witnessing a school shooting or store workers who are held up at gunpoint. Construction, manufacturing, or electrical workers may either suffer or witness someone being injured because of a fall, electrocution, severe burns at a job site, or being crushed by heavy machinery. Firefighters or police officers are often called to the scene of an accident where severe injuries or fatalities occurred. When a patient attacks a nurse, he or she may also experience PTSD following the attack.

To be eligible for workers’ compensation for PTSD from work-related events in Illinois, an employee needs to meet the same requirements as he or she would for any workers’ compensation claim under Illinois law:

• The injury occurred while at work. The injury must have occurred while the employee was acting in terms of his or her employment. This can be straightforward if the employee suffered injuries at the workplace. It can be more difficult to prove if the employee performs work that takes him or her away from workplace premises, or outside usual working hours. In this situation, it will help to have a workers’ compensation attorney who can advise on how to prove this requirement.
• Employment relationship. For there to be a valid claim, there must have been an employment relationship between the employee and employer. While this can seem obvious, there may be circumstances where a person performs work for someone else, and the employee-employer relationship does not exist. An example of this is when someone is hired as an independent contractor. If an independent contractor gets injured on the job, he or she does not have a workers’ comp claim, on the basis that he or she is not the employee. To decide if someone is an employee or not, you would consider whether there is an employment contract, and whether a person uses his or her own tools and equipment to perform a job, or if these are provided.
• What caused the injury. While the injury had to occur while at work, it must also be caused by the event that took place at work. If the injury was the result of a pre-existing condition or some other accident, there will be no workers’ compensation claim.
• Economic and non-economic damages. Workers’ compensation provides compensation for losses that an employee suffers. As such, there must be medical expenses, lost income, diminished ability to work, pain and suffering, or any other form of damages that can be proven.
• Notify the employer. In accordance with Illinois law, an injured employee must report the injury to his or her employer within 45 days.

Burden of Proof in a Workers’ Compensation Claim

To have a successful workers’ compensation claim, an employee has the burden of proof to establish a valid claim. Having the burden of proof means that the employee must provide evidence to establish all the facts necessary to satisfy the requirements for a valid claim. An employee should therefore collect evidence and documentation.

An essential part of this evidence is medical records. An employee should see a doctor after a work injury, Medical records provide documentation of any injuries suffered by the employee, as well as the extent of treatment received, and required for recovery.

Records of employment can also be vital to establish an employer-employee relationship at the time of the injury, which is one of the requirements for a valid claim. These records can be employment contracts, salary statements, or employment reviews.

Accident reports are useful evidence for several reasons. An accident report can contain information about the accident, the time, location, and cause of the accident, as well as people involved, and any injuries suffered. This can be helpful in proving that the injury was suffered while the employee was performing in terms of his or her employment and that he or she suffered injuries as a result. It may contain useful information supporting any claims about the injuries suffered. It may also contain information on any witnesses who can provide further evidence.

Witness testimony is another useful source of evidence, as it can prove that the incident caused the injuries and that the incident occurred while at work. There are many details that witnesses may be able to provide since they saw the incident first-hand.

Unfortunately, many insurance companies and employers do not take PTSD as seriously as other injuries, as the symptoms are not as clearly visible, and may not be as immediate as physical injuries. This can make a claim for PTSD more difficult to prove.

If you have suffered a severe emotional shock, leading to PTSD, increase your chances of proving a successful claim for workers’ comp for mental health by taking the following steps:

• Consult with a mental healthcare professional immediately. This can provide medical records of diagnosis and treatment.
• Journal and document your ongoing symptoms.
• Seek legal advice. Most cases involving PTSD without a related physical injury are initially denied.

These cases can be complex and difficult to prove. Keep as much written evidence as possible when building your claim. A workers’ comp lawyer can help you navigate the process and pursue the best outcome.