Workers Compensation for Mental Health in Minnesota

Mental illness is a prevalent problem in the United States. A 2005 study published in the Archives of General Psychiatry estimated that about half of Americans will meet the criteria for a DSM-IV disorder sometime in their life. Stressful working conditions are often part of the problem.

Unfortunately, the availability and adoption of mental health treatment remain problematic. According to the CDC, only 57% of employees who report moderate depression and 40% of those who report severe depression receive treatment to control depression symptoms. There have been some federal regulations that have sought to place the availability of mental health treatment on equal footing with other medical and surgical treatments.

The Minnesota Workers Compensation Act has not quite kept pace. However, workers’ compensation does, in some instances, provide coverage for mental health conditions. Workers’ compensation covers not only medical treatment, but also lost wages, permanent partial disability, and rehabilitation benefits. Workers’ comp benefits can be an important safety net for injured workers.

Workers Compensation Statute

Workers’ compensation claims include medical, rehabilitation, permanency, and wage loss benefits for injured workers. Minnesota workers’ compensation law requires employers to cover injuries or illnesses that “arise out of and in the course of employment.” The law has significant limitations for mental health injuries but does provide coverage for them in some circumstances.

Workers’ compensation will cover PTSD caused by employment. It will only cover other mental health issues if they result from or result in a physical injury. In practice, workers’ compensation sometimes covers these psychological conditions:

• Depression;

• Anxiety Disorders;

• Adjustment Disorder; and

• Post-Traumatic Stress Disorder (PTSD).

This is not an exhaustive or exclusive list. Those are generally the psychological conditions that tend to result from physical injuries.

Mental Stimulus Resulting in a Psychological Injury

The definition of an injury under the workers’ compensation statute describes psychological injuries using this language:

“Physical stimulus resulting in mental injury and mental stimulus resulting in physical injury shall remain compensable. Mental impairment is not considered a personal injury if it results from a disciplinary action, work evaluation, job transfer, layoff, demotion, promotion, termination, retirement, or similar action taken in good faith by the employer.”

The statute acknowledges that employees can and do suffer from psychological conditions that result from the work environment. However, the law excludes many of those conditions from coverage and only covers psychological injuries or impairment in these three situations:

1. Physical stimulus resulting in a psychological injury;

2. Mental stimulus resulting in a physical injury; or

3. Post-Traumatic Stress Disorder.

The sections that follow explain each of those three situations.

Physical Stimulus Resulting in a Psychological Injury

The law does provide coverage for psychological conditions that were caused by a physical stimulus. This usually comes up when an employee begins to suffer from depression or anxiety because of a physical injury.

Example 1:

• Employee John suffered a lifting injury to his lower back at work. Several years and surgeries later, Employee John continued to experience chronic lower back pain.

• Employee John socialized less often, slept longer, and struggled to find motivation for activities. His doctor suggested that he see a psychologist.

• The psychologist diagnosed Employee John with situational depression as a result of chronic pain syndrome. The psychologist recommended individual therapy and medication.

In this example, the “physical stimulus” is lower back pain and the “psychological injury” is depression. Employee John may be entitled to workers’ compensation benefits for depression.

Example 2:

• A metal beam hit Employee Jennifer in the head at work. She suffers a concussion.

• Jennifer had nausea, confusion, light-headedness, and difficulty forming memories for several months.

• Jennifer started to avoid social situations due to extreme nervousness. Her thoughts raced. She had difficulty sleeping.

• Jennifer's neurologist referred her to a psychologist. The psychologist diagnosed Jennifer with anxiety as a result of the concussion, and prescribed medication.

Jennifer may have a workers’ comp claim for anxiety. Practitioners often refer to this type of case as a “consequential psychological injury.”

Mental Stimulus Resulting in a Physical Injury

The law also provides coverage for “mental stimulus resulting in a physical injury.” An example of this would be extreme workplace stress that caused a heart attack. Alone, stress and anxiety are not covered. However, if that same workplace stress causes a physical ailment, then it is a compensable injury.

Post-Traumatic Stress Disorder (PTSD)

Minnesota workers’ compensation laws treat PTSD differently than other psychological conditions. The rules described above do not apply to PTSD. If PTSD is caused by a traumatic event that arises out of and in the course of employment, then PTSD is covered by workers’ compensation just as any physical injury would be. In order to be covered, PTSD must be diagnosed by a licensed psychiatrist or psychologist.

Ordinarily, the employee must prove that PTSD was caused by a work-related traumatic event. However, if the employee is a first responder that is first diagnosed with PTSD during the employee’s time as a first responder, then PTSD is presumed work-related. These employment situations are entitled to that presumption by law:

• Licensed police officer;

• Firefighter;

• Paramedic;

• EMT;

• Licensed nurse that provides emergency services outside of a facility;

• Public safety dispatcher;

• Correctional officer;

• Security counselor employed by the state or political subdivision at a corrections, detention, or secure treatment facility; and

• Sheriff or full-time deputy sheriff.

The insurance company can nonetheless deny a first responder's PTSD claim under some circumstances. PTSD is not compensable if it was caused by disciplinary action, work evaluation, job transfer, layoff, demotion, promotion, termination, retirement, or similar actions.

Burden of Proof

Psychological claims tend to be more challenging to prove than physical injuries. If an employee breaks her arm at work, an x-ray will conclusively show that the arm is broken. There will usually be evidence of an observable event that would have broken anyone’s arm. Psychological injuries, by their nature, leave behind little objective evidence. Typically, the injured worker will recount when and how the symptoms began to a mental health professional. That mental health professional will then give an opinion as to the diagnosis and cause. If the court believes that the injured worker’s description and the medical opinion are both reliable, then the court may find a psychological injury.

Conclusion

Does workers’ comp cover mental health? In Minnesota, an employee can use workers’ comp for mental health if it is:

1. PTSD caused by a work-related traumatic event; or

2. Another psychological condition caused by a physical work-related injury.

The law does not exclude any psychological condition. Generally, the compensable conditions tend to be depression, anxiety, adjustment disorder, and PTSD. 

LawSmith PLLC is a legal practice that represents employees in workers' compensation cases. A free consultation is available to Minnesota injured workers on request.

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