WILG Blog


Posted by: Julie Poirier on Nov 8, 2017

Contributed by Poirier Law Firm

 

At any given time, one-in-five American adults suffers with a mental health condition that may impacts their daily life. Mental health conditions remain the most expensive health challenge in the nation along with cancer and heart disease. Mental health is the leading cause of disabilities in high-income countries. In the workers’ comp system, mental health conditions have a significant impact on claim and claim duration.

 

            More than 50% of injured workers experience clinically-related depressive symptoms at some point, especially during the first month after the injury. Mental health problems can affect any employee at any time and the reasons they develop are varied. The stress of having an occupational injury can be a trigger for anxiety or depression.

 

            Interestingly, mental health conditions often surprise the injured worker himself. Depression can develop over time and the person is not clued in until he finds himself struggling. In workers’ comp claim, it can become an elephant in the room that no one wants to address. Stigma and social prejudice is one of the biggest challenges. Cultural differences also affect the ability to identify and address mental health challenges.

 

            Another hurdle to addressing mental health issues in the workers’ comp system is the focus on compliance, regulations and legal management. Employers are concerned about timelines and documentation, sometimes to the extent that we don’t think about potential mental health challenges, even when there is clearly a non-medical problem. Claim professionals are taught to resolve each claim as quickly and easily as possible.

 

            More importantly, different states vary in terms of how or whether they allow mental health-related claims to be covered by workers’ comp. Some states allow for physical/mental claims, where the injury is said to cause a mental health condition – such as depression. Less common are mental/physical claims, where a mental stimulus leads to an injury. For example, workplace stress related to a heart attack. Georgia is one of the states, which does not recognize physical/mental claims, and mental health issues developed after workplace injury in workers’ compensation system.

 

            Despite the challenges, there are actions employers and payers are successfully taking to identify and address psychosocial conditions. Training and educating claims professionals is a tactics some employers are taking to better address psychosocial issues among injured workers. Ongoing communicating with the injured workers is vital. Changing the workplace culture is something many employers can do. Providing resources to allow employees to do their jobs and feel valued within the organization helps create a sense of control, empowerment and belonging.

 

To remain successful, WC insurers must find ways to adapt to different workplace hazards and mental health issues among workers.

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