Many employers will argue that emotional injuries are insignificant or even frivolous. Accident victims should understand that they DO have the right to seek compensation if they need to see psychiatrist, psychologist, or any type of mental health counselor. It is easier to be approved for emotional distress wages and medical care, but not essential, if your emotional distress accompanies a physical injury.
Workers who suffer broken bones, back injuries, spinal cord damage, or other physical injuries often quite justifiably worry about whether their injuries will heal properly. Accident victims often suffer anxiety and depression about their job prospects and how their injuries will affect their ability to perform even routine tasks like sleeping, walking, and eating. Workplace accident victims often worry about how their pain and recovery process is hurting their spouse and children. Not to mention post- traumatic stress disorder (PTSD) if the injury was violent, such as an attack or fall from heights or an amputation.
In some cases, such as when a worker suffers a traumatic brain injury, it is virtually a given that the worker will need emotional counseling to address issues of confusion, memory loss, an inability to speak, extreme anger, and other difficulties.
In other cases, such as workplace violence, there may be no physical injury at all. If a worker observes someone being killed, comes upon a horrifically violent scene, or if a car nearly hits the worker – then these memories can vividly play over and over again in the worker’s mind, like an insane “loop,” interfering with the worker’s sleep and destroying all emotional stability, in some cases even causing hallucinations. This may justify the need to get psychiatric help and could lead to a diagnosis of post-traumatic stress disorder (PTSD).
While many workers may think it is “macho” to tough out their injuries and the reactions to them, experienced workers’ compensation lawyers explain that getting professional help is often the best course. Speaking with psychologists and other professionals may even quicken the date when you can return to work, or in some cases, protect you from prematurely being thrown back into a work environment which is full of the very “triggers” that must be avoided in order for you to heal from the PTSD.
Some of the key issues involved in proving emotional distress in work injury cases
Emotional injuries are harder to prove than physical injuries. Physical injures can be verified by X-Rays, MRIs, CT scans, and other diagnostic tests. Often, there is visual evidence in the form of bruises, scarring, redness, or other unsightly conditions.
Emotional injuries normally can’t be seen or tested objectively, although some aspects of an underlying condition, such as memory loss or other cognitive deficits can be measured by testing. Most emotional injuries are observed. They require a review with a mental health professional who will need to document the basis for the emotional injury. The psychologist, psychiatrist, or other emotional health provider will normally complete a report which addresses the following:
- The verbal responses to questions
- The ability of the worker to communicate his/her thoughts
- The ability of the worker to remember events, places, or things
- Whether the worker can focus or if the worker is easily confused
- The ability of the worker to reason
The emotional health doctor or counselor should be able to document:
- The depth and level of the worker’s anxiety, depression, or other emotional states that prevent the worker from doing his/her job. Disappointment is generally not compensable. Chronic depression, psychosis, or phobias are conditions that are more likely to justify the cost of seeking medical help.
- Whether the emotional injuries accompany any physical injury
- Whether the worker’s distress is a logical result of some work-related event such as being robbed
- If the distress was due to some intentional misconduct at work
- The length of the distress and whether the distress is improving with counseling
- The amount of time and sessions the health provider reasonably thinks are necessary to help the worker do his/her job again
- The expected emotional issues for the particular type of physical injury the worker suffered
- The extent of any underlying cognitive deficits which may contribute to the emotional distress, such as memory loss. This can be measured through a battery of tests given by a neuropsychologist.
The doctor should prepare a detailed medical report indicating the precise diagnoses, whether the diagnoses are connected to the work injury and come up with a treatment plan, and the worker’s prognosis.
Additional emotional distress considerations in workers’ compensation cases
In general, an employee can’t claim emotional distress if their negative emotional state is due to standard work conditions. For example, if an employer calls in an employee for a work review or assigns a worker to a new job task, the review or assignment may cause the worker to become quite nervous. Still, reviews and work assignments are routine parts of any job. An employer is not normally going to be required to pay for the worker’s need to seek emotional counseling for standard work conditions.
Please note: This article does not address other remedies that are outside the scope of our practice, such as discrimination or other claims to the EEOC due to a “hostile work environment.” For any such claims, we suggest you consult with a competent labor and discrimination attorney.
The employer’s insurance company may send you to their own doctor who will conduct their own examination. In Virginia, if you are given a psychiatric referral, you get to pick from a panel of three doctors. Often it is up to your attorney to first make sure that everyone on the suggested panel of psychiatrists or psychologists actually accept workers compensation patients. Unfortunately, most do not, so this is very important.
Typically, a key difference between a psychiatrist and a psychologist is that the psychiatrist can prescribe medications while the psychologist cannot write prescriptions. In terms of proving your case, it is very important that you see AT LEAST a psychologist. A licensed professional counselor or nurse practitioner may be able to treat you, but they cannot offer opinions in your case about any psychiatric condition or whether it is connected to the work accident. So if you are seeing such a counselor, and you want to prove your psychiatric diagnoses are connected to your work injury, you will need a referral to a psychologist or psychiatrist.
In addition, if you have suffered a brain injury and you are attempting to prove that you are suffering from psychiatric conditions connected to that injury, you will need a psychiatrist (who is an M.D.) or other medical doctor such as a neurosurgeon to testify that your psychiatric conditions are connected to that brain injury. A psychologist can testify about your diagnosis, but he or she is not allowed to testify that your psychiatric condition is related or a result of a physical brain injury. They CAN testify that you are suffering from a condition that occurred as a result of your reaction to a traumatic event, such as an attack or severe fall. But that is not the same as saying that your psychological diagnosis is the direct result of a physical injury. For that, you need an M.D.
If you can’t work due to emotional difficulties relating to your work injury, be wary of nurse case managers trying to convince your health care providers to return you to work before you are ready. We have found that on many occasions, the residual emotional issues relating to a traumatic injury are the last to disappear after a bad injury. Many times, it is the psychiatrist or psychologist who is the only health care provider who can protect a severely traumatized worker from being thrown back into a work environment that he or she is nowhere near ready to handle.
Attorney Joe Miller Esq. has been fighting for North Carolina and Virginia workers for more than 25 years. He’s helped thousands of work injury victims get justice. He’ll work aggressively to help you get all the wage loss and medical coverage you deserve. Call his office now at (888) 694-1671. You can also reach him through his contact form.