Is Stress Leave Covered by Work Comp?

 A wide variety of injuries  can occur on the job that can result in a workers’ comp claim. A less well-known type of these injuries falls under the category of stress injuries. To avoid further injury and help a worker recover, some employees are temporarily relieved of work duties through stress leave. 

But is stress leave covered by workers’ compensation insurance?

Table of Contents

In this article, we’ll answer this question and other related concerns about stress leave and workers' compensation:

Is stress leave covered by workers' compensation?
What are the different types of stress that may be covered by workers' comp?
What should I do If I’m suffering from emotional stress at work?
Can I receive workers’ compensation for stress or anxiety?
What can I do if my workers’ comp claim isn’t approved?

Be sure to write down any questions or concerns you may have, since an independent insurance agent can provide you with the answers you’re looking for. Having an independent agent can help you gain a broader understanding of what types of coverage are available to employees, which states offer compensated stress leave, and much more. 

Is stress leave covered by workers' compensation?

Yes, stress leave is covered by workers’ compensation laws in nearly every state. However, there is a distinction as to what types of injuries and stress are covered, as well as the requirements for each. These include:

• Physical stress injuries
• Emotional/mental stress injuries

When filing a claim, workers are required to prove that these injuries resulted directly from their employment. If you’re unsure if your stress-related injuries are covered by workers' comp, consult an independent insurance agent to understand how each state determines viable claims.

What are the different types of stress that may be covered by workers' comp?

Physical Stress Injuries

Workplace stress injuries are most often thought of as the physical variety. Repetitive movements required in an employee’s occupation can lead to and exacerbate conditions like:

• Carpal tunnel syndrome from typing
• Chronic back injuries from heavy lifting
• Nerve damage from excessive use of vibrating tools, such as jackhammers

In these examples, physical stress injuries occur when a worker performs an activity at work over a long period, suffering a physical problem as a result. 

By filing a claim through the workers’ compensation system in a worker’s state of employment, employees suffering from physical stress injuries are entitled to a portion of their average earnings while they are out of work receiving treatment for the injury. 

The first step in the process to receive benefits is to file an incident report with the human resources department and/or the company's insurance carrier. Workers suffering from physical stress injuries must seek medical treatment, so a physician can determine whether the condition is directly linked to their job duties. To officially confirm that an injury is work-related, individuals who file these claims may also be required to undergo an Independent Medical Examination by a doctor chosen by the workers' comp insurer. 

If it is determined that repetitive stress injuries were not preexisting and are related to the worker's physical activity at work, injured workers may be able to receive:

• Time off for stress leave
• Weekly compensation benefits
• Permanent impairment benefits
• Payment for medical treatment
• Payment for medication and medical devices
• Vocational rehabilitation

Emotional/Mental Stress Injuries

When compared to physical stress injuries, emotional stress injuries can be substantially more difficult to prove and receive workers’ compensation benefits for. While symptoms may manifest as physical symptoms, such as alopecia (temporary/permanent loss of hair) or ulcers, drawing a direct correlation can be difficult. 

Because of this difficulty, some states do not cover workers’ compensation claims for emotional stress. The reasoning for this is that it may be harder to prove that emotional distress was a direct result of work conditions and duties, rather than other areas of life outside employment.

What should I do if I’m suffering from emotional stress at work?

If you feel that you are suffering from detrimental emotional stress in the workplace, the first step is to discuss it with your superiors and ask for solutions to your problems. In these cases, it may be necessary to file a formal report to ‘officially’ begin documentation of evidence. 

It’s important to have documentation made in writing and follow company-specific rules about formally reporting incidents, including such information as:

• Dates of related incidents
• Description of related incidents
• Outcome and developments of reporting issues

Be sure to accurately follow time limits and procedures for filing reports of emotional-stress-related incidents and circumstances to ensure that your rights will be protected.

Furthermore, it can strengthen your case to talk with trusted coworkers and ask them to make notes about events they personally observe in case you need witnesses. While this can be a risky decision that may disrupt work environments, it should be noted that it is illegal for employers to intimidate employees about issues related to workers’ compensation. 

Last, keep a journal about emotional stress that you experience at work. Just like formal reports, be sure to write down exact dates and events, who was present and involved, what was said, and how you ultimately handled the situation. Also, be as specific as you can, since more details can prove helpful if you should decide to pursue a legal remedy or need to convince your state’s workers’ compensation board to approve stress leave and other forms of compensation.

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Can I receive workers’ compensation for stress or anxiety?

States vary widely in how they treat workers’ compensation cases for physical stress injuries, and emotional stress is no different. To illustrate this, let’s use California as an example. 

California Stress Leave Requirements for Workers’ Comp

First, California doesn’t have a law that explicitly covers stress relief. However, workers’ compensation laws do allow workers to file a claim for a psychiatric injury that can be caused by on-the-job stress. 

Under certain circumstances, for individuals who have a diagnosis of mental health problems or psychiatric disorders that arose or worsened due to their employment, employers must provide workers’ compensation benefits and keep their positions open while they recover. According to California Labor Code 3208.3, the following conditions may entitle a worker to obtain stress leave and other workers’ compensation benefits for psychiatric injury:

• The individual was worked for the employer for at least 6 months.
• The individual has a psychiatric condition outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).
  • Note that the DSM-V does not define “stress” as a psychiatric condition, but it can be a symptom of other conditions like major depression and generalized anxiety disorders.
• Proof must be established that the actual circumstances of employment caused 51% or more of the psychiatric condition.
• The personnel actions that the employer took in good faith did not cause the condition, including reasonable criticism about punctuality and work attendance, or decisions about qualifying for raises or promotions.
• The process of litigation itself did not cause the condition.
• A claim based on a psychiatric condition after notification of termination from employment, unless the employer knew about the injury or treatment before termination.

Obtain Physician Confirmation for Stress Leave

Additionally, individuals seeking stress leave for emotional injuries must have detailed physician testimony that supports the workers’ compensation claim. Important elements that must be included in the physician’s confirmation for stress leave include:

• Health history 
• Job satisfaction
• Objective test data
• Personal records
• Depositions from coworkers, family members, or friends

Once this information has been compiled and submitted as part of a workers’ compensation claim, workers will receive approval or denial of their claim within 2 - 3 weeks. 

What can I do if my workers’ comp claim isn’t approved?

If you believe that continuing to work in your current capacity results in sustained stress and possible injury that is not covered by worker's compensation, you may wish to consider taking action outside of the worker's compensation system by filing a lawsuit against your employer.

While stress-related injuries can be difficult to prove unless there’s definitive evidence - such as the early symptoms of nerve damage or prolonged documentation of emotional distress - having evidence can help create a more compelling case should you need to pursue compensation for damages. 

There is also the possibility of utilizing your employer’s short-term disability insurance policy to take stress leave to adequately recover. While you may not be able to recoup the same benefits as workers’ compensation, such as indemnity benefits, you can receive some type of compensation. Last, consult an attorney and/or an independent insurance agent to help you navigate the complexity of your state’s stress-related laws and relevant insurance policies. 

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