Certified Specialist, Workers' Compensation, The State Bar of California
Board of Legal Specialization
California allows a claim for psychiatric disability arising out of the nature of your employment or from harassment or abuse from supervisors. In such cases, temporary disability payments, medical and psychological treatment, and permanent disability money may be available to you.
You may also file a claim for emotional problems resulting from physical injuries. In this case you may be able to get necessary medical treatment and counseling; However, permanent disability payments may not be available as an add-on to a physical injury unless the physical injury is extremely serious (such as an amputation, for example).
A doctor must be able to provide a diagnosis for you that falls within the American Psychiatric Association’s Diagnostic and Statistical Manual or Mental Disorders. This treatise sets forth criteria for making a particular diagnosis. For example, at one time it was very popular for psychiatrists to make a diagnosis of “post- traumatic stress disorder” for emotional reactions to physical injury and pain. However, for this diagnosis, DSM 4 requires (paraphrasing here) the person be exposed to a traumatic event in which the person experienced or witnessed events involving serious injury or death and that the person’s response involved intense fear, helplessness or horror. Happily, most of us will never have a qualifying experience and therefore will not qualify for that particular diagnosis.
Major Depressive Episodes and Major Depressive Disorders also have specific diagnostic criteria and these are more common in pure psychiatric workers’ compensation claims that arise from highly stressful work conditions. In these cases it is very important that your attorney be provided access to facts and evidence to support the claim, for cases such as these are always denied by the Workers’ Compensation insurance company.
The presentation of a case for emotional impairment requires your attorney to navigate a minefield of technical defenses available to your employer or its insurance carrier. For example, it must be demonstrated that the work events complained of were real and not simply imagined. That may require presentation of supporting witnesses. There is a requirement that, for most cases, you must have been employed by the defendant employer for at least 6 months, although the employment need not have been continuous. In addition, if the emotional problem stems from some negative action the employer has taken against you (such as termination), the employer is allowed to attempt to establish that the action was both lawful and undertaken in good faith as a complete defense to the claim.
You can see from the above that assistance from an attorney with experience in the ins and outs of such claims will be very important to your success in obtaining medical care and indemnity payments.