Can You Get Workers’ Comp for Depression in Pennsylvania?

Many injured workers suffer from anxiety and/or depression as a result of their work injuries, often in conjunction with chronic pain, being out of work, adjusting to a new lifestyle, having difficulty with household chores, sexual dysfunction, and other effects. Including coverage for your mental health treatment can be difficult, but it is possible in some cases.

An injured worker in Pennsylvania can bring a claim for depression by either including it on a Claim Petition if you were denied, or by filing what is called a “Review Petition” challenging the description of the accepted work injury. The insurance companies rarely accept a mental claim voluntarily, and tend to vigorously defend these claims, making it important to work with an attorney and the proper medical experts.

For a free review of your potential claim, call our Certified Pennsylvania Workers’ Compensation Lawyers at Cardamone Law today at (267) 651-7945.

Choosing a Therapist or Psychiatrist Treatment for Workers’ Comp Mental Health Claims

You strengthen your claim if you treat with a therapist or psychiatrist, rather than a family physician or orthopedic doc. A family doc or orthopedic doc are competent to render opinions regarding depression and other mental claims if they regularly treat patients who have chronic pain and see how it affects their lives; however a workers comp judge is entitled to afford less weight to their opinion as compared to the opinion of a therapist or psychiatrist.

According to a case called Lombardo v. Workers’ Compensation Appeal Board (1998), judges are allowed to accept expert testimony and opinions from doctors that are outside of their specific field, but they are allowed to take that into account when weighing the credibility of the evidence. That means that having a primary care doctor or an ER doctor who treated you at the hospital testify about your depression and its work-relatedness can pale in comparison to the insurance carrier using a board-certified psychiatrist, for example. As such, it is best for us to have a medical expert who is in the correct field and has the proper certifications to diagnose your depression and help pinpoint its cause – i.e., your work injury.

Mental claims are more difficult to win than physical injuries. This is due in part to the fact that many people have prior mental issues, like anxiety, depression, ADHD, bipolar disorder, etc. The insurance companies and their lawyers will use the prior issues/episodes/diagnoses to try to say that the condition existed prior to the work injury and cannot be work-related. They do this with physical injuries, too, of course. Even so, proper documentation of your health and mental health can help show that your condition only arose after the injury and that it is part of this work injury case and not another unrelated condition.

What Does Workers’ Compensation Pay for Depression?

Workers’ Comp typically works to cover the cost of medical treatment after a work-related injury, and it covers 2/3 of your lost earnings while you are out of work because of the injury. If you can return to part-time or light-duty work, wage-loss benefits can instead cover 2/3 of the difference in your wages. There are some other benefits paid for permanent injuries like facial scarring, amputation, or lost vision/hearing, but the core issue to discuss here is how these benefits can be paid based on depression.

Depression usually is not the sole injury when it comes to work injuries. You are unlikely to have an accident and suffer no physical injuries but suddenly become depressed. Instead, there usually has to be some kind of physical injury, and the depression comes as a side-effect or result of the injury. For example, if you suffered a back injury and will be laid up for months while you recover, not working or fulfilling your career goals, it only makes sense that depression symptoms might emerge. Depression, along with other mental health issues like PTSD, are also likely to emerge with amputation injuries and substantial scarring (which can also result in specific loss damages), as well as other very serious injuries.

Medical Bills

With these kinds of injury cases, you can claim compensation to cover all medical bills, but your mental health costs should also be covered. This means that if you need to see a therapist, a grief counselor, a trauma expert, or a clinical psychologist to treat the mental effects and depression associated with your injury, that should be paid for. Similarly, if you need antianxiety or antidepression medication, those prescriptions should be covered, too.

Lost Earnings

Once your physical injuries heal, it might look like it is time for you to get back to work. If the only thing holding you back from resuming work tasks and getting a paycheck again is your depression, Workers’ Comp should still cover you during this period of disability. Often, proving to the court that your depression makes you unable to work will be an uphill battle, but proper testimony and documentation from your therapist and psychiatrist can help get these payments covered.

Specific Loss Benefits

As mentioned, serious injuries resulting in amputation (or lost function), as well as facial scarring and lost sight/hearing, can also result in specific loss benefits. In a traditional lawsuit, you might be able to claim “pain and suffering” damages, which increase based on how severe the effects on your physical and mental well-being were. Workers’ Comp does not allow for pain and suffering damages, but there are specific loss benefits you can claim paid based on a number of weeks’ worth of 2/3 of your average wage before the injury.

These payments are issued for specific injuries listed in the Workers’ Comp Act, and they are paid at certain values. You unfortunately cannot claim higher damages for emotional distress, mental anguish, or depression.

How Our Workers’ Compensation Attorneys Can Help with Mental Claims

Many attorneys like to just throw in a mental claim when challenging the description of the injury regarding the physical injuries – however, many judges are hesitant to grant the mental claim unless you have a very strong case. This isn’t to say that a mental claim should not be filed; you just have to have your “ducks in a row,” have solid medical evidence backing up the claim, and realize that all prior issues in their lives will come to surface when cross examined in court and from the medical records which will be secured by defense counsel. This can be emotionally draining and difficult for the injured worker – so be measured when thinking about pursuing this type of claim because it can get messy.

Our attorneys can help you get treatment from the right kind of therapists and psychiatrists who can bring their expertise to the case, analyze your condition, treat you for your depression, and come to court able to testify that your depression is real and that it is work-related. We can also file the proper petitions with a Workers’ Comp Judge to get the depression claim and treatment accepted as part of your case and, if there are issues with getting it accepted, appeal them to the Workers’ Comp Appeals Board and the Commonwealth Court.

We may also be able to negotiate with the insurance carrier, getting them to accept at least partial coverage for certain mental health treatment as part of an overall settlement of your case. This could be a speedy way to avoid lengthy battles, but only if the insurance carrier is willing to settle. If they are not, we can give the judge the information and arguments needed to decide in your favor.

Call Our Workers’ Compensation Lawyers in Pennsylvania Today

For help with your Workers’ Comp case, call Cardamone Law’s Philadelphia Workers’ Comp lawyers today at (267) 651-7945.