The Role of Mental Health in Workers’ Comp Claims


Workers’ Comp is a crucial type of  insurance. Claims often involve complex analysis because of the enormous number of factors to consider. Psychological issues, like mental illness, have a significant impact on the claim process. It is useful to understand how these problems may affect a claim and how to address them.

Often when a work injury occurs, the main focus shifts to the person who was hurt and the primary goal is saving the worker’s life. When the injury is not severe, the focus is to fix what is broken. The goal is to get the person back to the state they were in before the accident occurred. The worker may not have enjoyed the work environment but it is something that is familiar and is missed. This stage is one of the most important when it comes to the Psychosocial aspects of work.

One substantial problem is that the employee’s past is often overlooked. We may not think about whether or not this person has a background that includes medical and/or Psychosocial issues. Employees come from a variety of different lifestyles, with unique coping methods.

A vast array of traits influence the recovery of an injured worker. Consider how many people suffer from depression in the United States. Many individuals experience depression for long periods of time, defined as 12 months or longer. The percentage of people suffering extended bouts of depression stands at around 6.6%, most of those being 18-25 year old women. People with depression can be very hard to motivate. They tend to view life negatively. They often expect the worst outcome in a situation, which constantly brings them down. Anxiety is another issue to consider. The percentage of people with an anxiety disorder is around 10%. People experiencing anxiety typically over-think things. They may obsessively think about things like their families, the future, and previously made poor decision. Conditions such as these seriously affect a workers ability to recover from an injury.

Addressing A Psychosocial Problem

Experiencing an injury in combination with handling the insurance claim often causes confusion and stress. Mental health issues may become a crucial factor in an insurance claim. Here are some of the strategies to manage mental health issues on a claim.

  • Understand that Psychological issues generally slow the recovery process.
  • Distinguish people with prior psychological problems, previous work injuries, history of substance abuse and other medical problems.
  • Identify people who display unusual behaviors like dramatic complaints, anger or severe frustration. Consider other factors such as, frequent complaints and phone calls, and yelling or crying. These behaviors can lead to a prolonged claim.

Next you need to decide how these issues are affecting the worker’s recovery process. These questions include: “Are these issues delaying the return to work? Is the individual increasing their medicine, or are they engaging in inappropriate procedures?”

Some strategies offer necessary structure to injured workers, whose life may be hectic. The following interventions are helpful when you are working with injured employees.

  • Help the person with the insurance process. This process is very stressful for the injured person and it helps to have assistance.
  • Integrate the workplace and realize there may be psychosocial problems.

Workers’ Comp is important to protect both the employer and the employee. While these claims are often very complicated, it is useful to understand all factors that impact the process. Mental health is just one of the primary issues to consider. You can make the claim process more efficient by comprehending the role psychosocial issues play in the procedure. The best way to prevent problems is to avoid hiring potential problem employees. Discuss this with your HR department to ensure your organization has proper risk management in place.

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