When most people think of workers’ compensation claims, they picture physical injuries like broken bones, lacerations, or occupational illnesses. But what about mental health conditions caused by work? Does workers’ comp cover mental health conditions in South Carolina?
The short answer is yes, workers’ comp mental health claims are possible in certain circumstances.
But, these cases are often more complex than claims for physical injuries. Our experienced Greenwood workers’ compensation lawyers take a closer look at when mental health conditions may be covered by workers’ compensation in South Carolina.
Types of Work-Related Mental Health Conditions
Two main categories of mental health conditions may arise from work:
- Physical-mental injuries: This is when a physical workplace injury leads to mental health issues. For example, someone who suffers a traumatic amputation on the job may develop post-traumatic stress disorder (PTSD) as a result of the incident. The mental health condition stems from the physical injury.
- Mental-mental injuries: These are psychological conditions caused by workplace stress without any physical injury. Examples could include anxiety, depression, or PTSD triggered by extraordinarily stressful working conditions, a psychologically traumatic event at work, or harassment.
While physical-mental injuries are generally compensable under South Carolina workers’ comp law, mental-mental injuries face a higher bar. Ordinary job stress alone is not enough to qualify for workers’ comp mental health benefits.
Challenges With Workers’ Comp Settlement for Mental Health
Even when a mental health condition is clearly work-related, obtaining workers’ compensation benefits can be difficult for several reasons:
- Lack of physical evidence: With a physical injury, there are usually objective findings on medical tests like X-rays or MRIs. Mental health conditions are diagnosed based on an individual’s subjective symptoms and the observations of medical professionals. This lack of definitive “proof” can make mental health claims harder to verify for insurers.
- Pre-existing mental health conditions: Many people have pre-existing mental health issues to some degree. Workers’ comp insurers may try to argue that the mental health problems are longstanding and not primarily work-related. Especially if a worker had any prior treatment for things like anxiety or depression, the insurer may contend those issues were the main cause rather than work.
- Stigma around mental health: Despite growing awareness, there is still often stigma surrounding mental health issues. Some people may be reluctant to acknowledge the seriousness of psychological conditions. Insurers can be skeptical of these “invisible injuries.”
Requirements for Mental-Mental Workers’ Comp Claims
To have a compensable workers’ comp settlement for mental health without any physical injury (mental-mental), a worker must generally prove:
- The stressful conditions at work were extraordinary and unusual compared to the normal pressures of the job.
- The abnormal work conditions were the primary cause of the mental health condition.
- There is objective evidence from a mental health professional supporting the condition and its work-relatedness.
In Crenshaw v. Georgetown Steel Corporation (1991), the South Carolina Supreme Court allowed workers’ comp benefits for an employee who had a nervous breakdown due to unusual stress at work. The court found his breakdown directly resulted from extraordinarily tense relations between the employee and management. This case helped establish that mental health injuries can be compensable in rare cases of abnormal working conditions.
Covered Mental Health Treatments
If a worker has a compensable claim for a work-related mental health condition, workers’ comp should generally cover medically necessary treatments. This may include:
- Counseling sessions
- Therapy with a psychologist or psychiatrist
- Inpatient treatment at a mental health facility
- Prescription medications like anti-depressants or anti-anxiety drugs
The specific benefits depend on the individual case and needs of the patient. It is crucial to get professional mental health treatment and have the provider document the work-related cause of the condition.
Other Considerations with Mental Health Claims
When seeking a workers’ comp settlement for mental health issues, here are a few other important things to keep in mind:
- Deadlines to file a claim: In South Carolina, workers generally have 90 days from the date of injury to notify their employer. For mental health claims, this deadline is counted from when the condition prevents the worker from performing their job. The worker then has two years from that date to formally file a workers’ comp claim.
- Choosing a doctor: In South Carolina, employers have the right to select the doctor who treats an injured worker. However, if the employer does not offer a qualified mental health professional, the worker can request to see their own doctor. If the provider recommends treatment or work restrictions, the employer/insurer should cover it.
- Possible benefits: Workers’ comp benefits for a mental health condition may include payment of medical bills, temporary total disability payments while out of work, and permanent impairment benefits if there are long-term restrictions. If a worker cannot return to their previous job because of their mental health condition but could work in another capacity, they might be entitled to vocational rehabilitation services.
- Returning to work: The goal of workers’ comp is to help the injured worker recover and return to gainful employment when possible. A mental health professional should assess the employee’s ability to return to work and recommend any restrictions or accommodations. The employer may offer light duty or a different position compatible with mental health limitations.
Get Help From a Greenwood Workers’ Compensation Attorney
At McCravy, Newlon, Sturkie & Clardy, our Greenwood workers’ compensation attorneys understand the significant impact that work-related mental health issues can have on your life.
You have the right to pursue workers’ comp benefits for psychological conditions caused by your job.
However, we know insurers are often skeptical of mental health claims and may look for reasons to deny benefits. Our knowledgeable lawyers can help you document your condition and fight for the compensation you deserve. We serve injured workers across South Carolina.
If you are struggling with work-related mental health issues, contact McCravy, Newlon, Sturkie & Clardy today for a comprehensive consultation and case evaluation. Our attorneys will listen to your story and explain your legal options. You do not have to suffer in silence. Contact us now to get started.