Peg Kramer, AIC, CPCU April 10, 2019 6 min read

Mental Stress Claims

As an employer, you must realize that not all injuries are from a physical or occupational injury.  Mental stress injuries also occur and may be found to be compensable. Wisconsin is one of the few states that recognizes that mental injuries can be presented as worker’s compensation claims as outlined in Wisconsin Statute 102.01 (2) (c). There are three types of mental injuries that can be claimed as worker’s compensation: physical-mental, mental-mental, and mental-physical.

Physical-mental claims are those where a physical injury causes a mental injury. These types of claims can come from an actual traumatic incident at work or can arise from an occupation that a person has done for many years. Examples would be where a worker has a specific incident such as an amputation of a body part from a machine. The worker’s body heals but they now develop a fear of walking into the plant where they were injured. The diagnosis for these types of injures include; Post Traumatic Stress Disorder, (PTSD), depression, phobias, psychogenic pain disorder and hysteria neurosis. 

Mental-mental is the second type of mental injury that can be work-related. This type of injury brings the most amount of controversy as it is more difficult to prove.  The injured worker must substantiate that their job produced a higher level of stress versus a co-worker who performs the same duties.  Actual case law has set the standard for this type of injury declaring that non-traumatic mental injuries must result from a situation of a higher level than day-to-day emotional stress, events and nervousness. An example of this would be a manager who supervises staff but has gradually taken on additional responsibilities when people who leave are not replaced and departments pare down staff. His or her co-managers’ jobs have not changed. There is a clear distinction between these managers’ situations.

A mental-physical claim can occur when job-related mental stress precipitates, aggravates or accelerates a degenerative condition or a current deteriorating condition beyond its normal progression. An example of this would be someone whose pre-existing condition for migraines is accelerated because of job stress.    

When an employee presents one of these claims it can be very difficult to prove, as an x-ray or MRI will not reveal this condition.  In Wisconsin, a medical diagnosis and treatment needs to come from a qualified mental health specialist.

It is important to understand that these types of claims are very real and very expensive.  Several of these claims have ended up making case law in Wisconsin.  One prior case occurred in a county highway shop in northwestern Wisconsin.  One of the employees stuttered when he spoke and his coworkers started to tease him about the stutter. The teasing became so bad that the employee became very depressed and was unable to do his job. The courts ruled in his favor when he presented a claim for mental stress.

Employers are responsible in many ways for their employees’ overall well-being. This includes their physical health and mental health. Think about the culture you as an employer create at your business. You may not be able to control all of these claims but you can certainly look at your current environment to see where potential exists:

  • Are you overburdening your strong performers to the point where they are under substantial stress by taking on additional duties?
  • Do you give employees the right tools to be effective and efficient in their job?
  • Do you allow employees to be teased, laughed at or subjected to foul language?
  • Does sexual harassment exist?
  • Are your employees subject to extraordinary stress and tension in their day to day job activities?

Take the time now to assess your situation and correct any issues before they result in a mental stress claim.

To learn more, register for Peg's webinar, Mental Stress Claims & Worker’s Compensation:

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Peg Kramer, AIC, CPCU

Peg found her way to Hausmann Group in 2014 over a serendipitous lunch with a former coworker. She uses her 20+ years of experience in the claims field to be a champion for clients when they are faced with difficult situations. Peg’s word is solid - she is tenacious and will go to great lengths to problem solve to provide the right answers. Peg believes that Wisconsin has the fairest and most equitable workers compensation program in the nation for both the employee and the employer. She prides herself in educating clients on what their options are under the program and how to prevent accidents, work with injured workers, and save money doing it. Peg grew up in her parent’s grocery store and was the first “Cart Greeter” ahead of the big box stores starting at age 4. She graduated from the University of Wisconsin - Platteville with Bachelor’s degrees in Criminal Justice and Psychology. On the weekends she loves to relax at her lake home in Oxford, Wisconsin or you can find her at garage sales, thrift shops and consignment stores learning the stories behind all of the interesting pieces for sale. She also actively volunteers at her church on the Parish Life Committee.