For employees with mental injuries like post-traumatic stress disorder (PTSD), the path to a PTSD claim for workers’ compensation benefits can be filled with obstacles.
That’s because the Arizona Workers’ Compensation Act requires employees to meet high legal standards to get workers’ compensation for PTSD.
If you need to claim workers’ compensation for PTSD, please call Matt Fendon Law Group at (800) 229-3880.
Proving PTSD Is Work-Related
Check in with an experienced attorney before you apply for workers’ compensation for PTSD.
You’ll need to meet several requirements to make a successful PTSD claim. To prove that your PTSD is work-related, you must show that:
• You directly witnessed, experienced, or encountered a traumatic event at work.
• You are diagnosed and receiving treatment or have been treated for PTSD by a licensed professional who is carefully documenting your symptoms.
If both of these requirements are met, then you can make a workers’ compensation claim to cover your mental health treatment, along with lost wages because of time missed from during your recovery and other expenses allowed under Arizona workers’ compensation.
Arizona Workers’ Comp Law Requires “Unexpected, Unusual, or Extraordinary Stress”
To receive workers’ comp for PTSD in Arizona, you must be able to show that your psychological injury is the result of “some unexpected, unusual, or extraordinary stress related to the employment.” First responders, such as police officers, firefighters, and paramedics, are often in a position to experience or see traumatizing events while working.
For employees who struggle to get workers’ comp for post-traumatic stress syndrome, the problem often lies in the law’s ambiguous language: what counts as “unusual” or “extraordinary?”
Claimants have been denied benefits because of arguments that they didn’t experience enough of an unusual event to fall outside the scope of their employment.
Take the case of a former Gila County Sheriff’s Office sergeant represented by the our workers’ compensation legal team at the Matt Fendon Law Group. John France worked in law enforcement for 35 years until he shot and killed a man who pointed a gun at him and refused to put it down. He went on to develop PTSD but was denied workers’ compensation.
The Industrial Commission of Arizona decided that the circumstances of the incident—being involved in a highly charged situation involving firearms—were not “unusual” enough because France worked as a law enforcement officer. France disagreed, and eventually the Arizona Supreme Court found that he deserved benefits for his PTSD.
What is PTSD?
PTSD is a debilitating emotional injury that follows a traumatic incident. PTSD is most commonly associated with military veterans, but is not confined to them.
Anyone who experiences any kind of traumatic event—like a physical assault, a car accident, seeing a co-worker killed on the job, a natural disaster, or perceiving that his or her life is in danger—can develop PTSD.
But because the symptoms are invisible and affect every individual differently, PTSD and other mental health conditions like anxiety and stress tend to go untreated or undiagnosed.
Adding to this difficulty is that PTSD symptoms may not appear until months or, in some cases, years after the traumatic event. This is one reason why it is so important for a claimant to seek treatment as soon as symptoms become apparent.
What are PTSD Symptoms?
PTSD is commonly a psychological condition connected with traumatic events like a head injury (especially traumatic brain injury) or the death of a loved one. Following a traumatic experience in the workplace, you may experience some or all of the following physical symptoms or emotional symptoms:
- Severe depression that lasts over a prolonged period of time, up to and including suicidal ideation
- Persistent anxiety disorders and excessive worry
- Recurring unwanted thoughts or nightmares, or flashbacks of the traumatic experience
- Loss of appetite
- Withdrawing from family, friends and co-workers in your work and social life
- Insomnia
- Low self-esteem
These and other symptoms related to PTSD can affect your ability to work and also negatively impact your life outside of work.
Studies show that PTSD sufferers have higher rates of absenteeism, undergo more medical visits, have an increased likelihood of unemployment or underemployment, receive lower hourly pay, and have increased difficulty meeting work-related demands.
How is PTSD Diagnosed?
To receive compensation for work-related PTSD in Arizona, you must be diagnosed with PTSD by a medical professional or mental health professional.
During the diagnostic process, your doctor may have you undergo a physical examination to rule out any other medical conditions that may be responsible for your symptoms. Your doctor may also order a psychological examination to see if your PTSD symptoms are connected with a traumatic event that you witnessed or experienced.
Statements from people who know you and have seen the effects of PTSD symptoms on your ability to work, such as friends, family members, and co-workers, can also be valuable in establishing a diagnosis for PTSD.
Your examining doctor will likely evaluate your symptoms using the criteria that the American Psychiatric Association has established in its Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM-5.
The DSM-5 identifies eight factors that must all be present to diagnose you with PTSD:
- A stressor event. You must have been exposed to “death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence.” This can be a direct exposure, or from witnessing the stressor event, or come after learning that a close loved one was exposed to the stressor event.
- Symptoms. You must experience at least one recurring symptom, like unwanted memories and flashbacks of the trauma, nightmares, emotional distress, or a physical reaction to the traumatic event.
- Avoidance. You avoid thoughts, feelings or other triggering reminders of the traumatic event.
- Negative thoughts or emotions. You experience at least two changes in cognitive or behavioral well-being after the trauma. These can include memory loss, self-blame, loss of interest in activities, feelings of being isolated, negative perceptions of the world, and difficulty seeing things positively.
- Changes in arousal and reactions. You display destructive behaviors like increased irritability or aggression, risky behaviors, hypervigilance, being easy to startle, having difficulty concentrating, and insomnia.
- Duration. Your symptoms persist longer than one month.
- Impairment. Your symptoms disrupt or impair your life in some way socially or at work.
- Exclusion. Your symptoms do not have another cause, like medications, substance abuse, or another illness.
Get Help from an Arizona Workers’ Compensation Lawyer Today
If you file a workers’ compensation claim based on work-related PTSD that is not connected to a physical injury following an accident on the job, you can expect your claim to be subject to close scrutiny. Even having a formal PTSD diagnosis and documented symptoms is not a guarantee of approval, especially if you have a prior history of psychological issues.
This is why it is essential to seek help if you or a loved one is struggling after witnessing or experiencing a traumatic event at work and believes that PTSD may be involved.
Applying to receive benefits through workers’ compensation is a document-heavy and time-sensitive process. It’s not something you should have to worry about while you’re receiving treatment for PTSD.
Let the workers’ compensation lawyers at the Matt Fendon Law Group take the burden off your shoulders. In a free case evaluation, we can gather the information needed to make a solid case for maximum benefits on your behalf.
If you’ve already been denied benefits by your employer’s insurance company, you can count on us to build a strong appeal to pursue the best possible outcome for your case.
Call our law firm at (800) 229-3880 or contact us now for a free initial consultation with an experienced Arizona workers’ compensation attorney.
