Psychiatric injuries can be just as painful as a broken leg. In California, the law knows this. You can get benefits for emotional or mental harm caused by your job. Most people call these stress claims or mental-illness claims. This means the injury is purely psychological and did not start with a physical accident. While the state is progressive about mental health, these cases are often harder to prove than a back injury because you cannot see anxiety on an X-ray.
California Law and Psychiatric Injuries
California has some of the most detailed rules for workers’ compensation in the country. To get benefits, you must have an official diagnosis from a doctor. This diagnosis must come from the Diagnostic and Statistical Manual of Mental Disorders, which doctors call the DSM-V. Common conditions include generalized anxiety disorder, major depression, or post-traumatic stress disorder. Stress by itself is not a diagnosis. It is a symptom. If your work stress makes a condition like bipolar disorder worse, you might have a case. Other laws like the Family Medical Leave Act or the California Family Rights Act, might offer unpaid leave, but workers’ comp is what pays for your medical care and lost wages.
Requirements to Qualify for a Stress Claim
You have to meet specific tests to win a psychiatric claim. First, you must have worked for your employer for at least 6 months. There is a high bar for causation, too. You must prove that your actual work duties were the predominant cause of your condition. This means work was at least 51 percent responsible for your mental health struggles. If you experienced violence at your job site, this percentage might be lower. The law also says that your condition cannot come from the legal process of filing a claim. It must come from the job itself.
The Good Faith Personnel Action Rule
Not all workplace stress is covered. California protects employers when they act in good faith. If your boss gives you a bad performance review, criticizes your attendance, or denies you a promotion, you usually cannot sue for the stress those actions cause. These are considered normal parts of having a job. As long as the employer is acting reasonably and not out of malice, these personnel actions do not count toward a workers comp claim. Also, you generally cannot file a claim after you are fired unless you can prove your employer already knew about your condition before you left.
The Role of Medical Evidence
To win, you need a strong doctor on your side. An occupational physician will look at your whole life. They check your medical records, your job history, and even how happy you were at work. They might talk to your family and friends or look at test data to see how the injury affects your daily life. Because there is still a stigma around mental health, insurance companies often fight these claims harder than others. They want to see if your stress came from your personal life instead of your desk.
If you are struggling with workplace anxiety or depression, you do not have to fight the insurance company alone. A dedicated workers’ compensation lawyer can help you gather the right evidence and make sure the insurer takes your claim seriously. Reach out to Hinden & Breslavsky at (323) 954-1800 for a consultation to talk about your rights and how to get the treatment you deserve.