Do workers compensation benefits cover PTSD?

Do workers compensation benefits cover PTSDThe short answer is yes, if you sustain PTSD (post-traumatic stress disorder) following a physical work injury or traumatic event like a robbery at work then your condition should be covered. This sounds good but is not as good as it sounds because often your workers' comp insurance company will deny your PTSD claims for several reasons.

Here are a few company insurance company tactics in dealing with PTSD:

1. The insurance company, nurses, and their doctors will simply ignore the mental health issues which you are having including PTSD. You should bring up all of your problems you are having because of the work injury, but do not be surprised if the doctor says "I am only treating you for your (insert your injury, e.g. arm, shoulder, back, neck, leg, etc.). If this has happened to you, there are several ways that we can help you get the medical care and treatment that you need for your PTSD and may also be able to obtain additional financial compensation for you.

2. You complain about mental health problems such as PTSD so the insurance company decides to send you to one of their bought and paid for mental health providers. There are a number of psychiatrists and psychologists in Iowa that will say whatever the insurance company wants them to for a price. These doctors have a proven track record for helping the insurance company at all costs. If the insurance adjustor wants to send you to a doctor in order to address your PTSD claims, you should find out if the doctor they want to send you to is legitimate or not. Depending upon your circumstances, it may be better for you to just seek treatment on your own instead of going to the insurance company doctor. If you are facing these issues, we can tell you what the doctor's track record is. Then we will help you decide what is best for your PTSD and your workers' comp case.

3. The insurance company will ask that their treating authorized physician refer you to a reputable mental health provider. This is the least likely thing to happen in your case because it may cost the insurance company more money. I know, why wouldn't the insurance company want to help you so you get better and they likely end up paying less money in the long run? However, this is not how profit-driven insurance companies think. Often, they rather save the money now even though they are ignoring the human cost and may pay more later on. Note: If the doctor they send you to makes a specific referral to another doctor, then they should be responsible for paying for that care and treatment. If they refuse, then the alternative medical care procedure may be used to force the insurance company to pay for the mental health medical care that you need. There are very specific requirements that you must follow in order to have a chance at winning in an alternative medical care hearing. Chapter 4 of our Iowa Workers' Compensation book covers this topic in more detail.

 

If you would like a copy of our new no cost Iowa Work Comp book which includes the Iowa Injured Workers Bill of Rights and reveals 7 costly mistakes and how you can avoid them just click here to request the book. There is no cost or risk and you can finally learn about Iowa workers comp laws in the comfort of your own home with no pressure. We offer our Iowa workers comp book at no cost because we have seen far too many hardworking Iowans who following a work injury were suffering both physically and mentally who were treated badly by insurance companies because they did not know their rights or responsibilities.

 

Here are a few other things to keep in mind if you think you may have PTSD or have been diagnosed with it:

1. PTSD is a mental health anxiety disorder involving the over-activation of the flight or fight response.

2. PTSD symptoms can develop quickly or slowly after a traumatic event in which your life was put in danger.

3. Some signs and symptoms include: anxiety, grief, anger, feeling lonely, sleep issues, feeling out of control, etc. People with PTSD may feel disconnected from the world and lose their meaning and purpose in life.

4. Many PTSD sufferers relive the trauma through flashbacks, nightmares, avoiding people or places that bring back the memories of the trauma and/or constantly feeling on edge.

5. PTSD is not a result of moral failure or weakness in character but is a real condition caused by biological and physiological mechanisms.

6. Everyone is different some people who sustain the same trauma can have very different reactions from it including developing PTSD or not.

7. People with PTSD have a greater risk of alcohol abuse and other mental health conditions like depression.

8. You are not alone because an estimated 4% of men and 10% of women develop PTSD at some point in their lifetime which means approximately 8 million adults are dealing with PTSD in any given year.

9. The good news is that there are many ways to treat PTSD including individual and/or group psychotherapies, medications, etc.

 

If you or a loved one is having mental health issues following trauma the best thing you can do is to get help with a qualified mental health professional as soon as possible. While PTSD may get better on its own with time, at the very minimum you should get it checked out so it does not get worse.

Suffering from PTSD can be an isolating experience, but there are millions of other people dealing with similar problems and there are resources available to help you get your life back. If you do not have anyone else to turn to and are even considering hurting yourself, then please get help or at least call 800-273-8255 to speak with a trained person at the National Suicide Prevention Lifeline. If you are not comfortable calling someone on the phone for more information go to https://www.mentalhelp.net/ptsd/hotline/.


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Corey Walker
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With over 22 years legal experience, Corey has been recognized for his work as an injury attorney.