Does Workers’ Compensation Cover Depression?

Workers’ compensation covers you when you suffer an injury at work.  This insurance provides you with certain benefits after you suffer a work-related injury.

Two of the main benefits that Georgia workers’ compensation provides is:

1. Medical benefits (coverage for the medical treatment and testing you need for your injury)
2. Wage loss benefits (coverage for part of the lost wages you incur as a result of your injury)

Serious workers’ compensation injuries often cause other health conditions.  Two of the most common health conditions I see people hurt at work develop as a result of a workers’ compensation injury are depression and anxiety.

Many people develop depression and anxiety when they are in pain and cannot work as a result of an injury at work.  These conditions may require medical treatment and can make it even more difficult for someone to return to work.

Does Georgia workers’ compensation cover depression and/or anxiety which develops as a result of your injury at work?

It depends.  Georgia’s workers’ compensation law has special rules about when depression is covered.

The biggest situation where depression and anxiety are not covered is often referred to as “mental-mental” injuries.  What this means is that Georgia law requires you to have a physical injury at work to get a mental health condition covered under workers’ compensation.  If you do not have a physical injury, then mental health conditions are not covered.

Let’s take an example.  Suppose you injure your back at work and then develop depression as a result of the pain from your injury and being unable to return to work.  This depression would likely be covered under workers’ compensation in Georgia.

But, let’s look at another example.  Suppose you are a convenience store clerk who is robbed at gunpoint but you are not physically injured.  If you develop depression, anxiety, or another mental health condition as a result of the robbery, Georgia’s workers’ compensation law would not cover those mental health conditions because you did not suffer a physical injury.

This rule does not make a lot of sense to me.  Depression, anxiety, PTSD, and other mental health conditions can be caused without physical injuries.  But, it is currently the law in Georgia until the legislature or the Georgia courts change that rule.

If my depression or anxiety is covered under workers’ compensation, what benefits do I receive?

If you have a physical injury and develop depression or another mental health condition that is covered by workers’ compensation, you can receive the same benefits that Georgia workers’ compensation typically provides.  Those benefits fall into three basic categories:

1. Medical benefits (payment for the medical treatment and testing you need with certain authorized doctors)
2. Wages loss benefits (a percentage of your lost wages)
3. Permanent partial disability benefits (if you have a permanent impairment as a result of the condition)

Medical benefits will cover the medical treatment you need to treat your mental health condition.  Hopefully, this treatment will help you get better.

Wage loss benefits can be paid if your mental health condition keeps you from returning to work or cause you to earn less.  This can be important because depression and other mental health conditions can sometimes make it even more difficult to return to work than a physical injury.

Permanent partial disability benefits compensate you if your condition causes a permanent impairment.  If that is the case, your doctor will give you a permanent partial disability rating using the 5th Edition of the American Medical Association’s Guides to the Evaluation of Permanent Impairment.

What if the workers’ compensation insurance company refuses to pay for my depression or anxiety?

Many times, insurance companies deny treatment for depression and anxiety.  If this happens, you may receive a form WC-3 notice to controvert informing you that they are not paying for this treatment.

Sometimes, the insurance company does not file this notice to controvert.  They may just notify you over the phone or with an email or letter that they are not going to pay for your treatment.  Also, they may not tell you they are denying the treatment at all but instead just refuse to authorize the treatment.

You can take steps to get this treatment approved if the workers’ compensation insurance company refuses to pay for the treatment you need.  This article I wrote discusses some of the different steps you can take when insurance companies delay or deny medical treatment.