The classic examples of work-related injuries include falls from heights, vehicle accidents, mechanical malfunctions, and other sudden accidents. Not all workers’ compensation claims arise from such easily identifiable events, though. If you are suffering from a repetitive stress injury, an occupational disease, or a psychological condition, you may face a more complicated path to benefits.
For any type of injury or illness, a worker will need to prove that it arose from their employment. This can be challenging if the condition arose in a setting outside their normal workplace or if it is difficult to pinpoint when the condition arose. Some conditions have multiple causes or triggering events, not all of which may relate to the employee’s work. Read more here about the work-related requirement.
Repetitive Stress Injuries
If your job involves performing the same type of motion repeatedly, you may develop a repetitive stress injury. People often underestimate how devastating and life-changing these conditions can be. They can arise in many types of industries and are usually covered by workers’ compensation. In some states, however, an injured worker may need to meet a higher standard in proving that their disability is work-related, or only certain types of repetitive stress injuries may be covered. Read more here about repetitive stress injuries.
You can get workers’ compensation benefits for an illness that resulted from your job, such as mesothelioma or asbestosis. Benefits may be easy to obtain if a certain type of exposure is clearly linked to the type of condition that the worker has developed, and they would not have been exposed in any other environment. More challenging cases involve conditions that do not have a specific chemical trigger and can arise in a variety of settings, such as high blood pressure or heart disease. While some states exclude these conditions from coverage automatically, others allow a worker to get benefits for them if they can show that the disease resulted at least in part from workplace conditions. This usually requires compiling thorough medical documentation.
Special rules may apply to people who work in an inherently dangerous occupation, such as police officers and first responders. These employees may be able to take advantage of a presumption that their condition is work-related.
Some states draw a line between physical stress and psychological stress in determining eligibility for benefits. Conditions resulting from physical stress are generally covered, but conditions resulting from psychological stress may not be. However, our society’s increasingly sophisticated understanding of stress-related illnesses has led to expanded coverage for these conditions in some states. You may need to put more effort into documenting your case to get these types of benefits. In some states, such as California, benefits are available only if workplace conditions were the most significant factor in developing the condition. Read more here about whether you may be eligible for benefits based on PTSD or another psychological condition caused by stress.
If a psychological condition is a consequence of a physical injury on the job, a worker probably can get benefits for treating it, just as they would for the physical consequences of the injury.
Many workers worry that they will not be covered if their job aggravates a pre-existing condition that arose outside the workplace. You probably cannot get benefits to cover all of your costs, as you could if the original injury happened on the job, but you should be able to get benefits that are proportionate to the extent of the aggravation. As with the other conditions discussed here, you may want to retain an attorney to help you build this type of claim.
If a worker dies from a job-related accident or illness, dependents in their household should be able to receive death benefits. Most often, eligible recipients will be a spouse and minor children. Read more here about death benefits in the workers’ compensation system.