Mental health workers compensation: Are mental health issues covered under workers’ compensation?

Mental health and workers compensation

The workplace is evolving, and with it, employers’ understanding and awareness of mental health injuries. To keep up, the Victorian Government has introduced new compensation entitlement restrictions for mental injuries that may affect you.

This article can be your initial guide to navigating the sometimes-confusing WorkCover scheme and common law claim processes.

If you have already received approval for your WorkCover claim and you believe that you should be entitled to further compensation from your employer, please do not hesitate to contact to one of our expert workers compensation lawyers today.

Contact Gordon Legal via our online contact page, or call 03 9603 3000.

 Are mental health issues covered under workers’ compensation?

Yes, in Victoria mental injuries are covered by WorkCover in certain circumstances.

If you have suffered a mental injury at work, you may be eligible for compensation, regardless of whether you believe your employer caused or significantly contributed to causing your injury.

Definition of ‘mental injury’

The Workplace Injury Rehabilitation and Compensation Act 2013 (WIRC Act) defines a ‘mental injury’ as a condition that “causes significant behavioural, cognitive or psychological dysfunction” and has been diagnosed by a medical practitioner, such as a general practitioner or a psychiatrist but not a psychologist.

Aside from the necessity of receiving a diagnosis of a medical practitioner for any mental injury WorkCover claim, seeking medical and/or psychological help is important to ensure you protect yourself from suffering any further mental health damage.

Claims should be made quickly, as workers only have a limited amount of time to make a WorkCover claim after they have suffered an injury.

What types of mental health conditions are typically covered by workers’ comp?

Workers are eligible for compensation for an extensive range of diagnosable medical conditions.

Over the last couple of years, there has been a rapid growth in mental injury claims relating to Post Traumatic Stress Disorder (PTSD), anxiety, and depression, all of which can be triggered or exacerbated by work-related stress or traumatic events. Moreover, historically, WorkCover recognised mental injuries arising from work-related stress and burnout as potential grounds for compensation.

However, legislative changes in March 2024 made it more difficult for employees to claim for injuries relating to high stress working environments. There now exists some important exclusions that may affect you. For example, as of March 2023:

1. A mental health injury must be caused predominantly by work-related duties, as opposed to causes from outside of the workplace (such as at home). This means that the greatest cause or exacerbation of the mental injury must be work-related for it to be covered by WorkCover.
2. No worker is entitled to compensation for a psychological injury if it was caused by work-related stress or burnout that occurred from work duties that are considered usual or typical to the worker’s role. This means that any stress or burnout which occurs because of work-related tasks that are ‘reasonably expected’ under that role are excluded, unless the stress or burnout was caused by a ‘traumatic event’.

What evidence do I need to provide for a mental health workers’ comp claim?

Workers’ compensation claims are decided by WorkCover decision-makers who often have high evidentiary standards. The decision-makers are insurance companies.

To give yourself the best possible chance of success, here are a few tips to build a strong claim:

• Medical evidence: discuss your injury with a general practitioner or psychiatrist who can diagnose your condition. Psychologists should also be consulted if you feel this would be helpful, however, their diagnosis is not considered by WorkCover.
• Treatment records: If you’ve been receiving treatment from a medical practitioner), these records can help evidence your psychological injury as part of your compensation claim.
• Workplace environment: Document any practices or events that occur at your workplace that have contributed to stress, burnout, or trauma. This includes instances of bullying, harassment, unreasonable managerial directions, unsafe working practices and so on.
• Employer Records: Take note of any relevant records from your employer, such as incident reports, performance reviews, or company policy statements relating to harassment bullying or workplace mental health safety.
• Personal Statements: Personal statements from yourself and other employees detailing your working environment or the impact of the mental health condition on your daily life can also be beneficial.

Following these steps may seem like a daunting task. At Gordon Legal we understand that every case is personal. Our WorkCover lawyers are experts in the field and can help you get the best result possible. Contact us today on 03 9603 3000.

How long can I receive workers’ comp for mental health issues?

There are three phases of compensation payments a worker may be eligible for, assuming that the injuries render you incapable of working:

• Provisional Phase: according WorkCover rules relating to mental injury compensation, WorkSafe can cover the reasonable cost of treatment for 13 weeks prior to your claim being approved or declined.
• Entitlement Period: If your claim is approved, WorkCover will pay the equivalent your Pre-Injury Average Weekly Earnings (PIAWE) up to a maximum payment of $2,380 per week, for up to 130 weeks.
• Long-Term Weekly Payments: After 130 weeks, weekly payments will only continue if you are considered to be unfit to perform any suitable work indefinitely. You may also be entitled to ‘top-up’ payments if your injury prevents you from working to your full capacity over the long-term.

Will my workers’ comp claim affect my employment status?

Your employer is obligated to keep injured employees on the books for at least 52 weeks  of incapacity

If you have sustained a workplace injury and have been dismissed within 52 weeks, you should seek tailored legal advice to understand your options.

At Gordon Legal, we understand that every case is personal. Contact our experienced Workers Compensation team today on 03 9603 3000.

Other avenues of compensation

Victorian workplaces are required by law to vigilantly protect workers against reasonably foreseeable damage to their health, including their mental health. If this duty is breached, and you have sustained a serious injury you could be entitled to seek compensation for your pain and suffering and loss of income directly from your employer.

If you have been approved for your WorkCover claim and wish to discuss the possibility of other avenues of compensation, please do not hesitate to contact us by visiting our website or calling  03 9603 3000.