Stress Claims in California Workers’ Comp

When does “You can take this job and shove it!” rise to a successful Workers’ Comp stress claim?

Since the California Workers’ Comp Reform in 2004, some sanity has been restored to a claims process that had gotten off the rails.  Pre-reform, stress  claims were treated just like any physical injury.  All it took was 1% to come from work and the psyche claim was compensable.   With the reform came new rules for psyche claims.

As a result of  reform, the following  are  requirements to support a successful psyche claim:

  1. One must have worked for his employer for at least six months.
  2. The working environment must be the predominant cause of the stress, legally at least 51%.
  3. The stress can’t arise from a “good faith personnel action,” for example being passed over for a promotion, or as a result of a bad performance review.
  4. After one has  already left the job, it’s even harder to press a successful claim.  One must prove a higher percentage of the  stress problem is related to the former job, and must have doctor’s reports showing treatment  for the condition prior to leaving the job.

One should expect a perfunctory denial of a stress  claim when filed.  Courts have been confirming almost anything an employer does in the category of a “good faith personnel action.”  Employer conduct would have to be pretty outrageous and egregious in order to find in the favor of the applicant.  On the other hand, the employer’s best defense for these claims are well-documented actions and a good handbook.

One  exception might be for some sort of traumatic event, like a robbery or a physical assault in the workplace.

Another valid exception might be a psyche claim that accompanies a serious physical injury.  For example, depression as a result of a physical injury that renders the employee incapable of continuing in his former work duties, or a slow painful recovery process.

Finally, the process of pursuing a claim will open one’s  life to intense scrutiny, as an insurance company is entitled to look into all  aspects of one’s  life that could be contributing to the  stress, from kids and divorce to sexual dysfunction.  Interestingly, the background check these days begins with a review of one’s Facebook page!

In most cases, one might be well-advised to move forward in their life without the drag of an open claim attached to an unhappy past.

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