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What You Need To Know About Workers’ With Pre-existing Mental Health Issues And Workers’ Compensation

Posted on February 26, 2021 by Edward Singer

Many Workers, prior to starting employment, have diagnosed medical illnesses. There are a variety of forms of mental illness.

A study looked into mentally ill individuals in the workplace. This study discusses how work impacts the mentally ill. This information is important with respect to workers’ compensation stress claims.

This article will discuss mental illness, forms of mental illness, work’s impact on mentally ill individuals, and what it means in the context of workers’ compensation stress claims.

What Is Mental Illness?

Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities. Psychiatry.org. “ Mental illness is common. In a given year: nearly one in five (19 percent) U.S. adults experience some form of mental illness one in 24 (4.1 percent) has a serious mental illness, one in 12 (8.5 percent) has a diagnosable substance use disorder.” Psychiatry.org

There is a variety of mental illnesses. These include anxiety disorder, Attention-deficit/hyperactivity disorder, autism, bipolar disorder, clinical depression, dementia, obsessive compulsive disorder, post-traumatic stress disorder, schizophrenia,

What Is California Psychiatry Injury Causation Standard?

Labor Code Section 3208.3 provides the causation standard. The causation burden per (b)(1) is that “In order to establish that a psychiatric injury is compensable, an employee shall demonstrate by a preponderance of the evidence that actual events of employment were predominant as to all causes combined of the psychiatric injury” This means greater than 50 percent.

There is a lower standard in certain circumstances. Per (b)(2), “… in the case of employees whose injuries resulted from being a victim of a violent act or from direct exposure to a significant violent act, the employee shall be required to demonstrate by a preponderance of the evidence that actual events of employment were a substantial cause of the injury.” Substantial cause is at least 35 to 40 percent.

Does Working Impact Mental Illness?

The study found that “Individuals with mental illness who are employed, compared to those who are unemployed, reported slightly higher levels of overall life satisfaction and psychophysiological health”. Granjard A, Mihailovic M, Amato C, et al. Occupation and life satisfaction among individuals with mental illness: the mediation role of self-reported psychophysiological health. PeerJ. 2021;9:e10829. Published 2021 Jan 29. doi:10.7717/peerj.10829.

How Does The Study Relate to Work Injuries?

Mentally ill individuals may have improved health and satisfaction when they are working. Therefore, this improvement in their mental state should be factored into work injury causation analysis. Also, it may have value with respect to permanent disability apportionment.

What Was in the Study’s Reporting?

The study reported that “, the mechanism underlying the relationship between having an occupation and life satisfaction implies that having an occupation enhances individuals’ perception of their own physical and psychological health, which in turn might increase their satisfaction with life” Granjard A, Mihailovic M, Amato C, et al. Occupation and life satisfaction among individuals with mental illness: the mediation role of self-reported psychophysiological health. PeerJ. 2021;9:e10829. Published 2021 Jan 29. doi:10.7717/peerj.10829.

What Is the Impact of Unemployment on Mental Illness?

The study noted that “[u]nemployment can lead to, among other things, diminished social status, financial debt, reduced self-esteem, and feelings of guilt. Most importantly, unemployment is significantly associated with psychiatric problems and approximately 37% higher risk of suicide (Milner, Page & Lamontagne, 2014).” Granjard A, Mihailovic M, Amato C, et al. Occupation and life satisfaction among individuals with mental illness: the mediation role of self-reported psychophysiological health. PeerJ. 2021;9:e10829. Published 2021 Jan 29. doi:10.7717/peerj.10829.

Note: This finding is important. Mental health treatment and assessment of impairment during a pre-employment period is exacerbated by unemployment. Thus, with no unemployment In combination with work, a Mentally Ill individual’s mental state may be significantly elevated prior to confronting work stress.

What If I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for over 28 years. Contact us today for more information.

MEN, DEPRESSION, SUICIDE, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on February 4, 2021 by Edward Singer

Stress impacts Men and Women differently. Studies show there are differences in the workplace. The findings are both significant and complicated.

This article will discuss depression, suicide, the differences between men and women, and the implications with respect to workers’ compensation cases.

What Is the Psychological Diagnosis of Depression?

Per the American Psychiatric Association, Depression (major depressive disorder) is an illness that negatively affects how you feel, the way you think and how you act.

”Depression symptoms can include: Feeling sad or having a depressed mood, Loss of interest or pleasure in activities once enjoyed, Changes in appetite — weight loss or gain unrelated to dieting, Trouble sleeping or sleeping too much, Loss of energy or increased fatigue, Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech (these actions must be severe enough to be observable by others), Feeling worthless or guilty, Difficulty thinking, concentrating or making decisions, Thoughts of death or suicide.” APA

A depression diagnosis requires these symptoms last for an extended period of time. “Symptoms must last at least two weeks and must represent a change in your previous level of functioning for a diagnosis of depression.” APA

Which Sex Is Diagnosed Most with Depression?

Studies show that women are diagnosed at twice the rate as men. “[c]omparatively, in Western countries, men are formally diagnosed with depression at approximately half the rate of women” (Kessler et al., 2005; Wilhelm, Parker, Geerligs, & Wedgwood, 2008).” 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/1557988313490786

Note: These findings raise questions. There is the issue of “men’s reluctance to express concerns about their mental health and reticence to seek professional health care (Emslie, Ridge, Ziebland, & Hunt, 2006; Sharpe & Heppner, 1991; Winkler et al., 2006).” 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/1557988313490786

In other words, men may not seek mental health treatment. Thus, there would be fewer depression diagnosis for men.

Is There a Connection Between Depression and Suicide?

Severe depression can … significantly increase the risk for suicide. (Emslie et al., 2006; Kessler et al., 2005; Wilhelm et al., 2008; World Health Organization, n.d.), 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/1557988313490786

Which Sex is at Most Risk of Suicide?

Men have been found to have higher rates of suicide. “[S]uicide rates are approximately four times higher in Western men than in women (Centers for Disease Control and Prevention, 2012; Hawton & van Heeringen, 2009; Levi et al., 2003; Moller-Leimkuhler, 2003; Rihmer, Belso, & Kiss, 2002; Statistics Canada, 2012a, 2012b; Wasserman, 2000; Wolfgang & Zoltan, 2007).” 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/1557988313490786

Thus, there is the question as to why men’s suicide rates are higher when their depression rates are lower.

Are There Suicidal Issues Related to Occupation?

The issue of suicide has multiple issues. There is suicidal thought or ideation. There is the act of suicide.

Studies have found high suicide rates in male-dominated workgroups. This included manual workers, farming, military and nursing.” 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/1557988313490786

Suicidal ideation is also an issue for men. Being a failed breadwinner can have an impact on suicidal thoughts. “Linkages between men’s work, depression, and suicide have also been described. Self-perceptions of being a “failed breadwinner” led older men with a history of depression to think about suicide (Oliffe, Han, Ogrodniczuk, Phillips, & Roy, 2011), whereas some middle-aged men countered suicidal ideations by focusing on work as a means of providing for their family (Oliffe, Ogrodniczuk, Bottorff, Johnson, & Hoyak, 2012. 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/1557988313490786

Is There a Connection Between Depression and Retirement?

Depressed workers are more likely to retire than nondepressed workers (Doshi, Cen, & Polsky, 2008) 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/155798831349078

What Does This Information Mean with Respect to Workers’ Compensation Claims?

These studies impact workers’ compensation cases in that they provide insight into the injured worker.

There studies show that there is some uniqueness for a man to file a claim for depression. These studies provide “red flags” as to certain occupations that men perform and their risk for suicide. These studies may give some insight to employers as to whether depressed male injured workers are going retire or return to work. These studies show that working may assist a man’s mental state.

What If I Need Advice?

STRESS AND INJURED WORKERS: INJURED WORKERS WITH DIFFICULTIES POST WORK-INJURY AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on October 19, 2020 by Edward Singer

This article is to discuss injured Workers’ stressors and a recent study on the matter. Prior to reviewing the study, I took it upon myself to list the stressors based upon my 28 years of representing Injured workers. The following is my assessment of stressors for Injured Workers while they are pursuing their claims are as follows:

Dealing with medical facilities and doctors
Being out of work
Dealing with your employer
Dealing with insurance
Dealing with attorneys
Dealing with litigation
Dealing with the Workers’ Compensation Appeals Board

Wow! Injured Workers have a lot of stressors!

As I indicated, a study was recently done which sheds some additional light on the stressors of injured workers. Is my assessments correct? Are there other items of concern?

Are Injured Workers Stressed Out?

Yes. The study found that the “[t]he prevalence of psychological distress among workers’ compensation claimants is high.” Collie, A., Sheehan, L., Lane, T.J. et al. Psychological Distress in Workers’ Compensation Claimants: Prevalence, Predictors and Mental Health Service Use. J Occup Rehabil 30, 194–202 (2020). https://doi.org/10.1007/s10926-019-09862-1

What Did the Study Find as Being Stressors?

Severe psychological distress, being off work, worse general health and requiring support during claim were most strongly associated with greater odds of service use. Collie, A., Sheehan, L., Lane, T.J. et al. Psychological Distress in Workers’ Compensation Claimants: Prevalence, Predictors and Mental Health Service Use. J Occup Rehabil 30, 194–202 (2020). https://doi.org/10.1007/s10926-019-09862-1

Are Injured Workers more stressed out than other People?

Yes. According to the Study, it was found. Collie, A., Sheehan, L., Lane, T.J. et al. Psychological Distress in Workers’ Compensation Claimants: Prevalence, Predictors and Mental Health Service Use. J Occup Rehabil 30, 194–202 (2020). https://doi.org/10.1007/s10926-019-09862-1

What Were the Factors that the Study Found as Stressful?

The study found “being off work, poor general health, low work ability, financial stress, stressful interactions with healthcare providers and having diagnosed mental health conditions had the strongest associations with presence of psychological distress Collie, A., Sheehan, L., Lane, T.J. et al. Psychological Distress in Workers’ Compensation Claimants: Prevalence, Predictors and Mental Health Service Use. J Occup Rehabil 30, 194–202 (2020). https://doi.org/10.1007/s10926-019-09862-1

One additional item that came out of the study that caught me by surprise that Injured Workers with prior psychological issues are susceptible to increased stress.

Can an Injured Worker Claim This Stress as Part of Their Claim?

With changes in the law, psychiatric injury claims are limited. Further, stress resulting from litigation is mostly considered as non-industrial. In certain limited facts, stress may be claimed. It is a factual inquiry.

Is There Case Law Re: Stress from Litigation?

Yes. The Courts have found that a psychiatry injury caused as a result of the litigation process is not work-related. Rodriguez v. Workers’ Comp. Appeals Bd. (1994) 21 Cal.App.4th 1747 [27 Cal.Rptr.2d 93]. There are some limited exceptions. See Patrick v. Marina City Club, 2010 Cal. Wrk. Comp. P.D. LEXIS 19 (carrier misconduct as the basis for stress)

What Should An Injured Worker Do?

Injured Workers should approach matter on multiple levels. One level is to seek medical attention and/or counseling for one’s stress. Another level is to address the situations that are causing the stress. This can include changing doctors, getting an attorney, addressing the employment situation is a substantial way and perhaps opening up to a friend or family member to get this stress off their chest. Also, if you are unrepresented, contacting the Information and Assistance Officer at the local WCAB may be helpful. Also, your company may may have an Employee Assistance Program which can help as well.

In sum, if an Injured Worker is having stress, there is help and solutions out there. Don’t try to go it alone.

What if I Need Advice?

THE SERIOUS CONSEQUENCE OF WORK INJURIES: INJURED WORKERS, SUICIDE AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on September 6, 2020 by Edward Singer

After an industrial injury, Injured Workers are faced with a number of life obstacles. They have their body which has broken down in some shape or form and is in need of repair and healing. A claims process has arisen in which the Injured Worker’s Employee/Employer relationship has changed. They have taken on a new relationship with a workers’ compensation insurances company which is both trying to assist with the process and trying to manage the risk by taking steps to minimize the claim. They have a new relationship with doctors who, while they have a relationship with them, they are also beholden to the employer and insurance company. Finally, their family relationship may have changed. They may no longer be providing the economic contribution to the family. They may no longer be able to help perform chores in the house. They may need to be dependent upon others in the house for assistance. They may be spending more time in the house with other family members leading to more conflict.

These stressors can lead to serious consequences. This article will discuss a recent study from South Korea of import, which discusses the risk of suicide in individuals who have suffered occupational injuries.

What Factors Did the Study Look at?

The study looked at a variety of factors: loss of income, return to work, the nature and extent of the disability, pensions, and family disruption. Lee H, Kim I, Kim M, et al

Increased risk of suicide after occupational injury in Korea Occupational and Environmental Medicine Published Online First: 13 August 2020. doi: 10.1136/oemed-2020-106687

What Was Were the Conclusions?

Industrially Injured Workers are statistically at a higher risk of injury when compared to others that are economically active.

The study found that “Injured workers showed higher mortality from suicide for both men (SMR=2.22, 95% CI 2.14 to 2.31) and women (SMR=2.11, 95% CI 1.81 to 2.45) compared with the economically active population in Korea.” Lee H, Kim I, Kim M, et al Increased risk of suicide after occupational injury in Korea Occupational and Environmental Medicine Published Online First: 13 August 2020. doi: 10.1136/oemed-2020-106687

One interesting note, which is of import, was the more severely disabled workers had a lower suicide risk. Supra. One reason hypothesized as the fact that they have received a disability pension. This notion of disability pension, when translated into a United States analysis and within the State of California could imply a Social Security Disability Award, a Government Employee Disability Pension, such as CALPERS, LACERA, KCERA, CALSTRS or LACERS, or a Disability Pension from a Private Disability Plan. Further, on Workers’ Compensation Case of a high percentage, such as 100 percent, the disability payments are substantial.

What Do We Need to Learn from the Study?

Most importantly, it is those who have injuries that cause the loss of employment, but which do not cause permanent disability, that we should be concerned with. In essence, individuals who lose their job and does not get substantial financial assistance are at a greater risk for suicide. Increased risk of suicide after occupational injury in Korea Occupational and Environmental Medicine Published Online First: 13 August 2020. doi: 10.1136/oemed-2020-106687

What Should We Do?

For those Injured Workers it is important that efforts be made to get them treated promptly and get them returned to the workforce. Both expediting treatment and the prompt provision of the Job Voucher would certainly assist in these cases. Further, there should be awareness to identify these individuals and get them psychological counseling through the workers’ compensation system or through an Employee Assistance Program. Also, those Injured Workers may benefit from retaining Legal Counsel to assist them. They may need assistance in the handling of their workers’ compensation claim as well as potential claims related to disability discrimination.

What If I Need Legal Advice?

If you would like a free consultation concerning any workers’ compensation case, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. They have been helping people in Central and Southern California deal with their worker’s compensation cases for 28 years. Contact us today for more information.