Claiming for a mental health injury

Claiming for a mental health injury

In the workplace, mental health can be adversely affected by exposure to a range of hazards or factors which, when exposed to for a high or prolonged period, can lead to long-term psychological injuries such as depression and anxiety.

Some of these work-related factors/hazards/contributors include:

  • levels of job demand
  • lack of support
  • poor workplace relationships
  • uncertainty on role requirements
  • substandard environmental conditions
  • insufficient organisational change management
  • remote or isolated work
  • violent or traumatic events.

Lodging a claim for a psychological injury

It is important to notify your employer if you developed a psychological injury at work and seek medical attention as needed. In some cases, you may also lodge a claim for workers’ compensation following the three steps below:

1. Fill out an injury claim form

Fill out a Workers’ Injury Claim Form and make note of how your injury is work-related. If your condition came on over time, write this on the claim form instead of a specific date.

If you wish to seek weekly payments for time off work, you must also obtain a certificate of capacity from your GP. The first certificate can only cover a period of 14 days, and each certificate thereafter is valid for 28 days. Certificates can be backdated up to 90 days, beneficial for injuries that are sustained ‘over the course of employment’.

2. Lodge the claim with your employer

Once your claim is lodged with your employer, the WorkCover Insurer has 28 days from the date they receive your claim to decide whether to accept it or not.

3. Attend an independent examination

During the 28 day period, the Insurer will arrange for you to be examined by an independent psychiatrist to verify the injury and whether it is work-related. They will also appoint an independent investigator to speak to you, your employer and any witnesses.

You are not obligated to provide a statement, and it is recommended you obtain legal advice prior to doing so.

If your claim is accepted, you may be able to claim for medical and like expenses, weekly payments for time off work, permanent impairment, pain and suffering and/or loss of wages.

If your claim is rejected, we recommend you seek legal advice about disputing the decision via conciliation.

Why was my claim rejected?

Psychological injury claims are often rejected, and it could be because you do not meet the eligibility requirements under the legislation. Some of these requirements include:

Satisfying the definition of a “worker”

You must be a worker to claim compensation. Sub-contractors, or those cannot clearly identify whether they are an employee may wish to seek legal advice to determine whether they satisfy any of the tests.

The injury was not a recognisable psychological ‘injury’

A workers’ compensation claim can only be made for recognisable psychological injuries such as anxiety, depression, post-traumatic stress disorder and/or adjustment disorder.

Unfortunately, for the purposes of lodging a claim, it is not enough to be feeling stressed, overworked or excluded. You must demonstrate that you have suffered an injury caused by these pressures.

Employment was not proven to be a “significant contributing factor”

In cases where you have a pre-existing psychological or physical condition, for your claim to be accepted you must prove that your work was a significant contributing factor to the recurrence, aggravation, acceleration, exacerbation or deterioration of the pre-existing injury. This means showing that your employment contributed to the occurrence of the injury in a way that is not insignificant, trivial or minimal.

To satisfy the significant contributing factor test, there are several factors that are considered including:

  • length of employment
  • nature of work performed
  • employment responsibilities
  • possibility of the injury occurring outside of employment
  • hereditary risks
  • lifestyle and activities outside of work.

Reasonable management action

There is no entitlement to compensation for a psychological injury that is caused wholly or predominately by management action found to have been taken on reasonable grounds and conducted in a reasonable manner. This can include things such as:

  • performance reviews
  • counselling
  • transfers
  • disciplinary meetings
  • investigation into alleged misconduct
  • suspensions
  • reclassifications
  • dismissal
  • redeployment.

If you believe you are suffering from a psychological injury due to your employment, it is important to seek legal advice to understand your rights and entitlements. Call our lawyers directly on (03) 9321 9988 to arrange a free initial consultation to discuss your claim.

What do I have to do to lodge a claim for a psychological injury at work?

Fill out a Workers’ Injury Claim Form and make note of how your injury is work-related. Lodge the claim with your employer. Then attend an independent examination. 

What if your claim is rejected?

Psychological injury claims are often rejected, and it could be because you do not meet the eligibility requirements under the legislation.

What if I still believe I am eligible for compensation for a psychological injury?

It's recommended you speak to a specialist in Worker's compensation claims.

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