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Digital EditionMental Health Workers’ Comp Claims Rise 47% Since 2015, WCRI Finds
Mental health conditions accounted for a small but growing share of workers’ compensation claims between 2015 and 2024, according to new research from the Workers Compensation Research Institute.
The WCRI’s analysis of multistate claims data found that mental health claims, defined as cases in which a condition such as post-traumatic stress disorder, an adjustment disorder, anxiety or depression was the primary occupational injury, represented approximately 0.3 claims per 100 paid workers’ compensation claims overall and 0.5 per 100 among claims with more than seven days of lost time.
From 2015 to 2024, the frequency of these claims rose 47% for all paid claims and 40% for claims with more than seven days of lost time, WCRI found. The institute noted that rates were relatively stable through much of the 2010s, declined somewhat around 2020-2021, and then increased in more recent years.
Wide Variation by State, Industry and Worker Group
California stood out sharply from other states, posting 1.11 mental health claims per 100 paid claims, substantially above the rates observed in other study states, WCRI found. The institute cautioned that state-level variation in claim frequency may reflect not only differences in workplace risk exposures but also state approaches to reporting, compensability and adjudication of these conditions.
Frequency also varied by worker characteristics. Women accounted for 59% of paid mental health claims and had a rate of 0.38 per 100 paid claims, compared with 0.19 among men, according to the report. Claim frequency generally rose with wages, from about 0.13 per 100 paid claims among the lowest 10% of earners to 0.59 among the top quartile, and was generally higher among workers with longer job tenure.
By industry, clerical and professional workers had the highest overall rate, at approximately 0.65 mental health claims per 100 paid claims, though WCRI noted this does not necessarily indicate these workers experience the highest incidence of work-related mental health conditions, since industries with fewer physical workplace injuries may see mental health claims make up a larger share of their total claims. Public safety posted a rate of 0.47 per 100 paid claims.
Trends diverged from frequency levels: the clerical and professional rate showed little overall change, at 0.62 per 100 claims in 2015 and 0.68 in 2024, while the rate in health care increased from 0.19 to 0.42, in public safety from 0.40 to 0.66, and in transportation and utilities from 0.23 to 0.39 over the same period, the report found.
Diagnoses, Treatment and Costs
Among paid mental health claims with medical transaction data, 38% had a diagnosis code for an anxiety disorder, 22% had other stress reactions, 19% had PTSD, 19% had an adjustment disorder and 12% had a depressive disorder at 12 months of claim maturity, according to WCRI. These diagnosis categories are not mutually exclusive.
PTSD was more commonly observed among claims with more than seven days of lost time, appearing in 37% of those claims. Workplace violence was an important identifiable cause of these claims: robbery or criminal assault accounted for 11% of all paid mental health claims and 18% of those involving more than seven days of lost time.
Treatment commonly included psychological diagnostic evaluations, received by 37% of claims with medical transactions, and psychotherapy or other psychological treatment services, received by 26%, with both services considerably more common among claims involving more than seven days of lost time, at 59% and 52%, respectively, WCRI found.
General medical office visits appeared on 77% of claims. Among claims with at least one identified mental health medication, sertraline and trazodone were the most commonly observed, each appearing in 23% of such claims.
Mental health claims carried substantial indemnity costs relative to workers’ compensation claims overall, according to the report. Among claims with more than seven days of lost time, average indemnity payments were $14,250 at 12 months and $21,206 at 24 months for mental health claims, compared with $9,822 and $16,013, respectively, for all workers’ compensation claims.
Medical payments ran lower for mental health claims than for claims overall: $8,923 versus $13,125 at 12 months and $13,316 versus $16,814 at 24 months. Temporary disability duration for mental health claims with more than seven days of lost time averaged 19 weeks at 12 months and 26 weeks at 24 months, the institute reported.
Obtain the full report here. &
