Just because your boss makes unreasonable demands, your deadlines are crashing down on you and your cubicle-mate is driving you crazy with her incessant talking doesn’t mean you can opt out of work and expect to get paid. If, on the other hand, the extreme duress you’re under causes you to fall down the stairs running back from lunch or gives you a migraine that puts you in the hospital, the stress-related physical trauma may allow you to collect workers' compensation while you‘re out recovering.
Most injuries or illnesses created by your job are covered under the federally mandated workers’ compensation laws. Each state, however, creates its own version of the law, which basically requires employers to carry insurance to cover job-related injuries for their workers. How they carry that coverage varies widely from state to state. Some states make employers of any size buy workers' comp insurance, while others leave it up to employers to figure out a way to pay for work-related injuries. The kinds of claims covered by the insurance or the employer vary as well. In Montana, for example, stress-related claims are explicitly excluded from workers' comp coverage. You should check with your state Department of Labor before filing a claim for an injury or illness caused by stress.
Another factor the courts and insurance companies consider in workers' compensation claim cases is whether your illness or injury is a result of coercion from the company or created by some kind of self-imposed pressure. If you’re a nervous Nellie, for example, cowering anytime your boss approaches, and develop a migraine as a result of all that fear, you probably won’t make it past the first round of hearing interviews. If, on the other hand, it’s determined that you were targeted by your boss and played no role in your duress, then you might have a case.
Once you file a claim for an illness or injury based on undue stress, expect to get your life put under a microscope. Claims traditionally are denied if you have a history of alcohol or drug abuse or if you have other personal problems at home. If you’re going through a divorce or you recently lost a child, the insurance company may deny your claim because of the home-based stress caused by those problems. Even if you called the employee assistance program or are under the care of a mental health provider, your claim may come under investigation.
Burden of Proof
The burden of proof in workers' compensation claims usually is on the employer. The system basically is no-fault and unless your boss can prove that you willfully and blatantly caused your own illness, you’ll be covered by the insurance. Most workers' compensation claims are paid without incident, but tend to get really blurry when mental health is involved. When claims are disputed in court, judges tend to side more with the employees, even if part of the reason you filed the claim is a result of personal problems. As long as you can demonstrate how the work environment created the storm that lead to your illness or injury, you stand a good chance of getting a payoff. Some states, like California, include specific scenarios in their laws, allowing for claims when you experience violence from a coworker, for example.
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