Over the past few years, more and more Americans have been diagnosed with a mental health condition. According to Mental Health America, nearly 1 in every 5 adults will have a diagnosable mental health condition in any given year, and almost half of all American adults will meet the criteria for a diagnosable mental health condition sometime in their life. A recent study of Ohioans indicated that over 2 million residents had a mental illness in 2023, and this number is expected to continue to rise.
This begs the question: as an Ohio employer, when is a mental health condition a compensable workers’ compensation claim?
The definition of “injury” in Ohio law does not include “psychiatric conditions,” except when that psychiatric condition arose from an injury and/or occupational disease. (There are also carve-outs for psychiatric claims arising from sexual assault, as well as separate rules for first responders. We will avoid diving into these exceptions for the purpose of this article).
The key takeaway from this statute is that for a psychiatric condition, such as major depressive disorder or generalized anxiety disorder, to be compensable, it must arise from a physical injury or occupational disease.
One important case identifying when a psychological condition is compensable and when it is not is Armstrong v. John R. Jurgensen Co. The facts that gave way to the decision were as follows: Shaun Armstrong, while in the course of his employment, was involved in a motor vehicle collision that resulted in the death of another driver, which Armstrong witnessed. Soon after the accident, Armstrong developed PTSD. His workers’ compensation claim was allowed for physical conditions of cervical, thoracic, and lumbar strains, but the Ohio Supreme Court ruled that Armstrong’s PTSD was not compensable, as it was not caused by his injuries but rather by witnessing the accident and the death of the other driver. The Ohio Supreme Court held that there is a required nexus between the physical injury and corresponding mental condition. The important takeaway for employers is that in order for a psychological condition to be compensable, it must arise from the injured workers’ actual injury and/or occupational disease, not just arise contemporaneously with the injury.
For Ohio employers, it is important to review the allowed/alleged physical conditions before certifying a workers’ compensation claim for a psychological condition to make sure there is the required nexus. Having the injured worker examined by a BWC-certified mental health provider and obtaining past treatment records, including mental health records, are advisable in order to contest a psychological allowance claim.
