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Suffering from anxiety or depression following your work injury?

Most serious physical work injuries cause depression and anxiety. This article will hopefully provide you with an understanding of how our WorkCover system compensation deals with depression and anxiety and how it might affect your WorkCover claim.

Most physical work injuries cause pain, some a hell of a lot of pain. Pain often makes most people depressed, especially long-term (chronic) pain. Pain also causes sleep deprivation. A lack of sleep can also cause depression. Inaddition, most people find a purpose and often pride in the work they do. After an injury, especially a serious injury, injured workers lose their job and careers. This also causes depression. A serious injury also always interferes with your ability to do household chores, to participate in your sport(s) and hobbies. This too causes depression, and for many a serious injury also causes anxiety. Loss of control, including loss of financial control and independency, are main causes of anxiety.

How to get WorkCover to pay for treatment of depression and/or anxiety?

If your more serious work injury caused your depression and/or anxiety, you really need to talk to your treating GP about it.  S/he may prescribe some medication and/or refer you to a clinical psychologist, a psychiatrist or a counslor.

The WorkCover insurer will have to pay for the treatment of your depression/anxity if it is proven to be caused by your work injury.  It’s therfore important that you see your GP and obtain a referral for treatment. Without a referral, for example, to a clinical psychologist, the insurance Agent will most likely refuse to pay for your mental health treatment.

What to do is your depression affects your ability to return to work?

Depression and/or anxiety may well affect your ability to return to work. Just the fact that many people find it very hard to even get out of bed if they suffer from major depression can be a major issue in a return to work. In addition, depression and/or anxiety is likely to affect your concentration, stamina, and make you irritable to the point where working in a stressful environment is just impossible.

If you suffer from depression and/or anxiety because of your work injury, your employer may well have to accommodate you at work, taking into account your mental health limitations. Some injured workers become so depressed, they actually require time off work.

How does depression affect your WorkCover case?

If your depression/anxiety is severe enough to cause you symptoms and limitations, this will be classified as a “secondary psychological injury“. Unfortunately, when you go for your permanent impairment assessment (once all your injuries have stabilised), any secondary psychological injury will not count towards your whole person impairment (WPI). In other words, secondary psychological injuries do not rate, and you will not be compensated for them. Even if they are very serious. So apart from obtaining paid medical treatment from your workcover insurer for your depression/anxiety (e.g. medication, counseling possibly weekly payment if you cannot work), you won’t receive any compensation in the form of a lumpsum (in Victoria).

primary and secondary psychological injuries victoria

Example

In my personal injury case in Victoria, I was assessed with 22% secondary psychological injury. My phsyical injury rated 26% WPI. However – and we will address this below – I also suffered from a primary psychological injury, namely severe PTSD from my work accident (I was violently assaulted at work) at 23%. In total my injuries rated 43% WPI, this was a combination of my physical injuries and primary psychological injury, calculated with a complex formula.

permanent impairment assessment

So, even though my secondary psychological injuries were quite severe (anxiety, depression) and I am considered more than a “lunatic” (total of 45% psych injury) under the Victorian workers compensation legislation (one needs 30% primary psychological injury for it to be considered serious and modestly compensable), I only received compensation for the primary psych injury (23%).

However, the ‘good’ news was that, because of my primary psychological injury, I qualified for a “serious injury” under the Victorian workcover legislation (one needs 30% WPI to obtain a serious injury certificate the quantitative way). All up I scored 43% WPI.

What about depression/anxiety that arises from something other than a physical injury?

Currently, the Victorian Workers Compensation law covers treatment for depression and other mental conditions when they arise as a dirct result of a physical injury. These are called secondary psychological conditions. As stated above, an injured worker will receive paid treatment from WorkCover for the treatment of secondary psychological injuries, caused by a physical injury.

However, the worker’s compensation law also covers primary psychological conditions. In fact, when you suffer from a proven primary psychological condition caused at work (during the course of your employment), then this condition will actually rate on the permanent impairment assessment. (Note that in Victoria one needs a minimum of 30% WPI for a primary psychological condition to be eligible for a lumpsum compensation – and, worsee, it is very hard to score high).

Primary psychological conditions

Many people develop psychological conditions when exposed to traumatic events at work. Most commonly they suffer from Post Traumatic Stress Disorder (PTSD), which can be very debilitating. Fortunately, the Victorian worker’s compensation law currently does cover depression, PTSD, or other mental conditions if those conditions are primary conditions as a result of work.  However, because one needs a minimum of 30% permanent impairment for a primary mental injury to be eligible for a lumpsum (and/or qualify for serious injury), many people who have a mental condition caused by their work do not receive any compensation (lumpsum, common law damages).

Impairment benefit for psychiatric injuries under workcover
It is important to know that there are two types of psychiatric injuries: primary and secondary.

In Victoria, the impairment threshold for a primary psychiatric injury is now a whopping 30%. A psychiatric impairment that arises “as a consequence of, or secondary to” a physical injury (i.e. injured back then developed a depression) is a secondary psychiatric injury/impairment and secondary injuries do NOT get compensated in a lump sum.

However, a primary psychiatric injury/impairment does count for the lump sum compensation. For the purpose of assessing impairment under the VIC workers compensation law, a number of criteria must be met: there has to be a diagnosable psychiatric injury (i.e. depression, post traumatic stress disorder); the disorder must lead to an impairment which continues to be present at the time of the assessment; and the assessing psychiatrist considers it a permanent disorder; there has to be a direct and clearly established link between the circumstances of injury and the psychiatric disorder; the psychiatric disorder cannot be explained as secondary or a consequence of physical injury.

Questions about mental condition and WorkCover

Again, the worker’s compensation legislation is a very complex law, and it is not uncommon for people who suffer from severe PTSD to have their claims rejected, or to not reach the “serious injury” threshold.

Take the following scenario: If your injury at work caused your depression, the workers’ compensation insurer should pay for your treatment.  The insurance company may refuse to do this voluntarily.  You may need to get an lawyer involved.

Even if the WorkCover insurer pays for the treatment of your depression, many people have questions about whether they are receiving all the benefits they should receive. We believe the best way to get answers to your questions is to talk to a good lawyer and to read as many related articles and legal cases as possible.

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