Mental Health and Workers’ Compensation in Pennsylvania

When most people think about workers’ compensation, they picture physical injuries like broken bones, back injuries, or repetitive strain disorders. But not all workplace injuries are visible. Mental health conditions, such as depression, anxiety, post-traumatic stress disorder (PTSD), or other psychological harm, can be just as devastating as physical trauma.

In Pennsylvania, the workers’ compensation system recognizes that mental health injuries are real injuries. However, these claims are often harder to prove, more complex legally, and more likely to be challenged by employers and insurers.

This guide will walk you through the types of mental health claims recognized in Pennsylvania, the challenges injured workers face, and how to protect your rights if your job has caused psychological harm.

Can You Get Workers’ Comp for Mental Health in Pennsylvania?

Yes, but the rules depend on the type of psychological injury and how it occurred. Pennsylvania workers’ compensation law divides these claims into three categories:

1. Physical/Mental Claims

A physical injury/stimulus at work leads to psychological conditions.

• Example: A construction worker suffers a back injury and develops depression due to chronic pain and inability to return to work.
• These claims are generally easier to prove than other psychological injury claims because the it is not necessary to prove that an abnormal working condition caused the mental health condition. Rather, the employee must prove only that a physical stimulus resulted in the mental disability.

2. Mental/Physical Claims

A psychological injury causes a physical condition.

• Example: Extreme workplace stress causes high blood pressure or a stress-induced heart attack.
• These cases are more difficult to win than physical/mental claims, but not as difficult as mental/mental claims because the employee must prove that the mental stress at work directly led to the physical problem, but proof of abnormal working conditions is not required.

3. Mental/Mental Claims

A psychological injury arises from a workplace event, without any physical injury.

• Example: A cashier develops PTSD after being robbed at gunpoint.
• These are the hardest claims to prove. Under the Pennsylvania Workers’ Compensation Act and case law, the employee is required to prove that the psychological injury was caused by “abnormal working conditions”, not just ordinary workplace stress.

What Counts as “Abnormal Working Conditions”?

This phrase is key to Pennsylvania mental/mental health claims. Courts have ruled that:

• Ordinary workplace stress (deadlines, disputes with supervisors, job pressures) is not enough.
• The worker must show they experienced something outside the usual scope of their job,  such as workplace violence, witnessing a traumatic event, or a sudden, extraordinary incident.
• Further, the work-related stress must be caused by actual objective abnormal working conditions, as opposed to subjective, perceived, or imagined employment events.
• Moreover, the determination of what is considered to be an abnormal working condition is highly fact sensitive.

Example:

• A mental health worker who is exposed to combative patient behavior may not meet the test because such situations are considered part of the job.
• But if the mental health worker experienced an unusual or extremely traumatic event, the claim may be valid.

Exception – PTSD Claims for First Responders:

• In October 2024, Governor Shapiro signed Senate Bill 365 into law, which is set to go into effect in late 2025. The new law will apply to all claims filed after the effective date, even if the triggering event occurred up to five years earlier.
• Firefighters, police officers, emergency medical technicians, and paramedics will be entitled to benefits under the Pennsylvania Workers’ Compensation Act for psychological traumas arising from individual traumatic events or cumulative highly stressful experiences resulting from their employment, regardless of whether the trauma is accompanied by physical injuries requiring medical treatment.
• First Responders will be required to establish that the psychological injury was the result of the individual undergoing a qualifying traumatic event and was sustained in the course of the individual’s employment. A qualifying, traumatic event means an incident involving serious bodily injury or death to an individual, or an immediate threat to the life of the employee or another, a mass casualty event, responding to crime scenes for investigations.
• Post-traumatic stress injuries suffered by a first responder will not be required to be the result of an abnormal working condition to be compensable. However, benefits for such psychological injuries will be capped at two years.

Challenges in Mental Health Workers’ Comp Claims

Even though Pennsylvania law recognizes psychological injuries, these claims face extra hurdles:

• Stigma and Skepticism
  • Employers and insurers often question whether mental health conditions are “real” or exaggerated.
  • Workers may feel embarrassed or fear retaliation for reporting psychological injuries.
• Complex Medical Proof
  • Mental health claims require expert medical testimony from psychiatrists or psychologists.
  • You must demonstrate a clear connection between your work and the mental health condition.
• Insurance Company Resistance
  • Insurers may argue that depression, anxiety, or PTSD are due to personal issues outside of work.
  • They may send you to an “independent” psychiatric exam designed to downplay or deny your condition.
• Higher Burden of Proof for Mental/Mental Claims
  • Courts strictly enforce the “abnormal working conditions” rule.
  • Many legitimate claims are denied because stress is considered “ordinary.”

Examples of Mental Health Injuries Covered

• PTSD after workplace violence: A retail worker develops PTSD after being attacked during a robbery.
• Anxiety after catastrophic accidents: A factory worker witnesses a co-worker suffer a gruesome injury.
• Depression following physical injury: A truck driver injured in a crash develops depression due to chronic pain and loss of income.
• Stress-induced physical conditions: Prolonged work-related stress leads to hypertension or heart disease.

Protecting Your Rights in a Mental Health Claim

If you believe your job caused or worsened a mental health condition, here is how to protect yourself:

1. Report the Injury Promptly

• Notify your employer as soon as possible, just as you would with a physical injury.
• Put it in writing to create a clear record.

2. Seek Medical Help Early

• Get an evaluation from a qualified mental health professional.
• Document your symptoms and treatment consistently.

3. Keep Detailed Records

• Track workplace incidents, symptoms, and how your condition affects your daily life.
• Record any unusual or traumatic events that triggered your condition.

4. Expect Pushback

• Understand that insurers may fight these claims aggressively.
• They may claim your mental health issues are due to personal problems, not work.

5. Consult an Experienced Workers’ Comp Attorney

• Mental health claims require strong legal and medical presentation.
• An attorney can gather expert testimony, counter insurer tactics, and frame your case within the “abnormal working conditions” standard.

Why These Claims Matter

Mental health is health. Just like a broken bone or torn ligament, psychological injuries can take workers out of the job and affect every aspect of life.

Recognizing these conditions under Pennsylvania workers’ compensation law ensures that injured workers can:

• Undergo therapy and medications.
• Cover treatment costs without financial strain.
• Replace lost wages while recovering.

Without proper representation, many of these claims fail, leaving workers without help.

Workers’ compensation in Pennsylvania is not just about broken bones and back injuries. It is also about the mental and emotional toll the workplace can take.

While psychological injury claims face more scrutiny, the law does provide protection. If your mental health has been harmed by your job, you have the right to pursue benefits. The key is early treatment, strong medical evidence, and experienced legal guidance.