The Workers’ Compensation Research Institute (WCRI) published a new report focused on claims in which the primary diagnosis was a mental health condition, including post-traumatic stress disorder (PTSD), adjustment disorders, other stress reactions, anxiety disorders, and depressive disorders.
This study examines mental health claims in workers’ comp from October 2014 to September 2024 across 31 states, providing new evidence on the characteristics, treatment, costs, and disability outcomes associated with these claims.
Because this study did not focus on claims where a physical injury was the primary diagnosis, identifying mental health claims was challenging because no single data element distinguishes these claims. This required a comprehensive set of criteria to identify mental-only claims.
According to the study, mental health claims are infrequent, but their frequency has increased in recent years. Overall, approximately 0.3 mental health claims occurred per 100 paid workers’ comp claims. However, from 2015-2024, mental health claim frequency increased by 47% for overall claims, and 40% for claims with more than seven days of lost time.
Overall, frequency varied across states, with California demonstrating the highest frequency of 1.1 per 100 claims. Women accounted for 59% of paid mental health claims, compared to men accounting for 39%, and the remaining claims missing gender information.
Mental health claims were concentrated among workers aged 25-54, with the 35-44 population experiencing the highest frequency of 0.35 per 100 paid claims. Furthermore, frequency was higher among higher-wage earners, with a frequency rate of 0.59 compared to lower-wage earners, who had a frequency rate of 0.13 – over four times higher.
Those in clerical and professional occupations also had a higher frequency of mental health claims, but these findings are questioned as these industries experience far fewer physical injuries, impacting frequency rates significantly.
Among paid mental health claims with medical transactions, 38% had a diagnosis code for an anxiety disorder, 19% for PTSD, 22% for other stress reactions, 19% for an adjustment disorder, and 12% for depressive disorders. Among claims with more than seven days of lost time, PTSD appeared in 37% of claims.
Across paid mental health claims with medical transactions, 77% received general medical office visits – which may have included evaluation and management of a mental health condition, while 37% received a psychological diagnostic evaluation, and 26% received psychotherapy or other psychological treatment services.
Per-claim medical payments were lower overall when compared to all claims, though indemnity benefits payments were higher. Temporary disability duration averaged 19 weeks at 12 months and 26 weeks at 24 months. Administrative and medical-legal services were common.
Of note, common drug therapies across mental health claims included:
- Sertraline (Zoloft) – Found in 23%-28% of mental health claims, based on lost time and the presence of a physical injury
- Trazodone (Desyrel) – Found in 22-25% of mental health claims, based on lost time and the presence of a physical injury
- Escitalopram (Lexapro) – Found in 15-19% of mental health claims, based on lost time and the presence of a physical injury
Alprazolam (Xanax) – Found in 17-20% of mental health claims, based on lost time and the presence of a physical injury
