No Recovery: Analysis of Mental Injury Cases under Workers’ Compensation

By Dr. Andrew Hosmanek

Over the past several years, the topic of mental injuries at work has changed from an obscure area of worker’s compensation law to an all-too-common part of the daily conversation about life and work.  We now comfortably discuss terms like abusive supervision and workplace bullying, which were previously only seen in scientific journals.  We are also coming around to the idea that American workers suffer from anxiety disorder, depression, and other mental health conditions in vast numbers, and that these conditions meaningfully affect their ability to work.


As a management professor, I study how people perform at work- what causes them to be successful, or what impedes their performance.  As a practicing lawyer, I work with both employees and employers on legal compliance in the workplace.  My research interests led me into the workers’ compensation system.  This system, administered by each state, provides guaranteed benefits to workers who are injured on the job.  Many physical injuries (e.g., a broken arm) are relatively straightforward to diagnose and compensate.  But what about the workers who suffer mental injuries, either from long-term stresses on the job, or from traumatic incidents?




My colleague Dr. Sara Rynes and I studied over 4,000 mental injury cases from the federal worker’s compensation system, spanning 17 years of decisions appealed to the Employee Compensation Appeals Board (ECAB).  We were interested in finding out 1) what types of mental injuries workers most often suffered on the job, and 2) how often the workers received compensation for their injuries.  Our findings were surprising, and disheartening.  While one in three workers received compensation for their injuries in all appeals cases (predominantly, physical injury cases), we found that only about 5% of workers with mental injuries were compensated.  This suggests that workers with mental injuries face an uphill battle in receiving medical treatment and lost wages when they miss work.


            We also found that mental injuries at work could be separated into four main types, which we labeled “syndromes.”  These were labeled Abusive Supervision, Sexual Harassment, PTSD, and Severe Disorder (paranoia, psychosis and psychotic behavior, and bipolar disorder).  Of these four syndromes, we found that Abusive Supervision was the most common reason for claiming a mental injury, being present in 64.4% of the cases.  Sexual Harassment was the least common, at 7.8%, but it should be noted that our cases were drawn from the years 1994-2011, before the #MeToo movement and subsequent increased reporting of harassment.  Claimants who exhibited PTSD or Severe Disorder had a higher likelihood of winning their cases as compared to Abusive Supervision or Sexual Harassment claimants, possibly because the PTSD claims were likely linked to obvious stressful incidents (such as being robbed at gunpoint at work) and because the Severe Disorder claimants had more dramatic and severe symptoms of mental illness.  However, the absolute likelihood of winning for all claimants was very low.




            The real stories are in the text of the cases themselves.  For instance, in one case, a male supervisor grabbed his female employee’s breast, fondled himself while working with her in an airplane cockpit, and exposed his erection to her at work.  The judges would not compensate the claimant for her mental injuries, finding that “[claimant’s] perception of harassment is not compensable” (


In defending these appeals cases, the Office of Workers’ Compensation Programs (OWCP), under the US Department of Labor, often employs its own doctors and psychiatrists, and makes claimants submit to examinations by these hired doctors.  In studying the cases, I found the hired doctors’ opinions to be problematic at times.  For instance, one female claimant was stabbed by a patient while she was working.  She was subsequently diagnosed with PTSD symptoms, depression, and anxiety.  A psychiatrist retained by the OWCP, however, found that her claims of disability were not “causally related to the attack.” 




In his report, the hired doctor stated that the claimant had been married four times, had a family history of schizophrenia and diabetes, and had filed her emotional condition claim “six weeks following a hysterectomy, in the same month as the anniversary of her sister’s death, in the same month as the anniversary of her mother’s death, in the same month as her abusive ex-husband’s birthday and in the same month as her birthday” (  Due to the conflict between the doctor for the claimant and the doctor for the OWCP, the ECAB ordered the claimant to undergo further testing by yet another doctor before the claim could be adjudicated.




In our full article, we discuss these and other cases in detail, set out our methodology for the study, and discuss directions for future research.  While we have made progress in recognizing the prevalence of mental injuries in the workplace, it is clear that much more needs to be done to ensure justice for the workers who suffer these injuries.  The full text of our article is available at: