The three claim types — and why the labels matter
| Type | What it means | How states treat it |
|---|---|---|
| Physical-mental | A physical injury causes psychological harm — depression with chronic pain, anxiety after an amputation, distress over disfigurement. | Compensable almost everywhere. If you have a physical claim, its psychological consequences generally belong in it. This is the most common and most under-claimed type. |
| Mental-physical | Psychological stress causes physical harm — the classic example is stress-triggered cardiac events. | Recognized in many states, with causation fights. Medically driven. |
| Mental-mental | Psychological injury with no physical injury — PTSD from a robbery, from witnessing a death, from a violent incident. | The battleground. Some states cover it (often requiring an extraordinary or sudden event), some sharply limit it, a few essentially exclude it. Several states have expanded coverage for first responders' PTSD specifically. |
If you already have a physical injury claim, psychological consequences usually can be added to it — and routinely aren't, because nobody says the symptoms out loud. If your claim is purely psychological, the state you're in matters more than for any other injury on this site. California, for instance, generally requires six months of employment and work being the predominant cause; other states draw entirely different lines. This is a page where "check your state" is the load-bearing sentence.
What compensable psychological injury looks like
- PTSD after robberies, assaults, machinery fatalities, serious accidents witnessed — intrusive memories, hypervigilance, avoidance of the workplace or tasks, sleep disruption.
- Depression and anxiety with physical injuries — the most common pattern in comp: pain, lost identity, financial fear, and isolation compounding a body injury.
- What generally isn't covered: ordinary job stress, personnel actions (discipline, termination, workload) — most states exclude claims arising from lawful personnel decisions. Honest framing prevents wasted fights: the claim is about the event or injury, not about having a hard job.
How these claims are documented and won
- 1
Say the symptoms out loud, early
Tell your treating doctor about the nightmares, the panic at the machine, the mood collapse — in the same visits where the body is discussed. The record can't credit what you don't say, and late-appearing psych claims draw more skepticism than any other kind.
- 2
Get real treatment
A psychologist or psychiatrist, ideally with trauma experience — request the referral through the claim. Treatment is both recovery and record: diagnoses (PTSD, major depression, adjustment disorder) carry weight symptoms alone don't.
- 3
Expect the medical-legal exam
Psych claims almost always draw a psychiatric evaluation. The Blueprint™ rules apply doubled: total honesty in both directions, consistency with records, and no minimizing out of embarrassment. Standardized psych testing within these exams is normal — answer straight; the instruments detect both exaggeration and understatement.
- 4
Rate and value what remains
Lasting psychological impairment is rated like any other — treatment needs, work restrictions (no lone shifts, no cash handling, no heights), and future therapy belong in settlement math.
Beyond the claim: if you're in crisis or having thoughts of harming yourself, call or text 988 (the Suicide & Crisis Lifeline) — free, 24/7, in English and Spanish. The claim can wait an hour; you matter more than it does.