Workers' compensation for mental stress cases

Workers' compensation, the USA's oldest social insurance program, is encountering new challenges in the form of mental stress claims. It is necessary to sort these cases three ways, in the terminology of compensation practitioners, physical-mental, mental-physical, and mental-mental. Although each of these appear to represent only a small part of all compensation claims presently, each category is difficult to administer, and all hold the potential for large growth in activity. At the extreme, any of the three could swamp a state's compensation program, administratively or economically. A case can be made that mental stress cases are simply variants of challenges previously posed and in many instances, successfully resolved by the state systems. That question will be determined by the future decisions of legislators, courts, and state administrators. The economic impact of such cases is not known. Their importance, however, extends well beyond the direct costs of indemnity and medical benefits paid. Ultimately, the indirect efforts on employer-worker-union relations may be larger than the direct costs.