Mental health has been a key talking point in the workforce for years. In the non-occupational arena, mental health claims have increasingly become one of the leading generators of short-term disability.
Burnout, anxiety, stress, fatigue, decreased satisfaction, and increased substance abuse have all contributed and emphasize the need for a comprehensive understanding of the role mental health plays in non-occupational and occupational
Understanding state-by-state differences
The two main types of claims in
In tandem with acknowledging the unique place that mental health claims hold in this line of business is the importance of understanding the variation in coverage on a state-by-state basis. Some states consider mental health claims only for post-traumatic stress syndrome, such as Connecticut, Maryland, and Minnesota. Other states have more specific distinctions, such as Alaska, which only covers claims for mental health if it results from extraordinary or unusual work stress. States such as Florida, Nebraska, New Hampshire, Ohio, Oklahoma, and Texas, have established claims as compensable under workers' compensation for first responders under presumption rules.
Finally, it's important to note that mental health claims vary across industries. Technology and communications sectors have a claim rate of 4.4%. As mentioned, due to exceptions for first responders, their mental health claim rate of 3.6% is also on the higher end compared to other worker-types and sectors.
Treatment, support strategies, and proactive measures
With the typically long duration of mental health injuries and recovery, understanding effective treatment options, support strategies, and the importance of proactive measures is a key tool in administering these claims. The most critical tool is early intervention which can contribute to the best possible outcomes. Sedgwick's insights and analysis show that if behavioral support treatment is administered earlier in the claims process, return-to-work is expedited, claims durations are decreased, and outcomes are improved.
A critical aspect of driving these improvements in the process and overcoming key challenges is the use of emerging technologies, such as AI, decision engines, and modeling. By utilizing this technology, claims which could be supported through additional resources can be identified in a much timelier fashion, and encourage engagement with the claimant. Data proves this out. Per Sedgwick data, when behavioral health treatment is introduced into a mental health claim within 90 days, a substantial decrease in days away from work was achieved. With claimants who did not receive this treatment until 91-180 days out from filing their claim, the average temporary total disability (TTD) days was 1.5 times greater, and 3.6 times greater for those who did not receive treatment until after 180 days.
While there is no one-size-fits-all solution to mental health claims and the inherent challenges involved, there are solutions that can improve the process and outcomes for all. As mental wellbeing continues to become a priority concern and topic, embracing new technologies and early intervention will be vital in minimizing periods of disability and claim durations and providing resources and treatment throughout a complex recovery process. Specific, customized, and targeted care combined with a holistic approach to treatment can return employees to work in a safe and healthy manner and improve outcomes throughout the lifecycle of a claim.
