module 8 part 1

Question 1

Question Answer

Question 2

What is a “psychiatric injury” in CA WC? A diagnosed mental disorder (e.g.

Answer 2

depression

Question 3

Two major categories of psychiatric injury? Primary (directly from work events/conditions) vs Secondary (stemming from a compensable physical injury and its consequences).

Question 4

AOE/COE requirement for psych claims? Must satisfy both: AOE = caused by work events/conditions; COE = occurred within the scope of employment.

Question 5

“Actual events or work conditions” rule? The condition must be tied to specific workplace events/conditions (e.g.

Answer 5

traumatic incident

Question 6

Is ordinary work stress enough? Generally no—routine pressure/workload alone is insufficient unless stress is extreme or linked to a specific event.

Question 7

Functional impact requirement? The psych condition must produce measurable functional impairment affecting daily activities or job performance.

Question 8

Who carries the burden of proof? The employee—must prove the psychiatric condition is work-related under the statutory standards.

Question 9

Predominant cause threshold (general psych claims)? Actual events of employment must be ≥51% the predominant and substantial cause.

Question 10

Threshold after a violent event? Lower: ~35% (35–40% range referenced) if the injury was caused by a violent work event.

Question 11

Minimum employment duration? Generally must have worked for the employer at least 6 months.

Question 12

Exception to the 6-month rule? Sudden or extraordinary events waive the six-month requirement.

Question 13

How are pre-existing psych conditions handled? Claimant must show work aggravated the condition or caused additional psychiatric disability beyond baseline.

Question 14

Role of the QME/treating physician? Provide expert medical causation opinion linking workplace events to the psychiatric condition (history

Answer 14

exam

Question 15

Common work-related psych conditions (1)? PTSD—often from traumatic workplace events (accident

Answer 15

assault

Question 16

Common work-related psych conditions (2)? Depression—from long-term job stress

Answer 16

injury sequelae

Question 17

Common work-related psych conditions (3)? Anxiety disorders—from stress

Answer 17

bullying

Question 18

Common work-related psych conditions (4)? Adjustment disorder—emotional/behavioral symptoms in response to a work stressor.

Question 19

Common work-related psych conditions (5)? Chronic stress syndromes—sustained high demands/poor support → persistent anxiety/depression.

Question 20

Core qualification element for benefits? A diagnosed mental disorder that requires treatment or causes disability.

Question 21

Compensable benefit—medical care? Psychiatric treatment (therapy

Answer 21

medication

Question 22

Compensable benefit—temporary disability (TD)? Wage replacement (~two-thirds AWW up to statutory max) while unable to work due to the psych condition.

Question 23

Compensable benefit—permanent disability (PD)? Payments based on degree of permanent impairment as determined by QME/treating physician.

Question 24

Compensable benefit—vocational rehab? Retraining/placement if unable to return to prior job due to the psychiatric injury.

Question 25

Compensable benefit—death benefits? Payable to dependents when death (e.g.

Answer 25

suicide linked to work trauma) is causally related to the industrial psychiatric injury.

Question 26

Key challenges unique to psych claims? Subjectivity/measurement

Answer 26

causation disputes (work vs personal)