October 10, 2018 • Education

Addressing Mental Health Issues After Settlement

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Once injured parties settle their workers’ compensation or liability claims, all their problems don’t just disappear. Their medical needs continue and still need to be addressed.

Among those that are increasingly prevalent are mental health conditions; especially depression, anxiety, and Post-Traumatic Stress Disorder. Because of the stigma surrounding mental health issues, injured parties sometimes rarely discuss these with their families or talk about them openly, even when they have an open injury claim.  When they settle their claims, it can be critical that they have a resource to help them continue to secure treatment for these conditions.  A professional administrator can provide them with a much needed helping hand to stay on a path to recovery. This is why it is so important for injured parties to work with a professional administrator after settlement that has the skills to recognize and direct them to the get the help they need.

Anxiety on the Rise

Until a few years ago there were few, if any, concerns of mental health issues among injured parties post-settlement. But that has changed. There has been an uptick in incidents of anxiety and depression in recent years among injured parties as well as the general population. The reasons are likely multifaceted. In the case of injured parties, it could at least partially be attributed to reactions to certain medications.

Some injured individuals suffer from suicidal thoughts, although they are not likely to express them openly. Occasionally, a family member may have an inkling of a problem, but some injured parties have do not have supportive family structures and may be essentially on their own by the time they settle their claims. Therefore, a professional administrator who is cognizant of the signs of potential mental health issues and knows how to respond can be a valuable asset in ensuring these injured parties get the care they need.


The best professional administrators provide 24/7 support to injured parties post-settlement. However, often those providing front-line services are not typically clinicians. Providing the individuals who answer initial calls with adequate training enables them to properly assist people who may need help; for example, assisting someone who may be suicidal.

In one recent call at Ametros, a leader in professional administration, an injured party indicated to their client engagement manager that he was having suicidal thoughts and even revealed he had a firearm in his home. The manager kept him on the phone and conferenced in a suicide help-line. The 3-way call continued until local authorities arrived on the scene to help the individual. Since that day, the injured party has sent several notes, thanking the company for saving his life. He got the help he needed and his life has been turned around.

Nurses and other medical experts can be instrumental in training those who provide customer service to injured parties. For example, they can teach them:

  • Buzz words that may indicate a person is dealing with mental health concerns
  • Appropriate questions to draw out problems
  • Ways to keep the person on the phone and seek help, rather than letting the call end
  • Active listening skills ensuring the injured party feels a connection
  • Coaching skills to help injured parties who have PTSD and/or suicidal thoughts
  • Ways to provide other resources for help

The person speaking with an injured party who’s in emotional distress can connect them with the proper resources, direct them to care, and help them with any logistics in getting treatment. Another option that is becoming available is the use of telemedicine. A telehealth mental health provider can provide face-to-face help to the injured party via computer, tablet, or smart phone.

Attitudes on Mental Health

A positive development in recent years has been the increased acceptance and conversation around mental health issues. Until about 10 years ago, many payers were skeptical of accepting portions of a claim involving a mental health condition and were prone to deny it, even though the system increasingly recognizes mental health concerns as potentially work-related in many cases.

After settlement, getting payment for mental health treatment is easier. It can often be provided under Medicare and can be included in a Medicare Set-Aside, if applicable. When payment is an issue for an injured party post-settlement, there sometimes can be other ways they can receive aid and they never again have to answer to a state workers’ compensation board.  A well-trained professional administrator can help point its clients in the right direction.

While negative stigma surrounding mental health issues persists, it has lessened somewhat. Injured parties have become more willing to accept help. Experts say that the vast majority of psychiatric emergencies can be resolved within 24 hours — when appropriate assessment, intervention and treatment are provided. Professional administrators can and should play a significant role in ensuring injured parties who have settled a claim are included in that majority.

Reach out to our team!