Ready to Tackle the Mental Health Crisis? Start With Mental Injury Claims

By Karen Thomas, Vice President, Clinical Solutions, CorVel 

In our post-COVID world, mandatory masking is reminiscent of a bygone era. Yet, while we have removed our physical masks, many of us still wear invisible ones—obscuring emotions we would rather keep hidden. Behind a neighbor’s wave or a colleague’s smile may lie the pain of silent suffering. With one in five U.S. adults experiencing mental illness each year, this is not an isolated issue, but a widespread national crisis.¹ 

As with any health issue, the impact of mental health is not confined to the personal domain. It also impacts worker safety and well-being, becoming a factor that workers’ compensation programs cannot ignore. 

Defining the Challenge 

Today, we have a valuable opportunity to transform mental health outcomes for our workforce, and it begins with reimagining how we manage mental injury. The focus is not on encouraging more mental health claims, but on responsibly managing the ones that do arise. 

Ranging from excessive workloads to workplace violence, more than 80% of U.S. workers face these work-related stressors in their day-to-day lives.² Unlike physical injuries, psychological injuries are more complex to define and prove, with compensability standards varying widely by state. Some jurisdictions allow “mental-mental” claims, while others require a physical injury, and professions such as first responders and healthcare workers face higher risks due to exposure to trauma. This evolving patchwork underscores why focusing on data-driven insights and proactive solutions is critical in managing mental injury claims. 

The Data Tells the Story 

CorVel’s analysis of mental injury claims closed between 2020 and 2024 reveals stark contrasts when compared to physical-only claims. On average, mental health claims remain open about three times longer and are more than four times as costly. In addition, 69% of mental health claims involve lost time, compared with 37% of claims without a mental injury component. 

These findings make clear that while the number of mental health claims may be smaller overall, their disproportionate cost and duration create a significant challenge for employers, payers, and the broader workers’ compensation landscape. 

Barriers to Effective Management 

Managing these claims effectively is complicated by several factors. Stigma surrounding mental illness, shortages of qualified providers, and delays in referrals often contribute to inefficiencies. Operational breakdowns such as poor communication and fragmented case management add further complexity. 

The data also shows that half of workers with mental health-related claims do not receive appropriate treatment until six months after their date of injury. When treatment is delayed beyond 180 days, the number of temporary total disability days nearly triples compared to cases where care begins within 90 days. The consequences are both clinical and financial, compounding recovery challenges for the injured worker and costs for the system. 

Toward Holistic, Responsible Solutions 

These realities underscore that the primary imperative is not to expand the prevalence of mental health claims, but to address them promptly and responsibly when they occur. Data points to early intervention as the most critical opportunity, particularly within the first 30 days of a mental injury claim. Intervening during this window can stabilize recovery trajectories and significantly reduce downstream costs. To be effective, this approach must also be holistic, ensuring that workers have access to both physical rehabilitation and behavioral health support when needed. 

Without early intervention, these claims are not only slower to close, but they also escalate overall claims costs dramatically—costs that fall directly on employers and payers. 

Within the current status quo, mental injury is an urgent risk influencing deteriorated well-being and workplace performance. For professions with the highest incidences of mental injury, such as first responders and healthcare professionals, the stakes are especially high. These individuals carry the responsibility of safeguarding lives, and ensuring they have timely access to care is not just a best practice, but essential to a fully functioning society. 

Adopting a strategic, early intervention plan is one of the most effective steps an employer can take toward improving outcomes. This begins at the very first point of contact, when early triage can flag not just clinical needs but psychosocial barriers that may complicate recovery. By identifying these risks upfront, employers and payers can initiate targeted interventions that set the stage for faster recovery. Key elements of this approach include assessing the initial injury, determining the needs for immediate care, and streamlining the intake process to connect injured workers with mental healthcare providers. The responsibility falls to employers and payers to act early and decisively, ensuring that these processes transition from strategy to consistent practice. 

Technology also plays an important role in early intervention. Virtual care platforms allow timely access to treatment, connecting injured workers directly with licensed therapists and prescribers. Claims management systems highlight risk factors and centralize case information, enabling more proactive and coordinated interventions. Together, these tools support efficiency and coordination, helping employers and payers intervene earlier and manage claims with greater precision. 

Looking Ahead 

The future of workers’ compensation will involve a careful balance. On one hand, the industry must acknowledge the unique risks posed by mental injury claims; on the other, it must guard against escalating costs and delays that weigh heavily on both organizations and workers. Advances in artificial intelligence and predictive analytics provide new methods for identifying high-risk cases and tailoring interventions; however, human oversight remains crucial to ensure that these tools are applied ethically and in a cost-conscious manner. 

By leveraging essential data—such as compliance rates, psychosocial indicators, and return-to-work elements—AI gives case managers a comprehensive view of claims risk factors and potential outcomes. Predictive analytics then builds on this foundation by flagging high-risk claims through patterns like comorbidities, claim history, and psychosocial factors, offering an evolving picture of recovery risk. The value of these tools lies not in the technology itself, but in how they help case managers act sooner, coordinate care more effectively, and drive better recovery outcomes. 

Ultimately, while mental health challenges are real and cannot be dismissed, workers’ compensation’s role is to manage claims effectively, promote timely recovery, and safeguard system resources. Success will require a holistic approach that supports injured workers as individuals, not just claimants, recognizing that physical recovery and psychological well-being are often intertwined. 

Share This Article: