Early Behavioral Health Support Significantly Shortens Workers’ Comp Claim Duration

Though mental health claims comprise less than 2% of all workers’ compensation cases, they have an outsized impact on claim duration—tripling recovery timelines in many cases. Sedgwick’s recent analysis, featured in a commentary paper and podcast, underscores the power of early behavioral health intervention. According to Sedgwick Chief Claims Officer Max Koonce, engaging mental health professionals within the first 90 days of a claim can shorten disability periods by as much as 70 days compared to later-stage interventions.

The variation in how states treat mental health claims further complicates the picture. While most states allow ‘physical-mental’ claims tied to physical injury, only a few—like California and New York—permit ‘mental-mental’ claims, where no physical injury is involved. Some jurisdictions have adopted presumption laws for first responders, acknowledging their heightened exposure to traumatic events.

Despite their rarity, mental health issues have significant consequences on return-to-work timelines, care complexity, and overall claim costs. Kimberly George of Sedgwick emphasized that mental health is a top driver of disability claims, second only to pregnancy. These patterns affect workers across all demographics.

Ultimately, Sedgwick recommends a holistic, biopsychosocial approach to claims management. By integrating behavioral health support early in the recovery process, insurers and employers can not only speed up return-to-work outcomes but also improve the overall well-being of injured workers.