Claims of job-induced mental stress soared in California in the 1980s, providing a costly new dilemma for employers and increasingly turning the misty terrain of an individual’s mind into a legal battlefield.
Stress-related complaints now are the fastest-rising type of job disability claim in the state and may be costing hundreds of millions of dollars annually, said Thomas Parry, research director for the California Workers’ Compensation Institute, a nonprofit organization supported by the insurance industry.
“It’s quite dramatic what’s going on,” said Parry, whose San Francisco institute just finished a study in which it termed the increase “phenomenal.”
The workers cite such problems as stress, anxiety, depression and other mental troubles often exacerbated by modern life.
Such complaints are rising at a time when the U.S. work force is being forced to cope with unsettling changes, such as adapting to new technologies, heightened competition and, frequently, cutbacks in staff. In addition, many employees are struggling to balance conflicting responsibilities of work and family.
“People are facing new types of work challenges,” said Steven L. Sauter, a psychologist who specializes in stress research at the National Institute for Occupational Safety and Health. America’s shift to a service economy, he added, presents workers with new risks of stress--from dealing with other people and new technology--compared to the older industrial economy, where physical injury was the greatest fear.
In California, claims of mental stress resulting in lost work time rose from just 1,178 incidents in 1979 to 9,368 in 1988, the last year for which figures are available, according to the state Department of Industrial Relations. But the Workers’ Compensation Institute, analyzing data from 1985, concluded that the state was undercounting claims and that the number for 1988 could be as high as 35,000.
The rate of such claims soared 540%, even after accounting for the growth of the work force, Parry said. The statistics are striking in part because the overall rate of disabling work injuries fell 8% over the same period, perhaps reflecting the employment shift toward service jobs, he said.
Despite the growing attention to job stress, there is little agreement on how to determine when workplace demands become mentally debilitating or on how to evaluate the merits of an individual complaint.
“It’s a tricky area,” said Daniel A. Plotkin, a psychiatrist and UCLA professor. “It’s not like you can take an X-ray and see whether the bone is broken or not.”
The issue is an extremely touchy one for employers, who may recognize that stress is a fact of modern life but fear being exploited by opportunistic employees whose complaints are hard to disprove. Almost all stress-related claims are fought out in the workers’ compensation court system, where they can linger for years.
“There are legitimate stress cases, but it also is an opportunity--because it is so subjective--for a lot of abuse,” said Sandy Wagner, manager of human resource services for Kaiser Permanente in Pasadena, which has 31,000 employees in Southern California.
Wagner said that stress claims now account for 36% of the health care company’s workers’ compensation bill, although she declined to disclose the amount.
In its analysis of 1985 claims, the Workers’ Compensation Institute found that “job pressures” were most frequently cited by employees as the cause of mental stress (69%), followed by such causes as harassment (35%), being fired (15%), discrimination (7%), demotion (2%) and various other grievances (11%). (The numbers exceed 100% because workers often cite more than one reason for stress.)
Those who claimed stress-related disabilities most frequently came from sales, clerical, management and service jobs. “It’s a white-collar phenomenon,” Parry said.
The analysis also found that people with stress complaints differed from typical disability applicants in at least two ways: The average stress claimant was 40--several years older than the typical disability applicant--and 55% of those with stress problems were women, double the percentage of women making claims for other types of disability.
“Maybe that’s because there are more women in the work force now than previously--and there are more pressures to balance family and work,” said Cheryl Lambert, vice president of claims for the California Casualty Group in San Mateo.
The actual cost borne by insurers, and ultimately employers, is hard to measure, because thousands of the stress cases are unresolved. But claims for 1988, the most recent year of available data, seem to total between $150 million and $400 million, Parry said.
In trying to explain the increase, some industry experts cite a rise in overall health awareness, including a growing consciousness of mental health. “It’s more acceptable to claim stress,” Lambert said. “Certainly, people are more aware of it.”
Some of the awareness also is being generated by lawyers who have taken to reminding workers, in television and newspaper ads, that they may be compensated for stress and harassment.
“Lawyers want to make money off of this,” said Wagner of Kaiser Permanente. “Unfortunately, employees don’t get the windfalls they expect.”
The institute study provided three examples of mental stress claims from 1985: a 30-year-old female cashier who was fired after nine days on the job and received $681 for claims of harassment and other wrongs; a male factory worker, 61, who complained of mental injury after 18 years of pressure at work and was awarded $74,000; and a 32-year-old beauty parlor employee who got $12,600 after the trauma of witnessing a co-worker’s murder.
While some claims appear dubious, Parry said, others are lodged by long-term employees with real problems, “not the ones trying to grab a buck from their employers.”
Mason H. Brush, an attorney who specializes in workers’ compensation claims, took exception to the view that the legal profession has played a role in drumming up dubious stress complaints.
“That’s why we have judges in black robes--to determine what’s meritorious and what’s not,” said Brush, whose advertisements ask workers whether they have been injured “either emotionally or physically” on the job. “We can’t have insurance companies and employers deciding” which claims are warranted, he maintained.
A new law took effect Jan. 1 seeking to tighten California’s relatively loose requirements for mental stress claims. One provision, for instance, requires that at least 10% of a worker’s psychological injury must be caused by actual events, and not just the perception of events.
But the new law’s effect is not yet clear. In light of rising costs, companies face pressure to establish stress-prevention programs, Lambert said. For example, Kaiser Permanente last year began steering employees with mental stress complaints into a 10-step therapy program, and now reports a sharp drop in time lost by such workers.
Transamerica Life Cos. in Los Angeles features a variety of courses and programs designed to help workers combat tension, including support groups for parents, help in finding day care for children and for ailing parents, and even lunchtime yoga classes.
“They like to go and de-stress (with yoga) and go back to work refreshed,” said Laurie Bayless, a spokeswoman for Transamerica.