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Friday, December 18, 2009

Change in Mental Health Law May Help With Claims for Emotional Conditions

The Wellstone-Domenici Mental Health Parity and Addiction Equity Act, effective on January 1, 2010, ends health insurance benefits inequity between mental health/substance use disorders and medical/surgical benefits for group health plans with more than 50 employees.

How does this apply to federal workers? If you have an emotional condition caused or exacerbated by your job, or if you develop a psychiatric condition as a result of your physical injury, this Act may make mental health treatment more affordable. Later, if you file a workers' compensation claim, your treatment records provide the evidence necessary to establish the existence of your work-related condition. Without treatment records, it is virtually impossible to support a claim. Once a claim is approved, OWCP is responsible for paying for your past as well as future work-related treatment.

Note: In a federal workers' compensation claim, OWCP will only consider reports from “physicians” including psychiatrists or Ph.D. level Clinical Psychologists. Other providers such as social workers, Master’s degree level psychologists and spiritual counselors are not considered “physicians” in a federal workers' compensation claim, and their reports cannot be used to establish a claim.