Work-related mental stress injuries

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Work-related mental stress injuries happen when job-related stressors or traumatic events at work lead to a diagnosed psychological injury or illness.

At the WSIB, we provide benefits and services for work-related mental stress injuries diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, for the following categories: 

  • Chronic mental stress: a diagnosed mental stress injury for which a work-related stressor is the primary (predominant) cause. For example, workplace harassment.
  • Traumatic mental stress: a diagnosed mental stress injury that is caused or significantly contributed to by one or more work-related traumatic incidents such as witnessing an armed robbery or witnessing the death of a co-worker in a workplace accident.
  • Post-traumatic stress disorder in first responders: recognizing that first responders are often exposed to traumatic experiences in the course of their employment, we provide a presumption of work-relatedness for diagnosed post-traumatic stress disorder in first responders.

How we can help

If you submit a claim for a mental stress injury, we’ll work with you, your health care provider, and your employer to determine if you are eligible for benefits.

If your claim is approved, we provide a combination of supports including therapy, medication, employment income support, and/or help returning to work.

Not sure if you will be covered? Fill out our questionnaire for more information.

Is work the primary cause of your mental stress injury?
Do you work as a first responder or in a designated occupation?

See a list of designated occupations.
Have you been diagnosed with post-traumatic stress disorder?
Was your diagnosis provided by a psychiatrist or a psychologist?
If you have not been diagnosed with post-traumatic stress disorder because you have not yet sought medical attention, have you experienced trauma at work?
Is your mental stress caused by a business-related decision your employer made?
Here are some examples, of an employer’s business-related decisions:
  • transferring you from your usual work location to another location
  • advising you to increase the pace of your work to meet performance expectations for productivity, behaviour and/or service
  • cutting back your work hours due to lower demand for the company’s products/services
Did the stressful event(s) or situation occur during and because of your work, and was work the cause of your mental stress injury?
Has a qualified health professional (family doctor, nurse practitioner, psychologist or psychiatrist) diagnosed you as having a mental stress injury or injury based on diagnostic criteria set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5)?
Can your mental stress be shown to have resulted from one or more substantial work-related stressors or by one or more traumatic work-related events at your work?
 For example, did you witness a horrific accident while at work, or were you subject to behaviour such as intimidation, malicious rumours, gossip, or innuendo, social isolation or physical abuse or threats of physical abuse, coercion, humiliation, persistent insults, slurs and/or derogatory names?

You may be eligible for benefits. Submit a claim by reporting your mental stress injury to us online.

Because you answered yes to this question, you will not likely be eligible to access benefits. You may want to look for other resources that may be available to support you.

We generally cannot cover mental stress caused by an employer’s management decisions or actions, such as termination, transfer, changes in working hours and/or in changes in productivity expectations. 

Because you answered no to this question, you will not likely be eligible to access benefits.

Your mental stress injury must be shown to have been caused by work to qualify for benefits. You may want to look for other resources that may be available to support you. You can find some suggestions at the bottom of this page.

Because you answered no to this question, you will not likely be eligible to access benefits. You may want to look for other resources that may be available to support you.

We can provide benefits if you have been diagnosed by a qualified health care professional (general practitioner, nurse practitioner, psychologist or psychiatrist) as having a mental stress injury or illness listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5)

Because you answered no to this question, you will not likely be eligible to access benefits. You may want to look for other resources that may be available to support you. You can find some suggestions at the bottom of this page.

Your mental stress injury must be shown to have been caused by one or more substantial work-related stressors or by one or more traumatic work-related events to qualify for benefits.

Resources for health care providers treating patients with work-related mental stress injuries

Resources for businesses looking to report a mental stress injury or learn about the return-to-work process

If you believe that your stress is work-related, review the eligibility criteria for mental stress injuries. We use the Workplace Safety and Insurance Act, and our policies to help us decide if a claim should be approved.

Who we provide benefits to

For mental stress injury claims to be approved, they must meet all three of the following conditions:

  1. You have a mental health diagnosis made by a qualified health professional (physician, nurse practitioner, psychologist, or psychiatrist) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
  2. The primary (predominant) cause of your mental health diagnosis was from exposure to a substantial work-related stressor or work-related traumatic event.
  3. Your diagnoses resulted in chronic mental stress or traumatic mental stress.

For post-traumatic stress disorder in first responders claims to be approved, they must meet all three of the following conditions:

  1. You have to have been employed as a first responder for at least one day on or after April 6, 2014.
  2. You have to have been diagnosed with post-traumatic stress disorder on or after April 6, 2014, and no later than 24 months after your last day employed as a first responder.
  3. Your diagnosis was made by a psychologist or psychiatrist based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

What is likely to be covered

Examples of traumatic events and substantial work-related stressors that may result in a diagnosis include the following: 

  • You are working in a job that is highly stressful by nature. For example, one that carries responsibility over matters involving life and death, and/or regularly involves work in extremely dangerous circumstances.  
  • You witnessed a fatality or a horrific accident at work.  
  • You witnessed or experienced an armed robbery, hostage-taking, or physical violence.  
  • You received death threats, threats of physical violence (like a bomb threat) or were confronted with a weapon.  
  • You have experienced physical violence, threats of physical violence, or verbal abuse that turned into traumatic physical abuse.
  • You have been put in a life-threatening or potentially life-threatening situation. For example, someone damaging or altering safety equipment or causing you to do something dangerous.  
  • You have been exposed to multiple traumatic events as described above.  
  • You have experienced harassment. Harassment is any behaviour that someone knows – or can be reasonably expected to know – is not welcome. For example, unwanted sexual comments or advances, persistent following or invasion of physical space.  
  • You have experienced bullying, a common form of harassment, such as intimidation, malicious rumours, gossip, innuendo, social isolation, coercion, humiliation, persistent insults, slurs and/or derogatory names.

If you work as a first responder, or as another designated worker and have been diagnosed with post-traumatic stress disorder by a psychologist or a psychiatrist, you may be eligible for presumptive entitlement to benefits.

What is not covered

Coverage does not apply if:

  • your condition has not been diagnosed by a qualified health professional (physician, nurse practitioner, psychologist, or psychiatrist) using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
  • your mental stress was caused by regular management decisions or actions like firing, transfers, schedule changes, or workload adjustments  
  • your mental stress was caused by ordinary workplace conflicts unless they involve harassment or bullying

Examples of stress that are not covered:

  1. A grocery clerk experiences anxiety after his employer changes his shift schedule.
  2. A forklift driver has been seen numerous times breaking company safety rules. Her employer suspends her without pay for not following the rules, putting herself and others at risk. She experiences stress because she is not getting a pay cheque and is worried about what her colleagues think of her.
  3. An employer keeps extending an account representative’s contract instead of offering permanent employment. The account representative is stressed and uneasy about job security.
  4. A warehouse employee has an argument with their co-worker about their scheduled break times at work. Now, every time they see their co-worker, they feel stress and anxiety.

Note: These examples describe events that would not be covered. They do not meet the required criteria for a mental stress injury because they are a result of regular management decisions and actions or have no diagnosed psychological injury.

What to do if your claim isn’t approved

If your mental stress claim isn’t approved for benefits, there are other resources available to support you.

Community resources

  • Speak to your employer about what supports they can offer (e.g., peer support program, on-site or telephone counselling through an employee and family assistance program)
  • Call Telehealth Ontario at 8-1-1 or 1-866-797-0000 and speak to a Registered Nurse or live chat with Telehealth staff.
  • Access free and confidential health services for people experiencing issues with mental health, addictions and/or gambling through ConnexOntario by calling 1-866-531-2600 or texting CONNEX to 247247.
  • Book an appointment with your family doctor or nurse practitioner. If you do not have a family doctor or nurse practitioner, you can register online to find a family doctor or nurse practitioner through Health Care Connect or register by phone at 1-800-445-1822.
  • Contact 211 Ontario to get information and referral to community, government, social and health services, including mental health services across Ontario by dialing 2-1-1 or 1-877-330-3213 or use live chat to discover available services.
  • Visit Warrior Health to access confidential on-demand, stigma-free support for public safety personnel and their families.

More information about workplace stress

When to submit a claim

To receive benefits and services from us, you must have:

  • been diagnosed by a qualified health professional (physician, nurse practitioner, psychologist, or psychiatrist) as having a condition or diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.  
  • your mental stress injury must be caused by a substantial work-related stressor or work-related traumatic event, which must be the primary (predominant) cause of the condition.

If you have a diagnosis, report your mental stress injury to us online.

Here are examples of information you will need to complete your form:

  • Information about your employer
  • Information about your mental stress injury and diagnosis
  • Information about health care you received related to your mental stress injury
  • If you have been off work because of your mental stress injury and if you have experienced a loss in earnings
  • Information about the cause of your mental stress injury. Depending on the nature of the incidents being described, additional information may be required. For example, details about what happened including dates, names of people involved, witness statements, and employer investigation reports.

If you don’t have a diagnosis, you can get assessed.

If you have not been diagnosed with a mental stress injury by your physician or another qualified health care professional contact a health care professional (physician, psychologist, etc.) to assess your condition and get a diagnosis. You can then report your injury to us.

If you are a first responder and don’t have access to a health care professional, you may still submit a claim using our 

Worker’s Guide to Registering a Mental Health Claim
.

What to expect once you submit a claim

  • We’ll register your claim then send you a letter in the mail with your claim number for you to track your claim.
  • Your Case Manager will call you to walk you through the claims process.
  • We will determine if you qualify for a mental stress injury claim.
  • We may ask you to see a psychologist or other qualified health care professional in your community for an assessment. For a list of all psychologists and psychological associates who are registered with the WSIB Community Mental Health Network, visit our community mental health network pychologist directory.  
  • We will reach out to your employer and may ask to speak with any witnesses to gather information about what led to your mental stress injury.
  • Once we have reviewed your claim and supporting documents, we’ll make a decision and send you a letter letting you know if your claim has been approved.

What to do while you wait for a decision

While we try to make decisions quickly, we understand that the waiting period can be hard, and you may need help while you wait.

If you need support right now, explore the province-wide services available to all Ontarians in our community resources. You can also reach out to your Case Manager with any questions.

What happens if your claim is approved

  1. We’ll send you a letter telling you what benefits you’ll receive and any additional information that may be relevant to your claim. For example, we will tell you pre-approved for any treatment for your mental stress injury.
  2. Your Case Manager will call you to review your benefits and talk about next steps. They may also introduce you to other members of your team, like a Nurse Consultant and/or Return-to-Work Specialist. This is a great opportunity to ask any questions you may have about what is in your benefits letter.
  3. You’ll begin regular check-ins with your Case Manager and Nurse Consultant (when appropriate), to assess your situation and make sure you have the support you need.

Treatment: You’ll begin the treatment recommended by your health care provider that is outlined in your benefits letter. This could include assessments and treatment recommendations.

Ongoing communication: Stay in touch with your Case Manager about how you are doing and any challenges you may be facing. Let us know about any significant changes in your medical condition or income within 10 days of the change happening. If you’re not sure whether a change is significant, get in touch with us. Significant changes can include:

  • Returning to work
  • Starting to receive other income (including self-employment) or government benefits
  • Important updates in your medical condition
  • Any disputes or disagreements between you and your employer about your return to work

Return-to-work planning: Depending on your recovery, your Case Manager will begin talking with you about how and when you might return to work. We also have Return-to-Work Specialists who can help.

Stay active and engaged: It’s important to stay connected with friends, family, and co-workers to promote positive mental health and well-being.

What if I don’t agree with the decision on my claim?

If you disagree with a decision about your claim, speak to your Case Manager as soon as possible and explain why you disagree.

If you still disagree, visit our appeals page for more information on how to object to a decision.

We will tell you which benefits you’ll receive in a letter. Because every situation is different, the benefits offered are also different from person to person.

Types of benefits we offer include:

  • Treatment: Health care benefits, like treatment from a health care professional and prescription medication related to the workplace mental stress injury.
  • Return-to-work: Return-to-work services including a specialized team to help you and your employer find solutions to support your return to safe and suitable work.
  • Income support protection: Wage-loss benefits so you can maintain an income while you aren’t able to work.
  • Long-term support: Additional benefits for any injuries that result in a permanent impairment.

For a complete list of benefits please visit your guide to benefits and services. Your Case Manager will be happy to answer any questions you may have.

Potential treatment options

Your care and recovery are important to us. Everyone’s experience of a mental stress injury is different, and each recovery journey is unique.

We work with mental health providers to offer a variety of evidence-based mental health treatment options to support your recovery. These treatment options might change as your needs change throughout your journey.

  • Treatment services are provided by a variety of mental health professionals in your community and province-wide including psychiatrists, psychologists, psychotherapists, occupational therapists, and other physicians and allied health specialists.  
  • Depending on your needs, you may receive treatment with an individual therapist or a team of professionals working together to support your recovery. You may receive treatment in a clinic or hospital facility.  
  • Some treatments may include medication, while some may be a blend of psychotherapy, learning and practicing new skills in your community.
  • You will have access to different treatment options to ensure you’re receiving the best care possible at every stage in your journey.

All treatments are designed to help you explore your unique experiences, to feel more in control of your thoughts, feelings, and behaviours, and to develop healthy ways of achieving and maintaining wellness.

Working with your Case Manager

Your Case Manager is your main point of contact. They will help you with your recovery and return to work. If you have any questions, your Case Manager is the person to reach out to. Your Case Manager will be supported by a Return-to-Work Specialist and a Nurse Consultant, if needed.

Keeping your employer in the loop:

  • Your Case Manager will notify your employer that the claim has been approved.
  • Your employer will receive regular updates about your recovery. If you feel comfortable, we encourage you to keep in touch with your supervisor and/or employer to share your own updates and help identify the right time to discuss return-to-work planning.
  • When it’s appropriate, your Return-to-Work Specialist will work with you and your employer to figure out how to help you return to work safely.

Our goal is to help you return to health and to work when you’re ready. Once your claim is approved, we’ll assess your condition to understand how it affects your ability to work. This might include reviewing medical reports, speaking with you and your health care providers, and considering how the mental stress injury might affect your ability to perform your job. Each case is different, so the plan will depend on your situation and the cause of your mental stress injury.

A transition back to work could look like:

  • Returning to work with your existing employer: Your Return-to-Work Specialist will work with you and your employer to develop a personalized plan for your return. The plan will address any accommodation needs to make sure that solutions are in place to support your success. An accommodation is a change to your job or work environment that will allow you to return to work and perform your job following the mental stress injury. For example, you may return to work with different duties or on a progressive schedule. Depending on the accommodation required, you may also return in a different role.
  • Transitional activities: In some cases, it will not be possible to go back to your previous job right away. Your employer may not have work available until you are able to fully perform your previous duties. We will help you find different activities such as volunteering or taking a course to help you develop skills until you can return to your employer.
  • Training and development for new roles: We may offer training or skills development programs to help you transition into a different role with your current employer or into a role with a new employer.  
  • Long-term or permanent accommodation: Sometimes a mental stress injury has lasting effects and may require permanent accommodations. We can help explore other options for you.

Our goal is to help you return to health and to work when you’re ready. Once your claim is approved, we’ll assess your condition to understand how it affects your ability to work. This might include reviewing medical reports, speaking with you and your health care providers, and considering how the mental stress injury might affect your ability to perform your job. Each case is different, so the plan will depend on your situation and the cause of your mental stress injury.

A transition back to work could look like:

  • Returning to work with your existing employer: Your Return-to-Work Specialist will work with you and your employer to develop a personalized plan for your return. The plan will address any accommodation needs to make sure that solutions are in place to support your success. An accommodation is a change to your job or work environment that will allow you to return to work and perform your job following the mental stress injury. For example, you may return to work with different duties or on a progressive schedule. Depending on the accommodation required, you may also return in a different role.
  • Transitional activities: In some cases, it will not be possible to go back to your previous job right away. Your employer may not have work available until you are able to fully perform your previous duties. We will help you find different activities such as volunteering or taking a course to help you develop skills until you can return to your employer.
  • Training and development for new roles: We may offer training or skills development programs to help you transition into a different role with your current employer or into a role with a new employer.  
  • Long-term or permanent accommodation: Sometimes a mental stress injury has lasting effects and may require permanent accommodations. We can help explore other options for you.

How we support you during recovery and return-to-work planning

We may introduce you to your Return-to-Work Specialist shortly after your claim has been approved, or while you are receiving treatment.

Your Return-to-Work Specialist will be responsible for helping you return to work or find a suitable alternative job. They will:

  • Coordinate with your health care provider and your Case Manager to make sure you are ready to start your return.
  • Monitor your progress and adjust the plan as needed.
  • Help find other work options if returning to your employer isn’t possible.

Your Nurse Consultant will help guide your care and support your recovery while working closely with your Case Manager and Return-to-Work Specialist. They will

  • Monitor your recovery progress and how your treatment is going. They will ask you how your daily activities are going, how you are managing your emotions, how you are getting along in social situations, and if your symptoms are improving overall.
  • Ensure that your treatment is effective and help adjust it if needed to better support your mental health.
  • Communicate with your team to support coordination of care. They work with your Return-to-Work Specialist and Case Manager to provide clinical advice, opinions, and guidance on your recovery plan.
  • Connect you to the right care as quickly as possible by referring you to the right health care supports, including any specialized care unique to your needs.

Your role in recovery and return-to-work planning

Our role is to help guide and support you through recovery and safe return to work. Your cooperation in the return-to-work process is important. There are certain responsibilities and obligations required of you and potential consequences if you choose not to follow the process.

We expect that you will:

  • Follow treatment plans and medical advice from your health care professional, including going to any medical assessments that we arrange.
  • Follow recommendations from health care providers.
  • Stay in contact with your Case Manager and Return-to-Work Specialist about your progress or any change in your condition that caused your mental stress injury.
  • Follow your return-to-work plan.
  • Attend rehabilitation or training programs (if applicable) to help you transition back to work.
  • Work with your employer and your Return-to-Work Specialist to make necessary adjustments to your work environment.
  • Report difficulties or setbacks in your recovery to your employer and Case Manager.
  • Report any improvements in how you feel, especially if it involves looking for other employment activities for the time being.

Your employer’s role in return to work

Your employer’s involvement is essential to your recovery, and we’ll work closely with them to ensure a smooth transition back to work. We expect your employer to:

  • Create a supportive and safe work environment for you to return to.
  • Work with you and your Return-to-Work Specialist to develop a practical plan.
  • Offer modified or alternative work when appropriate and make necessary workplace accommodations.
  • Stay in touch and provide you with ongoing support.
  • Report to us and provide supporting documentation when needed, to ensure their compliance with the process.

If returning to your current employer is not possible, we will help you explore other job options.

Crisis support:

  • If you or someone you know is thinking of suicide – call 911, go to the nearest hospital or call 9-8-8 to access the Suicide Crisis Helpline for 24/7 crisis support.
  • If you are in distress, please visit the Distress and Crisis Ontario website for distress centres servicing your community.
  • If you are a first responder, access 24/7 confidential support and peer support by visiting Boots on the Ground or calling 1-833-677-2669.