Michelle Kerr is Workers’ Compensation Editor and National Conference Chair for Risk & Insurance. She can be reached at [email protected].
If you’ve read NCCI’s 2025 Legislative and Regulatory Trends Report, you know there was a lot to unpack in this edition.
One takeaway that’s been on my mind: Is mandated mental health coverage expanding faster than we can deliver it? This year alone, multiple states enacted or advanced legislation expanding workplace PTSD and mental injury coverage. Each of these laws represents important new protections for vulnerable workers.
But here’s my question: Who’s going to treat them? For decades, mental health claims in workers’ comp were few and far between. As laws and claim volumes have evolved however, mental health provider networks in workers’ comp are slow to catch up.
Workers’ comp doesn’t just need mental health providers. It needs providers with a specialized understanding of the unique landscape of issues impacting workers’ comp claims, including trauma and PTSD. First responders make up the lion’s share of mental health claimants in workers’ comp. But how many therapists have training in treating first responder trauma?
At National Comp 2021, I heard a sheriff speak about seeking treatment for PTSD The first provider he saw was so unprepared to hear about the horrors of his line of work that he feared he’d traumatized her as well.
Workers’ comp needs providers who understand occupational trauma and workplace cultures who can navigate workers’ comp documentation, can collaborate with employers on return-to-work planning, and will accept workers’ comp fee schedules and utilization review protocols.
That’s an alarmingly small pool. It creates a commitment to care without pathways to provide it. Some states are beginning to recognize this gap. But most are expanding coverage and hoping the treatment infrastructure will somehow materialize.
It won’t. Adjusters will struggle to find qualified providers who will even take workers’ comp cases. Employers will face months-long delays on evaluations. Injured workers will be caught in the middle, their treatment approved in principle but inaccessible in practice.
So what do we do?
First, we need transparency. Treatment capacity assessments should be a first step for legislators expanding mental health coverage mandates.
How many qualified providers exist? What are current wait times? What are the barriers to provider participation?
Second, we need investment in training programs for occupational mental health and initiatives that make workers’ comp more attractive to providers – reasonable fee schedules, streamlined authorization, and reduced administrative burden.
Third, we need innovation. Telemedicine can expand access. Peer support networks could also complement professional care. Insurers, employers, regulators, provider organizations, and advoсacy groups all have a role in building sustainable treatment networks. This is an area where the workers’ comp community is perfectly positioned to lead.
We have experience building specialized provider networks. We understand occupational injury. We know how to create personalized return-to-work protocols. The question isn’t whether to cover mental health conditions in workers’ comp. That debate is over. The question is whether we’ll build the systems needed to make that coverage meaningful. &