Is Mental Health Covered by Workers' Comp in Missouri?

AUTHOR: A.J. Bruning | April 27, 2026
Is Mental Health Covered by Workers’ Comp in Missouri?

Mental health conditions are only covered by Missouri workers' compensation under very specific and strict circumstances. Missouri law states that a mental injury must be directly caused by a work-related trauma or stress that is deemed "extraordinary and unusual." It is much harder to prove than a physical injury and is best handled by a St. Louis workers' comp lawyer.

Missouri law RSMo 287.120 states that a mental injury must be caused directly by work-related trauma or experiencing "extraordinary and unusual" stress greater than what an average employee in the same position faces. The coverage applies to what is known as physical-mental, or physical injury leading to mental illness, or mental-mental, a trauma without any physical injury.

The burden of proof is much higher than cases where workplace injuries are involved. Injured workers must prove with clear and convincing evidence that the workplace was the main factor that caused the injury. Routine work stress from general deadlines, performance work reviews, or layoffs is not covered by Missouri mental health coverage for workers' comp.

A formal diagnosis from a licensed psychologist or psychiatrist is required, and the mental health injury needs to be reported to your employer within 30 days, the same time limit required for physical injuries.

When is an employer required to have workers' comp in Missouri? If they have 5 or more employees, or just one in the construction industry, an employer has to have workers' comp insurance. If you are an independent contractor, you may wonder, can independent contractors get workers' comp in Missouri? When you're left high and dry, The Bruning Law Firm helps you understand your rights and options under Missouri workers' comp laws and fights to ensure that when applicable, mental health is covered for you too.

Frequently Asked Questions

Can I get workers’ comp for PTSD after witnessing a traumatic event in Missouri?

In certain workplaces, you may be exposed to witnessing a traumatic accident at work that leaves someone seriously injured or causes their death. This can cause you to develop post-traumatic stress disorder (PTSD), which may be covered. However, you will need to prove that the event you witnessed was extraordinary and unusual for your profession as well as provide an official medical diagnosis.

Are firefighters in Missouri treated differently for mental health claims?

Yes, the law in Missouri is designed to provide specific protections for first responders, including firefighters. Under Missouri law, firefighters are exempt from the stricter requirements that are applied to other types of employees for PTSD claims. Firefighters and first responders have a stronger pathway for receiving these benefits after witnessing horrific injuries or seeing a deceased child.

What can I do if my Missouri workers’ comp mental health claim is denied?

If your workers' comp mental health claim is denied in Missouri, you can use your right to file an appeal with the Missouri Division of Workers' Compensation. Since insurers tend to argue that mental health issues are pre-existing or the result of personal life stressors, it is imperative that you work with a St. Louis workers' comp attorney to help you establish that high burden of proof. Reading the Missouri Workers' Compensation Laws: Complete Guide can also provide insight.

Contact The Bruning Law Firm

The Bruning Law Firm helps workers who have experienced profound mental health impacts understand their rights and options under Missouri workers' compensation laws and fights to ensure benefits coverage. There is no fee unless we win, so call (314) 735-8100 today to schedule a free consultation with a St. Louis workers' compensation lawyer.

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A.J. Bruning

Founder

I was born and raised to represent individuals who have been needlessly injured. I mean that literally. At a young age my father would tell me about the clients he was representing. I would meet them and take pride in their admiration of my father. I always knew I wanted to be a lawyer and represent clients that needed my help.

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