A primary psychological injury is a mental health condition that’s a direct result of your work, such as PTSD after a traumatic incident or anxiety from workplace bullying.
A secondary psychological injury is a mental health condition that develops as a result of a physical work injury, such as depression brought on by chronic pain.
Both can qualify for compensation through WorkCover Queensland, but they are assessed in different ways.
Understanding primary and secondary psychological injuries
Both are mental health conditions connected to work. The difference is the cause, and that difference changes how claims are assessed.
What is a primary psychological injury?
A primary psychological injury is a mental health condition that was caused by your job on its own, with no physical injury involved. Common examples are post-traumatic stress after a violent or distressing incident, or anxiety and depression from sustained bullying, harassment or an unmanageable workload.
A paramedic who develops PTSD after repeated exposure to trauma would be considered to have a primary psychological injury, as would an office worker who develops clinical anxiety after sustained harassment.
What is a secondary psychological injury?
A secondary psychological injury is a mental health condition that develops because of a physical injury you already have. The psychological condition must follow a physical injury.
A worker with a serious back injury who develops depression because of constant pain, loss of independence and no longer being able to work would count as having a secondary psychological injury.
Why the label matters
The label decides how your condition is considered at the claim stage and whether it can qualify for a lump sum payout down the line.
It also affects which arguments an insurer is likely to use against you, so getting the causation story correct from the beginning is the single biggest thing you are in control of.
How each type is treated for compensation
Both primary and secondary psychological injuries can earn compensation from WorkCover Queensland, which means they can also give you access to statutory benefits.
The treatment starts to differ when permanent impairment is involved.
What both types can cover:
- Reasonable medical treatment, including psychology and psychiatry
- Rehabilitation and support for recovery and returning to work
- Weekly payments to replace lost income while you are unable to work
Where they differ:
- A primary psychiatric or psychological injury can be assessed for a Degree of Permanent Impairment (DPI) by the Medical Assessment Tribunal. If your injury meets a certain threshold, you could be awarded a lump sum payout.
- A secondary psychological injury is not usually given its own DPI. In the majority of cases it won’t be awarded a separate lump sum on top of the physical injury it stemmed from.
If your injury was the result of employer negligence, you may be able to make a separate claim through a lawyer on top of your WorkCover claim.
This is known as a common law claim, and your permanent impairment assessment affects your options here, so it’s worth doing some research into the permanent impairment assessment process before accepting an offer.
The "significant contributing factor" test
For any psychological injury to qualify for compensation, your employment must have been a significant contributing factor to the condition.
This is laid out in section 32 of the Workers' Compensation and Rehabilitation Act 2003 (Qld).
Until recently, a psychiatric or psychological injury was scrutinised more closely: employment had to be "the major significant contributing factor," but the Workers' Compensation and Rehabilitation and Other Legislation Amendment Act 2024 (Qld) removed the word "major."
For any injury sustained on or after 23 August 2024, employment only needs to be a significant contributing factor, which is the same criteria that applies to physical injuries.
This lowered the threshold and is expected to see a rise in the amount of psychological claims accepted. The new criteria applies to the date the injury occurred, so the timeline matters for your claim.
The reasonable management action exclusion
The most common reason for a primary psychological claim being rejected is the reasonable management action exclusion.
A psychiatric or psychological disorder is not considered an "injury" if it arises from reasonable management action taken in a reasonable way.
The Workers' Compensation and Rehabilitation Act 2003 (Qld) lists examples of management action, including action to transfer, demote, discipline, redeploy, retrench or dismiss a worker, and a decision not to give a promotion or benefit. It also covers your expectation or perception of that action, and action taken by the insurer or regulator about your claim.
The exclusion only applies when the action was both reasonable to take and taken in a reasonable way. Poorly handled disciplinary proceedings or performance management used as a cover for bullying will not always fulfill that criteria.
This exclusion is a bigger issue for primary claims than for secondary claims, which stem from a physical injury that has already been accepted.
Common scenarios and questions (FAQs)
How do I know if my injury is primary or secondary?
Ask whether a physical injury came first. If your mental health condition developed because of a work event that didn’t involve a physical injury, it is primary. If it developed because of a physical work injury you already have, it is counted as secondary. If you’re not sure, your treating doctor's opinion on the cause carries significant weight.
Can I claim if my depression came from chronic pain after a back injury?
Yes, this is the classic secondary psychological injury. You would report the psychological injury as connected to your already accepted physical claim. Inform your doctor that the depression is linked to the pain and limitations caused by the back injury, so that the connection is documented from the beginning.
My claim was rejected as "reasonable management action," what does this mean?
It means the insurer decided your condition came from ordinary workplace management, not a compensable injury. The action still has to have been reasonable and carried out in a reasonable manner. If discipline, performance management or a restructure was handled unfairly, that decision can be challenged.
Does it matter which type I have if I just want my treatment covered?
When it comes to treatment and weekly payments, both types are covered when the claim has been accepted. The distinction matters most later on, when permanent impairment and any lump sum are considered. It is still worth getting the causation correct early on because it affects the later stages.
Can I get a lump sum for a secondary psychological injury?
Usually not as a separate amount. A secondary psychological injury is not usually assessed for its own degree of permanent impairment, so it does not qualify for a stand-alone lump sum. A primary psychiatric injury can be assessed by the Medical Assessment Tribunal and may result in a lump sum if it meets the required threshold.
What if bullying from my employer caused my psychological injury?
Bullying that is not part of reasonable management action can support a primary psychological injury claim. Keep records of any incidents, the dates they occurred and all reports you made. If negligence was a factor, you may also have options beyond a statutory WorkCover claim.
Your rights and what you must do
Once you have a claim accepted, you have clear entitlements as well as obligations that keep your claim on track.
What you are entitled to:
- Payment for reasonable medical and psychological treatment
- Weekly compensation while you are unfit for work (based on your pre-injury earnings)
- Rehabilitation support to aid your recovery and return to work
- Assessment of permanent impairment for a primary psychiatric injury (where applicable)
What you must do:
- See a doctor and get a workers' compensation medical certificate
- Tell your employer about the injury and lodge your claim
- Follow any and all reasonable treatment and rehabilitation recommendations
- Give accurate information about how the condition is connected to your employment
What the numbers show
Secondary psychological injuries are becoming more and more common as scheme data gets better at spotting them.
According to WorkSafe Queensland, the number of secondary psychiatric injury claims almost tripled between 2013 and 2023.
WorkSafe Queensland also reports that around 5.1% of accepted physical-injury claims involving time off work now also have an accepted secondary psychological injury, a two-fold increase over the last five years.
Those claims cost around five times more than a physical injury alone, and involve almost triple the average time off work.
This trend isn’t exclusive to Queensland either. Safe Work Australia found that mental health conditions made up about 9% of serious workers' compensation claims across the country in 2021-22, a 36.9% rise since 2017-18.
Red flags and warning signs
Watch out for these signs that a psychological injury is being handled poorly:
- The insurer treats your psychological condition as part of your physical claim and never investigates it on its own
- Your claim is rejected as "reasonable management action" with no details on what the action was or why it was considered reasonable
- You are pressured to return to work before your treating doctor agrees you are fit to do so
- No independent psychiatric assessment is arranged before a decision is made
- You are asked to give a recorded statement about workplace conflict before you have had advice from a professional
Common mistakes to avoid:
- Delaying seeing a GP, which weakens the medical record of the advent of the condition
- Not telling your doctor that the condition is work-related
- Accepting a first-instance rejection without checking your review options
When to get legal advice
Some psychological claims are straightforward, but many hinge on causation, the management action exclusion or how a permanent impairment is assessed.
It’s always a good idea to seek legal advice at the earliest opportunity in cases involving psychological injury, especially if:
- Your claim has been rejected, especially on "reasonable management action" grounds
- Your condition is being treated as secondary when you believe it stands on its own
- You are being assessed for permanent impairment or offered a lump sum
- You think employer negligence contributed to your injury
Why early advice matters: in Queensland, an application to review a WorkCover decision must be made to the Workers' Compensation Regulator within 3 months of the decision in most cases, so waiting can cost you the right to challenge it.
Insurers also resolve represented claims differently from unrepresented ones because when a claimant has a lawyer, the insurer knows the matter can be taken further if it isn’t handled in good faith, and that changes the negotiation rather than just the paperwork.
For more detail on the wider category, see our guides to workplace psychological injury claims in Queensland and secondary psychological injuries in WorkCover claims.
Key takeaways
Remember these essential points:
- A primary psychological injury is caused directly by work; a secondary one develops from a physical work injury. The cause decides how the claim is treated.
- Both types can be compensable for treatment, rehabilitation and weekly payments.
- Employment must be a significant contributing factor, a test that became easier for psychiatric injuries sustained on or after 23 August 2024.
- Primary claims fail most often on the reasonable management action exclusion, which only applies when the action was reasonable and carried out reasonably.
- A secondary psychological injury usually doesn’t get its own lump sum payout, while a primary psychiatric injury can be assessed for permanent impairment.
Get Help Now
If you have a work-related psychological injury in Queensland, Smith's Lawyers can review your situation at no cost and explain your options.
Call 1800 960 482 o request a free case review, or use the form below this article.
There is no upfront cost and no risk to start because every claim is handled under our No Win, No Fee, No Catch® promise.
