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Nightmares After a Work Accident? Your Workers Comp Claim Can Pay for a Psychologist

Nightmares After a Work Accident? Your Workers Comp Claim Can Pay for a Psychologist

The physio says your back is getting better, but at 3am you’re awake again. It’s the same dream about the accident, and your heart is beating fast. You lie very still so the pain doesn’t start. The nightmares after a work accident often arrive like this, weeks after everyone else has decided you’re recovering.

In the day it’s smaller things. A truck reverses in the supermarket car park and the beeping makes you jump. You drive the long way to work so you don’t pass the loading dock.

At dinner you get angry at the kids over small things. Everyone says it’s the pain.

It was your body that got hurt, but now it’s your mind that won’t settle, and you feel ashamed and confused.

It makes sense that this is happening to you. It can be treated. When your body is healing and your sleep and your temper are still not right, that can be part of the same injury. And the workers compensation claim you already have can pay for a psychologist too.

Nightmares after a work accident can be part of the same injury

A frightening work accident can hurt you twice. Once in the part the X-ray can see, and once in the part that remembers how close you came to something worse.

Three months after an injury, some people have depression, or fear reactions that won’t fade (post-traumatic stress disorder, or PTSD). A year later, they’re more than three times as likely to be struggling with daily life. An Australian study found this. It followed more than 800 people treated at four hospitals, including Westmead in Sydney, after injuries serious enough to need a hospital stay.

After something frightening, the brain area that watches for danger learns to watch for it happening again. (There’s more on how that works in how trauma and PTSD change the brain.) That’s why a reversing beeper can frighten you far more than a small noise usually would.

Then the pain gets involved. It reminds you of the accident. Your body gets ready for danger again. Being afraid tightens your muscles, and tight muscles make the pain feel stronger.

It’s like two babies sharing one small room. When one wakes up crying, it wakes the other. Then neither of them sleeps. Researchers Timothy Sharp and Allison Harvey described pain and PTSD in a similar way: each one makes the other last longer.

For a lot of people, stress is felt in the body. Headaches every afternoon. A sore stomach. A tight chest for no clear reason. A study of Vietnamese people living in New South Wales found that body symptoms were the most common sign of distress. If “my head hurts” is easier to say than “I’m stressed”, tell your doctor about the headaches anyway.

For example, a forklift driver’s foot is crushed under a pallet. Over two months he sees his GP three times about headaches and a sore stomach. He never mentions that most nights he wakes up seeing the pallet fall, or that he now parks far away from the forklifts. So the GP treats the headaches, but the nightmares never get treated. If this sounds like you, tell your GP about your sleep and the nightmares too.

You can start before your body has healed. A psychologist can treat the nightmares and the jumpiness in the same weeks the physio is treating your body. As the fear eases, the pain can get easier too.

What you can do this week

Here are six things you can start now that might help.

1. Write down what’s changed

Before your next GP appointment, spend five minutes writing down what’s different since the accident. How you’re sleeping. Whether you jump at sounds. Places you now avoid. Headaches or stomach trouble. How often you’ve lost your temper this week.

Two or three lines in your phone’s notes are fine. Your doctor gets something clear to work from. You won’t have to think of the words during the appointment.

2. Tell your GP, and ask for a psychologist

Your GP is the person who starts this, usually in this order:

  • Tell your GP what you wrote down, in your own words.
  • Ask them to add it to your medical certificate as part of your work injury.
  • Ask for a referral to a psychologist.
  • When you book, check the psychologist is approved to treat workers comp patients.

It goes on the claim you already have. The insurer decides whether to accept it and approves the psychologist sessions before they start. When workers comp pays, there’s nothing for you to pay (no gap fee).

Seeing a psychologist through your claim is treatment for an injury, like seeing the physio. Some people don’t tell their GP because they’re afraid it could cost them their job or their visa. If that’s you, a lawyer can explain your rights before you decide.

3. If you hit your head, say so

A knock to the head and a frightening accident can cause similar problems: trouble concentrating, getting angry quickly, poor sleep, low mood, forgetting things. If you hit your head at any point in the accident, tell your GP, even if you didn’t lose consciousness. Both need checking.

4. Keep moving, gently

Rest helps in the first days. After that, weeks of lying still keep both babies crying, because the muscles get weaker and the worry about moving grows.

Do the small, regular movement your physio has agreed to. On a bad day, that might be a walk to the corner and back, or standing at the sink to wash up.

5. Save the full story for your psychologist

People will ask what happened. Some want every detail. You may feel you have to give it. In the early weeks, what helps most is information about what’s happening to you, emotional support, and practical help with the things you can’t do right now. Australia’s national PTSD guidelines, from Phoenix Australia, suggest this kind of help early on. Going through the accident in detail is work to do with someone trained to do it safely.

6. Ask for an interpreter

If English isn’t your first language, ask for an interpreter when you book your GP appointment. When you see us, we provide interpreters where needed.

If there’s no open claim

Everything above assumes the claim for your physical injury is open. For advice on your own situation, talk to a lawyer or the Independent Review Office.

  • Injury never reported. Tell your employer and your GP. A late claim can sometimes still be made.
  • Claim disputed or declined. The Independent Review Office is independent of the insurer, has interpreters, and can pay for a lawyer to advise you.
  • Claim closed, or payments stopped. Ask the insurer whether psychology can still be approved. If it can’t, you can see a psychologist privately.

What changes when the nightmares get treated too

With the right treatment, the accident can become something you remember without your whole body reacting to it. You sleep through more nights. You drive past the loading dock on the way to work.

Treating the fear can help the physio work go better. Left alone, the two babies can keep each other awake for a long time. The people at home feel it too.

Have your list from step 1 open on your phone when you sit down with your GP.

How ProActive can help

ProActive Psychology takes workers comp referrals at our Fairfield and Bankstown clinics, with interpreters where needed. When workers comp pays, you pay nothing extra. If your claim is closed or was declined, we also see people privately.

Either way, the first step is to ask your GP for a referral at your next appointment. Then book your first session.

References