Two states are taking steps to address the shortage of qualified mental health professionals in workers by authorizing licensed clinical social workers to treat injured workers.
California passed a law in 2022 that cleared the red tape for social workers to process in the workers’ compensation system, and New York, after passing a law in 2020 that addressed some hurdles, is considering legislation — AB 1014 — that would change the requirements. Workers comply with regulations in a third state, Texas, allowing licensed clinical social workers to assist with vocational rehabilitation.
Mark Debus, Chicago-based clinical director of behavioral health with Sedgwick Claims Management Services Inc., said the move toward allowing licensed clinical social workers to treat under worker competency makes sense, because they can handle many of the same issues typically handled by psychologists.
“Licensed clinical social workers have as much graduate-level experience as licensed psychologists in New York,”; he said. “They have to meet a certain level of supervised clinical expertise, basically, and direct treatment. It’s similar to the licensed psychologist requirement.”
California is another state where many of the requirements for both fields are equally stringent, according to Marcia Schwartzman Levy, Larchmont, New York-based former president of the New York chapter of the National Association of Social Workers and a licensed clinical social worker in private practice.
Both states have “some of the most stringent requirements to become a licensed clinical social worker,” she said.
Schwartzman Levy spent much of his career working in public hospitals in New York, including as clinical supervisor of the trauma unit. The link between physical injury and psychological injury has been well established, she said, pointing to literature dating back to 2001 on injuries and the “biopsychosocial model,” a term now widely used in workers’ compensation.
“I deal with grief, which is not just death in the larger sense; disability is a form of grief,” Schwartzman Levy said, adding that linking mental health problems and physical injuries has long been part of what licensed clinical social workers are asked to do. “The biopsychosocial model is at the core of our belief system and our training,” she said.
A big difference in the professions of licensed clinical social worker and psychologist is the salary. “Just look at the fee schedules,” said Mr. Debus, who called social workers “underpaid.”
Medicare, on which many workers’ compensation fee schedules are based, reimburses clinical social workers at 75% of the physician fee schedule, which varies by state, according to a 2021 report from the National Association of Social Workers. By comparison, psychologists are compensated at 100%.
Jennifer Cogbill, Frisco, Texas-based senior vice president of GB Care with Gallagher Bassett Services Inc., said many psychologists are reluctant to work at Medicare rates, which has led to a shortage of medical professionals in the workforce. Licensed clinical social workers can help make services more accessible to injured workers, she said.
“The benefit is that there is a wider network of professionals that they can tap into,” she said.