Do work leaves cause depression or does depression cause work leaves? We teamed up with researchers at The Standard, The Council for Disability Awareness, and The University of California, Davis to try and shine some light on this question.

Using an integrated database of medical and disability claims with more than 496,000 short-term disability cases,1 we found that 5% of employees going out on work leaves for a physical injury or illness without pre-existing depressive disorders (herein called “depression”) ended up experiencing new-onset depression in the following year. When comparing to employees without a work leave, the rate of new-onset depression was only 2%. These results underscore that illnesses or injuries requiring a work leave place a strain on employees’ mental health.

Although understanding the rate of new-onset depression is important, an even greater proportion of employees (7.8%) had pre-existing comorbid depression before going out on a work leave. The relationship between the prevalence of pre-existing depression changed depending on the reason for the work leave. For example, employees going out for work leaves due to endocrine, nutritional, and metabolic diseases (e.g., obesity, diabetes mellitus) had the highest rate of pre-existing depression (13.7%), whereas employees going out for work leaves for diseases of the circulatory system (e.g., hypertension, cerebral infarction) had the lowest rate of pre-existing depression (5.7%).

Our research shows that depression can behave as both chicken and egg, with depression being a risk factor for an initial injury or illness requiring time away from work, and the onset of depression may occur as a result of being injured or ill and time away from work. Clinicians and case managers overseeing disability claims should understand the varying risks employees face from pre-existing and new-onset depression. Our research, to be published in a peer reviewed journal, will provide a detailed analysis of work leave reasons on which disability managers should place the most focus.  We hope that this research will provide useful, real-world numbers that help make sense of the industry’s dogma on the relationship between depression and work leaves.

Need help managing a work leave claim with depression? ACOEM’s clinical practice guidelines on Depressive Disorders are now available at

1 Data used are from IBM® Watson™ MarketScan® databases. This is deidentified general data that may not reflect any particular disability insurance carrier’s or individual’s experience. Any analysis, interpretation, or conclusion based on these data is solely that of the authors and not IBM Corporation.


Information provided on this blog is intended for general educational use. It is not intended to provide medical advice. ReedGroup does not provide medical services. Consult a physician for medical advice on this or any other topic.

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