International Journal of Law and Psychiatry, Vol. 22, No. 1, pp. 79–89, 1999 Copyright © 1999 Elsevier Science Ltd Printed in the USA. All rights reserved 0160-2527/99 $–see front matter PII S0160-2527(98)00019-3 79 Workers’ Compensation and Stress Gender and Access to Compensation Katherine Lippel* Introduction Workers’ compensation schemes in many North American jurisdictions com- pensate for psychological disability related to workplace stress. In North America those who become unable to work due to psychological disability of- ten have, as their only access to economic support, recourse to workers’ com- pensation legislation. Laws in all North American jurisdictions were initially conceived for physical accidents in the workplace. Compensation legislation dates back to the turn of the century, when far fewer women were in the work- force. Over the years, in most jurisdictions, the courts have adopted an evolu- tionary approach when construing provisions defining work accidents and oc- cupational illnesses. This sometimes implies stretching the literal meaning of the words used in the statute to cover the new factual situation caused by evo- lution in work practices over the decades. Stretching meaning necessitates the use of discretion by the decision-maker, and discretion is often exercised on the basis of the values of the decision-maker and his or her perception of what would be an equitable result in a given case. The majority of North American jurisdictions now compensate for psycho- logical disability related to workplace stressors, although the scope of the leg- islation varies greatly from state to state and from province to province (Lip- pel, 1989, 1992). Access to compensation implies access to health care, medication, some form of salary replacement during the period of temporary disability, monetary compensation for permanent disability, and in some cases *Professor, Département des Sciences juridiques, Université du Québec à Montréal, Canada. I am grateful for the financial support of the Conseil québécois de la recherche sociale and for the invaluable assistance of Professor Diane Demers, Mme Nicole Filion, Mme Catherine Néron, and Mme Solange Pronovost in the preparation of preliminary research used in this article. Address correspondence and reprint requests to Prof. Katherine Lippel, Département des Sciences juridiques, Université du Québec à Montréal, C.P. 8888, Succursale Centre Ville, Montréal, Québec, Can- ada, H3C 3P8; E-mail: lippel.katherine@uqam.ca