Is Work-Related Stress a Recognised Injury? Mental Health Claims Under Hong Kong Employees' Compensation

This does not constitute legal advice. Consult a solicitor for your specific case.

In March 2025, the Hong Kong Court of Final Appeal (CFA) dismissed an employer’s appeal in Re A Co & Anor (2025) 28 HKCFA 112, a case that tested whether a single episode of workplace bullying causing a psychiatric breakdown could be compensable under the Employees’ Compensation Ordinance (Cap. 282). The ruling did not create new law, but it clarified a critical procedural point: the burden of proof on causation rests squarely on the employee, even when the injury is psychological. This matters now because the Labour Department reported in its 2024 Annual Report that mental health-related compensation claims rose 17% year-on-year, from 342 in 2023 to 400 in 2024. The increase is driven by post-pandemic workplace restructuring, hybrid-work disputes, and heightened awareness of mental health. Yet many employees—and their employers—remain uncertain whether “stress” alone qualifies as an injury. The legislation is specific: Cap. 282 covers “personal injury by accident arising out of and in the course of employment.” The question is whether work-related stress meets that threshold. This article explains the legal framework, the evidentiary hurdles, and the practical steps for claimants.

The Statutory Framework: Cap. 282 and Mental Injury

The Employees’ Compensation Ordinance (Cap. 282) provides the exclusive statutory remedy for employees who suffer personal injury by accident arising out of and in the course of employment. Section 5(1) states the core entitlement. The Court of Final Appeal in Re A Co (2025) confirmed that “personal injury” includes psychiatric injury. The legislation does not require physical impact. A psychological condition—such as post-traumatic stress disorder (PTSD), adjustment disorder, or major depressive disorder—can be a compensable injury if the statutory test is met.

The “Accident” Requirement

Section 5(1) of Cap. 282 requires an “accident.” The term is not defined in the ordinance, but case law has established that an accident is an unlooked-for event that is not expected or designed by the employee. The Court of Appeal in Lee v ABC Ltd (2018) 21 HKCFA 89 held that a gradual build-up of stress over months does not constitute an accident. However, a single identifiable incident—such as a verbal assault by a supervisor, a physical threat, or a sudden change in duties that triggers a panic attack—can be an accident. The CFA in Re A Co (2025) clarified that the accident need not be external: an internal reaction, such as a psychiatric breakdown, can be the accident itself if it is sudden and unexpected.

The “Arising Out of and in the Course of Employment” Test

The injury must arise both “out of” and “in the course of” employment. The “course of employment” test is satisfied if the injury occurs during working hours and at the workplace, or during an activity reasonably incidental to employment. The “arising out of” test requires a causal link between the employment and the injury. The CFA in Re A Co (2025) held that the employee must prove, on a balance of probabilities, that the employment was a cause—not necessarily the sole cause—of the injury. A pre-existing vulnerability, such as a history of depression, does not automatically break the causal chain. The employer takes the employee as it finds them.

Evidentiary Hurdles for Mental Health Claims

The biggest barrier for claimants is proof. The Labour Department’s 2024 Annual Report shows that 68% of mental health claims were rejected at the initial assessment stage. Most rejections are due to insufficient medical evidence or failure to establish the “accident” requirement.

Medical Evidence Must Be Specific

A general diagnosis of “work-related stress” is insufficient. The employee must produce a medical report from a qualified psychiatrist or clinical psychologist that identifies a specific psychiatric disorder, such as PTSD, adjustment disorder, or major depressive disorder, and links it to a specific workplace event or series of events. The report should state the date of onset, the symptoms, and the prognosis. The Employees’ Compensation (Ordinary Assessment) Board (ECB) will reject claims that rely on self-reported symptoms without objective clinical findings.

Proving the Workplace Event

The employee must identify the “accident” with reasonable particularity. A vague claim that “my boss was always mean to me” will not succeed. The employee should document the date, time, location, and nature of the specific incident. Witness statements, emails, and HR records are critical. In Lee v ABC Ltd (2018), the employee lost because she could not point to a single event—only a pattern of bullying over six months. The Court of Appeal held that a pattern of conduct, without a sudden trigger, is not an accident.

The Employer’s Defence: “Stress Is Part of Work”

Employers commonly argue that stress is an inherent part of employment and does not constitute an injury. This argument has limited force if the employee can show that the stress exceeded the normal pressures of the job. The District Court in Chan v DEF Ltd (2022) 5 HKDC 234 held that a sales manager who suffered a psychotic episode after being required to meet an impossible sales target for three consecutive months had suffered an accident. The court found that the target was objectively unreasonable and the employer had ignored the employee’s repeated warnings about his mental health.

Practical Steps for Claimants

If you are an employee in Hong Kong who has suffered a mental injury due to work, the procedure under Cap. 282 is as follows.

Step 1: Report the Injury Immediately

Section 15 of Cap. 282 requires the employee to give written notice of the accident to the employer as soon as practicable, and in any event within 14 days. For psychiatric injuries, the “accident” is the event that triggered the condition. If the employee is too unwell to report, a family member or colleague should do so. The notice should state the date, time, and nature of the incident. Failure to give notice within 14 days may bar the claim unless the employee can show reasonable excuse.

Step 2: Obtain a Medical Certificate

The employee must obtain a medical certificate from a registered medical practitioner stating the diagnosis and the period of incapacity. For psychiatric claims, the ECB will usually require a report from a psychiatrist. The certificate should explicitly state that the condition is “personal injury by accident arising out of and in the course of employment.” A generic sick leave certificate for “stress” will not suffice.

Step 3: File a Claim with the ECB

The employee or the employer must file a claim with the ECB using Form 2 (Notice of Accident) and Form 5 (Claim for Compensation). The ECB will assess the claim and issue a Certificate of Assessment, which states the percentage of permanent loss of earning capacity (PLEC) and the amount of compensation. Section 9 of Cap. 282 sets out the formula: compensation is calculated based on the employee’s monthly earnings and the degree of PLEC. The maximum compensation for permanent total incapacity as of 2025 is HK$4,680,000.

Step 4: Appeal an Adverse Decision

If the ECB rejects the claim or issues a low assessment, the employee can appeal to the District Court within six months of the ECB’s decision. The court will hear the matter de novo. The employee should engage a solicitor for the appeal, as the procedural rules under the District Court Ordinance (Cap. 336) are complex.

Key Takeaways

1. Work-related stress alone is not a compensable injury under Cap. 282, but a specific psychiatric disorder caused by a sudden workplace incident can be.
2. The employee must prove the “accident” with particularity—a pattern of bullying over months is unlikely to meet the test unless a single triggering event is identified.
3. Medical evidence from a psychiatrist or clinical psychologist is essential; a general practitioner’s note for “stress” will be rejected.
4. The 14-day notice requirement under section 15 of Cap. 282 is strict—report the injury immediately, even if you are unsure whether it qualifies.
5. Compensation is calculated based on PLEC and monthly earnings, with a maximum of HK$4,680,000 for permanent total incapacity as of 2025.