Purpose <p>Prior studies demonstrate that many injured workers find involvement in workers’ compensation processes complex and stressful. This study sought to identify experiences, events and interactions contributing to system-generated mental ill health.</p> Methods <p>Mixed methods design utilising an online survey and follow-up interviews. Eligible participants were workers employed in Australia, at least 18&#xa0;years of age, proficient in English, who had submitted a compensation claim. Survey items assessed demographic and claim information, claim experiences, and impacts of interactions with claim stakeholders and processes. Between September 2023 and July 2024, the survey was distributed through community organisations, worker support groups, and social media. Qualitative interviews took place between February and July 2024.</p> Results <p>A total of 533 participants completed the survey, and 20 completed an interview. Most survey participants (<i>n</i> = 503, <i>Median</i>_<i>age</i> = 45–54&#xa0;years, 59.2% women) reported negative mental health impacts. Of those, 279 reported negative experiences throughout the claim process, while the remainder reported more positive or mixed experiences. Hierarchical logistic regression indicated that negative interactions with insurers (<i>OR</i> = 5.22, 95%CI [1.89, 14.42]) and delays in claim approval (<i>OR</i> = 4.12, 95%CI [1.88, 8.99]) were significantly associated with negative claim experiences. The full logistic regression model accounted for 40% of the variation in claim experiences. Qualitative analysis of injured workers revealed themes around claim-related sources of stress and negative consequences from illness or injury.</p> Conclusion <p>Findings provide insights into modifiable aspects of compensation claim processes that, if actioned, may improve worker experiences during their claim and reduce the risk of secondary psychological injury.</p>