State approaches to PTSD coverage vary

The push to cover post-traumatic stress disorder for first responders is likely to continue despite challenges, according to experts.

Legislation “has flipped the burden of proof, and there are more cases being filed,” said Mark Kleinschmidt, partner at Mendota Heights, Minnesota-based law firm Cousineau, Waldhauser & Kieselbach PA.

“It’s very difficult to figure out … objective measurements by which to say the person was exposed to a traumatic incident. You’re looking at a treatment cost that’s difficult to manage, and along with the treatment cost comes the period of disability … that might be longer than a physical injury.” 

California, Maine, Minnesota, Oregon and Vermont have passed occupational presumption legislation for PTSD. Colorado, Connecticut, Florida, New Mexico, New Hampshire, New York, Nevada, Texas and Washington have passed legislation that makes PTSD diagnosis compensable for certain first responders. Some bills, like those in Florida and Connecticut, define exactly what types of traumatic events must be witnessed for PTSD to be compensable.

Hawaii, Michigan, North Carolina, Tennessee, Virginia and West Virginia all introduced some form of first responder PTSD legislation at the beginning of the 2019 legislative session but none have become law.

Ohio had considered the addition of PTSD presumption for first responders, but the language was stripped from the 2019 budget by the state’s Senate until further study into the cost of the presumption could be conducted.

South Carolina took a different approach by creating a fund to help first responders with out-of-pocket medical costs related to PTSD treatment.

Although most of these PTSD laws limit coverage to firefighters, police officers and emergency medical technicians, other public workers and even some groups in the private sector are fighting for PTSD presumption coverage, said Desiree Tolbert-Render, Orlando, Florida-based assistant vice president of national technology compliance for workers compensation at Sedgwick Claims Management Services Inc.

“What you are seeing more are attempts to expand” coverage, she said. “For instance, in some states where they started out with firefighters and police, it’s expanded to include other state employees, correctional officers.”

That includes the private sector. California nurses and Connecticut private ambulance drivers have been lobbying to have PTSD preemptively compensable, said Ms. Tolbert-Render, and teachers have also argued why they may witness a tragic event — such as the Sandy Hook Elementary School shooting in 2012 — but don’t have the same benefits as a first responder on the scene.

“If it keeps expanding, it’s probably going to end up being cost-prohibitive,” she said.