More States Move To Cover PTSD For First Responders

Liz Carey

Tallahassee, FL ( – Frequent shootings in 2018 prompted some lawmakers to protect first responders suffering from PTSD through legislation.Providing workers’ compensation benefits to first responders who develop PTSD as a result of exposure to work-related trauma may again be a prevalent issue in state legislatures this year.

A new law taking effect in Minnesota this year will help first responders with PTSD get workers’ compensation coverage. The new law will ensure that any public safety employee diagnosed with PTSD will be covered by workers’ compensation, and that the PTSD will be presumed to be work-related.

A bill in Kentucky that would make PTSD a compensable condition without an associated physical injury has been pre-filed for the legislative session, said Robert Swisher, commissioner for the state’s Department of Workers’ Claims.

“Kentucky [currently] covers a psychological, psychiatric and stress-related condition only if such condition is the direct result of a physical injury,” Swisher told “PTSD is not specifically mentioned in the Kentucky Workers’ Compensation Act but would be treated the same as any other alleged psychological injury: compensability is triggered only if the psychological condition is the direct result of a physical injury.”

Ironically, Swisher said, PTSD would have been covered prior to 1994 even without an injury. A statutory amendment was filed in 1994 that changed the definition of “injury” from “any work-related harmful change in the human organism, arising out of and in the course of employment…” to a more constrictive definition that added “’Injury’ when used generally, unless the context indicates otherwise, shall include an occupational disease, but shall not include a psychological, psychiatric, or stress-related change in the human organism, unless it is a direct result of a physical injury.”

Last year, Florida legislators passed a law that expanded workers’ compensation coverage of PTSD in first responders. The law, which went into effect in October, arose out of concern for first responders dealing with mental trauma in the days following the Pulse nightclub shooting and the Parkland, Fla. Shooting at Marjorie Stoneman Douglas High School shooting in 2016 and 2018, respectively.

Previously, such coverage for first responders with PTSD only included medical benefits. Last year’s law extended coverage to include indemnity benefits.

But some advocates for first responders say the law doesn’t go far enough.

Geoff Bichler, an Orlando attorney who represents first responders in workers’ compensation cases, said PTSD can’t be linked to just one incident and generally builds up over time.

“PTSD is not typically diagnosed in first responders after a tragic event like Pulse,” he told a Tampa media outlet. “This is something that occurs as an accumulation over time, most often. One of the severe limitations of this bill is all of these triggering events that limit coverage.”

The bill provided that PTSD was covered by workers’ compensation provided that the condition arises as a result of the first responder’s employment, that the first responder is examined and diagnosed by a licensed psychiatrist authorized to treat injured workers; that the PTSD arose due to one of eleven specific traumatic events – such as seeing a deceased minor, or the death of a minor; or witnessing events surrounding deaths involving “grievous bodily harm of a nature that shocks the conscience,” and that the PTSD is proven by medical evidence.

Also last year, a bill covering PTSD in first responders passed through the Washington House and Senate, but required that coverage would be provided to an employee provided that they had received pre-employment screening that ruled PTSD out prior to employment.

Washington’s Department of Labor & Industries estimated that the law would result in $2.6 million and $7 million in new exposures. According to the Washington Self-Insurers Association, the state actuary has estimated that the new law would cause a nearly $35 million increase in state pension costs “for law enforcement officers due to new claim in their pension system for line-of-duty disability on top of workers’ compensation.”

Arizona last year passed a law to provide first responders with more counseling services to help deal with the effects of PTSD. The legislation would cover up to 36 visits with a licensed therapist, and ensure that first responders not lose pay or benefits if they are found to be not fit for duty because of PTSD, and that their employers can’t make them use paid time-off to attend counseling.

PTSD legislation was passed in 2017 in several states, including Texas, Vermont and Colorado. South Carolina passed a law that provided counseling for first responders suffering from PTSD, but made payment for those counseling sessions through third party non-profit organizations.

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