VT and CO Legislative Watch: PTSD Coverage Action


By Angela Underwood

Vermont and Colorado (WorkersCompensation.com) – Nationwide attention for Post-Traumatic Stress Disorder (PTSD) coverage has turned to Colorado and Vermont recently.

The evidence is present in both states, where legislation for the mental health injury respectively passed last week in the Northwest and is considered almost two-thousand miles away in the Northeast.

Vermont Representatives Sarah Copeland-Hanzas (D-Bradford) said the reason why she introduced H 197 is because she was offered the opportunity to come into contact with community members “whose lives are still impacted by the fact that they were never able to assimilate the horrific things they have seen as police and firefighters and first responders,” decades ago, she said.

After researching the matter, the representative said it was clear to her that “it is very difficult under Vermont statute for someone to get their injury paid for through workers’ compensation if it is a work-related injury.”

California-based Dr. David Reiss has treated first responders in Vermont, noting not all patients have classic symptoms, including flashbacks. “A good number of the first responders I treated in Vermont would come in for alcoholism or depression. When you question them you find there is PTSD underneath,” said Dr. Reiss, who is a member of Society for Exploration of Psychotherapeutic Investigation and International Psychohistory Association.

The doctor said state insurance companies must recognize first responders’ cry for coverage since it is a matter of “pay now or pay later.” Since working with New England first responders battling depression and frequent substance abuse as a result of PTSD at the Uniformed Services Program at the Brattleboro Retreat in Vermont, the doctor said if you “wait till someone is pretty far gone, then you have to deal alcoholism and depression.”

“Many have barely averted personal disasters before they come in — treated early on, they can go back but again, many cannot recover sufficiently because they waited too long,” he said.

Citing a FireRescue1.com report, the doctor noted the prevalence of suicide among first responders as well as PTSD. “Suicides among first responders, often driven by emotional strain in a culture that long discouraged showing weakness, are too common, according to organizations that track death,” reads the report. If not death, then broken marriages and failed parenthood step in, according to Dr. Reiss.

“I've seen many first responders who come in for help much too late, when treatment is difficult and the odds of returning to work are low — as opposed to being able to seek help earlier on,” he said. The doctor added not all first responder develop PTSD and some are malingering for retirement benefits.

“In my experience, while I have definitely seen some malingerers, the human and monetary costs of not treating those with legitimate problems is many, many more times the rather insignificant cost of those who ‘get away with’ malingering for benefits,” he said.   

Dr. Reiss said while “we are seeing more of the human face of first responders because of some of these tragedies,” Missourinet.com recently reported how a Missouri Department of Transportation worker “Linda Mantia was diagnosed with multiple disorders after being exposed to graphic scenes at fatality accidents while employed as a maintenance supervisor in St. Louis County.”

Though Mantia’s case is not resolved as of yet, it proves coverage of first responders is becoming an issue in other government departments. Colorado Sen. Nancy Todd (D-Aurora) said the legislation she introduced that passed last week has been a long time coming.

HB 1229 went through repeated iterations over a few years before lawmakers got it right, according to the Senator.

“I think it is important because the way the statute is in Colorado, for our police officers and first responders, it is just assumed that is their job and they are always going to be under those same circumstances and so they shouldn’t develop PTSD and have special treatment because of that,” she said. “But the problem with that is regardless of them being the position of seeing some pretty awful things, no one can prepare oneself for what that is going to do to you emotionally and so the fact that PTSD was not set aside for first responders was why this bill was necessary.”

U.S. health and workers’ compensation data analysis expert Dr. Laura B. Gardner, who specializes in predictive modeling, outcomes assessment, and healthy policy research, among other areas, said Colorado’s imminent addition of PTSD to the conditions that are covered by workers’ compensation is a welcome development.

“PTSD and other serious work-related mental health issues significantly reduce an impaired worker’s ability to return to full capacity and thus it is in employers' and payers' best interests to provide coverage of these conditions,” said the doctor from Albert Einstein College of Medicine, who also holds a M.P.H. in health policy and a Ph.D. in health economics from the University of California at Berkeley.

She said in general, mental, emotional and psychological health are drastically underserved and undervalued, and the field of workers’ comp is no exception. “PTSD coverage is an important step in the right direction but we still have a long way to go for there to be parity between mental health coverage and physical health coverage,” Dr. Gardner said.    

Sen. Todd said community consciousness of the first responders cry for coverage is key. “I think it is important for the public to recognize the fact that the human soul is not immune to seeing some of the horrible things that are happening in our world,” she said, noting both the public and politicians should provide all needed support. 

The bill, also sponsored by Sen. John Cooke (R- Greeley), is now on its way to the governor’s office for approval.

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