Can I Get Workers' Comp Benefits for Post Traumatic Stress Disorder?
You should expect an uphill battle when filing for workers' comp based on PTSD, but first responders may have an easier time getting benefits in some states.
Did the injury occur at work?
Most people think of post-traumatic stress disorder (also known as post-traumatic stress injury) in connection with soldiers who’ve been in combat. But people can develop PTSD after other kinds of trauma as well, including traumatic events at work. If you’re suffering from PTSD because of your job, you may be wondering if you can get workers’ compensation benefits. The answer largely depends on where you live and the nature of the event that caused your symptoms.
PTSD and How It Can Happen at Work
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-V), PTSD is a cluster of symptoms that happen after someone is exposed to actual or threatened death, serious injury, or sexual violence. Some examples of workplace situations that might give rise to a PTSD claim include:
Recently diagnosed with post-traumatic stress, our Sacramento firefighter isn’t ready to give up on what he calls a ‘dream job.’
He still loves his “fire family,” exciting workdays and having a job that lets him help others. He’d rather take time off to treat his post-traumatic stress with financial support from workers’ compensation than allow his injury to cause an early end to his career.
“If I came to work so consumed with my anxiety or depressed and was so consumed and can’t do the bare minimum, I shouldn’t be there,” Katz, 34, said. “Because the public trusts us to provide a service for them without question. Without fail, I need to be able to do that.”
After consecutive record-breaking fire seasons and a deluge of mass shootings, California firefighters and police organizations are pushing for a new law that would help first responders by giving them opportunities to receive compensation for psychological injuries they sustain over their careers.
Once PTSD is understood, it is easy to see how workplace events and environments can cause PTSD. There are two different ways that PTSD can arise from work: (1) Something scary, traumatic, or dangerous happens at work leading to PTSD from the event; or (2) Something scary, traumatic, or dangerous occurs outside of work but was triggered by something at work. No matter the exact cause of the PTSD, it must be “work-related” to be covered by workers’ compensation and qualify someone for disability benefits. A company’s insurance carrier will need medical evidence to verify you are an injured worker entitled to workers’ comp benefits.
PTSD arises from a person’s natural, but harmful, reaction to an event, not from the harm the event itself causes. Accordingly, both persons harmed in traumatic workplace events and those who are not harmed by the event itself but by their reaction to it may be entitled to workers’ compensation benefits from PTSD. They’re backing Senate Bill 542, sponsored by the California Professional Firefighters and the California Association of Highway Patrolmen, which would compel government agencies to grant police and firefighter workers’ compensation claims post-traumatic stress.
Today, workers struggling with psychiatric injuries qualify for workers compensation only if the disorder causes disability or requires medical treatment. They must also prove job experiences are a “substantial cause” — meaning 35 to 40 percent — of their injury. SB 542 would instead require local agencies to bear the burden of proof if they contend injuries are not job related.
By contrast, a host of physical ailments are considered “presumptive” conditions for workers’ compensation claims from public safety officers in California. They include heart disease, pneumonia, cancer and tuberculosis. The system awards coverage for hospital, surgical and medical treatments, and certain disability and death benefits to workers.
Sen. Henry Stern, D-Canoga Park, who is carrying the bill, said the proposal, paves way to “treating mental health illnesses as equal to any of those other workplace injuries.”
The bill comes at a critical moment, he argued in a Senate Committee on Labor, Public Employment and Retirement hearing on April 10, citing reports of rising suicides among police and firefighters.
But the expansion might come with a hefty price tag to government agencies. A bill analysis from the Senate public employment committee reports “the costs to local governments are likely quite high.”
SB 542 would also retroactively apply back to 2017 and 2018, the height of wildfire destruction in California, which adds additional unknown costs to the equation.
The League of California Cities, the California State Association of Counties and the Rural County Representatives of California oppose the bill.
The California Association of Joint Powers Authorities also criticized the bill, contending it could open employers to bogus claims.
“Not only is there a lack of evidence that a presumption is needed, but there is also a lack of information about the cost associated with the changes,” the California Coalition on Workers Compensation wrote in a letter to Stern. “We believe the current workers’ compensation system strikes the appropriate balance with respect to psychiatric injuries.”
‘WHAT IT IS TO BE TOUGH’ Though local government representative argue that workers could take advantage of the system, Stern said expanding workers’ compensation allows firefighters and police officers to seek much-needed mental health services and return to work without fear of financial setbacks. The bill cleared the committee by a 3-0 vote.
“Folks need to get past the fact that this is something to be ashamed of and ought to be hidden, and what it is to be a man, what it is to be tough,” Stern said.
Katz’s post-traumatic stress stems from a house fire call in March 2017, in the thick of an unusually busy season. He remembered it as a “very dangerous operation” fruitlessly searching for the homeowner in the packed halls of what he called a hoarder home. Later, police arrested the homeowner on suspicion of arson and firefighters wondered whether the man lit the fire to harm them. Although Katz initially brushed off the incident, he realized how close he came to death when he talked about it with his wife. “It wasn’t until she freaked out,” Katz said. “Like oh s---, someone tried to kill me. That was when it clicked in my head.” Kat’z feelings toward work changed. He didn’t jump on overtime opportunities. He hesitated before going into work. His life suddenly felt more “intense.” “Even at home, I was less motivated and less engaged,” he said. He and his wife separated in November, and Katz decided then to seek counseling. During a December session, his therapist explained that Katz exhibited signs of post-traumatic stress. “I didn’t believe him,” Katz explained. “I didn’t think he was correct. I thought I was invincible.” He said he’d apply for worker’s compensation if he knew he’d win his claim and suspects colleagues who need help would apply, too, if they felt their traumatic experiences would be taken seriously. “I wasn’t the first person to be diagnosed with (post-traumatic stress),” he said. “And I sure as hell won’t be the last.”
No comments