States Are Beginning to Allow Workers’ Comp For PTSD

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May 21, 2019

Watch an episode of “Mad Men,” turn on the nightly news, or beef up your knowledge of the Industrial Revolution, and it’s easy to conclude that workplace trauma isn’t new in this country. Sex harassment, shootings and other forms of violence, and accidents caused by dangerous working conditions may be a HR manager’s worst nightmare — but they also aren’t new or novel.

What is new, having only really emerged in recent years, is the prospect that an employee who develops a mental condition like “post-traumatic stress disorder” (PTSD) from work-related duties or circumstances may receive workers’ compensation benefits under changing state laws. The developing trend could affect you and your place of work.

Workers’ compensation for PTSD is growing

There seems to be growing momentum nationwide to consider legislation or take legislative measures to grant or expand coverage for PTSD and other “mental-only” injuries incurred on the job. In 2018, for example, at least 16 states considered new legislation addressing workers’ compensation coverage for PTSD and other “mental-only” injuries, according to a “Regulatory and Legislative Trends Report” from the National Council on Compensation Insurance (NCCI). (In the year prior, a handful of states had passed or considered PTSD-specific legislation for first responders.)

The NCCI report went on to note that Florida (where I work) was one of two states (the other being Washington) to pass a law expanding benefits for first responders with PTSD. Senate bill 376, which took effect here in Florida in the fall of 2018, expands workers’ compensation benefits for firefighters, paramedics, EMTs, law enforcement officers and other first responders.

Criteria for work-related PTSD

If first responders stand to benefit most from this nationwide trend, it may also be a misconception to assume that workers’ comp benefits for PTSD only pertain to people whose jobs regularly involve responding to traumatic events. One reason is that while PTSD that is eligible for workers’ comp benefits must typically involve an experience of trauma while performing one’s job, some state laws and rulings have opened the door to compensation for PTSD caused by chronic job stress (not necessarily triggered by a traumatic event).

In California, according to a briefing by the state’s Commission on Health and Safety and Workers’ Compensation that cites Labor Code Section 3208.3, first responders or any other employee in California who suffers a job-related psychiatric disability can file a claim for workers’ compensation to receive benefits— including treatment coverage for “stress-related conditions” associated with one’s employment.

In Connecticut, there is now legal precedent for employees to receive workers’ comp for PTSD that is a purported consequence of being over-worked. In the case of William D. Hart v. Federal Express Corp, the Connecticut Supreme Court ruled that a FedEx Corp. driver who had been diagnosed with PTSD as the result of a new manager’s high-pressure demands, was entitled to workers’ comp benefits.

Court rulings

As in Connecticut, there have been other cases around the country that have involved courts siding with employees in workers’ comp disputes. Just two examples:

  • In Tennessee, in Gerdau Ameristeel, Inc. v. Steven Ratliff, the Tennessee Supreme Court ruled that a worker who had witnessed the deaths of two co-workers in 2008, but who did not file a PTSD claim until more than a year after the second death, was still entitled to workers’ compensation benefits.
  • In Oregon, in Sheila L. Minor v. Saif Corp. and Coos County, a court sided with a “911” dispatcher who said she developed PTSD from having to send police officers to the scene of a shooting; she, too, was awarded compensation.

PTSD an Occupational Disease?

Because state laws can vary widely in how they determine what’s compensable PTSD and what’s not, it may be worth exploring what laws are on the books in your state. One question that may be worth asking: Is PTSD an “occupational disease” where you work, and, if so, does this language only apply to first responders (firefighters, law enforcement officers, EMTs, paramedics, etc.) or does it have broader application.

Note: Even when PTSD did not arise from a work-related situation, the affected employee may be eligible for leave under the FMLA and may have an ADA disability.

PTSD symptoms

You may also benefit from knowing how to recognize PTSD in the workplace. PTSD is diagnosed by the presence of these symptoms, according to the National Institute of Mental Health:

  • Flashbacks, hallucinations and/or nightmares that involve reliving the trauma
  • Avoidance behaviors (avoiding any potential reminders of the trauma, including people and places)
  • Hyper-reactivity, interpersonal issues, sleeping disorders, irritability, and/or difficulty concentrating.
  • Negative thoughts and moods related to blame, estrangement, and memories of the event

In order to diagnose someone with PTSD, a psychiatrist or psychologist will first want to know whether the patient has been experiencing all of the following for at least one month:

  • At least one re-experiencing symptom
  • At least one avoidance symptom
  • At least two arousal and reactivity symptoms
  • At least two cognition and mood symptoms

What you can do

If you notice or learn of any of the above symptoms in an employee — particularly in the aftermath of a traumatic event or series of traumatic events that you are aware of — early intervention is critical. This may involve connecting that employee with your employee assistance program (EAP), or referring them to a trusted mental health resource, such as on-site counseling services or an outpatient program for PTSD, that can address their symptoms before these escalate into a full-blown diagnosis of PTSD.

Early intervention is key for another reason, too. PTSD can become so debilitating that it keeps an employee from performing their job duties. The resulting drain on productivity can cost a company money and employee morale. In some cases, an employee’s mental health and capacity to work may deteriorate to such an extent they feel compelled to file a worker’s comp claim or worse, file a lawsuit against their employer. HR professionals who intervene early —ideally before the one-month mark when a diagnosis of PTSD can be made — will therefore be acting in the best interests of the employee and their employer (not to mention their own).

Finally, where possible, be proactive about looking for ways to reduce your employees’ stress levels. This might mean encouraging work-life balance with flexible schedules, including telecommuting options; offering positive incentives to exercise and eat healthy; valuing employees and showing you care; providing classes in stress management, self-care and healthy communication; or all of the above.

Happy employees who aren’t stressed-out will be more resilient to PTSD and other behavioral health issues— and, probably much less likely to file workers’ comp claims.