February 4, 2019

PTSD Coverage: More States Draft Legislation

As Healthesystems previously reported, legislation across the country continues to expand workers’ compensation coverage for post-traumatic stress disorder (PTSD), particularly for first responder occupations. And as legislative sessions across the country kick into gear, more and more states have begun introducing legislation to establish or expand PTSD coverage in workers’ compensation.

In January, Kentucky pre-filed B.R. 140, proposing changes that would clarify the definition of “injury” for first responders to include psychological, psychiatric, or stress-related changes in the human organism that are not a direct result of physical injury. As written, the bill recognizes first responders as police officers, firefighters, emergency services personnel, and front-line staff, casting a slightly wider net than other states.

But casting a somewhat smaller net than other states, Connecticut introduced Senate Bill 699, which would allow only police officers and firefighters to use workers’ compensation coverage for the treatment of post-traumatic stress disorder (PTSD), discounting emergency service personnel who are typically included in these bills. As currently drafted, the Connecticut bill is a placeholder for what could later become a more robust piece of legislation. The current draft lacks clarity on the types of covered injuries and thresholds for eligibility.

Speaking of a need for clarity, West Virginia lawmakers introduced House Bill 2321 and Senate Bill 114, identical bills that would recognize PTSD as a compensable injury for first responders under workers’ compensation. These bills do not explicitly clarify whether a physical injury is necessary for compensation, but they state that PTSD is compensable if a licensed psychiatrist makes the diagnosis and finds that the disorder occurred as a result of events within the scope of duty. As currently written, there is enough ambiguity that the coverage could apply to non-physical injuries.

And late last year, the Idaho Industrial Commission wrote the first draft of a bill to provide first responders with workers’ compensation coverage for PTSD, though this draft specifically excluded coverage of PTSD claims that do not involve a physical injury. In a recent interview with the press, Idaho House Representative Matt Erpelding spoke of his support for a PTSD bill currently in the House, stating that the bill has gained support across the state. However, it was not clear if the bill he spoke of is the same bill as the one presented by the Industrial Commission.

As chatter surrounding these individual bills grows, the larger conversation on how to manage PTSD within a workers’ comp claim will continue to ring on the national platform. To learn about formulary and claims management considerations for employee populations at risk for PTSD, read Hero’s Welcome: Growing PTSD Coverage for First Responders from RxInformer journal.

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