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Disability

Dealing With The Horrific

More states are offering workers’ comp benefits to first responders suffering from post-traumatic stress.
By: | December 14, 2016 • 7 min read

More and more states are amending their workers’ compensation laws to allow police officers, firefighters and other first responders to file claims for post-traumatic stress disorder triggered by horrific events on the job.

The evidence is scant on how these new laws are impacting both the cost and scope of public sector workers’ comp programs. But virtually everyone agrees that PTSD is a serious issue that departments with first responders must tackle head on.

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Currently, 32 states have laws that permit first responders to file workers’ comp claims for PTSD without accompanying physical claims, and efforts are underway in additional states to similarly amend their workers’ comp laws, according to Norwalk (Conn.) Police Sgt. David Orr.

Orr is president of the Norwalk Police Union, which is lobbying for the State of Connecticut to change its law.

While first responders there can currently file PTSD claims if they witness the death of fellow first responders, there is a push to amend the law so that such claims can be filed after witnessing the death of anyone.

“After Sandy Hook, many of the officers who responded to the school and investigated the aftermath of that devastating tragedy suffered from intense PTSD,” but, he said, “their claims under workers’ comp were rejected by the insurance company and the town.”

“They were forced to go back to work or lose their paychecks, or worse, their jobs. Many did not get the mental health care that they needed.”

In Colorado, unions representing first responders are pushing for changes in that state’s workers’ comp law to delete what they believe is outdated language stating that first responders can only file PTSD claims for traumatic events outside of their usual work experiences, said Longmont (Colo.) Police Sgt. Sean Harper, representing the Colorado Fraternal Order of Police.

Medical Need for PTSD Coverage

Harper said there is medical evidence to support claims that even typical work experiences for first responders can cause extreme distress for some, particularly if the experiences are cumulative.

“As police officers, our job is to protect and serve the community, but we can’t serve at our best if we’re not at our healthiest,” Harper said. “It is in the best interest of the State of Colorado to keep the police as mentally healthy as possible, and that means paying for treatment so these traumatic events do not evolve into PTSD.”

Edie Sonn, vice president, communications and public affairs, Pinnacol

Edie Sonn, vice president, communications and public affairs, Pinnacol

Colorado’s state-chartered workers’ comp carrier Pinnacol Assurance opposed two recent bills in the Colorado legislature, said Edie Sonn, vice president, communications and public affairs.

The Denver-based carrier was concerned about the first bill because it carved out one occupational group, and Pinnacol said the second bill, in the last session, “went too far in the other direction, saying that a claim for mental distress could not be denied based solely on the occupation of the worker.”

“Such a broad approach would create ambiguity in the existing statute and thereby increase litigation,” Sonn said. “We believe there is a middle path between these two extremes to ensure that first responders are covered appropriately.”

Police and firefighter unions in Pennsylvania are also preparing to “push the issue,” said Michael G. Dryden, an attorney at Willig, Williams & Davidson in Philadelphia.

“The laws will make people feel more comfortable getting therapy because their reactions will be treated more as an injury or illness than look like catering to weakness,” Dryden said.

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The cost to workers’ comp programs has yet to be fully measured.

Peter Burton, senior division executive for state relations at National Council on Compensation Insurance in Wayne, Pa., said that many municipalities self-insure for workers’ comp and do not report data to NCCI. Consequently, the organization has little information on claim exposure to price PTSD claims.

“But intuitively, adding this additional compensable injury exposure will likely increase the costs of classifications of municipalities that have first responders, firefighters and EMTs, but not necessarily a significant effect to the entire workers’ compensation system within a particular state,” Burton said.

Workers’ Comp Law Varies

If more states amend their workers’ comp laws, there could be an increase in PTSD claims “due to the apparent availability of an avenue of income without working for those employees so inclined,” said Terri Evans, risk manager for the city of Kingsport, Tenn. and president of the Public Risk Management Association in Alexandria, Va.

Currently, there is no push to change Tennessee’s workers’ comp law.

“In some states, there might be disability benefits and workers’ compensation benefits that would be available to the injured employee at the same time, further enticing disgruntled or unhappy employees,” she said.

Dan Greensweig, assistant director, League of Minnesota Cities, St. Paul, Minn.

Dan Greensweig, assistant director, League of Minnesota Cities, St. Paul, Minn.

“All would depend on how the statute was worded, and what was included or excluded in benefit availability.”

However, Evans stressed that public sector risk managers have a duty to help first responders deal psychologically with traumatic events.

In the City of Kingsport, if an employee feels a work-related incident has impacted them, they can file a claim with the city’s workers’ comp program to determine eligibility of the claim at the onset. That way, even if for some reason the claim is not eligible for workers’ comp, the city can assist the first responder via its employee assistance program, she said.

“We try to be proactive in providing assistance to our employees during times of adversity, whether or not the issue rises to the level of a workers’ compensation claim, because it is important that our employees know they, and their mental and physical health, matter to us,” Evans said.

The Minnesota law that extended workers’ comp coverage for PTSD took effect in October 2013, and so far, the increased cost to public sector workers’ comp programs within the state appears to be “relatively modest” — about 1 percent or so for cities that are members of the League of Minnesota Cities Insurance Trust, said Dan Greensweig, LMCIT’s assistant director at the League of Minnesota Cities in St. Paul, Minn.

The numbers of PTSD claims have been small, about three to five per year, but some of the claims have been very expensive because the individuals needed significant medical care and likely won’t ever be able to return to work as police officers, Greensweig said.

Proactive Counseling

PTSD is “definitely a risk we and our members need to be aware of, not just because of the potential cost implications but also from the standpoint of the public safety officers’ health and well-being,” he said.

“Just as with any other type of injury, the best solution is if we can find ways to prevent the injury in the first place. But of course that’s a challenging thing to do, given the nature of the job for police officers, firefighters, EMTs and other public safety professionals.”

The nonprofit Metro CISM Team in Bloomington, Minn., provides “critical incident stress management teams” throughout the state to help first responders in the aftermath of stressful events, and at least two police departments now require every officer to undergo an annual evaluation that looks for signs of unhealthy levels of stress, Greensweig said.

Ronald F. Meuser, Jr., founder of Meuser Law Office P.A.

Ronald F. Meuser, Jr., founder of Meuser Law Office P.A.

Moreover, LMCIT has paired with Fairview Health Services to offer training to emergency personnel on how to handle situations involving people with mental illness.

“We hope the discussions that result will lead to a greater understanding of mental health issues in general,” he said.

Ronald F. Meuser, Jr., founder of Meuser Law Office P.A. in Eden Prairie, Minn., said that in the hiring process, entities that employ first responders should invest in diagnostic tools such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) that will show if someone is suffering from PTSD, depression or anxiety, or indicate whether the person demonstrates a proclivity to developing PTSD in the future.

After first responders experience traumatic events, one-on-one debriefings may be more effective than group debriefings, as first responders may be reluctant to express emotion in front of their co-workers, Meuser said.

First responders should also have yearly psychological check-ups in which they can talk openly and confidentially about any issues, including such taboo issues as recurring nightmares, excessive drinking or moodiness.

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Departments can also be more proactive by looking for changes in a first responder’s demeanor and then referring them for additional help within their EAPs, he said.

For workers who return to work after being involved in violent incidents, risk management programs need to have proactive elements necessary to monitor the workers’ mental recovery, including status check-ins and voluntary counseling services, said Matt Gatewood, a partner at Sutherland Asbill & Brennan LLP in Washington, D.C.

“Achieving the balance of ensuring workers have the necessary means to obtain help while not being too intrusive on the workers’ personal lives is complicated,” Gatewood said. “The most effective programs resist the urge to create a one-size-fits-all approach to this process.” &

Katie Kuehner-Hebert is a freelance writer based in California. She has more than two decades of journalism experience and expertise in financial writing. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

Risk Management

The Profession

The risk manager for Boyd Gaming Corp. says curiosity keeps him engaged, and continual education will be the key to managing emerging risks.
By: | May 1, 2018 • 4 min read

R&I: What was your first job?

I was trained as an accountant, worked in public accounting and became a CPA. Being comfortable with numbers is helpful in my current role, and obviously, the language of business is financial statements, so it helps.

R&I: How did you come to work in risk management?

Working in finance in the corporate environment included the review of budgets and the analysis of business expenses. I quickly found the area of benefits and insurance — and how “accepting risk” impacted those expenses — to be fascinating. I asked a lot of questions. Be careful what you ask for — I soon found myself responsible for those insurance areas and haven’t looked back!

R&I: What is the risk management community doing right?

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I have found the risk management community to be a close-knit group, whether that’s industry professionals, risk managers with other companies or support organizations like RIMS and other regional groups. The expertise of the carriers and specialty vendors to develop new products and programs, along with the appropriate education, will continue to be of key importance to companies going forward.

R&I: What’s been the biggest change in the risk management and insurance industry since you’ve been in it?

As I’m sure many in the insurance field would agree, Hurricanes Katrina and Rita in 2005 changed our world and our industry. It was a particularly intense time and certainly a baptism by fire for people like me who were relatively new to the industry. This event clearly accelerated the switch to the acceptance of more risk, which impacted mitigation strategies and programs.

Bob Berglund, vice president, benefits and insurance, Boyd Gaming Corp.

R&I: What emerging commercial risk most concerns you?

The fast-paced threat that cyber security represents today. Our company, like so many companies, is reliant upon computers, software and IT expertise in our everyday existence. This new risk has forged an even stronger relationship between risk management and our IT department as we work together to address this growing threat.

Additionally, the shooting event in Las Vegas in 2017 will have an enduring impact on firms that host large gatherings and arena-style events all over the world, and our company is no exception.

R&I: What insurance carrier do you have the highest opinion of?

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With the various types of insurance programs we employ, I have been fortunate to work with most of the large national and international carriers — all of whom employ talented people with a vast array of resources.

R&I:  How much business do you do direct versus going through a broker?

We use brokers for many of our professional coverages, such as property, casualty, D&O and cyber. We are self-insured under our health plans, with close to 25,000 members. We tend to manage those programs internally and utilize direct relationships with carriers and specialty vendors to tailor a plan that works best for team members.

R&I: Who is your mentor and why?

I have been fortunate to have worked alongside some smart and insightful people during my career. A key piece of advice, said in many different ways, has served me well. Simply stated: “Seek to understand before being understood.”

What this has meant to me is try everything you can to learn about something, new or old. After you have gained this knowledge, you can begin to access and maybe suggest changes or adjustments. Being curious has always been a personal enjoyment for me in business, and I have found people are more than willing to lend a hand, offer information and advice — you just need to ask. Building those alliances and foundations of knowledge on a subject matter makes tackling the future more exciting and fruitful.

R&I: What have you accomplished that you are proudest of?

Our benefit health plan is much more than handing out an insurance card at the beginning of the year. We encourage our team members and their families to learn about their personal health, get engaged in a variety of health and wellness programs and try to live life in the healthiest possible way. The result of that is literally hundreds of testimonials from our members every year on how they have lost weight, changed their lifestyle and gotten off medications. It is extremely rewarding and is a testament to [our] close-knit corporate culture.

R&I: What’s the best restaurant you’ve ever eaten at?

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Some will remember the volcano eruption in Iceland in spring of 2010. I was just finishing a week of meetings in London with Lloyd’s syndicates related to our property insurance placement when the airspace in England and most of northern Europe was shut down — no airplanes in or out! Flights were ultimately canceled for the following five days. Therefore, with a few other stranded visitors like myself, we experimented and tried out new restaurants every day until we could leave. It was a very interesting time!

R&I: What is the riskiest activity you ever engaged in?

I am originally from Canada, and I played ice hockey from the time I was four years old up until quite recently. Too many surgeries sadly forced my recent retirement.

R&I: What do your friends and family think you do?

That’s a funny one … I am a CPA working in the casino industry, doing insurance and risk management, so neighbors and acquaintances think I either do tax returns or they think I’m a blackjack dealer at the casino!




Katie Dwyer is an associate editor at Risk & Insurance®. She can be reached at [email protected]