Column: Workers' Comp

New Mindset on Mental Health

By: | July 27, 2017 • 2 min read
Roberto Ceniceros is senior editor at Risk & Insurance® and chair of the National Workers' Compensation and Disability Conference® & Expo. He can be reached at [email protected] Read more of his columns and features.

Societal changes are tilting public opinion in favor of enacting laws that provide first responders with workers’ compensation benefits for post-traumatic stress disorder.

In June alone, at least two states — Colorado and Texas — enacted laws easing the way for police, firefighters and paramedics diagnosed with PTSD to receive benefits. During the same month, lawmakers in Vermont and Maine sent legislation to their governors that would presume PTSD suffered by first responders is work-related.


As expected, unions representing first responders support these laws. Local governments, along with some insurer groups, have opposed, for fear of paying for a flood of new claims. Debate over adopting the laws includes conventional workers’ comp considerations like whether the claims are legitimately work-related.

But there is another, not-so traditional force at work.

Nearly six years ago when a former fire captain named Jeff Dill launched an organization called Firefighter Behavioral Health Alliance, few people talked about suicide prevention, addiction, and PTSD among first responders.

 There is a cultural shift underway. The stigma around acknowledging mental ailments is falling away, lending legitimacy to treatment.

That is shifting.

Today, you hear more people openly talking about mental health challenges. There is a cultural shift underway. The stigma around acknowledging mental ailments is falling away, lending legitimacy to treatment.

More first responders are similarly voicing stories about the trauma they experienced following horrific events, Dill said.

Couple that trend with the rise in high-profile mass shootings and you get greater sympathy-generating awareness of the mentally unsettling, war-like situations that police officers, firefighters and paramedics confront.

That adds significant emotional depth to arguments that the nation must take care of its first responders so they can take care of us. The idea of covering mental health conditions, however, still collides with workers’ comp systems that reflexively oppose assuming responsibility for mental injuries that are not as readily apparent as, say, a mangled hand.

Paul H. Sighinolfi took heat, as he put it, from his state’s municipalities for supporting adoption of legislation stating that first responders diagnosed with PTSD presumably acquired the condition as a result of their work


Sighinolfi is executive director and chairman of Maine’s Workers’ Compensation Board.

“They are exposed to things that the human psyche just isn’t capable of dealing with,” Sighinolfi said of the types of traumatic events that first responders have described to him.

Sighinolfi supported the law’s adoption on the condition that it would mandate that a licensed psychologist or psychiatrist renders the PTSD diagnosis, and that work was the predominant cause.

He figured that would eliminate frivolous claims.

Workers’ compensation historically hasn’t adequately addressed mental health injuries caused by workplace injuries, said Mark Walls, VP of Communications & Strategic Analysis at Safety National.

With more people speaking out about mental trauma, that may be changing. &

More from Risk & Insurance

More from Risk & Insurance

Risk Management

The Profession

Janet Sheiner, VP of risk management and real estate at AMN Healthcare Services Inc., sees innovation as an answer to fast-evolving and emerging risks.
By: | March 5, 2018 • 4 min read

R&I: What was your first job?

As a kid, bagging groceries. My first job out of school, part-time temp secretary.

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

Risk management picks you; you don’t necessarily pick it. I came into it from a regulatory compliance angle. There’s a natural evolution because a lot of your compliance activities also have the effect of managing your risk.

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


There’s much benefit to grounding strategic planning in an ERM framework. That’s a great innovation in the industry, to have more emphasis on ERM. I also think that risk management thought leaders are casting themselves more as enablers of business, not deterrents, a move in the right direction.

R&I: What could the risk management community be doing a better job of?

Justified or not, risk management functions are often viewed as the “Department of No.” We’ve worked hard to cultivate a reputation as the “Department of Maybe,” so partners across the organization see us as business enablers. That reputation has meant entertaining some pretty crazy ideas, but our willingness to try and find a way to “yes” tempered with good risk management has made all the difference.

Janet Sheiner, VP, Risk Management & Real Estate, AMN Healthcare Services Inc.

R&I: What was the best location and year for the RIMS conference and why?

San Diego, of course!  America’s Finest City has the infrastructure, Convention Center, hotels, airport and public transportation — plus you can’t beat our great weather! The restaurant scene is great, not to mention those beautiful coastal views.

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

The emergence of risk management as a distinct profession, with four-year degree programs and specific academic curriculum. Now I have people on my team who say their goal is to be a risk manager. I said before that risk management picks you, but we’re getting to a point where people pick it.

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


The commercial insurance market’s ability to innovate to meet customer demand. Businesses need to innovate to stay relevant, and the commercial market needs to innovate with us.  Carriers have to be willing to take on more risk and potentially take a loss to meet the unique and evolving risks companies are facing.

R&I: Of which insurance carrier do you have the highest opinion?

Beazley. They have been an outstanding partner to AMN. They are responsive, flexible and reasonable.  They have evolved with us. They have an appreciation for risk management practices we’ve organically woven into our business, and by extension, this makes them more comfortable with taking on new risks with us.

R&I: Are you optimistic or pessimistic about the U.S. health care industry and why?

I am very optimistic about the health care industry. We have an aging population with burgeoning health care needs, coupled with a decreasing supply of health care providers — that means we have to get smarter about how we manage health care. There’s a lot of opportunity for thought leaders to fill that gap.

R&I: Who is your mentor and why?

Professionally, AMN Healthcare General Counsel, Denise Jackson, has enabled me to do the best work I’ve ever done, and better than I thought I could do.  Personally, my husband Andrew, a second-grade teacher, who has a way of putting things into a human perspective.

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

In my early 20s, I set a goal for the “corner office.” I achieved that when I became vice president.  I received a ‘Values in Practice’ award for trust at AMN. The nomination came from team members I work with every day, and I was incredibly humbled and honored.

R&I: What is your favorite book or movie?

The noir genre, so anything by Raymond Chandler in books. For movies,  “Double Indemnity,” the 1944 Billy Wilder classic, with insurance at the heart of it!

R&I: What is your favorite drink?


Clean water. Check out for how to help people enjoy clean, safe water.

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

Liqun Roast Duck Restaurant in Beijing.

R&I: What is the most unusual/interesting place you have ever visited?

China. See favorite restaurant above. This restaurant had been open for 100 years in that location. It didn’t exactly have an “A” rating, and it was probably not a place most risk managers would go to.

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

Eating that duck at Liqun!

R&I: If the world has a modern hero, who is it and why?

Dr. Seuss who, in response to a 1954 report in Life magazine, worked to reduce illiteracy among school children by making children’s books more interesting. His work continues to educate and entertain children worldwide.

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

They’re not really sure!

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