PTSD and Workers’ Compensation

At least 34 states have passed, or are considering passing, legislation that would provide workers’ compensation benefits for post-traumatic stress disorder (PTSD) for first responders. Some insurance experts believe more states will expand coverage and may include claims from other types of workers who experience PTSD on the job.

For certain workers, like first responders and police officers, extreme stress often is inherent to the job. In fact, 30 percent of first responders develop behavioral health conditions such as PTSD or depression, according to the Substance Abuse and Mental Health Services Administration. However, any employee may develop PTSD after witnessing the death, serious injury, or sexual assault of a co-worker, or after a robbery or other violent act in the workplace.

It’s important to note that even if your state doesn’t recognize PTSD as a compensable condition, employees experiencing PTSD are protected against workplace discrimination and may have a legal right to reasonable accommodations in the workplace through the Americans with Disabilities Act (ADA). Theyalso may have additional rights under the Family and Medical Leave Act (FMLA) and other medical insurance laws.

Defining PTSD

It’s estimated that eight out of every 100 people will have PTSD at some point in their lives, according to the National Center for PTSD. Roughly 8 million adults have PTSD during a given year. The disorder affects women more often—nearly ten of every 100 women develop PTSD sometime in their lives compared with about four in every 100 men.

The National Institute of Mental Health (NIMH) defines PTSD as “a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened, even when they are not in danger.”

Not everyone with PTSD has been through a dangerous event, and not everyone who lives through a dangerous event develops PTSD. In fact, most people will not develop the disorder.

Characteristics of PTSD include a range of symptoms across four categories:

  1. Intrusive symptoms related to the event, such as flashbacks, nightmares, or unwanted thoughts about the trauma; also called re-experiencing symptoms
  2. Actions to avoid people, places, or situations that are reminders of the event
  3. Negative changes in one’s thoughts and mood, including blaming themselves or others, having persistent negative beliefs, or loss of interest in enjoyable activities; also called cognition and mood symptoms
  4. Feeling hyper-aroused or overly reactive, such as being easily startled or irritable, feeling “on edge,” having angry outbursts, or having difficulty sleeping

It’s natural to have some of these symptoms for a few weeks after a traumatic event. However, to be diagnosed with PTSD, according to NIMH, an adult must have all of the following for at least one month:

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

Is PTSD covered under workers' comp?

The states that do compensate workers for work-related PTSD vary in the way these claims are compensated:

  • Some states just cover medical treatment
  • Some also may provide wage replacement benefits based on any permanent or temporary disability related to the disorder
  • Some allow workers with job-related PTSD to receive benefits, but only if the disorder resulted from a certain type of “extraordinary and unforeseeable” event. In this case, some first responders might not be eligible for benefits related to PTSD because their jobs regularly expose them to traumatic situations.
  • Some require that a workers’ comp claimant show that the PTSD was connected to a physical injury, but may include exceptions for law enforcement
  • Some grant benefits for PTSD only if the worker’s job was the chief cause of the disorder
  • Some also open the door for compensation for PTSD caused by chronic job stress, not necessarily due to a traumatic event

Recent trends in the field suggest that employees other than first responders suffering from PTSD may be eligible for benefits in the future, as events like workplace shootings, unfortunately, become more commonplace.

Experts say costs associated with workers’ comp claims for PTSD are difficult to estimate but admit that an individual PTSD claim has the potential to be very costly. For example, if a work-related traumatic incident or injury prevents a worker from returning to any employment, he or she may be eligible for lifetime indemnity benefits. Additionally, there could be continual psychiatric visits and medications or other complications, such as medical issues directly related to the disorder. Catastrophic events like mass shootings or terrorist attacks can affect many workers simultaneously, leading to a significant number of PTSD claims from that single event.

Be sure to research the laws in effect in your state and speak with your workers’ comp carrier about your company’s specific policy.

How to support employees with PTSD

Workers with PTSD have increased difficulty meeting work-related demands and greater rates of work absenteeism. For privacy reasons, you can’t ask employees or applicants if they have PTSD, but if a worker has volunteered this information, ask how you can help. Talking to an employee about their specific triggers can help you ensure that the proper accommodations are in place.

Create a supportive workplace for workers with PTSD by providing:

  • An environment free of triggers that may remind the employee of the traumatic event
  • Flexible schedules to take time off for treatment appointments
  • Classes on healthy communication, self-care, and/or stress management
  • Telecommuting options
  • Extra time to complete non-urgent tasks
  • Leniency if an employee wants to rearrange office furniture to improve sightlines to the doorway
  • Incentives to exercise and eat healthy
  • Noise-canceling headphones to reduce distractions while working
  • Ample light in the workplace to improve concentration
  • Well-lit parking lots or security staff to accompany anyone who feels unsafe after dark
  • Procedures to request job accommodations in writing in public areas
  • Referrals to the company’s employee assistance program (EAP) for mental health, stress management, and coping services. If you don’t have an EAP, provide local or national resources so workers can easily access mental health services

People with PTSD may not ask for help, but you can establish a culture in your workplace that encourages employees to ask for assistance. Providing sensitivity training, break rooms, and group relaxation activities like meditation or yoga help convey the message that your company cares about the physical and emotional health of its employees.

Thanks for reading! Please note that this content is intended for educational purposes only. As laws change regularly, you should refer to your state legislation and/or an advisor for specific legal counsel. If you’re a small business owner, learn more about workers’ compensation insurance or check your current rate in 3 minutes.

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