Nearly a dozen states have introduced legislation this year to expand or improve workers’ compensation benefits for employees who suffer psychological injuries by assuming they were suffered on the job.
“The trend will continue,” said Brian Allen, Salt Lake City-based vice president of government affairs, pharmacy solutions, for Mitchell International Inc., a subsidiary of Enlyte Group.
Most of the bills apply only to first responders and propose changes to post-traumatic stress disorder coverage, but three separate bills filed this month in Virginia would expand the definition of psychological injury beyond PTSD to include anxiety and depression for first responders. And a bill introduced in Connecticut would extend the presumption of PTSD to any worker who witnesses a “qualifying event”; such as a death. A similar bill last year failed to pass.
Connecticut and Virginia also introduced bills this month that would expand the definition of first responders to include dispatchers.
Last year saw a similar surge in legislation aimed at making it easier to claim compensation for psychological injuries, with mixed results suggesting a slowdown in successful bills. By 2022, only three states had enacted changes after more than 60 bills were introduced, according to two separate analyzes by the National Council on Compensation Insurance. Optum Workers’ Comp and Auto No-Fault published findings in 2021 that over half of states have made changes to workers’ compensation mental health injury coverage since 2018.
Some of the concerns among those who oppose such legislation are unknown costs, according to experts.
NCCI Assistant Actuary Bruce Spidell said data on PTSD presumption claims is “scarce” and each state’s presumption parameters are different, making it difficult to predict claim activity. “Every single (team) is different and there’s not really a benchmark,” he said. “We just don’t know how much this is going to cost.”
Police and fire departments are typically self-insured, which adds to the difficulty of collecting data on costs, he said.
The issue hit a roadblock for that reason in 2022 when California lawmakers sought to extend a 2020 PTSD presumption law — set to expire in 2025 — to dispatchers and several other classes of first responders.
California Governor Gavin Newsom, in a September 29, 2022 letter to lawmakers on why he would not sign such a bill, said that “extend coverage of the presumption of PTSD injury to significant classes of employees before any studies have been conducted on existing class for which presumption temporarily applies may set a dangerous precedent that has the potential to destabilize the workers’ compensation system going forward, as stakeholders push similarly unfounded presumptions.”
Mr. Allen said the uncertainty around cost is the main issue: “You’re always trying to look to find out if we make this policy change, what will it look like five years from now, ten years from now. What’s the upside? What’s the downside?”
The way many current laws are written, most first responders would qualify for coverage if they are diagnosed with PTSD, he said.
“Potential for abuse” is another issue, Mr. Allen, citing the possibility of PTSD claims being filed by those already retiring, resulting in higher benefits.
Although opposition to such bills has usually been easy to muster, few municipal groups speak out. Calls and requests to several state advocacy groups for cities and other jurisdictions seeking comment were not returned.
Michelle Gowdy, executive director of the Virginia Municipal League, wrote in an email that the organization “continues to monitor this matter, but we are not in a position to comment at this time.”
The mental health of first responders is “a real issue out there,” Mr. Allen. “The question is how do we approach it? How do we handle it? What is the appropriate way to cover it?”