WORKERS' COMPENSATION UPDATE: Presumption of Injury for Posttraumatic Stress Disorder (PTSD) for Peace Officers and Firefighters

Senate Bill (SB) 542 was signed into law by California Governor Gavin Newsom effective January 1, 2020. The law created a rebuttable presumption (Labor Code Section 3212.15) that posttraumatic stress disorder (PTSD) diagnosed in peace officers and firefighters is a work-related injury covered by the state's Workers' Compensation system. The presumption is that the PTSD developed or manifested arising out of and in the course of employment.  Although an employer may attempt to rebut the presumption by showing that the PTSD was solely caused by some event(s) outside of work, in most cases this is an impossible task.

A recent study commissioned by the California Division of Workers' Compensation and prepared by the RAND Corporation sheds some light on the impact of this law since it was enacted.

The Statistics Speak Volumes

According to RAND statistics, 0.9 percent of California Workers' Compensation claims filed by firefighters and 0.7 percent of claims filed by police officers involved PTSD, compared to 0.4 percent of claims filed by all workers in the state. But, initial denial rates were higher for both firefighters and police officers.

However, denials of public safety PTSD claims were often reversed, thus supporting the reasoning behind creating the presumption, according to RAND researcher Denise D. Quigley.

"If they're going to get reversed and accepted anyway, the time it takes between when it's initially denied and it gets reversed—during that period of time, that's when first responders were sort of suspended and many times not able to get the care that they need, and that causes in itself additional trauma," says Quigley.

"SB 542 specifically stated that 'firefighting and law enforcement are recognized as two of the most stressful occupations,'" says Joanna Sacavitch, a partner in the law firm of Gordon, Edelstein, Krepack, Grant, Felton & Goldstein, LLP (GEK).  "In addition, the bill stated, 'on any given shift, firefighters and law enforcement personnel can be called on to make life and death decisions, witness a young child dying with their grief-stricken family, or be exposed to a myriad of communicable diseases and known carcinogens.' At GEK we see the psychological impact such working conditions have on public safety officers and firefighters."

Meeting More Needs

PTSD has a wide-ranging effect on both the personal and professional lives of those who suffer from the disorder. Outside of work, PTSD sufferers often struggle with alcoholism, substance abuse, depression, anxiety and other challenges that hinder their ability to function and maintain relationships with those they love. At work, PTSD can manifest in a variety of ways, ranging from difficulty focusing or following orders to over/underreacting in a situation where someone's health and safety are in the balance.

"Presumptions for such conditions as cancer, heart trouble and hernia have long been in place to expedite Workers' Compensation claims for police officers and firefighters," explains Sacavitch. "But because of the stigma surrounding PTSD among firefighters and police, many claims go unfiled." 

Understanding this law, and its stated goal to expedite delivery of Workers' Compensation benefits for a PTSD injury, will hopefully encourage those that need help to reach out and file a claim when necessary.  When the claim is accepted, the person will get compensation that includes full medical treatment and disability indemnity (Labor Code 4850 pay, temporary and permanent disability benefits) among other potential benefits.

The PTSD presumption for public safety officers and firefighters applies to those who have worked at least six months with the department or unit.  The PTSD must have developed or presented itself while the person was working for that agency or unit. And, it extends post-termination for three months for each full year of service, but no longer than five years after the last date worked.

This presumption law is applicable to injury claims that occur between January 1, 2020 through January 1, 2025, when the law is scheduled to expire.   It is anticipated that there will be a legislative effort to make this law permanent. GEKLAW supports this effort.

"GEK has long proudly served the men and women who repeatedly put their lives on the line to ensure our safety," says Sacavitch.  "We are always here to ensure they receive the full range of benefits to which they are entitled."