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Four Reasons Why Employers Struggle to Determine Compensation Claims for PTSD

Four Reasons Why Employers Struggle to Determine Compensation Claims for PTSD

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Editor’s Note: This article is the third in four-part series addressing challenges related to workers’ compensation and pension benefits for psychological injuries. Read the first article about why first responders suffering from PTSD must be eligible for compensation. Read the second article about why states need clearer laws on PTSD compensation claims.

By Dr. Chuck RussoProgram Director of Criminal Justice at American Military University and
Dr. Stephanie Myers-Hunziker, Faculty Member, Criminal Justice at American Military University

Public service agencies and state workers’ compensation funds appear to be in the beginning stages of understanding how to best manage claims from those who suffer from post-traumatic stress disorder (PTSD). However, understanding entitlement to benefits and how to address psychological injury is no easy task. Here are four common questions employers are forced to ask when determining compensation claims based on psychological injuries:

How many employees will be affected by PTSD?

Many public safety organizations are unsure how many of their employees, who regularly respond to traumatic events, are likely to be diagnosed with PTSD. However, there are currently no commonly accepted estimates that employers can refer to. Research needs to be done to help figure out what employers and insurance companies can expect in terms of the number of claims to assist them with budgeting.

Can I ensure PTSD claims are based on objective standards of evidence?

Workers’ compensation claims based solely on PTSD symptoms, without accompanying physical injuries, have proven challenging to employees, employers, and administrators alike. One of the primary obstacles is that there is no objective test to demonstrate PTSD. Unlike physical illnesses or diseases like diabetes and heart conditions, psychological diagnoses can appear to be subjective.

As an example, out of two bills previously proposed in the state of Florida, one bill called for the evidence of a PTSD diagnosis to be by a “preponderance of the evidence” standard while the other called for a “clear and convincing evidence” standard for diagnosis. The subjectivity of the diagnosis coupled with the absence of physical signs of a disability results in some people having a difficult time “believing” PTSD can be a career-ending condition (Robinson, 2014).

How much does compensation cost and how long should it last?

Once a person is diagnosed with PTSD resulting from a work-related episode, real-time estimates need to be made about the overall costs associated with compensation. Substantive discussions and decisions are needed about the costs of coverage and how long any awarded coverage should last. Workers’ compensation is typically paid by the employer’s insurance company. Questions remain about what these costs will mean to insurance companies and the agencies of employment.

What are the consequences of not extending benefits?

First responders need to support themselves and their families. If those who are suffering from PTSD are not awarded assistance and benefits to help them adequately recover, that individual is likely to return to work before they are psychologically ready to do so. The danger in this reality is that it may place that person, and others, in harm’s way.

Public safety agencies and leaders need to have more information about what’s involved with issuing compensation claims for PTSD. More research is needed to determine the legal obligations of agencies that hire public safety professionals and send them into dangerous situations. Currently, we appear to have more questions than answers as to how to best help first responders who are suffering.

About the Authors:

claimsDr. Chuck Russo is the Program Director of Criminal Justice at American Military University (AMU). He began his career in law enforcement in 1987 in Central Florida and was involved all areas of patrol, training, special operations and investigations before retiring from law enforcement in 2013. Dr. Russo continues to design and instruct courses, as well as act as a consultant for education, government and industry throughout the world. His recent research and presentations focus on emerging technology and law enforcement applications, post-traumatic stress, nongovernment intelligence actors, and online learning.

claimsDr. Stephanie Myers-Hunziker is a Professor of Criminal Justice at American Military University.  She has a tremendous amount of practical work and research experience working inside public agencies. Early in her professional career, Dr. Myers-Hunziker was awarded a National Institute of Justice fellowship for her dissertation research on police interactions with juveniles. While conducting other research sponsored by the National Institute of Justice she has on several occasions worked inside police departments.  Her specialty is helping public organizations identify their goals and better understand how to achieve them. To that end, Dr. Myers-Hunziker has published an article on the art of identifying and implementing best practices from the field.  

To contact the authors, email IPSauthor@apus.edu. For more articles featuring insight from industry experts, subscribe to In Public Safety’s bi-monthly newsletter.

References:

Robinson, T. A. (2014, June 21). The post-traumatic stress disorder dilemma for workers’ compensation claims. LexisNexis Workers’ Compensation eNewsletter. Retrieved from https://www.lexisnexis.com/legalnewsroom/workers’-compensation/b/recent-cases-news-trends-developments/archive/2014/06/21/the-post-traumatic-stress-disorder-dilemma-for-workers’-compensation-claims.aspx

 

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