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Florida bill to expand PTSD benefits for first responders criticized

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A Florida bill that would cover mental health treatment for first responders with post-traumatic stress disorder absent any physical injuries under workers compensation moved forward last week, but opponents have questioned its cost and the standard it would use to judge benefits eligibility.

S.B. 376, sponsored by Sen. Lauren Book, D-Plantation, revises the evidentiary standard for demonstrating mental and nervous injuries for first responders. Under the bill, law enforcement officers, firefighters, emergency medical technicians and paramedics are entitled benefits under the Florida Workers’ Compensation Law for mental or nervous injuries, regardless of whether the injury is accompanied by physical injuries requiring medical treatment, according to the bill’s latest text.

In the bill’s introduction, Sen. Book stated that more firefighters and police officers commit suicide as a result of PTSD than are killed in the line of duty. Under the current law, first responders can’t receive workers comp for PTSD without an accompanying physical injury.

James Tolley, Tallahassee, Florida-based president of the Florida Professional Firefighters association, said the government, at both local and state levels, has a responsibility to the firefighting community.

“We have many members that have experienced tragic and troubling events and then we have a few that have experienced horrific events such as the Pulse Nightclub shooting in Orlando, which compound the situation,” Mr. Tolley said. “Post-traumatic stress and cancer-causing exposures are priority legislation for the Florida Professional Firefighters ...when our firefighters seek treatment for mental health concerns, they should not be tied to a physical injury. When diagnosed with mental health issues or cancer caused by job-related exposures, our firefighters should get the treatment they need and deserve.”

However, S.B. 376 has received pushback from the Florida League of Cities, a policy group that represents the state’s municipal governments, which believes the bill would be too costly for Florida taxpayers.

“With the most respect to our first responders, we feel like part of the conversation that should be had when discussing PTSD and workers comp is the cost associated with any new benefits,” said David Cruz, Tallahassee, Florida-based legislative counsel for the Florida League of Cities. “Unfortunately, our taxpayers would be on the hook ... The League of Cities has tried to look at other states that have studied this issue, and one such study was done by the Ohio Bureau of Worker's Compensation, who studied a similar proposal. They estimated that it would cost Ohio $182 million a year for the impacted first-responder employers. Ohio is a smaller state ... so the impact in Florida could be even greater.”

Mr. Cruz said that the intent isn’t to deny first responders treatment, but the issue is workers compensation coverage.

“The bill was amended in committee, and I think two big issues we have with the current version of the bill is the broadness of the events that are covered,” he said. “The other issue that we have is the evidentiary standard that the first responder has to meet. I believe they changed it from a clear and convincing standard to a preponderance standard, which would make it easier for them to meet that evidentiary standard.”

The American Insurance Association was also critical of the bill’s evidentiary standards for workers comp coverage.

“While we all have the utmost respect and appreciation for law enforcement and first responders, AIA opposes permitting recovery of mental stress claims in the workers compensation system in the absence of any physical impairment,” said Ron Jackson, Atlanta-based vice president for state affairs, Southeast region for the AIA. “It’s necessary to have a higher standard for mental injury claims because of the greater challenge in connecting these injuries, which are inherently subjective, directly to the workplace. Without restrictions and clear evidentiary standards, mental stress claims can flood the system and result in workers compensation simply becoming general health insurance for psychological injuries.”

Sen. Book will continue discussions with the Florida League of Cities about their concerns, according to a spokeswoman for Sen. Book.

In other states that have passed similar legislation, the cost increase has not been an issue and there are greater costs at many levels if first responders are not receiving PTSD treatment without also having an accompanying physical injury, the spokeswoman said in an emailed statement.

The next stop for the bill is the second committee of reference, which is the Senate Commerce and Tourism committee, according to the spokeswoman.

Other states have also pursued legislation allowing first responders to receive workers comp benefits for mental stress injuries. In April, the Vermont House of Representatives passed a bill that would provide workers comp coverage to first responders with work-related PTSD. The bill is now in the Vermont Senate.

In June, Texas Gov. Gregory Abbott signed a bill into law that made PTSD a compensable injury for first responders.