After last month's Sandy Hook Elementary School shooting in Newtown, Conn., the state is expected to weigh whether to expand the presumption of workers compensation coverage to first responders who suffer psychological trauma.

The Connecticut discussion is one of several legislative issues nationwide that experts say could impact the workers comp landscape for 2013.

Connecticut workers comp law does not cover mental health claims that do not have a corresponding physical injury, according to the Connecticut Workers' Compensation Commission. The Connecticut General Assembly is expected to consider a bill this month that would expand benefits for first responders that weren't injured but need counseling.

Though some first responders did not suffer physical injuries in the Newtown tragedy, workers comp case law still may allow them to receive coverage for their psychological injuries outside of any reforms, said Bruce Wood, Washington-based associate general counsel and director of workers compensation for the American Insurance Association.

The shootings could be proven to be a direct cause for the first responders' mental conditions and allow them to receive benefits even without Connecticut passing new legislation, Mr. Wood said.

“That may, under some workers compensation jurisprudence, qualify as a physical event, even though there wasn't a physical injury to the first responder himself,” he said.

Coverage for mental health claims is part of several workers comp reforms that could be on the table for Connecticut this year, said Peter Burton, Wayne, Pa.-based senior division executive for state relations for NCCI Holdings Inc.

The state is working to deal with workers comp rates that have increased for four consecutive years, Mr. Burton said. Connecticut also had the second-highest workers comp premium rate nationwide in 2012, according to a biennial study conducted by the Oregon Department of Consumer and Business Services.

Workers comp coverage presumption is an issue that public employers nationwide are watching out for in regard to first responders, said Dan Hurley, senior director of risk management and safety at Norfolk, Va., Public Schools and president of the Public Risk Management Association.

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“There's been some movement by public safety unions ... to include things such as cancer, to presume that if I have cancer that it must have come from employment,” Mr. Hurley said. “Another one is communicable diseases, where your first responders or police are on the scene (and) you presume that whatever they got came from work.”

In Oklahoma, proponents of an “opt-out” workers comp system are expected to revive their efforts this year after a similar measure was defeated by the Oklahoma House of Representatives last April.

The bill would have established an alternative workers comp system that lets certain employers exempt themselves from the state system. The plan would require employers opting out to establish a substitute plan — including medical, disability and death benefits for injured workers — that meets Employee Retirement Income Security Act requirements.

“We strongly oppose opt-out,” Mr. Wood said.

The Oklahoma opt-out bill was supported by retailers such as Oklahoma City-based Hobby Lobby Stores Inc. and Seattle-based Nordstrom Inc.

California employers and insurers are starting to see the implementation of sweeping workers comp reforms passed by the state in September. Most will see costs go up in the short term because an increase in permanent disability benefits took effect Jan. 1, said Mark Sektnan, president of the Sacramento, Calif.-based Association of California Insurance Cos.

The state has begun to implement reforms that aim to reduce some workers comp system costs, such as new fee schedules and an independent medical review process meant to quickly resolve medical treatment disputes.

Though the changes are expected to limit rising comp costs this year in California, Mr. Sektnan said it will take years to determine the full effect of last year's reforms.

“We hope that the reforms will flatten the curve of what are necessary cost increases over the next couple years,” he said. “Without the reforms, costs would have gone up a lot higher. With the reforms, we hope they'll go up a little less. We don't want anybody to have the impression that costs are actually going to go down, because that's not likely to happen.”