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Connecticut PTSD presumption expansion raises concerns

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PTSD

A new law in Connecticut that will make post-traumatic stress “injuries” compensable by presumption for all workers who experience a “qualifying event,” such as witnessing a death, may not be as narrow as opponents had hoped, according to insurance and business experts.

Connecticut Gov. Ned Lamont on June 12 signed S.B. 913, which goes into effect Jan. 1, 2024, and expands the compensability for mental injuries already provided to first responders. Under the law, a mental health professional must examine the claimant and diagnose post-traumatic stress disorder “as a direct result of an event that occurs in their course of employment.”

The measure was a long time in the making. Similar legislation had been introduced in the past, and two separate bills were filed this year. Connecticut was also among the first states to enact PTSD laws for first responders — now a national trend.

Some states, such as California, already accept workers compensation claims for mental injuries that occur due to something experienced at work, such as witnessing violence or being robbed, without a physical injury component.

The new Connecticut law is different in that it presumes a person is suffering due to the work experience, without the worker having to prove that the incident caused the suffering.

Christy Thiems, Chicago-based assistant vice president, workers compensation, for the American Property Casualty Insurance Association, said the insurance industry and businesses opposed the legislation due to the potential for increased workers compensation costs. She said the compensability “expansion is concerning, but there are a number of eligibility criteria and limitations which may reduce the impact of this legislation.”

One such parameter is the list of qualifying events that a worker has to witness in order to qualify. These include viewing a deceased minor, witnessing a death or an accident that later results in a death, and witnessing a major injury such as a disfigurement.

The Connecticut Business Industry Association lobbied to include that a claimant had to have witnessed something disturbing at work to qualify.

“We wanted to make sure that if this was enacted that the scope of coverage stayed as narrow as possible to avoid the potential risk of fraud, obviously, and to make sure if people have PTSD from their job that it's covered, of course, but to make sure it's not because of other events in their life,” said Peter Myers, Hartford, Connecticut-based government affairs associate with the CBIA.

However, problems with the new law remain, said Les Kertay, a Chattanooga, Tennessee-based psychologist and senior vice president of behavioral health with Axiom Medical Consulting Inc., which provides comp services. 

“There's kind of a presumption built in that if you're exposed to one of these events that you're automatically traumatized, and therefore have been presumed to have had a work injury, and that just doesn't match the science,” he said.

Mr. Kertay said only a small percentage of people would be diagnosed with PTSD following a traumatic event. “To me this potentially really broadens the issue,” he said.

Another concern regards a possibly preexisting diagnosis, he said.

“The qualifying event has to be at work, but what if the person has combat exposure that led to PTSD and then witnesses another event at the workplace?” he said. “How do we determine if the work event caused or substantially contributed to a diagnosis of PTSD if the person is already diagnosed? That’s just one of the problems with causation analysis.”