An emerging trend in workers’ compensation nationally is workers filing post-traumatic stress disorder claims from events that they experienced on the job.
These events will typically be something traumatic like witnessing a violent event while on the job or the aftermath of a horrific accident – but not always.
Most recently, the Connecticut Supreme Court held that a Federal Express Corp. driver diagnosed with PTSD in part due to his manager’s demands and stress of a really bad day is eligible for workers’ compensation benefits. In that case, William D. Hart vs. Federal Express Corp. et al., the court upheld 47 weeks of temporarily total disability that had been awarded by the state’s Workers’ Compensation Review Board.
Increasingly, insurers have been denying these claims only to be thwarted by workers’ compensation appeals boards or higher courts when the cases are appealed. Courts are increasingly siding with workers and awarding them disability benefits.
For the most part, PTSD claims are filed by police officers or other first responders, but increasingly, employees that witness a violent crime or a horrific accident while on the job are starting to file workers’ comp PTSD claims.
Many states, but not all, allow workers’ compensation claims based on PTSD. In order to qualify for benefits, a worker must have experienced or witnessed a traumatic event while acting in the scope of employment, and then suffer PTSD symptoms that interfere with the ability to work.
Examples of work-related PTSD claims
Some examples of workplace situations that might give rise to a PTSD claim are:
• A police officer, firefighter or emergency medical technician responds to a horrific or gruesome situation.
• A construction worker observes a co-worker’s serious injury or death.
• A teacher witnesses a school shooting.
The individual must also receive a formal diagnosis of PTSD from a psychiatrist or psychologist.
PTSD symptoms can include:
• Flashbacks
• Heightened startle response
• Depression
• Anxiety
• Irritability
• Cognitive decline
• Nightmares
• Physical symptoms such as headaches, ulcers, nausea and fatigue
In many cases, PTSD symptoms may not appear until months or even years after the trauma. Many claimants say the symptoms are so severe that they cannot perform their jobs properly, and they may take long periods off from work.
Defending PTSD claims
Under workers’ compensation regulations:
• The employment must be the “predominant cause” of the employee’s claim.
• The claim must not arise from a “good-faith personnel issue.”
• Psychiatric injuries can arise from a specific, traumatic, event-triggering PTSD.
• Psychiatric injury can be compensable if the worker has a serious physical disability and has been employed at least six months.
If you are faced with a stress or PTSD claim, Safety National Insurance Co. recommends that:
• When you receive the first report, reach out and communicate to the injured worker immediately. Sometimes the issue may be a misunderstanding or they may just want someone to care.
• Be proactive, not reactive, with trauma cases. If this is a situation that would cause you traumatic stress, it is probably causing the injured worker traumatic stress.
• You consider your “confirmation bias” and other biases when collecting statements.
• You document reactions to personnel actions.