Based on claims data from years before the PTSD presumption created by Senate Bill 542 took effect in 2020 in California, policy think tank Rand Corp. found that first responders filed more claims for the condition and that those claims were more frequently denied when compared to other workers.
Rand researcher Denise D. Quigley said during a state Commission on Health and Safety and Workers’ Compensation meeting Thursday that denials of police and firefighter PTSD claims are frequently reversed, which supports the rationale for creating the presumption.
“If they’re going to get reversed and accepted anyway, the time it takes between when it’s initially denied and it gets reversed — during that period of time, that’s when first responders were… suspended and many times not able to get the care that they need, and that causes in itself additional trauma,” Ms. Quigley said.
Rand found that about 0.9% of comp claims filed by firefighters and 0.7% of claims filed by police officers involved PTSD, compared to about 0.4% of claims filed by all workers in California.
Initial denial rates, however, were higher for both firefighters and police.
Some 23.6% of firefighter claims were initially denied, compared to 15.9% of claims filed by ambulance drivers and EMTs, according to Rand’s report. And 27.3% of police officer PTSD claims were initially denied, compared to 24.5% for correctional officers and 16.9% for security guards.
PTSD claims were also denied more often than other conditions such as cancer, heart trouble, hernias and lower-back impairments that are also presumed to be compensable for first responders, Rand found.
Michael Dworsky, a co-author of the report, said Rand calculated that without S.B. 542, PTSD claims would cost state and local governments a combined $19.5 million per year: $6 million for firefighters and $13.5 million for police officers.
This article was first published in Business Insurance.