Colorado Legislative Committee to Consider Latest PTSD Effort

Denver, CO (WorkersCompensation.com) – A hearing next week will give members of a Colorado House panel the chance to explore proposed legislation concerning workers’ compensation coverage for workers with Post-Traumatic Stress Disorder. But the legislation is less clear-cut than similar proposals in other states that expressly target first responders.

“The bill does not carve out protections for 911 dispatchers,” said Edie Sonn, VP Communications and Public Affairs for Pinnacol Insurance; “nor does it preclude anyone else who has experienced repeated exposure to audible trauma from getting the same protection.”

What SB 26 actually does is simply add “audible exposure” to the definition of those available for benefits included in legislation enacted three years ago. But, contrary to what Sonn says has been misinterpreted by some, it does not specifically pertain to workers in any one profession.

“While 911 dispatchers are the ones who advocated for the bill and are the most likely to use the benefit, it’s possible that hospital workers or others might file claims,” she said. “But, as with the previous bill,  repeated exposure and a diagnosis of PTSD from a psychiatrist or clinical psychologist is required.”

Colorado’s PTSD Legislative History

One of the concerns about PTSD legislation for first responders is that it excludes other workers who may be equally deserving of benefits. 

“Our position was always that it’s a bad idea to carve out any one group of professionals,” Sonn said. “As soon as you carve out one group, everybody else wants to be carved in. That’s certainly what we saw with the first attempts in Colorado. As soon as you say it applies to ‘first responders,’ you have to define what they are; and you get others, like corrections officers, and this group and that group. You end up with everybody trying to be carved in. The thing is, how can you really say who is most qualified for this coverage.”

Prior to the 2017, Colorado already had a law on the books that provides workers’ compensation benefits for anyone who may have PTSD resulting from a traumatic work experience.

“The law we amended in 2017 provided workers’ compensation coverage if the claimant experienced a psychologically traumatic event ‘outside a worker’s usual work experience,'” Sonn said. “That language takes care of the teacher who is part of a horrific school shooting or the worker at the retail store who gets held up. It’s a one time event but psychologically traumatic and outside the worker’s usual experience.”

But that law precluded many first responders from access to coverage. “The problem first responders had in Colorado … is that traumatic events are not considered to be ‘outside their usual work experience.,” Sonn said. “The response when police or state patrol officers or EMTs would say they were traumatized, some would say ‘that’s what you signed up for.’ Well, yes, and these people want to be heroes; they sign up to be heroes. They do that every day. But even heroes can be affected by the cumulative burden of what they witness and deal with every day.”

The 2017 legislation aimed to provide benefits for first responders with PTSD. While Pinnacol has not supported legislation that carves out coverage for members of any single profession, testimony before the state Legislature prompted the insurer to support efforts to expand the existing legislation.

“Our solution was to craft a bill that addressed what we had heard in testimony over the years. It is: repeated exposure to traumatic events that mounts up until the affected worker can’t take it any longer,” Sonn said. “Accordingly, our bill (HB 17-1229) said ‘if you have been repeatedly exposed to violent incidents and are diagnosed with PTSD by a psychiatrist or clinical psychologist, you can get workers’ comp coverage for your treatment.”

However, the 2017 legislation refers only to workers who have had ‘visual exposure’ to repeated trauma. Hence, this year’s SB 26 that includes audible exposure, which Pinnacol is supporting.

Pinnacol’s Experience with ‘Mental Stress’ Claims

In analyzing its data in the 10 years prior to 2017, Pinnacol found “a handful of such claims and saw that they averaged approximately $1,000,” Sonn said. “So if similar claims were covered in the future it would not affect rates – even if you assume, as we did, a certain level of pent-up demand.”

In the short time since implementation of the 2017 legislation, the insurer has not seen any significant increase in ‘mental stress’ claims.

“We looked at mental stress claims per month from 2013 through June 2018, then compared those to claims per month from July 2018 (when the law took effect) through December 2019,” Sonn said. “The average was essentially the same: 6.52/month pre-implementation, 6.6/month post-implementation. Now, of course, it’s a much smaller data set for the post-implementation time period. But if there were pent-up demand for the benefit, you might expect to see a spike in late 2018; we did not.”

Sonn pointed out that the numbers are only for claims filed and not claims on which the insurer did not pay.

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