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Do You Know the Rule? PTSD Compensability in Mo.

08 Aug, 2023 Chris Parker

ambulance 2000195 640

St. Louis, MO ( -- Fire and police departments, and other employers of first responders in Missouri, may see a rising number of workers’ compensation claims, now that state law recognizes PTSD as a compensable occupational disease when certain criteria are met.  

Missouri Governor Bill Parsons recently signed into law Senate Bill 24, which becomes effective Aug. 28, 2023. The law provides that a first responder’s PTSD is a compensable occupational disease, regardless of whether the responder suffers a physical injury, if the requirements discussed below are met. 

Evidence of Causation and Diagnosis 

For the condition to be compensable under the new law, the first responder will have to: 

  1. Demonstrate by clear and convincing evidence that PTSD has resulted from the course and scope of employment; and 
  1. Be examined and diagnosed with PTSD by an authorized treating physician (the responder must meet criteria for a PTSD diagnosis, as described in the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition). 

Qualifying Events 

The PTSD must be due to the first responder experiencing one of the following qualifying events: 

  1. Seeing for oneself a deceased minor; 
  1. Witnessing directly the death of a minor; 
  1. Witnessing directly the injury to a minor who subsequently died prior to or upon arrival at a hospital emergency department, participating in the physical treatment of, or manually transporting, an injured minor who subsequently died prior to or upon arrival at a hospital emergency department; 
  1. Seeing for oneself a person who has suffered serious physical injury of a nature that shocks the conscience; 
  1. Witnessing directly a death, including suicide, due to serious physical injury; or homicide, including murder, mass killings, manslaughter, self-defense, misadventure, and negligence; 
  1. Witnessing directly an injury that results in death, if the person suffered serious physical injury that shocks the conscience; 
  1. Participating in the physical treatment of an injury, including attempted suicide, or manually transporting an injured person who suffered serious physical injury, if the injured person subsequently died prior to or upon arrival at a hospital emergency department; or 
  1. Involvement in an event that caused or may have caused serious injury or harm to the first responder or had the potential to cause the death of the first responder, whether accidental or by an intentional act of another individual. 


The claim must be properly noticed within 52 after the qualifying exposure, or the diagnosis of the disorder, whichever is later. 

Types of Workers Covered 

Those who qualify as a first responder under the law include: 

  • Law enforcing officers 
  • Firefighters 
  • Emergency medical technicians 
  • Air ambulance pilots and 
  • Air ambulance nurses. 

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