Expanded Work Comp Coverage for Florida First Responders
A new law will take effect October 1, 2018 that expands workers’ compensation benefits for firefighters, paramedics, EMTs, law enforcement officers and other first responders that develop post-traumatic stress disorder following an exposure to extremely traumatic events or stressors on the job. Following the 2016 Pulse Nightclub shooting in Orlando, there developed a public outcry of sorts when it became widely known that workers’ compensation benefits were not available for the first responders that developed PTSD after being exposed to such a horrific incident.
Beginning next month, Senate Bill 376 goes into effect providing work comp coverage for post-traumatic stress disorder caused by witnessing such horrific events as the death of a minor or “grievous bodily harm of a nature that shocks the conscience.” While the definition of “grievous bodily harm” is still being finalized, the proposed rule includes witnessing such injuries as decapitation, degloving, enucleation, evisceration, exposure of internal organs, impaling, severance of body parts, and severe burns.
Prior to the law’s passage, PTSD was only covered by worker’s comp if a mental injury was accompanied by a physical injury that required medical treatment. This limitation of coverage still exists for everyone other than first responders. For instance, a bartender at the Pulse Nightclub that was present for the shooting and witnessed all the same atrocities as the first responders and later develops PTSD will not be covered by work comp. Just first responders are getting this expansion of coverage.
This law has been described as a “straightforward, common-sense solution to a terrible problem.” However, as is often the case in workers’ comp, the application of the new law in practice may not make as much sense as first thought. Consider this:
Florida workers’ compensation laws allow the insurance company providing the work comp coverage complete control of the choice of doctor to provide the treatment needed for a work injury. Now that PTSD is a covered condition for our first responders, they no longer get to choose the psychiatrist, psychologist, or counselor they want and feel comfortable with to provide treatment. The adjuster on the other end of the phone will tell the first responder the doctor he/she must use for treatment. What if the first responder doesn’t have a good relationship with this chosen doctor? There is a provision that allows the injured worker to request a one-time change of doctor….but the adjuster gets to choose that doctor as well. Does it really make common-sense for an injured worker, first responder or otherwise, to have no input into which doctor will provide their treatment?
There will also be those situations where the first responder initially seeks counseling on his/her own by getting treatment through personal health insurance that most first responders already had as a benefit. However, once the diagnosis of PTSD is made related to a work event, personal health insurance is no longer an option for the first responder. It becomes a work comp case to be covered by the work comp insurance. Under current law, the adjuster with the work comp company does not have to honor the existing doctor-patient relationship with the counselor/doctor chosen by the first responder. The adjuster can, and likely will, choose another psychiatrist, interrupt existing care trusted by the first responder, and be in almost complete control of the timing of all future authorizations for treatment of the PTDS.
So, what have we really done to our first responders by making them get treatment through workers’ compensation? We’ve taken an already fragile situation and potentially made it worse.
Kimberly J. Syfrett
Attorney at Law