SC bill aims to cover PTSD under workers’ compensation

Deputy Sheriff, shot and injured in the line of duty, champions PTSD coverage as a workers’ comp benefit


By Ann Marie Farina

A bipartisan group of South Carolina senators have introduced a bill, S429, that would permit some first responders to file for workers’ compensation benefits for treatment of PTSD. I spoke with Deputy Sheriff Michael Ackerman, who is responsible for the bill being introduced and who has been working diligently to raise enough support to get it passed.

Ann Marie: What is SC Senate Bill S429?

Michael:  Senate Bill S429 basically changes a couple of words in the state workers’ compensation law so that all first responders would be able to claim PTSD, (if they are diagnosed as having PTSD by a licensed medical professional), as a compensable injury under workers’ comp if the PTSD was related to any incident on the job.

Ann Marie: How did you get involved with the bill?

Michael: I got into law enforcement July 1, 2004, and served as a law enforcement officer in Arizona until 2009, when I moved back to South Carolina. I have been with the Charleston County Sheriff’s Office since October 2010, where I just rose to the rank of master deputy. On Sept. 8, 2014, I responded to a disturbance call with four other deputies. In the two minutes this fire fight lasted my partner and friend Joe Matuskovic was shot and killed, and I was shot in my right leg before I shot and killed the suspect.

Besides the physical injuries I have been dealing with some very severe emotional injuries. In October 2014 I was in a very dark place mentally and emotionally. It was at that point that I realized I need specialized help. I needed to see someone who understood the nature of law enforcement, and what we go through every day. So I began looking and asking around, and notified my workers’ comp case manager I needed to see someone. I found a doctor who specializes in first responder trauma and made an appointment.

A few days after my first appointment, I was notified by my case manager that the appointment would not be covered. I found out that workers’ comp case managers were not educated in how to get mental health appointments approved because requests were so infrequent. I contacted a number of people, including the governor's office and was eventually told that what I wanted wasn’t possible and if I wanted it to happen the law needed to be changed.

I eventually contacted Sen. Paul Thurmond (R-Charleston) and he has truly been a champion of this cause. It (S429) passed Senate sub-committee fully intact 5-0 and full committee.

But (S429) has been blocked in the full Senate. The Association of Municipalities and Counties are lobbying hard against it. That is where we stand right now.

Ann Marie: What does the current workers’ comp law say?

Michael: Basically if you are physically injured on the job and you develop PTSD because of that physical injury, the PTSD is supposed to be compensable through workers’ comp, but please note I still had to fight with them and retain an attorney before they finally agreed to cover my psychiatric treatment … and I was physically injured.

However, if you develop PTSD because of an on-the-job incident and were not physically injured, workers’ comp will NOT cover you for the PTSD. So if you take my incident, and let’s say everything else about it stays the same BUT I was not physically injured and I developed PTSD, workers’ comp would not have covered my psychiatric visits.

Ann Marie: Section F of the bill says "an employee shall establish by medical evidence that the injury arose in the course of employment." Could this wording result in employees having to pay for those tests themselves?

Michael: Most agencies have an employee assistance program (EAP) and through this they could receive the diagnosis, but yes there could be some upfront costs associated with being diagnosed (out-of-pocket medical expenses), but once diagnosed those would all be reimbursed like anything else with workers’ comp.

Ann Marie: Since there is no commonly accepted standard to diagnose mental health conditions via tests like those listed in section F, could that result in claims being denied due to a lack of evidence?

Michael: In the past few years with the U.S. military’s acknowledgement of PTSD and its effects on service members, the diagnosis and treatment has moved into mainstream medicine. So I don’t think that would be an issue. 

Honestly the biggest issue in the first responder community is the long standing belief that we should just 'suck it up and deal with it,' which is why we lead all professions in suicide rates. The mentality in the first responder community is still not fully accepting of this issue.

Ann Marie: How can people get involved with SC Senate Bill S429?

Michael: South Carolina first responders can call or email their senator and representative and ask them to pass Senate Bill S429. It is only through constituent pressure that we will get this passed.

Additional information on S429

  • The only mental health condition covered will be PTSD.
  • The causative event does not have to be extraordinary or unusual, unlike the current law.
  • It is unclear if mental health issues caused by repetitive incidents versus one single traumatic incident will be covered. The bill currently has provisions for when repetitive physically traumatic injuries are covered, and hopefully the same guidelines will also apply to repetitive mentally traumatic events. 

Summary
Ackerman's experience shows that it is possible to get the attention of legislators, and one person advocating for change can have significant results. EMS providers should keep an eye on the South Carolina bill to see if it passes and if it is further amended. If it does pass, it is likely legislators from other states will look at the text of the South Carolina bill when introducing bills in their own state.

With the growing awareness about first responder mental health and PTSD, EMS providers and advocates should expect to see more bills addressing the restrictions in workers’ compensation benefits. 

About the author
Ann Marie Farina is a NR-P in Washington state. She has been in EMS since 2003 and has worked in a variety of positions in Alaska and Washington since then. Over the years her jobs have included working as a wildland fire medic, a dual-role firefighter/paramedic, a 911 transport medic, and as an educator.

In March of 2014 Ann founded The Code Green Campaign, a mental health awareness campaign that raises awareness about mental health conditions and suicide in first responders. Through Code Green, Ann has worked as an educator, researcher and consultant in order to assist agencies in improving their mental health programs.

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