Across the U.S., lawmakers are reconsidering their approach to mental health coverage under their workers’ compensation systems, particularly for first responders.

Catherine Montgomery

Bills in the Connecticut, Wisconsin, Montana, Kentucky and Oklahoma legislatures aim to expand workers’ ability to file work-related mental health claims, and providers should be ready.

If these state measures pass, they will likely drive more injured workers into treatment, increasing the demand for providers who are eligible to deliver mental health services to injured workers.

Here's a bill-by-bill breakdown of the potential changes in motion.

Connecticut

House Bill 6954 adds coverage for workers with a post-traumatic stress injury resulting from witnessing any serious physical injury. Current statutes limit coverage to witnessing injuries that lead to the victim’s death or disfigurement. HB 6954 is out of committee and on the legislature’s calendar.

More workers may qualify for PTSI claims. Providers may want to familiarize themselves with what defines a “serious injury” in the context of workers’ comp and how to navigate Connecticut’s authorization processes for PTSI.

Wisconsin

Senate Bill 168 would extend the post-traumatic stress disorder coverage that Wisconsin firefighters and law enforcement receive to emergency medical technicians, emergency medical services practitioners, volunteer firefighters, correctional officers, dispatchers, coroners and medical examiner staff.

Specifically, these workers would no longer have to demonstrate that their PTSD stems from “unusual stress of greater dimensions than the day-to-day emotional strain and tension experienced by all employees.”

State senators referred the bill to the Committee on Insurance, Housing, Rural Issues and Forestry.

Practices may see an influx of non-firefighter, non-police frontline workers, expanding the pool of patients eligible for workers' comp treatment. Injured workers may also come in from rural and volunteer fire departments.

Montana

Senate Bill 394 offers first responders workers’ comp coverage for PTSD, a first in Montana. Advocates frame the move as both fiscally responsible and a tool to normalize seeking mental health services and aid in suicide prevention.

SB 394 passed the state Senate and the state House of Representatives.

The possible influx of patients may be significant. Unlike other state measures that aim to expand post-traumatic stress coverage, this bill would institute such care for first responders for the first time.

Kentucky

Current Kentucky statutes recognize PTSD as a compensable injury for first responders only when it accompanies physical harm. House Bill 420 would make PTSD a stand-alone, work-related injury with a presumption of compensability if the provider diagnoses PTSD within three years of the worker’s last day of active duty.

Legislators sent HB 420 to the House Economic Development & Workforce Investment Committee.

With this bill, workers will not need to seek treatment for a physical injury as a prerequisite for mental health care. Plus, the burden shifts to employers to prove that the PTSD isn’t job-related. Mental health providers may see more injured workers and play a newly central role in qualifying claims.

Oklahoma

House Bill 1842 enhances PTSD coverage for first responders and adds requirements to collect the weapons of armed first responders and suspend their certification until the provider clears their return to work.

Legislators referred HB 1842 to the House Rules Committee.

Law enforcement PTSD cases will trigger administrative procedures in addition to care. Practices must coordinate with employers to meet treatment and clearance requirements.

What providers can do now

Brush up on each state’s evolving PTSD criteria. Train billing staff on mental health authorization and documentation for workers’ comp. Update intake procedures to identify and distinguish work-related injuries, particularly those requiring mental health services.

Even if the state you practice in is not on this list, pay attention. Any bill that significantly reshapes assumptions and legal precedent around workers’ comp compensability can have ripple effects.

Catherine Montgomery is the co-founder and CEO of daisyBill, a provider of end-to-end revenue cycle management software for workers' compensation. This post appears with permission.