Kansas bill would provide workers' comp for first responders with PTSD
Currently, the state only provides coverage for PTSD if there is a corresponding physical injury
The Kansas City Star
TOPEKA, Kan. — When Kent Vosburg visited a counselor after finding himself in "a bad way" a decade ago, it was the counselor who left the room crying.
"The person that's supposed to come help me can't do it," Vosburg said.
In his career as a paramedic, Vosburg has witnessed several horrifying scenes.
There was the woman who passed out on top of her infant daughter, smothering her for hours. Another time his ambulance arrived to a car fire minutes before a fire truck. Without fire gear, the crew couldn't do anything as the people in the vehicle burned. A man once shot himself in front of Vosburg.
"When the general public needs help, they call 911. But when 911 needs help, what do they do?" said Vosburg, training chief at the Junction City Fire Department.
Kansas is one of a shrinking minority of states that doesn't extend workers compensation for post-traumatic stress to first responders. Only 12 states don't offer at least some type of coverage, according to a January 2020 report by Atlanta-based workers compensation law firm Gerber & Holder.
Kansas provides coverage for PTSD only if there is a corresponding physical injury. For first responders like Vosburg, who may not come away from scenes physically wounded but have experienced psychologically traumatic events, the help available may be limited by what their resource-stretched departments can offer.
But the toll of mental injuries can sometimes outweigh physical ones. Firefighters and police officers are more likely to die by suicide than in the line of duty, according to a 2018 study released by the Ruderman Family Foundation, a mental health advocacy group.
The COVID-19 pandemic only compounded the stress placed on first responders, as fear of infection loomed over calls and intense precautions added to workloads. Vaccinations for frontline personnel and falling case counts have begun to ease the burden, but Vosburg said the height of the crisis several months ago took a toll.
"We are automatically assuming everybody's sick," Vosburg said. "We don't have a good way to know who has COVID and who doesn't."
Advocates for first responders are now calling on the Legislature to extend workers compensation in Kansas to cover PTSD suffered by first responders. A bill introduced in February would provide coverage to firefighters, law enforcement officers and paramedics.
"It has been an issue that has been silent for so long and so many have suffered in silence," said Chrissy Bartel, president of the Kansas Emergency Medical Service Association's peer support society.
The bill sits in the House Commerce Committee and a hearing hasn't been scheduled. Rep. Eric Smith, a Burlington Republican who introduced the proposal, said he hasn't been guaranteed a hearing yet, but also hasn't been told no.
Major proposals sometimes take years to become law. But proponents say this one holds the potential to transform how first responders in Kansas approach mental health.
"We do this for those injuries we're familiar with, the ones that we can see, the ones that provide specific evidence. What we don't have is the ability to acknowledge at this point a workmen's comp option for someone who is enduring a traumatic incident," said Smith, an undersheriff in Coffey County. "What we're finding here is we've been doing it this way and that's why we continue to do it."
Encouraging getting help
Workers compensation operates as a type of insurance. Employees are paid for injuries sustained on the job, including for lost wages and medical treatment. In exchange, they surrender their right to sue over the injury.
The bill approaches PTSD coverage in the same way. Compensation may be given for PTSD if it "arises out of and in the course of employment." It also allows compensation for workers who are taken off the job or given modified duties by a licensed psychologist or psychiatrist.
"Workers comp is a program that's put in place for on-the-job injuries. And PTSD, if the PTSD stems from an incident that occurred on the job, you shouldn't treat mental health any different than a physical injury," said Jill Barron, a psychiatrist who treated New York firefighters after 9/11 and was a mental health advisor in Newton, Conn., following the Sandy Hook shooting in 2012.
Expanding worker's compensation to PTSD would almost certainly result in increased costs as first responders seek care. The Kansas Department of Administration estimates an additional $4.6 million in spending next year on claims by state-employed first responders. Cities and counties would likely pay more, too, but no firm estimates exist.
As of 2017, Kansas employers paid $1.07 in worker's compensation costs for every $100 of wages covered by the program, according to the National Academy of Social Insurance.
"In general, broadening the workers compensation statutes to provide compensation for post-traumatic stress disorder without an accompanying physical injury has the potential to significantly impact system costs for the affected occupational groups, which in this bill are defined as firefighters, law enforcement officers and emergency medical service providers," said Jeff Eddinger, senior division executive at the National Council on Compensation Insurance.
But Eddinger added that the costs to the states' overall workers compensation systems are often "more muted" because first responders make up a limited share of total costs.
Ed Klumpp, a lobbyist for several Kansas law enforcement associations, said a major aim of the measure is making first responders comfortable asking for help.
"This legislation, if nothing else, will help not only to provide those services for them, but also will encourage them to seek help if they feel like they are struggling with PTSD," Klumpp said.
Vosburg said in Kansas there's no fast and efficient way to get emergency workers the mental health care they need. In his own case, when he sought counseling about 10 years ago through an employee assistance program, he got caught in a Catch-22.
His program offered two free visits with a counselor, who then decided whether more care was needed. After his counselor, who he said appeared fresh out of college, left in tears, she was unable to finish her evaluation to let him continue visiting a counselor, Vosburg said.
"The local therapist, it's $200 an hour. I want therapy, but I'm looking at, what bill am I not going to pay for?" Vosburg said.
Vosburg eventually began running and started training for marathons. He said he avoided drug and alcohol abuse, but knows of numerous people in the profession who are alcoholics.
Now that he trains employees, he teaches them about the stress of what are called "critical incidents" and the importance of getting debriefed afterward.
"Go sit in the meeting. You don't have to talk, just physically be there. Even if you don't say anything, it helps," he said.
'I've lost friends'
In the past, "suck it up" attitudes prevailed among first responders, encouraging them to move on quickly after traumatic events, Bartel said. But that's begun to change in the last few years.
"It's finally making people comfortable enough to speak up and say, 'this really bothered me' or 'I'm having problems and I'm having issues because of what I saw or what I experienced,'" Bartel said. "So what we're finding is there's a large number of providers and first responders that have really been silent with their pain because there's nowhere for them to go or there has not been an acceptance of it."
The peer support society, created in 2018, aims to help first responders emotionally and mentally as well as physically. The goal, Bartel said, is to provide a "listening ear" to workers.
People reach out to her unsure where to get help or are looking for a therapist they can afford, she said. Placing PTSD under worker's compensation will help provide them the financial ability to get help, she contends.
"I've lost friends to suicide ... I think many of us are at the point where we're tired of losing friends and co-workers and the number of the people who are leaving the profession just due to the emotional stress and the mental stress and the help that they're not getting," Bartel said. "It's time to start doing something."
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