The Pitfalls of the Proposed PTSD Legislation

Mental health concerns, including post-traumatic stress disorder (PTSD), are endemic among law enforcement officers, firefighters, and correctional officers. According to the Center for Disease Control and Prevention (CDC), “[l]aw enforcement officers and firefighters are more likely to die by suicide than in the line of duty.”[1]

Unfortunately, mental health concerns among first responders are often unreported or underreported[2], meaning some will not get the help they need before it is too late.

In 2013, the Minnesota legislature revised the Workers’ Compensation Act to recognize post-traumatic stress disorder as a compensable injury.[3] But, first responders with PTSD continued to confront significant barriers to accessing mental health care under the Workers’ Compensation Act because employers and insurers denied that their condition was work-related.

Something had to change.

In 2018, the Minnesota legislature revised the Workers’ Compensation Act to create a presumption that if a first responder is diagnosed with post-traumatic stress disorder (and certain other criteria are met), then their condition is presumptively an occupational disease and shall be presumed to have been due to the nature of employment.[4]

Notwithstanding the statutory presumption that was passed unanimously in the House and Senate[5], nothing has changed. Employers and insurers continue to deny nearly 100% of first responders’ claims for work-related post-traumatic stress disorder, often claiming that their condition does not exist, or that the employer and its insurer are not responsible.

After the death of George Floyd, many first responders reached a breaking point. First responders’ accounts of the days after the death of George Floyd are harrowing. After days-and-days of 12-20+ hour shifts in what was akin to a domestic war zone, many first responders were in severe distress.

It is not unsurprising—at least it shouldn’t be—that the number of first responders seeking mental health care increased after the riots. It is also not surprising that employers and their insurers, then sought to reduce their costs by changing the laws that require them to provide this care.

Let’s be clear, insurance companies, including the League of Minnesota Cities, do not actually care about your mental health, they care about their bottom line.

The League of Minnesota Cities is an insurance trust that represents 786 out of 854 cities and is committed to “control[ling] losses” and providing its member cities with “the lowest long-term cost” for insurance.[6]

The League of Minnesota Cities has been lobbying for years to change the laws that provide first responders with access to mental health care. The League of Minnesota Cities has consistently advocated for an interpretation of the Workers’ Compensation Act that would make it more difficult for first responders with PTSD to access workers’ compensation benefits, due to the financial cost of providing mental health care.[7] Now, the League of Minnesota Cities is seeking to change the law outright.

The proposed PTSD legislation, advocated for by the League of Minnesota Cities and other Minnesota insurance providers, has three stated objectives: (1) expand wellness training, (2) shift the cost of providing health insurance to first responders who are duty disabled from Cities and Counties to the State of Minnesota, and (3) provide first responders with access to mental health care and wage-loss benefits (that are theoretically already available under the Workers’ Compensation Act), while preventing first responders from applying for PERA/MSRS duty disability benefits unless/until they complete 32 weeks[8] of therapy.

Significantly, MPPOA, LELS, and other unions agreed to support the legislation drafted to expand wellness training for first responders and shift the cost of providing health insurance to the state. The authors of the proposed legislation, however, refused to move forward with these aspects of the legislation, for which there was broad support.

The unions also agreed to continue to participate in the working group to draft legislation to provide first responders with access to mental health care and wage-loss benefits but expressed serious concerns about limiting first responders’ ability to apply for PERA/MSRS duty disability benefits.

The unions are understandably concerned that the employer and insurer may not actually provide the mental health care that is being promised. Given that employers and insurers deny approximately 100% of workers’ compensation claims for the same benefits, this is to be expected.  Currently, there are no enforcement measures to ensure that the employer and insurer will uphold their end of the deal.

Another concern is that the PERA/MSRS duty disability application process is already complicated, and the proposed legislation makes this problem worse. The proposed legislation would require first responders to apply to PERA/MSRS for treatment and wage-loss benefits (which may be denied and appealed), before even applying for PERA/MSRS duty disability benefits. This extra step would significantly extend the timeline to receive PERA/MSRS duty disability benefits. Imagine being injured in the line of duty and having to wait even longer before even being allowed to apply for PERA/MSRS duty disability benefits—benefits you paid for throughout your career—when you need those benefits most.

Meuser, Yackley & Rowland is committed to helping first responders get the mental health care they need to thrive personally and professionally; but the proposed PTSD legislation falls short, and more work needs to be done to get it right. Until then, Meuser, Yackley & Rowland will continue to advocate for meaningful change that prioritizes reducing the human costs of PTSD, rather than the financial costs to insurance companies.

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[1]  Suicides Among First Responders: A Call to Action, Centers for Disease Control and Prevention, April 6, 2021 by Hope M. Tiesman, PhD; Katherine L. Elkins, MPH; Melissa Brown, DrPH; Suzanne Marsh, MPA; and Leslie M. Carson, MPH, MSW (https://blogs.cdc.gov/niosh-science-blog/2021/04/06/suicides-first-responders/).

[2] “First Responder Mental Health and Suicide: An Evidence-Based Approach”, NHTSA Office of EMS (Fall 2021) https://www.ems.gov/newsletter/fall2021/first_responder_mental_health_and_suicide.html

[3] Minnesota Statutes section 176.011, subdivisions 15(a) and 16.

[4] Minnesota Statutes section 176.011, subdivision 15(e).

[5] See Journal of the House, May 15, 2018  – https://www.house.leg.state.mn.us/cco/journals/2017-18/J0515097.htm#10551; and Journal of the Senate, May 17, 2018 – https://www.senate.mn/journals/2017-2018/20180517099.pdf#page=11

[6] https://www.lmc.org/insurance-trust/about-the-trust/trusts-mission-values-advantage/

[7] Amicus Brief filed by the League of Minnesota Cities in Juntunen v. Carlton County.

[8] H4026DE6 requires 32 weeks of treatment; however, different drafts required different periods of treatment.