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Research highlights gaps in workers’ compensation, policy solutions for FFs, EMS providers

Firefighters and EMS providers face barriers in seeking workers’ compensation, such as latency periods and pre-existing health conditions, FIRST Center research shows

Man embracing his friend who is sharing his story at the group therapy session

Close up shot of compassionate man embracing his friend who is sharing a heavy story regarding his mental health during a group therapy session.

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By Sarah Roebuck
FireRescue1

PHILADELPHIA — Federal workers’ compensation laws outline support for physical injuries and traumatic events at work. However, research from the Center for Firefighter Injury Research and Safety Trends (FIRST) shows significant state-by-state differences in prioritizing compensation for first responders with mental injuries.

Published in the Journal of Public Health Policy, this research led by FIRST Center affiliate Sherry Brandt-Rauf, JD, MPhil, from the Dornsife School of Public Health, comprehensively reviews U.S. state workers’ compensation laws and their support for first responders with psychological conditions.

The findings from the FIRST Center indicate that, in most states, mental health issues for first responders are classified into three categories:

  1. Physical-to-mental injury: Mental health issues resulting from a physical injury.
  2. Mental-to-physical injury: Physical harm caused by a mental health crisis.
  3. Mental-to-mental injury: A mental health issue arising from unresolved psychological concerns.

According to the FIRST Center, all 50 states support physical-to-mental injury claims, 44 states support mental-to-physical injury claims and 40 states support mental-to-mental injury claims.

Additionally, more states have presumption of causation laws for diseases linked to firefighting and EMS work, like cardiovascular, respiratory and infectious diseases, compared to mental health conditions, according to the FIRST Center. For instance, 23 states passed presumption laws for COVID-19 during the pandemic, whereas only nine states have such laws for mental health conditions.

In addition to inconsistencies in presumption policies across states, first responders face several barriers in seeking workers’ compensation, such as latency periods, time limits and pre-existing health conditions. Proving that a psychological injury is work-related is particularly challenging.

To address these gaps, states could adopt presumptive coverage for first responder mental illness, with a statute including a “sunset” clause, similar to the approach used during the COVID-19 pandemic.

“There is a precedent in this country to protect people who put their lives at risk in service of others,” says Jennifer Taylor, PhD, MPH, CPPS, director of the FIRST Center. “We have a moral duty to make first responders whole again after they serve our communities. While presumptive laws are neither perfect nor uniform, they are an important tool in caring for the unique needs of first responders.”

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