WA bill would help coroners, correctional officers get PTSD coverage

After fatal car crashes, fires or other emergencies, coroners and medical examiners are among the first to respond.

But unlike police, firefighters and other first responders, they’re limited in the types of workers’ compensation claims they can file when their mental health is affected.

A new bill in the Washington state Legislature would make it easier for coroners and medical examiners to file claims for post-traumatic stress disorder that cumulates from responding to emotionally intense scenes. Similar bills moving through the House and Senate would add the same ability for correctional workers in prisons and jails.

Advocates say it’s important to recognize the mental health impacts of these jobs. Correctional workers witness assaults, suicides and threats to their safety. Coroners and medical examiners respond to graphic death scenes, and in rural areas, they often must investigate the deaths of people they know.

Others are concerned the cost of these claims could cause a spike in workers’ compensation rates that would trickle down to all business owners.

“My hope is that not only it raises awareness of what medical examiners and coroners go through but gives them the opportunity to get the right treatment so they can get back to work,” said Rep. Peter Abbarno, R-Centralia, who sponsored House Bill 1002, focused on coroners and medical examiners.

Whitman County Coroner Annie Pillers said she’s experienced the cumulative toll of responding to deaths. Living in a small community makes the job much more personal.

“This bill acknowledges that we’re side by side with others who are serving people,” Pillers said in an interview. “It can have an emotional toll over time.”

Witnessing deaths and assaults can also have lasting mental health effects on correctional workers. Studies have found that they experience PTSD at higher rates than military veterans; the life expectancy for correctional officers in the U.S. is just 59 years, compared to the general population expectancy of 75.

Correctional workers are often hypervigilant, both at work and in the community, said Brenda Wiest, director of government affairs for Teamsters 117, the union representing more than 6,000 Department of Corrections employees. Working long hours or overnight shifts can make it more difficult for struggling workers to take care of their mental health.

“Working in corrections should come with a disclaimer about retiring with a mental health disorder that you didn’t start your career with,” Department of Corrections classification counselor Sheena Bates said at a House committee hearing. “Training and education cannot prepare you for what the job may entail.”

The Senate and House bills covering correctional workers began with the same language but have diverged as they move through the respective chambers. The Senate bill only includes correctional workers at state prisons and is projected to cost the state $686,000 from 2025 to 2031.

Lawmakers amended the House bill to include staff at juvenile facilities, community corrections officers and employees at city and county jails. Broadening the employees covered also increases the cost to the state; the Legislature’s fiscal note projects costs to the state at more than $1.5 million from 2025 to 2031. The Office of the State Actuary projects an additional $1.4 million in retirement benefits administered by the state in that period.

The state hasn’t provided a cost estimate for the bill covering coroners and medical examiners. The Department of Labor and Industries, which manages workers’ compensation claims, projects two claims will be filed over the next five years.

How does PTSD develop?

PTSD can develop after experiencing or witnessing a traumatic situation. Most people start to feel better within a few weeks, but some have lingering symptoms that keep their body in a heightened state, even when they’re no longer in danger.

Symptoms can include flashbacks to the traumatic event, avoiding reminders of the event, mood changes or trouble sleeping and feeling tense or on edge. To meet the diagnostic criteria for PTSD, someone must experience symptoms for more than a month, and the symptoms must interfere with aspects of their daily life.

Any worker in Washington state can file a workers’ comp claim for PTSD resulting from a single incident, like a physical assault or witnessing a co-worker’s death. Claims based on a single event are called “workplace injury” claims.

“Occupational disease” claims cover workers who develop health conditions from work over a period of time, like carpal tunnel or hearing loss. State law prevents most workers from filing occupational disease claims for mental health conditions, including PTSD, caused by the ongoing stress of a job.

Since 2018, the state Legislature has added exemptions that allow certain professions to file these claims. Firefighters, fire investigators, law enforcement officers, emergency medical technicians and registered nurses providing direct patient care can all file claims for PTSD if they have a diagnosis from a doctor. As long as they’ve worked a minimum amount of time, which varies by job, the law automatically assumes the PTSD diagnosis came from their work.

Public safety telecommunicators, including 911 operators and dispatchers, can also file PTSD claims but must prove that their job caused the illness.

The proposed bills would allow correctional facility workers to file PTSD claims with the presumption that their jobs caused the condition. Coroners and medical examiners could file the claims but would have to prove that their work led to the PTSD diagnosis.

Structuring the coroner and medical examiner bill that way was a strategic choice based on cost, Abbarno said. If the claims were automatically presumed to be connected to work, the bar for acceptance would be lower, which could cost the state more money.

Those costs are the concern of the National Federation of Independent Businesses, which testified against both House bills. The average firefighter and law enforcement officer PTSD claim costs $650,000 for treatment and lost work time, according to an L&I presentation to legislators. If workers don’t return to work and begin drawing a pension, claims cost over $1 million on average.

Patrick Connor, the Washington state director for the National Federation of Independent Businesses, raised concerns about how expensive PTSD claims could raise workers’ compensation rates across the board. L&I sets rates for specific industries based on their claims but sometimes taps into reserves to cover workers’ compensation costs, effectively subsidizing some industries with funds from others.

“It’s clear the system is not properly set up to handle these kinds of situations,” Connor said in a House committee hearing in January. “We should be doing much more at the front end, having discussions with employers about what more they should be doing to provide robust mental health benefits and counseling for our essential first responders so they’re getting the treatment they need early.”

Sen. Manka Dhingra, D-Redmond, who sponsored the Senate bill that would allow correctional workers to file claims, acknowledges costs could be a challenge to the legislation, particularly in a tight budget year.

“Especially in the Senate, anything with a big fiscal note for a new program simply has a large hurdle,” Dhingra said in an interview. “Even if it doesn’t pass, this is something we’re going to continue to work on.”