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LNI outlines PTSD claims trends, extended public comment on clinical guidelines and a pilot proposal
Summary
Labor & Industries reported PTSD claim trends since the 2018 presumption law, described an extended public-comment process on draft clinical guidelines, and said a legislative pilot could provide pre‑claim and post‑closure treatment sessions and streamlined administrative processes.
Brenda Heilman, assistant director for Insurance Services, updated the committee on post-traumatic stress disorder (PTSD) in workers' compensation claims and the rulemaking path for clinical guidelines. She reminded the committee that presumptive coverage for firefighters and law enforcement began in 2018 and said the department has continued reporting on PTSD since then.
Brenda said the presumptive claims peaked in 2021 and have stabilized; this year the department recorded about 80 state-fund and 44 self-insured presumptive PTSD claims so far. She described occupation distributions (firefighters and law enforcement most prevalent in state fund; nurses and EMTs also represented) and age patterns (most filings occur between ages 40 and 60). On closure outcomes she said many claims close as compensable (temporary total disability or permanent partial disability) while a subset result in pensions.
On clinical guidance, she described a year-long subcommittee process under the Industrial Insurance Medical Advisory Committee (IMAAC) that produced draft guidelines, an extended written public-comment period and an oral public-comment hearing in October. "We heard that we need to slow down and be very thoughtful and take this feedback into consideration," she said. The IMAAC subcommittee began review in December and will continue in January; IMAAC may receive recommendations in April. If IMAAC forwards a guideline, Labor & Industries will decide whether to adopt and how to implement it.
Brenda also described operational steps: the department is developing a psychologist position to support claim adjudication, testing a PTSD pilot to provide finite pre-claim treatment sessions and post-closure sessions regardless of claim allowance, and plans to report quarterly on PTSD metrics. She emphasized partnering with stakeholders to shape pilots and measure success.
What happens next: the PTSD subcommittee will continue reviewing public comments; possible IMAAC action is anticipated in spring, followed by departmental adoption decisions and implementation planning if adopted.
