MN Legislature Passes New First Responder Work Comp PTSD Bill

Great news for Minnesota’s first responders! A bill has been passed by both the House and Senate, and is expected to be signed by the Governor, that adds additional workers’ compensation rights for our state’s first responders who are suffering from mental illness.

House Bill HF 3873 and the companion Bill in the Senate SF3420 have both passed with overwhelming support, and the bill is expected to be signed by Governor Dayton. The portion of the bill as it relates to first responders and post-traumatic stress disorder (PTSD) will take effect January 1, 2019.

This bill has been in the works for a few years now, but finally had enough support to pass. While it won’t necessarily have a significant impact on people who are currently in the Minnesota workers’ compensation system, we expect that it will make a major difference to those who find themselves struggling with work-related PTSD in the future.

Post-traumatic stress disorder is a major problem amongst Minnesota’s first responders. Our state’s first responders see and experience the worst of humanity. They are on the front lines when it comes to dealing with violent crimes, child abuse, medical emergencies, fatal accidents, and death. It should come as no surprise that repeated exposure to this kind of trauma puts our first responders at risk for developing PTSD. Post-traumatic stress disorder is a devastating condition that affects a person’s ability to process stressors. The symptoms can pervade every area of life – from work to home life.

There is effective help out there for people suffering from PTSD. But, for our state’s first responders, historically, there have been barriers to getting access to this help. Hopefully, this bill will reduce the barriers to accessing help.

Until October 1, 2013, Minnesota work comp law did not recognize post-traumatic stress disorder as a compensable injury. This meant that an individual with work-related post-traumatic stress disorder – no matter how valid the diagnosis, and no matter how disabling the condition – was ineligible for workers’ compensation benefits.

Our legislature finally took action and passed legislation recognizing post-traumatic stress disorder as a compensable injury beginning October 1, 2013. Since that time, Meuser Law Office, P.A. has helped hundreds of our state’s first responders suffering from PTSD navigate the complexities of the workers’ compensation system.

As the law has developed in this area, one thing has become very clear – too many of our state’s first responders are being denied Minnesota workers’ compensation benefits at the outset. While in our experience, some workers’ compensation insurers have been better than others in accepting primary liability on post-traumatic stress disorder claims, we estimate that approximately 75% of these claims involving police officers and firefighters are denied at the outset. Notwithstanding an initial denial of liability, Meuser Law Office, P.A. has an excellent track record of getting good results on these types of cases. It’s not always easy or straightforward, and it can be very difficult emotionally for an individual suffering from post-traumatic stress disorder to go through the process of litigation. We are hopeful this new first responder PTSD bill will change that.

The Minnesota bill that was just passed creates a statutory presumption of work-relatedness for certain classes of workers, who have been diagnosed with post-traumatic stress disorder.
Here is the relevant text:

If, preceding the date of disablement or death, an employee who was employed on active duty as: a licensed police officer; a firefighter; a paramedic; an emergency medical technician; a licensed nurse employed to provide emergency medical services outside of a medical facility; a public safety dispatcher; an officer employed by the state or a political subdivision at a corrections, detention, or secure treatment facility; a sheriff or full-time deputy sheriff of any county; or a member of the Minnesota State Patrol is diagnosed with a mental impairment as defined in paragraph (d), and had not been diagnosed with the mental impairment previously, then the mental impairment is presumptively an occupational disease and shall be presumed to have been due to the nature of employment. This presumption may be rebutted by substantial factors brought by the employer or insurer. Any substantial factors that are used to rebut this presumption and that are known to the employer or insurer at the time of the denial of liability shall be communicated to the employee on the denial of liability. The mental impairment is not considered an occupational disease if it results from a disciplinary action, work evaluation, job transfer, layoff, demotion, promotion, termination, retirement, or similar action taken in good faith by the employer.

This provision will only apply to individuals with a date of injury on or after January 1, 2019, but it should hopefully result in more individuals being approved at the outset for workers’ compensation benefits.

This bill specifically includes the following individuals for additional protections under the Minnesota workers’ compensation act:

• Licensed police officers
• Firefighters
• Paramedics
• EMTs
• Licensed nurses employed to provide emergency medical services outside of a medical facility
• Public safety dispatchers
• Officers employed by the state or a political subdivision at a corrections, detention, or secure treatment facility
• Sheriffs, full-time deputy sheriffs
• Members of the State Patrol

In theory, under this statute, an employer/insurer must demonstrate a “substantial factor” to overcome the statutory presumption of work-relatedness. We anticipate that despite this new statutory presumption, employers/insurers will still fight PTSD cases, by alleging 1) that the diagnosis isn’t actually PTSD, 2) that the PTSD is due to something non-work-related, or 3) that if the person has PTSD, that it’s a temporary condition. Even though we don’t think this statutory change will eliminate all litigation on post-traumatic stress disorder in cases involving Minnesota’s first responders, we think it’s a big step in the right direction to helping those individuals suffering from PTSD overcome barriers to accessing early, appropriate medical and financial care.

If you or someone you know is a Minnesota first responder, police officer or firefighter suffering from post-traumatic stress disorder, Meuser Law Office, P.A. can help you understand your rights. The knowledgeable attorneys at Meuser Law Office, P.A. will help you navigate the system and help you obtain access to a variety of resources and benefits with compassionate, expert legal counsel. Contact us for a free confidential, no-obligation consultation. Call us today at 1-877-746-5680.

by Jen Yackley
More posts by Jen

Fired for Cause: The Complex Issue of Misconduct and PTSD in Law Enforcement

Allegations of misconduct are not necessarily a barrier to asserting a claim for workers’ compensation and PERA/MSRS Duty Disability benefits for Minnesota police officers and firefighters.

Post-traumatic stress disorder (PTSD) is finally getting recognition as a serious problem for Minnesota’s law enforcement officers. Since October 2013, Minnesota worker’ compensation law now recognizes PTSD as a compensable injury, as does PERA and MSRS for purposes of Duty Disability benefits and Continuation of Healthcare Benefits in accordance with Minn. Stat. § 299A.465. Meuser Law Office, P.A. has been litigating PTSD claims for over a decade, and our track record speaks for itself.

One issue that occasionally arises in claims involving PTSD is allegations of misconduct, administrative leave, internal investigations, and disciplinary actions. All too often, police officers suffering silently with symptoms of post-traumatic stress disorder don’t seek help until there is a crisis. For some there is an alcohol abuse problem and the officer tests positive for alcohol at work. Some officers are involved in an alcohol-related criminal issue, such as a DWI. Unfortunately for some, there are allegations of domestic abuse or infidelity. Sadly, sometimes an officer has attempted or threatened suicide. Too often due to the symptoms of PTSD, an officer begins to make mistakes – big or small – on the job, and they suffer discipline as a result.

Post-traumatic stress disorder causes a variety of symptoms that can seriously interfere with an officer’s ability to effectively and safely perform his or her job. For example:

• Sleep disturbance, including difficulty falling asleep or staying asleep – lack of sleep may affect job performance.
• Nightmares – can cause sleep disruption.
• Avoidance of places, people, and activities that are reminders of traumatic events – may result in an officer delaying or avoiding performing certain job duties that cause symptoms.
• Hypervigilance and exaggerated startle response – an increased state of arousal that is out of proportion to the threat. This can cause a variety of problems, such as outbursts of anger causing problems with co-workers or supervisors. Most problematic, hypervigilance can cause an officer to over-react in response to a threat, leading to allegations of excessive use of force or abusive conduct. Meuser Law Office, P.A. also believes that hypervigilance and exaggerated startle response may also play a role in controversial shooting situations. 
• Difficulty concentrating – concentration problems can result in making mistakes in writing reports, missing evidence, or worst-case, overlooking a dangerous situation.
• Feelings of detachment or estrangement from others – can cause feelings of being cut off from family, friends, and colleagues, which can cause interpersonal work problems.
• Physiological reactions to reminders of the traumatic events – PTSD can cause stress-related physical symptoms, such as nausea, stomach upset, and headaches. It can also cause panic-attack-like symptoms such as rapid heart-beat, tremors and shaking, excessive sweating, and tunnel vision. An officer suffering serious physical stress symptoms in the midst of responding to a call may be physically incapable of carrying out his or her duties.
• Irritable or aggressive behavior – changes in behavior can have a serious negative impact on an officer’s home and work life, and can result in breakdown of a marriage, interpersonal issues with colleagues or superiors, or allegations of abusive behavior or excessive use of force during interactions with the public.
• Engaging in self-destructive or risk-taking behaviors – “bad” behavior and poor decision-making is unfortunately, a common symptom of post-traumatic stress disorder. This can be excessive alcohol use or abuse, marital infidelity, driving at excessive speeds and engaging in risky driving, pathological gambling, responding to calls without wearing a vest, taking unnecessary risks during calls, or other means of “self-sabotage.” These behaviors sometimes result in disciplinary action.

All too often, officers who are suffering from mental health issues do not seek help until these symptoms cause a serious problem at home at work, placing their family or livelihood at risk. In hindsight, it’s often evident that the officer going through a disciplinary issue has been having issues for years, and that the behavior that resulted in discipline was due to a serious untreated mental health condition.

An officer who is subject to disciplinary action, including internal affairs investigations, administrative leave, probation or suspension, or even termination, and who is also suffering symptoms consistent with post-traumatic stress disorder or another work-related mental health condition may still be eligible for benefits, including but not limited to, PERA/MSRS Duty Disability benefits, 299A.465 healthcare continuation benefits, and/or workers’ compensation benefits.

Meuser Law Office, P.A. has successfully represented dozens of police officers suffering from PTSD who found themselves subject to discipline, including administrative leave, investigations, suspension, and even termination. Often, in addition to securing Duty Disability benefits and workers’ compensation benefits on behalf of the officer, we are able to assist in coordinating a separation agreement with the officer’s employer to avoid a formal termination for misconduct on terms that are favorable to the officer. You don’t have to go through this process on your own.

If you or someone you know is a Minnesota police officer or firefighter facing discipline for misconduct based on behavior that may be the result of a mental health condition, contact Meuser Law Office, P.A. The knowledgeable attorneys at Meuser Law Office, P.A. can help make the process easier to navigate. Contact us today for a confidential, free, no-obligation consultation by calling 1-877-746-5680.

by Jen Yackley
More posts by Jen

Move Over for Police Officers on the Side of the Road!

When winter weather strikes, Minnesota’s State Troopers, police officers, and sheriff’s deputies are out in full force to assist motorists involved in crashes or in need of assistance due to bad road conditions. Move over and slow down when you see an officer on the side of the road. Watch this powerful video from the Minnesota State Patrol's Facebook page:

https://www.facebook.com/MnStatePatrol/videos/10155267944773144/

Unfortunately, while they are helping motorists in need of assistance, our State’s law enforcement officers are placed in harm’s way. Every winter, dozens of Minnesota police officers suffer injuries as a result of a car accident. All too often, these crashes occur while an officer is assisting a motorist and another motorist loses control or is not paying attention and hits the officer who is stopped on the side of the road. An officer is far more likely to be killed or seriously injured as a result of a car crash than being killed or seriously injured by gunfire.

State Troopers, police officers and sheriff’s deputies who suffer injuries as the result of a car crash –whether it is on the side of the road during a stop, while helping motorists involved in a crash, during a pursuit, while responding to a call with lights and sirens, or while on patrol – may be eligible for a number of different types of benefits. Securing these benefits on behalf of the injured officer will ensure access to medical care and cover any lost wages that may occur:

Public Employees Retirement Association (PERA) Police and Fire Plan Duty Disability Benefits or Minnesota State Retirement Association (MSRS) State Patrol Plan Duty Disability Benefits

A State Trooper or police officer who suffers serious injuries resulting in limitations on their ability to perform full duty for a period of at least a year may be eligible for PERA/MSRS Duty Disability benefits. This monthly benefit provides a base rate of 60% of the injured officer’s high five salary. These benefits are non-taxable though age 55 or for 5 years, whichever is longer. Usually, injuries that are the result of an on-duty car crash will qualify for this benefit.

Minnesota Statute 299A.465 Continuation of Health Insurance Benefits

Minnesota troopers and police officers who are determined to be eligible for Duty Disability benefits through PERA or MSRS are also eligible for Continuation of Health Insurance Benefits in accordance with Minn. Stat. § 299A.465. This statute requires the State Trooper or police officer’s employer to continue to pay insurance premiums for health insurance coverage for the officer, and the officer’s family if the officer had family coverage at the time of the injury. This benefit continues through age 65.

Minnesota Workers’ Compensation Benefits

Troopers and other law enforcement officers are also eligible for workers’ compensation benefits for injuries suffered in the line of duty, including injuries that occur as a result of a car crash. Minnesota workers’ compensation includes medical expense benefits, wage loss benefits, permanent partial disability benefits, and rehabilitation benefits. In many cases, the officer may also be eligible for a lump sum settlement.

Personal Injury Civil Liability Claims

In addition to disability pension benefits and workers’ compensation benefits, a police officer who suffers injuries as the result of a motor vehicle crash may also be able to assert a liability claim against the at-fault driver. These claims allow an officer to make claims for past and future medical expenses, past and future wage loss, and past and future pain and suffering – which is not covered by workers’ compensation.

Choosing the right lawyer matters. For Minnesota police officers and State Troopers involved in car crashes, choosing the right lawyer is important. There are several large personal injury firms that do a fantastic job on personal injury claims. BUT, what they don’t do is just as important for Troopers and police officers – those large firms do not handle workers’ compensation or PERA/MSRSA disability claims.  That means that if you hire one of these firms to handle your personal injury claim, you will need to have a second lawyer to handle your workers’ compensation claim, and you are on your own or might even need to hire a third lawyer to help you with your pension claim.

We have heard it time and again – a police officer has hired a lawyer to assist them with their car accident claim, but they are getting no help or guidance on their workers’ compensation or pension claims. They don’t know what steps to take, how to deal with disputes that pop up on their workers’ compensation claims, how to deal with their employer, what to do about their work restrictions and light duty, and what to expect as far as whether they will be able to continue in their job.

At Meuser Law Office, P.A. we handle ALL claims arising out of an in the line of duty car crash for Minnesota police officers. Meuser Law Office, P.A. is the pre-eminent law firm in the State of Minnesota for police officers and firefighters. Coordinating the various claims is complex and a misstep, such as missing a deadline, not filling out paperwork properly, or simply not providing appropriate guidance can cost a officer hundreds, if not thousands of dollars in benefits.

As we get into the homestretch of winter, we can expect several more snowfalls and more bad road conditions. Don’t be the one that is responsible for injuring one of our State’s law enforcement officers. Slow down and move over if you see an officer on the side of the road!

If you are an officer who has suffered injuries due to a car crash, call us first! The experienced attorneys of Meuser Law Office, P.A. will coordinate all of your potential claims to ensure you and your family have access to the full benefits you are entitled to. Call us today at 1-877-746-5680.

by Jen Yackley
More posts by Jen

Is My PTSD Still Compensable if Caused by Numerous Traumatic Events?

Under the Minnesota Worker's Compensation Act, post-traumatic stress disorder (PTSD) may be characterized as a personal injury or as an occupational disease. Minn. Stat. §176.011, subd. 15(a). PTSD may develop as a result of exposure to a traumatic event or multiple traumatic events, which cause a person's capacity to cope with stress to be overwhelmed and clinically disabling. Particularly in cases involving law enforcement or firefighters, a claimant's PTSD diagnosis cannot be tied to one particular event; rather, each new traumatic event compound stress until the stress becomes psychologically and physiologically disabling.

The Minnesota Workers' Compensation Act defines PTSD as "the condition as described in the most recently published edition of the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association." Minn. Stat. 176,011, subd. 15(d). All the parties agree that the DSM-V is the most recently published edition of the DSM by the American Psychological Association. The statute requires psychiatrists, psychologists, and the court to use the DSM-V in determining whether an employee suffers from compensable PTSD.

The DSM-V explicitly states that PTSD may develop from an event or multiple events, noting that a person may witness "event(s)" as it occurs to others and "experiencing repeated" exposures, specifically citing police officers performing job duties involving witnessing repeated trauma to others. (DSM p. 271). Based upon the plain language of the DSM-V, examinees are not required to tie their symptoms to a single traumatic event. If this were the intention of the American Psychiatric Association, the authors would have written "traumatic event" and not "traumatic event(s)." (DSM-V at 271-72). Prong 4 under Criteria A of the DSM-V also demonstrates that medical professionals must examine multiple traumatic events. If an examinee qualifies only under the aversive details prong then they, by definition, would be referring to many or several incidents with regard to his or her symptoms listed in Criteria B-E because the fourth prong refers to repeated exposure. 

Unfortunately, insurers use "independent psychological examiners" or "IPEs," who are paid experts hired to find that you do not suffer from PTSD and if you do suffer from a psychological condition, the condition is not PTSD and is caused by non-work-related activities.

Typically, IPEs exclude employees from a PTSD diagnoses by attempting to circumvent the explicit text of the DSM-V by imposing additional requirements. An IPE's personal interpretation of how physicians should diagnose PTSD is above and beyond what the Minnesota legislature requires in the statute as well as the actual authors of the DSM-V.

IPEs may use the CAP-5, a structure interview that mirrors the symptoms described in the DSM-5. Physicians use the CAPS-5 to track fluctuations in PTSD symptoms, for research and to determine if treatment is working. IPEs may limit the CAPS-5 interview is limited to several of an employee's "worst" traumatic events and only inquire of symptoms within the past 30 days. The CAPS-5 has a few different versions, the lifetime and the "current" version, which examines reported symptoms within the past 30 days. The DSM-V does not limit reported symptoms to a set time frame, unlike the CAPS-5. (DSM-V at 271-280).

IPEs may also then creatively interpret psychometric testing to exclude claimants from a PTSD diagnosis. The MMPI-2 and the MMPI-2-RF are not diagnostic tools are not required by the DSM-V. As much as both the legal and scientific community would desire a brain scan or a blood test to check for PTSD or any other mental health disorder, that's simply not possible. Additionally, the MMPI-2 is the only test that contains a scale specially tailored to examine the likelihood of PTSD; yet, IPEs may use the MMPI-2 RF that does not contain that scale.

If you believe you or someone you love suffers from work-related PTSD, contact the experienced attorneys at Meuser Law Office, P.A. for a free, no-obligation intensive case consultation. You may be entitled to thousands of dollars in benefits from PERA/MSRS, or under the Minnesota Workers' Compensation Act. Call us today at 1-877-746-5680.

by Mary Beth
More posts by Mary Beth

Meuser Law Attorneys Speak to Burnsville Police Officers and Firefighters

We are pleased to share that Ron Meuser, Jennifer Yackley, Mary Beth Boyce and Ashley Biermann of Meuser Law Office, P.A. were invited recently to speak to the City of Burnsville police officers, firefighters and HR Generalists. Ron and his team of experienced attorneys were asked to educate the group of first responders and HR Generalists on the basics of PERA disability, Minnesota work comp, as well as other benefits available in the event an injury occurs in the line of duty.

Once combined, Burnsville's police and fire departments have been operating since 1981 as individual units with the shared commitment to the preservation of life, safety and protection of property for the city's residents, business owners, and visitors. Although highly trained in safety measures to not only keep the public safe, but also the city's first responders as well, injuries do occur. In fact, according to the Bureau of Labor Statistics, police officers are four times more likely to be injured on the job than other occupations. The types of injuries to firefighters, such as cancer, are growing as well according to the National Fire Protection Agencies. The City of Burnsville understands the increased danger the police officers and firefighters face each day and want to ensure their first responders know what steps to take when an injury happens to ensure they receive the full benefits they are entitled, including continuation of health insurance and PTSD.

Ron, Jen, Mary Beth and Ashley met with the entire group and presented an overview and basic information. The attorneys went more in depth with the 20 police officers and 10 firefighters in attendance after the chiefs and HR Generalists exited the presentation. The following topics and others were discussed:

• The importance of timing when reporting an injury
• When to seek treatment for an injury
• PTSD
• Firefighters with cancer

Discussion included the types of benefits available to first responders who are injured in the line of duty, and information regarding post-traumatic stress disorder (PTSD) including the new workers' compensation rules that govern PTSD claims, as well as complex timing and coordination rules that apply specifically to Minnesota's peace officers who receive Duty Disability and workers' compensation benefits.

Meuser Law Office, P.A. is one of the few workers' compensation law firms in the state of Minnesota that also handles PERA and MSRS disability claims. We've successfully represented hundreds of Minnesota's first responders for both work comp and PERA/MSRS disability claims. Sitting down with us to learn more about your potential claim is a lot like financial planning. We can explain what benefits you may be eligible for and make recommendations to you in terms of how to best protect your rights to those benefits. The knowledgeable attorneys at Meuser Law Office, P.A. can help the often-complex process easier to navigate.

Why choose Meuser Law Office, P.A. for your PERA, workers' compensation and personal injury representation? The difference in experience between Meuser Law and an attorney who isn't as versed in this area of the law can mean hundreds of thousands of dollars to your claim. Contact us today for a free no-obligation consultation by calling 1-877-746-5680. Ron Meuser and the attorneys at Meuser Law Office, P.A. are available to speak at ANY police or fire department in Minnesota to educate and inform on the valuable information and ensure injured first responders are receiving the benefits to which they are entitled.

by Ron Meuser
More posts by Ron

PERA Police and Fire Plan 18 Month Filing Deadline: Do Not Miss It!

There are several important deadlines that Minnesota police officers and firefighters need to be aware of when filing a PERA disability benefits claim, including the 18-month post-termination filing deadline.

Applications for Public Employees Retirement Association (PERA) Police and Fire Plan Duty or Regular Disability Benefits MUST be filed within 18 months after the person’s termination from public service. If an application is not filed within 18 months, an otherwise eligible disabled police officer or firefighter is barred from filing for PERA disability benefits. Missing this deadline can cost a disabled police officer or firefighter hundreds of thousands of dollars.

We have seen this issue come up several times. If a disabled police officer or firefighter has missed the 18-month deadline, no matter how strong his or her claim for PERA Duty Disability benefits and no matter how much we want to help, there is nothing the attorney can do.

Unfortunately, the attorneys at Meuser Law Office, P.A. see this issue come up occasionally. For example:

• An attorney in our office was contacted by a police officer who was involved in an on-duty shooting incident. The officer developed some mental health issues as a result and went on a medical leave for a short period of time. At the officer’s request, the officer’s doctor cleared her to return to full duty, even though she was still having mental health issues. After a short time back on the job, she realized things weren’t going well and she knew she couldn’t continue. She resigned from her job and didn’t pursue anything even though she was suffering from serious post-traumatic stress disorder (PTSD) as a result of the on-duty shooting incident. Thankfully, a former colleague of hers suggested she call Meuser Law Office, P.A. to see if she was eligible for any benefits. We got her application in just shy of the 18-month deadline, and this officer was awarded PERA Duty Disability benefits, 299A.465 Continuation of Health Insurance benefits, and workers’ compensation benefits. 

• An officer contacted us to evaluate his potential PERA Duty Disability claim. He was referred to Meuser Law Office, P.A. by his workers’ compensation lawyer, having just settled his workers’ compensation claim. This Minnesota police officer had suffered a low back injury while wrestling with a suspect which required surgery. After his physical restrictions due to his low back injury were deemed permanent, his employer terminated him based on his inability to perform his full duty job. Over the next two years, he collected various workers’ compensation benefits, and his work comp lawyer ultimately settled his workers’ compensation case. Unfortunately, his workers’ compensation lawyer also instructed him not to file for PERA Duty Disability benefits during that time. By the time he met with an attorney in our office, his PERA claim was barred because he had failed to file within 18 months of his termination. There was nothing that we could do to help him. Because this officer’s workers’ compensation lawyer didn’t know the rules associated with PERA, he gave the officer bad advice that cost him several hundred thousand dollars.

• An attorney in our office met with a Minnesota police officer who had terminated from his employment over two years prior to our meeting. He had resigned as a police officer when he started to struggle with some mental health issues. Unfortunately, he didn’t seek help for his symptoms and he wasn’t diagnosed with post-traumatic stress disorder until more than two years after he terminated. Because he didn’t seek help and tried to manage it on his own, this officer didn’t even know he had PTSD until two years after he resigned. This gentleman didn’t receive a diagnosis until after the 18-month deadline had passed, but currently PERA does not have an exception for latent conditions that are not diagnosed until much later in time, such as cancer or post-traumatic stress disorder.

For Minnesota’s police officers and firefighters who suffer significant on-duty injuries, it is imperative to have the right lawyer from the beginning. At Meuser Law Office, P.A., the first time we meet with a client, our knowledgeable and experienced attorneys evaluate every potential claim, including but not limited to, Minnesota workers’ compensation, PERA/MSRS disability, Continuation of Health Insurance claims, and third-party claims. Our attorneys develop a timeline and a plan to ensure every possible resource for benefits is explored, which includes the coordination of claims every step of the way. Experience matters. For a free, no-obligation consultation, contact Meuser Law Office, P.A. Call us today at 1-877-746-5680.

by Jen Yackley
More posts by Jen

Independent Psychological Evaluations

When do I have to submit to an IPE?

An independent psychological evaluation (IPE) may be required for mental disability claims. Under the Workers’ Compensation Act, only certain mental disorders are compensable. Post-traumatic stress disorder (PTSD) is defined by Minn. Stat. 176.11, subd. 15 as the condition described in the most recently published addition of the DSM-V. See article entitled Cumulative Post-Traumatic Stress Disorder and Police Officers for a full description. PTSD is not compensable if it is the result of a disciplinary action, such as a work evaluation, job transfer, layoff, demotion, etc.

All other mental health conditions must be related to a physical injury to be compensable. For example, if a workers’ compensation claimant injuries his back at work and develops depression due to his pain, the depression would be a compensable injury. This is what is referred to as a physical-mental injury.

What is an IPE?

Your date of injury employer and its insurance company may ask that you submit to an IPE. This involves meeting with a psychologist selected by the insurer. Typically, the IPE evaluator is given a foundation letter by the insurance company’s attorney, which explains the employer-insurer’s legal position and summarizes the pertinent portions of your case, including the medical records, diagnoses, and job duties. If the IPE arises out of a PTSD claim, the insurer’s attorney provides a summary of your Criteria A Events. As such, the IPE evaluator knows the employer-insured’s position prior to the evaluation, and the IPE evaluator will search for ways to support their position during the course of the evaluation. Be honest and truthful with the evaluator—but, also remember, the IPE evaluator is not your friend.

During the evaluation, the IPE evaluator will typically have you undergo a series of psychometric testing, including the MMPI-2 and MMPI-2-RF. The evaluator will also ask that you submit to an interview, which can last anywhere from 45 minutes to 2 hours. Depending on the claim, this may be a structured interview using the CAPS-5 or the PTSD Checklist. Again, it is important that you are open and honest with the evaluator—but, it is also important that you are not simply agreeing with the evaluator’s questions.

What is an IPE Report?

Following the evaluation, the IPE evaluator will issue a report. In this report the evaluator will determine: 1) whether you have a mental health diagnosis (e.g., PTSD, anxiety, depression, adjustment disorder, etc.); 2) whether this diagnosis is related to specific incidents and/or your work duties; 3) your functional capacity (i.e., work restrictions); 4) whether your treatment to-date has been reasonable and necessary; and 5) future treatment recommendations, if any.

The opinions of the IPE evaluator are typically at odds with the opinions and recommendations of your treating physician(s). It is important that you continue to follow the treatment recommendations of your treating physician, even if they are not supported by the IPE evaluator. Your treating physician and the IPE evaluator have very different goals in making their recommendations. With the IPE evaluator, no therapeutic relationship is being established and they are not providing treatment. The IPE evaluator’s sole purpose is to determine whether or not you are eligible for disability benefits. Conversely, your treating physician is making recommendations in an effort to improve your mental health.

Can I object to an IPE?

Technically, you can object to an independent psychological evaluation, however, if a mental health disability is the subject of your claim, a judge will compel you to attend the IPE. As such, as a general rule, we advise our clients to voluntarily attend the IPE. Prior to attending the appointment, we make sure that our client knows what to expect so the process is a little easier.

If the insurer requests a second IPE, we would likely object and force the insurer to file a motion to compel your attendance at the second IPE. A judge may ultimately order the second IME—this decision is typically dependent upon the opinions of the first IME evaluator and how much time has elapsed since the first IPE. Either way, because an independent psychological evaluation is invasive and uncomfortable, we will try to avoid a second IPE whenever possible.

If you are scheduled for an IPE and are not currently represented by a Minnesota workers’ compensation attorney, it is imperative that you speak to a lawyer regarding your options and next steps. Employer-insurers will attempt to use the independent psychological evaluation report to deny primary liability on your claim, cut off your workers’ compensation benefits, or assert defenses to your claims. Contact Meuser Law Office, P.A. for a free, no-obligation workers’ compensation legal consultation to discuss your rights. Call us today at 1-877-746-5680.

by Ashley Biermann
More posts by Ashley

What if the Critical Incidents Which Cause PTSD Happen Prior To October 1, 2013?

Frequently, Minnesota police officers, firefighters, and corrections officers worry that they may not be entitled to workers’ compensation benefits arising out of his or her employment because the critical incidents pre-date October 1, 2013. Due to the nature of post-traumatic stress disorder (PTSD), classifying PTSD as a specific injury with a specific “exposure” date may be illogical, especially in cases involving police officers who participate in many traumatic events during the course and scope of their employment. The law changed in Minnesota on October 1, 2013. PTSD is now compensable as a strictly mental-mental injury. The date of injury in these cases are particularly important because the date of injury determines what benefits are available to injured employees.

1. Minnesota Statute §176.011, subdivision 15, defines PTSD as an occupational disease

PTSD may also be considered an occupational disease. Therefore, the applicable date of injury is the date the employee became disabled or diagnosed, not a single specific traumatic exposure under Minn. Stat. §176.66, subd. 1. The employee’s entitlement to benefits is established by the law in effect on the date of disablement, not the law in effect on the last date of exposure. Stillson v. Peterson & Hede Co., 454 N.W.2d 430 (Minn. 1990). As set forth in Criterion G of the DSM-5, the diagnostic tool used to diagnosis PTSD as required by Minnesota Statute 176.011, subdivision 15(d), in order for an employee even be diagnosed with PTSD, the employee must experience a later functional disturbance or impairment in social, occupational, or other areas of function. Many officers are exposed to traumatic events, but not all officers develop PTSD as they may not ever experience a functional impairment.

2. Minnesota Statute §176.011, subdivision 16, also allows PTSD to be defined as a Gillete type injury 

The date of injury in Gillete cases is the date of disablement and include ascertainable events that evidence the culmination of a disability, which include the date the employee initiated medical attention, date of a definite diagnosis, when the treating doctor determined the condition was work-related, and when the employee sought regular medical care. Schnurrer v. Hoerner-Waldorf, 345 N.W.2d 230 (Minn. 1984); Schaffer v. Minn. Orchestra, 53 W.C.D. 341 (1995); Reel v. Loftness Specialty Farm Equipment, slip op. (W.C.C.A. February 3, 2004); Neff v. Supervalue, Inc., 71 W.C.D. 217 (W.C.C.A. 2011); Cramer v. United Parcel Services., 72 W.C.D. 519 (W.C.C.A. 2012). As set forth in Criterion A in the DSM-5, PTSD may develop from the exposure to one or more traumatic events. It is questionable whether a physician could even pinpoint to a degree of medical certainty which event accounts for what percentage of the employee’s overall PTSD; therefore, the date of disablement is the logical date of injury.

3. A date of injury before October 1, 2013 does not bar an employee’s claim for benefits arising out of his or her PTSD post October 1, 2013

Even if an employee developed PTSD before October 1, 2013, his PTSD prior to October 1, 2013 would constitute a pre-existing condition. If subsequent traumatic events were substantial contributing causes or factors to the worsening of the condition, then his condition after October 1, 2013 would be compensable.

If you or someone you know suffers from PTSD due to a work-related accident or traumatic incident, you should consult with an attorney experienced in this area of the law. At Meuser Law Office, P.A., we have represented many clients with PTSD, including police officers, firefighters, first responders and correctional officers. We understand this nuanced area of the law and work with our client to ensure you receive the full benefits you are entitled. Contact Meuser Law Office, P.A. for a no-obligation consultation today. Don’t let the insurance company unfairly deny you benefits as a result of their misinterpretation of the law surrounding PTSD in Minnesota. Call us today at 1-877-746-5680.

by Mary Beth
More posts by Mary Beth

Important Changes Regarding Post-Traumatic Stress Disorder (PTSD) and Law Enforcement: DSM-V vs. DSM-IV-TR PTSD Diagnostic Criteria

This article was originally published in December, 2015 in the Minnesota Police Journal. PTSD was and continues to be an important topic with major implications for Minnesota’s first responders who suffer from PTSD. In October of 2013, the Minnesota workers’ compensation law recognized post-traumatic stress disorder as a covered or compensable injury for purposes of workers’ compensation law. Since then, law makers continue to fight for the rights and benefits of Minnesota’s first responders as well as continue to raise awareness of PTSD, including the re-introduction of a crucial bill in the 2017 legislative session that directly affects first responders who suffer from PTSD.

Written by Dr. Michael Keller, Ph.D and published in the Minnesota Police Journal

Introduction 

There have been some important changes regarding the diagnosis of post-traumatic stress disorder (PTSD), and these changes have a significant effect on those employed as licensed Minnesota Peace Officers relative to such matters as eligibility for disability benefits under the Public Employees Retirement Association (PERA), the Minnesota State Retirement Association (MSRS), and workers’ compensation. Due to changes in Minnesota Law taking place over the past few years, it is now the case that Minnesota Peace Officers must meet the diagnostic standards for PTSD as indicated in the Diagnostic Statistical Manual, Fifth Edition (DSM-5, 2013), whereas previously, the diagnostic criteria for PTSD as indicated in the Diagnostic Statistical Manual, Fourth Edition, Text Revised (DSM-IV-TR, 2000) have been relied upon for the determination of the diagnosis of PTSD.

The official effective date for the transition from DSM-IV-TR diagnoses to DSM-5 diagnoses took place on October 1st, 2015. It was at this time that all medical and psychiatric providers were to cease using diagnostic coding (and relevant diagnostic criteria) relative to ICD-9-CM standards, to diagnostic coding as indicated by ICD-10-CM standards (including any changes relevant to diagnostic criteria of various disorders, conditions or problems). ICD codes (International Classification of Diseases codes), more formally identified as the International Statistical Classification of Diseases and Related Health Problems, is copy written by the World Health Organization (WHO) and owns and publishes the classification. For example, under the DSM-IV-TR, diagnostic coding and ICD-9 coding for PTSD are both identified as 309.81, whereas coding for PTSD under DSM-5 is identified as F43.10 as to ICD-10 and 309.81 diagnostically.

It is important to understand that although the official date for the transition from DSM-IV-TR to DSM-5 took place on October 1st, 2015, changes in Minnesota State Statutes regarding the diagnosis of PTSD requiring DSM-V diagnostic criteria, as in the case of workers’ compensation benefits for Peace Officers, took place prior to October 2015 (see Minnesota Statute §299A.465 and Minnesota Statute §299A.475 for important details regarding PERA, MSRS, and workers’ compensation).

More important than the differences in diagnostic coding between DSM-IV-TR (PTSD, 309.81) and DSM-5 (PTSD, 309.81 F43.10) are the substantive distinctions in the differences between PTSD diagnostic criteria as indicated in the DSM-V as compared to the DSM-IV-TR.

Post-Traumatic Stress Disorder, DSM-V vs. DSM-IV-TR

According to the Diagnostic Statistical Manual, Fifth Edition, (DSM-V), PTSD is described specifically, in part, as follows.

Post-Traumatic Stress Disorder (PTSD) 309.81 (F43.10) – Diagnostic Criteria:
 Note: The following criteria apply to adults, adolescents, and children older than 6 years.

A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
1. Directly experiencing the traumatic event(s).
2. Witnessing, in person, the event(s) as it occurred to others.
3. Learning that a traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.
4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains, police officers repeatedly exposed to details of child abuse).

Note: Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work-related.

B. Presence of one (or more) of the following intrusive symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:
1. Recurrent, involuntary, and intrusive distressing memories of the traumatic events(s).
2. Recurrent distressing dreams in which the content and/or affect of the dream are related to traumatic the event(s).
3. Dissociative reactions (e.g., flashbacks) in which the individual feels or act as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings).
4. Intense prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
5. Marked psychological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following:
1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
2. Avoidance of or efforts to avoid external or internal reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
1. Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and to other factors such as head injury, alcohol or drugs).
2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted,” “The world is completely dangerous,” “My whole nervous system is permanently ruined”).
3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.
4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).
5. Markedly diminished interest or participation in significant activities.
6. Feelings of detachment or estrangement from others.
7. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).

E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
2. Reckless or self-destructive behavior.
3. Hyper vigilance.
4. Exaggerated startle response.
5. Problems with concentration.
6. Sleep Disturbance (e.g., difficulty falling asleep or restless sleep).

F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.
G. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
H. The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

Specify whether:

With dissociative symptoms: The individual’s symptoms meet the criteria for post-traumatic stress disorder, and in addition, in response to the stressor, the individual experiences persistent or recurrent symptoms of either of the following:

1. Depersonalization: Persistent or recurrent experiences of feeling detached from, and as if one were an outside observer of, one’s mental processes or body (e.g., feeling as though one were in a dream; feeling a sense of unreality of self or body or time moving slowly).
2. Derealization: Persistent or recurrent experiences of unreality of surroundings (e.g., the world around the individual is experienced as unreal, dreamlike, distant, or distorted).
Note: To use this subtype, the dissociative symptoms must not be attributable to the physiological effects of a substance (e.g., blackouts, behavior during alcohol intoxication) or another medial condition (e.g., complex partial seizures).

Specify if:

            With delayed expression: If the full diagnostic criteria are not met until at least 6 months after the event (although the onset and expression of some symptoms may be immediate).

American Psychiatric Association (2013). Diagnostic and Statistical Manual, Fifth Edition, Text 
           Washington, DC: American Psychiatric Association (271- 272).

According to the Diagnostic Statistical Manual, Fourth Edition, Text-Revised (DSM-IV-TR), PTSD is described, in summary, as requiring two critical features, as follows: (1) The person has been exposed to a traumatic event whereby they have experienced, witnessed, or were confronted by an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others and, (2) the person’s response involved intense fear, helplessness, or horror. Research informs us that the traumatic event alone does not cause PTSD but that it is the individual perception of the event by the involved person and the thoughts generated about the traumatic event that results in the traumatic emotional and memory response that characterizes PTSD. In other words, the way we think about things shapes how we emotionally respond to things, thus we suggest that individual differences in perception, cognitive appraisal of the event, emotions generated, and memories produced regarding the traumatic event or events are important contributory variables in terms of the development of PTSD in terms of intensity of response. Overall, it is the emotional memory of the traumatic event that seems to be a significant source of PTSD symptoms and complaints as opposed to the material facts of the traumatic event itself.

Among the most significant changes in the DSM-5, which, as indicated above, was released in May of 2013, are both the classification and conceptualization of PTSD. The condition is no longer indicated as being an anxiety disorder, but rather a “Trauma-and-Stressor-Related Disorder.”  Also, the DSM-5 reflects a number of changes relative to PTSD criteria whereas a traumatic event is more clearly defined than it was previously in the DSM-IV-TR. The DSM-5 specifies examples of experiencing or witnessing a traumatic event, such as sexual assault or the repeated indirect exposure to adverse events, such as in the case for public safety professionals, and requires the necessity of being explicit as to how the event was experienced (i.e., directly or indirectly).

Determination of a PTSD Diagnosis

As was the case previously under DSM-IV-TR, and is the case now regarding the DSM-V, the recommended best practices regarding the process to be used in determination of a diagnosis of PTSD includes the completion of a structured interview of the individual wherein some sort of specific instrument or protocol is used so as to identify the triggering traumatic exposure or exposures (e.g., the story of traumatic exposure), the reported and observed associated symptoms and complaints including onset, intensity, frequency and duration and frequency (e.g., individual self-report and the use of some type of PTSD symptom check-list), the completion of psychometric evaluation (e.g., MMPI-2/MMPI-RF testing), and the review of relevant current and past treatment records, if available, depending on the date of injury and onset of problems.

Conclusion

PTSD, whether understood and diagnosed in the context of DSM-IV-TR or DSM-V diagnostic criteria, remains a very serious condition and needs to be taken seriously. It is important to seek and obtain professional help if you think you might be experiencing PTSD.

It is also important to understand that from a clinical diagnostic perspective, if an individual meets DSM-IV-TR diagnostic criteria for PTSD secondary to their work-related traumatic exposure or exposures while working as a licensed Minnesota Peace Officer, they will continue to meet DSM-V PTSD diagnostic criteria going forward. The change from DSM-IV-TR to DSM-5 did not have a more limiting and/or restrictive affect as to an individual potentially meeting diagnostic qualification for a formal diagnosis of PTSD; rather it clarified and more so expanded potential qualification as a result of clarification of what is understood to be a traumatic event and what is meant by exposure or repeated exposures to said traumatic events as compared to the previous criteria of witnessing and/or participating in a traumatic event or events.

Sources:

 American Psychiatric Association (2000). Diagnostic and Statistical Manual, Fourth Edition, Text 
             Revision, Washington, DC: American Psychiatric Association.

American Psychiatric Association (2013). Diagnostic and Statistical Manual, Fifth Edition,
           Washington, DC: American Psychiatric Association (271- 272).

Centers for Disease Control and Prevention (2015). Clarification of Diseases, Functioning, and 
             Disability, Washington DC: U.S. Department of Health and Human Services

Houston, A.A., Webb-Murphy, J., & Delaney, E. (2013). From DSM-IV-TR to DSM-5: Changes in 
            Posttraumatic Stress Disorder, Naval Center for Combat & Operational Stress Control, Boston, MA.

Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., & Schnur, P.P. (2013), The PTSD 
            Checklist for DSM-5 (PCL-5). National Center for PTSD.


Dr. Michael Keller is a licensed clinical and forensic psychologist who serves a variety of Minnesota and Wisconsin law enforcement agencies as well individual members of the law enforcement community and their families. He is a retired law enforcement officer and a member of the American Psychological Association (Clinical Psychology and Police & Public Safety Psychology Sections) and is a member the Police Psychological Services Section of the International Association of Chiefs of Police.

Dr. Michael Keller, Ph.D., LP
121 Adams Street
Cambridge, MN 55008
763-442-4111
www.psychologicalserviceassociates.com

by Ron Meuser
More posts by Ron

In the Line of Duty Injuries: Minnesota State Troopers

Workers’ Compensation Benefits

Minnesota State Troopers are entitled to a variety of benefits to cover medical expenses and wage loss if they are injured in the line of duty. Whether the injuries are due to a car accident, a lifting incident, a slip and fall while chasing a suspect, or wear-and-tear over time, if the State Trooper’s work activities are a substantial contributing factor to the injuries, the Trooper is eligible for Minnesota workers’ compensation benefits.

Minnesota workers’ compensation covers all injuries arising out of and in the course and scope of employment. This includes physical injuries incurred as the result of a specific incident, physical injuries that occur over time due to repetitive use or wear-and-tear, injuries that aggravate or accelerate a pre-existing condition, or post-traumatic stress disorder (PTSD) that is the result of work-related traumatic exposures. Minnesota workers’ compensation benefits include medical expense benefits for reasonable and necessary medical care, including hospital charges, imaging like MRI’s or CT scans, diagnostic tests, surgery, prescriptions, physical therapy, mental health care, chiropractic care, and mileage expenses. If a Minnesota StateTrooper misses time off work or experiences reduced pay as the result of a work-related injury, workers’ compensation pays wage loss benefits including temporary total disability (TTD) benefits, temporary partial disability (TPD) benefits, and/or permanent total disability (PTD) benefits. A State Trooper may also be eligible for rehabilitation services, including retraining benefits, if that Trooper cannot return to his or her former position as a Minnesota State Trooper as the result of a work-related injury.

MSRS State Patrol Plan Duty Disability Benefits

Minnesota State Troopers who suffer in the line of duty injuries may also be eligible for Duty Disability benefits under the MinnesotaState Retirement System (MSRS) State Patrol Plan. A Trooper who suffers an injury or illness that 1) prevents the Trooper from performing his or her normal duties for a period of at least a year, 2) that injury or illness occurred during the performance of inherently dangerous duties that are specific to Troopers, and 3) the duties that the Trooper was performing at the time of the injury or illness were specific to protecting safety and property. In short, if a Trooper suffers an in the line of duty injury while performing “inherently dangerous duties,” and that Trooper cannot return to full duty as a result of the injury, he or she is eligible for Duty Disability benefits. Duty Disability benefits are payable at a base rate of 60% of the Trooper’s high-five salary. Unlike State Patrol Plan retirement benefits, Duty Disability benefits are non-taxable through age 55 or 5 years, whichever is longer. There are extremely complex rules regarding the coordination of Minnesota workers’ compensation benefits and Duty Disability benefits for State Troopers. Discuss these coordination issues with an attorney experienced in handling both workers’ compensation and MSRS pension benefits.

Health Insurance Continuation Benefits Under Minn. Stat. § 299A.465

Minnesota State Troopers who qualify for MSRS State PatrolPlan Duty Disability benefits are also eligible for continued health insurancebenefits under Minn. Stat. § 299A.465. This statute requires the Department of Public Safety to continue to provide health insurance coverage to the disabled Trooper and his or her family, if applicable, as though the Trooper remained on the payroll. This means that the state continues to pay its share of the Trooper’s health insurance premiums. This benefit continues through age 65.

Civil Liability Claims – Auto Accidents

Given the sheer amount of time Minnesota State Troopers spend on the state’s roadways, unfortunately injuries as the result of crashes are quite common. If a Minnesota State Trooper suffers injuries as the result of an auto crash that is the fault of a third party, that Trooper may be able to pursue a civil liability claim against the at-fault driver, in addition to workers’ compensation and MSRS Duty Disability benefits. A civil auto liability claim allows a Trooper to assert claims for losses that are not covered by workers’ compensation, including:

• future wage loss beyond the time limits available under workers’ compensation
• future loss of earning capacity
• pain and suffering
• loss of enjoyment of life
• loss of consortium

Coordination of benefits for disabled Minnesota State Troopers is complex. This is a very specialized area of law, and it’s easy to overlook claims or to make mistakes that can cost the Trooper hundreds of thousands of dollars in benefits. For Minnesota State Troopers, to ensure you are maximizing all potential sources of benefits, contact Meuser Law Office,P.A.

Meuser Law Office, P.A. is one of the few workers' compensation law firms in the state of Minnesota that also handles PERA and MSRS disability claims. We've successfully represented hundreds of State Patrol, police officers and firefighters throughout the state for both workers' compensation and PERA/MSRS disability claims. The knowledgeable attorneys at Meuser Law Office, P.A. can help make the process easier to navigate. Contact us today for a free no-obligation consultation by calling 1-877-746-5680. 

by Jen Yackley
More posts by Jen