Firefighters throughout California are under increasing pressure amid more frequent, intense wildland fires. However, Sacramento firefighters face a similar foe when it comes to the silent epidemic of PTSD among our state and local firefighter personnel.
Recently, CalMatters published an article entitled, “Trial by Fire: The trauma of fighting California’s Wildfires.” The article described a “total system breakdown” that firefighters face when seeking workers’ compensation for mental health.
If you have received a denial for your workers’ compensation claim for mental health or are just having difficulty navigating the maze-like workers’ compensation system in California, help is available. Most importantly, you should know the law is on. Your side, even when it seems like everyone else, especially the insurance company, is not.
Workers’ Compensation for Firefighters in Sacramento
Getting Approval: Why is it an uphill battle?
Unfortunately, insurers often wait for a firefighter or other first responder to reach the “in crisis” level before they will validate a claim. According to the CalMatters article, this is known as the “fail-first” system.
Denial Statistics Show Overwhelming Bias Against Mental Health Claims
The RAND Corporation conducted a study that stated PTSD claims are denied at far higher rates than physical injury claims, like a dislocated shoulder or broken leg. However, firefighters must understand this: A denied claim does not mean your injury is not real; it means the insurance company is hoping you will give up.
From 2008 to 2019, California workers’ comp officials denied firefighters’ and other first responders’ PTSD claims twice as often as other work-related conditions, such as back strains or lung infections. In fact, approximately 24% of the 1,000 PTSD claims filed by firefighters in that same time period were denied, which is a higher rate than PTSD claims made by other workers in the state.
The Presumption Law Helps, But It’s Not Enough
In California, SB 542 presumes specific injuries or conditions to be work-related. This means the injured firefighter does not have to jump through the usual hoops to prove that an injury was caused by work or working conditions. In theory, SB 542 should make it easier for firefighters to get workers’ compensation benefits.
Unfortunately, insurance companies still fight presumptive injury claims by rebutting the presumption. One method they use is snooping around in your personal life to find events like divorce, financial stress, death of loved ones, even military service, to place the blame for the PTSD anywhere but your current job and the cumulative trauma it has caused.
An experienced and aggressive workers’ compensation attorney will protect you from the rebuttal push-back and ensure the focus of your claims remains squarely where it belongs. Your attorney will shield you from invasive questions to keep your workers’ compensation claim moving forward.
Sacramento Firefighters Deserve the Workers’ Compensation for PTSD they Deserve
When you are facing the reality of being unable to fulfill the responsibilities of your job due to PTSD, you shouldn’t have to face a battle to get the benefits you deserve. You have supported and saved others, and someone must have your back for a change.
The workers’ compensation attorneys at Eason & Tambornini are ready to provide the help you need to secure the benefits you deserve. We offer a free consultation and case review. If we take your case, you pay nothing unless you win a settlement.
Call (916) 438-1819 to schedule your consultation. The appointment is free, and there is absolutely no obligation to hire us.