American Association of State Compensation insurance Fund
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member fund.

CopperPoint Mutual Insurance Company
Phone: (602) 631-2000
Address: 3030 North Third Street
Phoenix, AZ   85012

State Compensation Insurance Fund
Address: 333 Bush Street
Suite 800
San Francisco, CA   94104

Pinnacol Assurance
Phone: (303) 361-4000
Address: 7501 East Lowry Boulevard
Suite 800
Denver, CO   80230-7006

Hawaii Employers' Mutual Insurance Co. Inc.
Phone: (808) 524-3642
Address: 1100 Alakea Street
Suite 1400
Honolulu, HI   96813

Idaho State Insurance Fund
Phone: (208) 332-2100
Address: 1215 West State Street
P.O. Box 83720
Boise, ID   83720-0044

Kentucky Employers Mutual Insurance
Phone: (859) 425-7800
Address: 250 West Main Street Suite 900
P.O. Box 83720
Lexington, KY   40507-1724

Louisiana Workers' Compensation Corporation
Phone: (225) 924-7788
Address: 2237 South Acadian Thruway
P.O. Box 83720
Baton Rouge, LA   70808

Maine Employers Mutual Insurance Company (MEMIC)
Phone: (207) 791-3300
Address: 261 Commercial Street
P.O. Box 11409
Portland, ME   04104

Chesapeake Employers’ Insurance Company
Phone: (410) 494-2000
Address: 8722 Loch Raven Boulevard
P.O. Box 11409
Towson, MD   21286-2235

SFM Mutual Insurance Company
Phone: (952) 838-4200
Address: 3500 American Boulevard West Suite 700
P.O. Box 11409
Bloomington, MN   55431-4434

Missouri Employers Mutual Insurance
Phone: (800) 442-0590
Address: 101 N Keene St
P.O. Box 11409
Columbia, MO   65201

Montana State Fund
Phone: (406) 495-5015
Address: 855 Front Street
P.O. Box 4759
Helena, MT   59604-4759

New Mexico Mutual Group
Phone: (505) 345-7260
Address: 3900 Singer Boulevard NE
P.O. Box 4759
Albuquerque, NM   87109

New York State Insurance Fund
Phone: (212) 312-7001
Address: 199 Church Street
P.O. Box 4759
New York, NY   10007

Workforce Safety and Insurance
Phone: (701) 328-3800
Address: 1600 East Century Avenue Suite 1
P.O. Box 4759
Bismarck, ND   58506-5585

Ohio Bureau of Workers Compensation
Phone: (800) 644-6292
Address: 30 West Spring Street
P.O. Box 4759
Columbus, OH   43215-2256

CompSource Mutual Insurance Company
Phone: (405) 232-7663
Address: 1901 North Walnut Ave.
P.O. Box 53505
Oklahoma City, OK   73152-3505

State Accident Insurance Fund (SAIF)
Phone: (503) 373-8000
Address: 400 High Street SE
P.O. Box 53505
Salem, OR   97312-1000

Pennsylvania State Workers Insurance Fund
Phone: (570) 963-4635
Address: 100 Lackawanna Avenue
P.O. Box 5100
Scranton, PA   18505-5100

Beacon Mutual Insurance Company
Phone: (401) 825-2667
Address: One Beacon Centre
P.O. Box 5100
Warwick, RI   02886-1378

South Carolina State Accident Fund
Phone: (803) 896-5800
Address: P.O. Box 102100
P.O. Box 5100
Columbia, SC   29221-5000

Texas Mutual Insurance Company
Phone: (800) 859-5995
Address: 6210 East Highway 290
P.O. Box 5100
Austin, TX   78723-1098

Workers Compensation Fund
Phone: (800) 446-2667
Address: 100 West Towne Ridge Parkway
P.O. Box 2227
Sandy, UT   84070

Washington Department of Labor and Industries
Phone: (360) 902-5800
Address: P.O. Box 44001
P.O. Box 2227
Olympia, WA   98504-4001

Wyoming Division of Workers Safety & Compensation
Phone: (307) 777-7159
Address: Cheyenne Business Center
1510 East Pershing Boulevard
Cheyenne, WY   82002

Workers Compensation Board - Alberta
Phone: (780) 498-3999
Address: 9925-107 Street
P.O. Box 2415
Edmonton, AB   T5J 2S5

Workers Compensation Board of British Columbia (WORKSAFEBC)
Phone: (604) 273-2266
Address: P.O. Box 5350 Station Terminal
P.O. Box 2415
Vancouver, BC   V6B 5L5

Manitoba Workers Compensation Board
Phone: (204) 954-4321
Address: 333 Broadway
P.O. Box 2415
Winnipeg, MB   R3C 4W3

Phone: (506) 632-2200
Address: 1 Portland Street
P.O. Box 160
Saint John, NB   E2L 3X9

Workers Compensation Board of Nova Scotia
Phone: (902) 491-8999
Address: 5668 South Street
P.O. Box 1150
Halifax, NS   B3J 2Y2

Prince Edward Island Workers Compensation Board
Phone: (902) 368-5680
Address: 14 Weymouth Street
P.O. Box 1150
Charlottetown, PE   C1A 7L7

Saskatchewan Workers Compensation Board
Phone: (306) 787-4370
Address: 200 - 1881 Scarth Street
P.O. Box 1150
Regina, SK   S4P 4L1

Puerto Rico State Insurance Fund Corporation
Phone: (787) 793-5959
Address: G.P.O. Box 365028
P.O. Box 1150
San Juan, PR   00936-5028
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Latest Newsletter

Post-Traumatic Stress Disorder Claims in Workers' Compensation

By John M. Hollick, Staff Counsel, SFM Mutual Insurance Co.

The term post-traumatic stress disorder (PTSD) has become a household name only recently. According to the U.S. Department of Veterans Affairs, many associate this diagnosis with the legacy of the Vietnam War. Earlier wars had used terms like “shell-shock,” “battle fatigue” or “combat exhaustion.”

In 1980, the American Psychiatric Association added PTSD to the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-3). This stemmed from research involving returning Vietnam War veterans and others.

The current DSM-5 diagnosis of PTSD requires exposure to actual or threatened death or injury. The individual must have directly experienced or witnessed the event or learned about the event through a close family member or friend. Then there must be persistence of intrusive symptoms along with avoidance of trauma-related stimuli after the event. Finally, there must be negative alterations in cognition, mood, arousal, and reactivity. The symptoms must last for more than a month as well.

In the context of workers' compensation, claims involving psychological/mental problems are generally divided into three categories:

  1. Cases in which mental stimulus produces physical injury.
  2. Cases in which physical stimulus produces mental injury.
  3. Cases in which mental stimulus produces mental injury.

Many states recognize as compensable cases in which work-related mental stress or stimulus produces identifiable physical ailments. The physical ailments should require discrete medical treatment, separate from the emotional condition. An example of this type of claim could be extreme work-related mental stress aggravating a seizure disorder.

The majority of states also recognize as compensable cases in which physical stimulus produces mental injury. Examples of these types of injuries would be a physical injury resulting in pain and subsequent depression.

Many states, however, do not recognize so-called “mental-mental” claims. Other states, such as Montana, for example, do not recognize either “mental-mental claims or mental-physical claims.” In states that do recognize so-called mental-mental cases, the employee generally must prove that he or she was subjected to extraordinary stress.

Some states that generally do not recognize the so-called “mental-mental” injuries, however, carved out an exception for post-traumatic stress disorder claims. The laws in these states generally require a diagnosis of PTSD by a licensed psychiatrist or psychologist and further define mental impairment as not a compensable personal injury if it results from a disciplinary action, work evaluation, job transfer, layoff, or similar action taken in good faith by the employer.

More recently, many states have enacted legislation specifically for first responders such as licensed police officers, firefighters, paramedics, and EMTs. These first responder statutes generally create a presumption of compensability for PTSD if other factors such as diagnosis can be proven.

Dr. Robert Schreter, associate professor of psychiatry at the University of Maryland, recently spoke at the AASCIF CEO, Law and National Issues Conference in Washington, D.C. He pointed out that there now is a variety of treatments available for post-traumatic stress disorder. One of the most promising treatments is cognitive behavior therapy (CBT). CBT is a psychosocial intervention focused on challenging and changing unhelpful cognitive distortion (thoughts, beliefs, and attitudes) and behaviors to improve emotional regulation and develop coping strategies. CBT is a problem-focused and action-oriented solution rather than past history, unconscious, or relationship-based treatment. The goal of CBT is to learn new information processing and coping skills to address symptoms and distress and is often used in combination with psychoactive medications. Treatment is generally limited up to 20 sessions occurring in 1–3 week intervals.

Trauma focused CBT is also used for PTSD. This form of CBT therapy focuses on re-experiencing the traumatic event by repeatedly engaging with memories and everyday reminders rather than avoiding triggers. Another promising treatment for PTSD is eye movement desensitization and reprocessing therapy, which involves repeatedly recalling distressing images while receiving sensory input.

As many states now recognize PTSD claims, it is important for insurers to understand that there are effective treatments for this condition.



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