Posttraumatic Stress in California's Workers' Compensation System: A Study of Mental Health Presumptions for Firefighters and Peace Officers Under Senate Bill 542

Abstract

This report describes work undertaken by the RAND Corporation for the California Commission on Health and Safety and Workers' Compensation (CHSWC) in the Department of Industrial Relations (DIR). The goal of this study is to evaluate mental health conditions or illnesses among California's firefighters and peace officers to inform the policy debate surrounding the rebuttable presumption that posttraumatic stress disorder (PTSD) among first responders is work-related and thus eligible for full workers' compensation benefits. The main tasks of the mixed-methods evaluation are to (1) produce prevalence estimates and conduct claims analysis and cost estimations and (2) document the experiences of firefighters and peace officers seeking mental health care in the workers' compensation system and capture the perspectives of mental health providers, claims administrators, and department leaders in urban and rural departments across Northern and Southern California. This research builds directly on a number of past RAND studies for DIR and CHSWC, including several recent studies on workers' compensation issues primarily affecting firefighters, peace officers, and other public safety workers. Although this study focused on California, our findings may be of interest to state policymakers throughout the country who are considering adoption of, or modifications to, laws establishing similar mental health presumptions for public safety workers. RAND Community Health and Environmental Policy ProgramRAND Social and Economic Well-Being is a division of the RAND Corporation that seeks to actively improve the health and the social and economic well-being of populations and communities throughout the world. This research was conducted in the Community Health and Environmental Policy Program within RAND Social and Economic Well-Being. The program focuses on such topics as infrastructure, science and technology, community design, community health promotion, migration and population dynamics, transportation, energy, and climate and the environment, as well as other policy concerns that are influenced by the natural and built environment, technology, and community organizations and institutions that affect well-being. For more information, email