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Workers Comp

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HisWife22

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Is anyone here dealing with getting workers comp for their PTSD?

My husband is (first responder). It adds a whole new layer of hell to what we're dealing with. So much so that it almost doesn't feel worth it.

Just wondering if there's any shared experiences out there.
 
Yes, I did.

It was an excruciating years-long battle (3? 4?). I refused to engage with them for the last year, beyond being physically present for appointments where I was being paid to show up, but refused to actively participate. I finally got rid of them completely after some nasty threats, which left my employer fighting alone against my doctor & I. It was a very negative and damaging experience, almost worse in a way than the ptsd. They definitely made the ptsd worse. 3 years later, I'm finally just starting to make progress on picking up the pieces, but there are some things I won't ever be able to fix.

I'm sorry to hear that you and your husband are having a negative experience with workers' comp.
 
I was on disability through work for PTSD. I had a breakdown at work so it wasn't too difficult to get, but long term disability was horrific. I did get SSDI through a company called Allsup. Maybe shoot for SSDI instead? I went on workers comp for a shoulder injury and it was a nightmare!
 
t was a very negative and damaging experience, almost worse in a way than the ptsd
This is so true! He was sent to a psychiatric "independent" medical exam. What a joke. She wrote a report saying he doesn't have PTSD and is faking it. His own psychiatrist and psychologist wrote a rebuttal. Now it's just a matter of who the judge believes when he gets a hearing.

Meanwhile, he can't work. He can't even talk about work without getting highly symptomatic.

So, yes..... its almost worse than the ptsd itself! Having someone say you're faking it, losing his 25+ year career, feeling like a burden on the family because hes not bringing in an income.... i honestly just wish in some ways that he'd never filed an injury report after the run that "broke the camel's back".

Maybe shoot for SSDI instead?
I wish we could. As a firefighter, he doesn't qualify for social security. We've realized now that he'll probably never be able to go back to the department, so he's filed for a disability retirement. But, that's at the mercy of whether or not they approve it.

The whole process just sucks. If he'd have broken his leg, they would've paid for his treatment and recovery without question. But he broke his brain.... which clearly just means he's a lying piece of shit. 🙄
 
He was sent to a psychiatric "independent" medical exam. What a joke. She wrote a report saying he doesn't have PTSD and is faking it

If the workers' comp where you are is similar to the one here, there is no ''independent'' evaluation. Workers' comp is, at heart, an insurance company, with the underlying goal to pay out as little as possible and as seldom as possible. They use specific practitioners for evaluations, obtain predictable results, then deny a certain number of initial cases, knowing that a certain number of those people won't appeal or dispute. Then it's on to round 2. And on, and on. Lather, rinse, repeat. It's a formula.

It's not personal, it's just business... there is NO you, there's a number, a file, a checklist, a schedule - and a bottom line.

I spent years in the denial-appeal rabbit hole. I've been accused of lying, faking, exaggerating, throwing tests, cheating on tests, and even being a narcissist.

It took me years to really get it...

until I stopped engaging.

I just stopped speaking to any of their employees and approved practitioners. Pay me and I'll show up, that's all they get, I'm not speaking. That's not part of the formula, and made me ''the most difficult patient I've ever had'' according to the final T they assigned me to. That ultimately worked in my favour - the claim was finally approved, I dumped workers comp and closed the claim when they tried forcing me to return to work, and my employer was forced to medically accommodate.

I found an awesome T and paid for my own private therapy for a short time while I was in the rabbit hole. She believed me, understood uniform culture, went to bat for me against workers comp, and explained some of the tests and why they don't work on first responders. I couldn't afford to pay for T for very long, but just being believed made a huge difference.

I've still been a disaster in the years since all of that, but since this spring I'm finally seeing some real results.


wish in some ways that he'd never filed an injury report

yup! Worst decision I've ever made. Caused so much damage, some of it permanent. Unless I have a catastrophic, obvious, inarguable, physical injury that I can't hide or fake my way through, I won't ever file another claim. And even then I'll hesitate.



I feel for you and your husband, being in the workers comp rabbit hole. It's such an unhealthy place to be. I hope he can identify his needful things* and work on those, either with workers comp or privately

my list:
- be believed
- claim approved so that workers comp can't come after me for $70,000+ in costs
- workers comp to get the f*ck out of my life
- medical accommodation from my employer so they can't fire me, and have to relocate me to a new division
- relocation to be geographically as far from those involved in the incidents as possible
- relocation to where no one knows who I am or what happened, where I have no "reputation", and can start over
- relocation so I can return to my career if I choose
- rebuild my finances
I made a lateral move, career-wise, and am finally making progress on rebuilding my finances. With all the rest of these things off my list, I can actually work on the ptsd. And for the first time in years, I can say that I actually feel good.
 
Wow, so much info, thank you!

Can you help me understand what you mean here? They dont? Why? Im intrigued. Becasue she DID do a test and she said it showed theres nothing wrong with him, that hes exaggerating his symptoms, that hes lying. Its utter crap, really.
explained some of the tests and why they don't work on first responders
 
It has to do with how first responders are trained to do their jobs... basically compartmentalize and work the call, put your emotions/whatever aside so you can get the call done without losing your crap on scene, because otherwise you just wouldn't be able to do the job and the public will suffer. Even after the call, depending on what the call was and your service, there's a limit to how much you can admit to being affected by the call - that bar is moving in recent years, with more understanding of acute stress, cumulative stress, ptsd, cism, etc. but the longer you've been on the job, likely the more you've internalized ''don't show weakness'', and admitting to struggling with mental health because of your job is a huge weakness in the emergency response world. The tests are based on how ''normal/typical'' people ''should'' think/feel/process/react/answer the questions, but first responders are really good at compartmentalizing, and that messes with the tests.

That T, and I think @Freida here, explained that you also don't actually ''fail'' some the tests - it just means that your answers to the questions can't be defined/categorized, and is quite common among first responders.

Interestingly, that T also told me that psychologists take those tests while they're learning, and many of them ''fail'' the first time or two, until they ''learn how to answer the questions''.
 
That makes so much sense. He's been on the job for 25+ years. The tests were administered after his IME, during which he became highly symptomatic. So, he was very likely locked down while taking the tests, trying to control his symptoms. The tests show that he's "normal", no PTSD. Our every day existence says that's just plain wrong.

But of course, those tests and that psychiatrists conclusions is what the City is using to deny his claim. His psychiatrist and his psychologist both utterly disagree and have said so on the record.

It's just a big game of he said, she said. It's exhausting.

I wonder if there is any literature or studies about the validity of psych testing in certain patient populations (i.e. first responders, etc). Would be interesting.

Our state is in its infancy in recognizing PTSD as a valid work related injury. There's no road map, so employers are fighting it with everything they have.

He's very likely going to have to go off the job on disability retirement. Even with 25 years, he's not eligible yet for service retirement (he doesn't have age yet). The combo of losing his career, his identity, and being called a liar over it all is really not helping in his treatment.

I so appreciate your input on this, thank you.
 
any literature or studies about the validity of psych testing in certain patient populations (i.e. first responders, etc)

I imagine there is. If your husband's claim is heading towards some kind of hearing, it would probably be helpful to his case for his psych & T to find that info, and present it at that hearing.


My personal experience with workers comp here was that it fit their formula if the ptsd was related to one single horrible call, especially if it was something that was in the news, and that fit their idea of a "bad call" e.g. peds code, MCI, and where symptoms developed immediately/quickly. They just weren't equipped to recognize cumulative injury, delayed symptom onset, or in my case co-worker violence.
 
It is heading to hearing, and yes, we're going to check into that.

Our experience so far is that they're completely unprepared to deal with ANY type of PTSD at the department level. Delayed onset particularly. Is his cumulative? Probably, makes sense. But he was able to "power thru" until the one call that just did him in last year. We kept thinking he'd get better, he's had shitty days before, he'll come around. Then, he didn't. He got worse. And he's still in that dark place, all these months later. He can't even talk about work or the firehouse without getting shaky.

And the whole work comp process retraumatizes at every step. It should be criminal.
 
Just an update, cuz why not.....

He was denied a duty disability retirement. Expected, but it sucks. They have a clause that you need to show the trauma experienced is beyond the "normal" trauma those on the same job experience. Which is an impossible legal standard when you're a first responder.

No word yet on ordinary disability retirement. Still hopeful. The lack of income is starting to really hurt.

Vocational expert did an exam and found that he has suffered a 100% loss of earning capacity. Which is good legally, but a kick in the nuts personally. Even though we kinda knew that, given how his symptoms affect every day.

Still waiting on a hearing. It sounds like it's going to be a long wait.

And for the record, even summarizing those two bits of info for him spiraled him off into a ptsd tailspin. Sigh. His stress cup literally explodes with any talk of the job or the legal stuff. He's handling it fairly well, with a retreat to the bedroom and isolation time. So, I'm sleeping on the couch tonight lol. That's ok. He's got to process stuff like this slowly. I kinda feel like I have to really measure how to communicate stuff to him like this. There's no good time or way. It's GOING to be a trigger, but it also can't be avoided. Never quite sure what to do with those. This time, I chose a middle of the week day so it doesn't mess up the whole weekend, and a time when he could retreat afterwards without any real impact (I mean, except for the couch thing), and I summarized the info rather than handing it to him to read. Like a 30 second elevator speech.

Anyway, just venting and chronicling the workers comp ptsd firefighter shitshow. Thanks for listening.
 
I kinda feel like I have to really measure how to communicate stuff to him like this.
yep.
I fought with disability folks and social sec and the VA for 5 years and hubby got really good about deescalating me, most of the time. Because it is a huge blow. It's like all of the sudden I was this pathetic whiner who couldn't just suck it up, and in the first responder world that is just.....I don't even have words but it's bad.

No words of wisdom, but hopefully letting you know it's not just you.
 
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