Washington State
House of Representatives
Office of Program Research
BILL
ANALYSIS
Labor & Workplace Standards Committee
HB 1593
Brief Description: Concerning industrial insurance coverage for posttraumatic stress disorders affecting registered nurses.
Sponsors: Representatives Macri, Bronoske, Berry, Simmons, Reeves, Bateman, Ramel, Doglio, Lekanoff, Reed, Callan and Fosse.
Brief Summary of Bill
  • Creates a rebuttable presumption that post-traumatic stress disorder is an occupational disease under workers' compensation for direct care registered nurses.
  • Allows the presumption to be rebutted by clear and convincing evidence.
Hearing Date: 2/8/23
Staff: Trudes Tango (786-7384).
Background:

Workers Compensation Coverage for Mental Health Conditions.
Under the state's industrial insurance (workers' compensation) laws, administered by the Department of Labor and Industries (Department), a worker who, in the course of employment, is injured or suffers disability from an occupational disease, is entitled to certain benefits.  An occupational disease is one that arises naturally and proximately out of employment.
 
The Department was required to adopt a rule establishing that claims based on mental conditions or mental disabilities caused by stress do not fall within the definition of occupational disease.  Examples in the rule of conditions caused by stress that do not fall within occupational disease include, among other things, those conditions and disabilities resulting from:  (a) changes in employment duties; (b) conflicts with a supervisor or relationships with coworkers or the public; (c) work load pressures; (d) subjective perceptions of employment conditions or environment; and (e) fear of exposure to chemicals, radiation biohazards, or other perceived hazards.
 
Stress resulting from exposure to a single traumatic event, such as actual or threatened death, actual or threatened physical assault, actual or threatened sexual assault, and life-threatening traumatic injury, may be considered an industrial injury.  The worker must have been exposed to the event either by:  directly experiencing the event; witnessing, in person, the event as it occurred to others; or extreme exposure to aversive details of the event.  Repeated exposure to traumatic events, none of which are a single traumatic event, is not an industrial injury or an occupational disease.  However, a single traumatic event that occurs within a series of exposures may be considered an industrial injury.
 
Presumption for Certain First Responders.
The Department's rule does not apply to occupational disease claims resulting from post-traumatic stress disorders (PTSD) of certain firefighters, law enforcement officers, and public safety telecommunicators who receive calls for assistance and dispatch emergency services (dispatchers). 
 
For those workers, there is a presumption that PTSD is an occupational disease if certain conditions are met.  If the firefighter, law enforcement officer, or dispatcher was hired after a certain date, they must have submitted to a psychological examination that ruled out the presence of PTSD from preemployment exposures, if the employer provided such an examination.  The firefighter, law enforcement officer, or dispatcher must also have served for at least 10 years before the PTSD develops. 
 
The presumption may be rebutted by a preponderance of the evidence.  Evidence may include the worker's lifestyle, hereditary factors, and exposure from other employment or nonemployment activities.
 
The presumption is extended following termination of service for a period of three calendar months for each year of service, but may not extend more than 60 months following the last date of employment.
 
The worker's PTSD is not considered an occupational disease if it is directly attributed to disciplinary action, work evaluation, job transfer, layoff, demotion, termination, or similar action taken in good faith by an employer.

 

When a determination involving the presumption is appealed to the Board of Industrial Insurance Appeals (Board) or a court, and the final Board decision or court order allows the claim, the Board or the court must order the opposing party to pay reasonable costs and attorneys' fees to the claimant.  When costs of the appeal must be paid by the Department in a state fund case, the costs must be paid from the Accident Fund and charged to the costs of the claim.

Summary of Bill:

A rebuttable presumption that PTSD is an occupational disease is created for direct care registered nurses covered under the workers compensation statutes who are employed on a fully compensated basis.  A direct care registered nurse is an individual licensed in the state as a nurse providing direct care to patients.
 
The presumption may be rebutted by clear and convincing evidence.  The presumption extends to the claimant for a period of three calendar months for each year the claimant was a direct care registered nurse employed on a fully compensated basis, but may not extend more than 60 months following the last date of employment.  The PTSD is not considered an occupational disease if it is directly attributed to disciplinary action, work evaluation, job transfer, layoff, demotion, termination, or similar action taken in good faith by an employer.
 
When a determination involving the presumption is appealed to the Board of Industrial Insurance Appeals or a court, and the final Board decision or court order allows the claim, the Board or the court must order the opposing party to pay reasonable costs and attorneys' fees to the claimant.  When costs of the appeal must be paid by the Department in a state fund case, the costs must be paid from the Accident Fund and charged to the costs of the claim.

Appropriation: None.
Fiscal Note: Requested on February 1, 2023.
Effective Date: The bill takes effect on January 1, 2024.