Kentucky bill proposes workers’ comp expansion for PTSD in first responders

A new bill introduced in the Kentucky General Assembly would significantly broaden workers’ compensation eligibility for first responders suffering from post-traumatic stress disorder (PTSD) or other mental health-related injuries, even when no accompanying physical injury has occurred.

House Bill 1228 creates a carveout to Kentucky’s long-standing rule that excludes psychological injuries from workers' compensation coverage unless directly caused by physical harm. The bill, which applies to police officers, firefighters, emergency medical personnel, front-line state workers, and Kentucky National Guard members, introduces a presumption of compensability for PTSD diagnoses stemming from job-related trauma.

The legislation modifies Kentucky Revised Statutes § 342.0011 and creates a new section under Chapter 342 to include:

• Mental injuries as compensable claims for designated first responders, even without accompanying physical harm.
• A rebuttable presumption that PTSD diagnosed within three years of a first responder’s last day of active employment is a work-related injury, provided the diagnosis is made by a qualified mental health professional.
• The burden of proof shifts to the employer to disprove work-relatedness by showing the PTSD was caused by nonservice-connected factors.

To qualify for compensation, the claim must demonstrate that:

• The event or cumulative stressor was “extraordinary and unusual” in comparison to pressures experienced by the average worker, and
• The event was the proximate cause of the mental injury.

The bill includes language to protect employers from liability in cases involving routine administrative actions. Psychological injuries resulting from “disciplinary action, work evaluation, job transfer, layoff, demotion, or termination” made in good faith will not be considered work-related injuries under the bill.

Additionally, only the last employer to expose the worker to harmful stress will be held liable for compensation — a provision likely designed to simplify coverage disputes and assign clear financial responsibility.

This proposal marks a potential shift in how Kentucky insurers will need to assess, price, and manage claims related to mental health injuries. If enacted, HB 1228 would:

• Require insurers and self-insured employers to prepare for increased mental health claims from eligible first responders.
• Potentially impact reserves, claims duration, and litigation exposure, especially given the presumption clause for PTSD.
• Drive the need for more robust mental health provider networks and qualified evaluators under workers’ compensation programs.

Critically, the bill creates no cap on benefits for psychological injuries beyond what is already in the system, meaning permanent disability awards may be available where PTSD renders a worker unable to return to duty.