If you are a First Responder and have been diagnosed with PTSD from line of duty (especially if you are unable to work due to PTSD), dealing with Workers Compensation can be a source of frustration at a time when you are poorly equipped to deal with it. That may be an understatement… dealing with Workers Compensation may be a horribly stressful experience… there are some things early on that can make life easier and move your claim along-
- Be honest. Never, NEVER try to take shortcuts in this process by lying or misleading Workers Compensation, your healthcare providers, your employer, or anyone else. If you do not feel comfortable providing the information requested, say so, and find a work-around.
- Do NOT talk to Workers Compensation on the phone if you can avoid it; e-mail, fax or some type of paper trail is best. Phone calls are often recorded, are never used to help you, and are often used against you. It is highly unlikely you can turn a refusal into a “yes” by talking to the decision maker on the phone, and it will only lead to a shouting match where you are labelled a hothead (or worse).
- Don’t take on too many battles at first. Yes, Workers Compensation often violates basic Human Rights, but to try to fight them on those points takes years, does nothing to help you get approved (generally) in the short term, and only takes away from your coping resources.
- If you are in a relationship, tell your significant other. Be honest, and include them in the process. PTSD is incredibly hard on relationships, but it does not have to be an ending to a good partnership. If you have kids, you are well advised to explain in an age appropriate way that something is up.
- Apply for EI. Unless you have used your EI sick benefits lately, you are entitled to 16 weeks of benefits. I understand it is not ideal, but rather than focusing on the injustice, focus on solutions that can delay bad financial consequences. Some money is better than no money coming in. Be sure to have a note from a medical doctor, psychologist, psychiatrist or the like to verify you are off work due to your PTSD.
- Contact the Tema Conter foundation, explain that you feel you have PTSD from line of duty, and request assistance for a full evaluation. Tema has a FANTASTIC program to help with initial diagnosis, and it is worth its weight in gold. Initial (full) assessments can run $1200 – $1500, and take hours of testing and interviews. Tema can help, and this will give you a starting point for documentation.
- Chose your healthcare providers carefully. This is not about looking for “yes” people, this is about finding professionals who have the expertise to point you in the right direction, who know and understand PTSD.
- Save every doctors note, scrap of paper, and keep a journal to record appointments, with whom, time, date, and a brief description of what happened in that appointment.
- Ensure that your employer has submitted the appropriate forms to Workers Compensation, and ask Workers Compensation if they received all relevant material to make a decision. Most cases I have seen often have documentation that disappears without explanation (which is a good thing you are saving your own copies of everything, right?)
- Ask for any decisions on your claim to be made in writing. Understand that Workers Compensation is an insurance scheme, and you have to approach it as such. Their first answer is very often “NO”, find out what it takes to turn it into a “YES”. Wait for the decision maker to commit the rationale to paper, then find ways to poke holes in that rationale. For example, the decision maker claims that your PTSD does not appear to be directly related to your work; Find out why they said that, then have your clinicians document that it IS related, and provide Workers Compensation with that evidence.
- Bite things off in small chunks, pace yourself.
That’s it for the basics. I will try to post another blog entry with specifics on some other matters later.