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Opinion PTSD: The arc of justice bends toward first responders

On Jan. 1, a change to Manitoba's Workers Compensation Act took effect that means it will now be far less onerous to claim post-traumatic stress disorder as a work-related injury.

This is a potential game-changer for first responders such as paramedics, firefighters and police officers, who suffer from disturbingly high rates of PTSD.

It should also inspire other jurisdictions to reconsider what a workplace injury really looks like, and adjust their legislation and policies to recognize that a damaged mind can be as great a harm as a lost limb.

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First responders provide crucial, often under-appreciated service – everything from helping to find lost children to putting out fires, not to mention rushing people with sudden health woes such as a heart attack to the hospital.

For the most part, it's rewarding work. But police officers, firefighters and paramedics also witness more than their fair share of life's horrors: children burned beyond recognition in house fires, teenagers mutilated in car crashes, the many people who suffer heart attacks and can't be revived, the victims of crime who are stabbed or shot, as well as sometimes being in the line of fire themselves.

The death, the fear, the powerlessness, the stress and the expectations can take their toll on the psyche.

While good data are hard to come by – first responders, like soldiers, are often reluctant to come forward and risk being perceived as weak – research consistently shows that they have rates of PTSD and suicide that are significantly higher than the general public.

(And, yes, PTSD is widespread: According to a large U.S. study, about 3.6 per cent of adults suffer PTSD in any given year and 7.8 per cent at some point in their lifetime. Victims of sexual assault, assault, robbery, car crashes, natural disasters and other traumatic events can all suffer sequelae. The biggest surprise is how few actually do – the human brain tends to be quite resilient.)

In recent years, there has been a growing recognition of the pervasiveness of mental illness, and a better understanding of its causes. Like most health conditions, mental illness can result from a complex mix of genetics, environment and triggers. Trauma is one of the most common triggers.

Mental illness now accounts for more than 40 per cent of all disability claims in the workplace. Increasingly, mental illness is also a prime cause of workers' compensation claims, with psychological "injuries" now accounting for more than one in four cases.

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In most jurisdictions, however, the burden of proof is on the claimant to show that work activities were the cause of PTSD. What the changes in the Manitoba law do is reverse the onus, so the employer (and the insurer, Workers' Compensation) must show it is not.

Both Ontario and New Brunswick have proposed legislation that would make similar changes. In Ontario, a private members' bill from NDP MPP Cheri DiNovo to amend the Workplace Safety and Insurance Act will be debated Feb. 16.

The bill is strongly supported by the Tema Conter Memorial Trust, an advocacy group founded by a paramedic who suffered from PTSD after witnessing the scene of a violent rape and murder.

The fear of employers (and governments, who tend to have the ear of business) is that this kind of change will be costly. But Alberta, which made PTSD an eligible condition for workers' compensation back in 2012, has not seen a spike in claims. What it has seen, however, is PTSD claims settled more quickly and fairly, particularly for first responders.

British Columbia has also made legislative changes that recognize the right of employees to make claims to WorkSafeBC for work-related mental disorders, although it opted to not use the term PTSD specifically.

Legislators across the country should take note of the legal case that brought about those changes. BC Hydro worker Peter Plesner fought for six years to have his claim of work-related PTSD recognized.

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The B.C. court ruled that the fact there were more stringent conditions for recognizing mental trauma than physical trauma violated Mr. Plesner's rights – because Section 15 of the Charter of Rights and Freedoms guarantees equal protection of the law to all.

That is essentially what first responders are asking for – equal protection under the law. That those who serve and protect are being denied that fundamental right is injustice as grave as PTSD itself.

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