Department of Environmental & Occupational Health, Dornsife School of Public Health at Drexel University, Philadelphia, PA, USA.
J Public Health Policy. 2024 Sep;45(3):562-574. doi: 10.1057/s41271-024-00501-5. Epub 2024 Jul 12.
We conducted a comprehensive review of state workers' compensation laws in the United States to evaluate the extent to which they support first responders with mental injury. Most state workers' compensation systems divide mental injuries into categories based on their presumed etiology: physical-mental, mental-physical, and mental-mental. Major differences exist among states as to which workers are eligible. Proving workplace causation can be difficult where no traumatic physical injuries exist. Latency periods, time limits, preexisting health conditions, restrictions as to types of condition covered, and complex chains of causation may make this burden, which falls on the claimant, even more challenging. Only nine (9) states enacted presumption of causation laws for mental health conditions to ease claimants' burden of proof. This contrasts starkly with presumption laws for chronic and infectious diseases. State decision-makers should create presumptions that mental health conditions in first responders are caused or significantly exacerbated by their stressful workplaces.
我们对美国的州工人赔偿法进行了全面审查，以评估它们在多大程度上支持有精神伤害的急救人员。大多数州的工人赔偿制度根据假定的病因将精神伤害分为三类：身心、心身和心身。各州之间在哪些工人有资格获得赔偿方面存在重大差异。如果没有创伤性身体伤害，证明工作场所的因果关系可能很困难。潜伏期、时间限制、先前存在的健康状况、对所涵盖疾病类型的限制以及复杂的因果关系链可能会使这一落在索赔人身上的负担更加具有挑战性。只有九个（9）个州制定了精神健康状况的因果关系推定法，以减轻索赔人的举证责任。这与慢性和传染病的推定法形成鲜明对比。州决策者应推定急救人员的精神健康状况是由其紧张的工作场所引起或显著加重的。
