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Post-Traumatic Stress Disorder (PTSD) Claims and The Defense Base Act

PTSD claims are presumed compensable under the Act unless rebutted by substantial evidence.

How long do I have to file a claim?

Claims must be filed within two years after the employee or claimant becomes aware, or by reason of medical advice should have been aware, of the relationship between the employment, the disease, and the death or disability, or within one year of the date of the last payment of compensation, whichever is later.

What is PTSD?

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (1994) (DSM-IV), provides the criteria for a PTSD diagnosis:

  1. The person has been exposed to a traumatic event in which both of the following have been present:
    • the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
    • the person's response involved intense fear, helplessness, or horror.
  2. The traumatic event is persistently reexperienced in one (or more) of the following ways:
    1. recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions.
    2. recurrent distressing dreams of the event.
    3. acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated).
    4. intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
    5. physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
  3. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:
    1. efforts to avoid thoughts, feelings, or conversations associated with the trauma
    2. efforts to avoid activities, places, or people that arouse recollections of the trauma
    3. inability to recall an important aspect of the trauma
    4. markedly diminished interest or participation in significant activities
    5. feeling of detachment or estrangement from others
    6. restricted range of affect (e.g., unable to have loving feelings)
    7. sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)
  4. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:
    1. difficulty falling or staying asleep
    2. irritability or outbursts of anger
    3. difficulty concentrating
    4. hypervigilance
    5. exaggerated startle response
  5. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.
  6. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Problems with PTSD claims

Identifying, treating, and paying for PTSD claims take more time than typical traumatic-injury-only claims, because post-employment claims are more difficult to investigate:

These delays in the claims process cause the claimants even more stress and anxiety.

Source: U.S. Department of Labor, Office of Workers' Compensation Programs

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