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Session Evaluation

AOHC 2026 Concurrent Sessions

Clinical Occupational and Environment Medicine

311 - PTSD presumptions for First Responders: Medicolegal implications and Occuptational Medicine

Tuesday, April 21, 2026
10:15 AM - 11:15 AM CT
Location: Sheraton Ballroom IV
Claim 1.0 CME

All relevant financial relationships have been mitigated.


Disclosure(s):

Les Kertay, PhD, ABPP: No financial relationships to disclose
Miranda Kofeldt, PhD: No financial relationships to disclose
Brenna Hampton, J.D., Master's Law Firm Management: No financial relationships to disclose
Fabrice Czarnecki, MD, MA, MPH, FACOEM: No financial relationships to disclose
Session Description: PTSD presumption laws in workers' compensation are rapidly spreading across jurisdictions. They are widely believed to be about diagnosing PTSD, especially when it comes to first responders. Instead, they are actually a varied set of legal rules that presume that properly-diagnosed PTSD in a first responder is causally related to work. Confusion is common: which first responders are impacted, what is required to warrant the diagnosis of PTSD, how does PTSD impact functioning at work, and what does this mean for Occupational Medicine providers called upon to evaluate fitness for duty?

In this engaging panel presentation, we will explore PTSD and presumptions from mental health, legal, and occupational medicine perspectives. We will address the epidemiology of PTSD, its differential diagnosis and treatment, the legal aspects of some of the varied ways that the presumptions are being applied, and impacts on work capacity and medicolegal issues in occupational clinics and practices. We will also describe and discuss some of the larger social contexts surrounding how we assess and treat trauma, and potential impacts on the workers' compensation system as a whole.

Educational Gaps: Occupational Medicine physicians and other health practitioners are often involved in evaluating first responders and others claiming PTSD. However, they often lack the tools to make a proper diagnosis and/or determination about functional impact. Presumption laws are likely to exacerbate systemic problems and complicate best practices in medicolegal/occupational health.

Is this session being sponsored by an ACOEM Section or Component?: No

Has this session previously been presented?: No

The AOHC 2026 theme is Healthy workers. Healthy world: Exposure to potentially traumatic situations is high, but the incidence of PTSD is low, suggesting that resilience is the default response. Moreover, PTSD remains a highly treatable condition, including for but not limited to first responders and health care providers. Properly evaluating and treating first responders exposed to traumatic events addresses a significant public health problem.

Learning Objectives:

  • Upon completion, participants will be able to define the criteria for evaluating PTSD from clinical and functional perspectives.
  • Upon completion, participants will be able to demonstrate an understanding of presumption laws and their implications for occupational health and safety.
  • Upon completion, participants will be able to demonstrate the ability to more effectively address fitness for duty, functional impacts in safety-sensitive positions, and medicolegal determinations in occupational health settings within the workers' compensation system.