It’s no surprise police are at a higher risk for post-traumatic stress disorder (PTSD) than civilians. Dr. Ellen Kirschman, a psychologist who’s been counseling cops and their families for 30 years, has observed,
“There are approximately 900,000 sworn officers in the United States. According to some studies – 19% of them may have PTSD. Other studies suggest that approximately 34% suffer symptoms associated with PTSD but do not meet the standards for the full diagnosis.”
PTSD can occur in response to a singular traumatic event. Officers can also suffer cumulative PTSD from multiple stress-related events over time, no single one of which might have resulted in any disability.
The intent of this article is to alert you to gaps in the profession’s response to psychological injuries that could leave you financially impacted – and worse – and what needs to change to prevent that.
One tragic example
What happened to Phoenix Officer Craig Tiger shouldn’t have, and it shouldn’t happen to another cop – ever again. But it could, unless the profession and legislators act.
In 2012, Tiger and his partner responded to a man behaving erratically and waving a bat at a pool. He’d threatened to bash in children’s heads. Later investigation established he was on spice, a synthetic marijuana. As the patrol car pulled up, the man threatened bystanders again, ignored both officers’ commands to drop the bat, then charged toward Tiger and his partner.
Tiger shot, hitting the man in the head, and he died. The incident was over in seconds but it would haunt Tiger for over two years. What happened then sparked a lot of media attention from which I gleaned these facts.
Tiger underwent the then standard protocol – three days of paid leave and an evaluation of his fitness to return to duty, which included an interview with IA officers, a firearms test and a psych eval by the department counselor. Tiger described the one-hour psych eval to his then-wife as a perfunctory “joke.”
Tiger was cleared to return to duty. He began unraveling. His wife said their already troubled marriage became worse and Tiger lost interest in saving it. He wasn’t sleeping. When he did, he was tormented by nightmares. He tried to use alcohol to address his fears, anxieties and nightmares. Within six months, he was divorced.
On the first anniversary of the shooting, Tiger decided to kill himself. He loaded guns in his car, drank and began to drive to a family cabin. He was stopped and arrested for DUI.
Tiger was placed on admin leave pending the outcome of his misdemeanor DUI. He admitted to suicidal thoughts and was ordered to do inpatient treatment. He was diagnosed with PTSD and voluntarily received 30 days of treatment. His insurance wouldn’t cover more.
Tiger showed medical records of his PTSD diagnosis originating from the shooting to his chief and pleaded for his job, as did his ex-wife, who also worked for the department. Termination would result in loss of income and insurance, which she predicted would worsen his PTSD and depression. The department fired him.
After the firing, Tiger applied for workers’ compensation. His claim was denied and he went without pay or insurance while he appealed. He won only after a 9-month long fight. During that time, Tiger tried to move on, but couldn’t. He continued mental health treatment, stopped drinking and worked to regain joint custody of his kids. Still, he wasn’t eating or sleeping and ended up hospitalized three times.
Fourteen months after he was fired, Tiger took his own life. In a handwritten note found next to his body, he’d written to his chief, "The city failed me, plain and simple. I despise you. I showed you all medical records but yet you threw me aside like a piece of trash. For that I hate you. See you on the other side. I hope you get what’s coming to you … You and the city of Phoenix failed me. Plain and simple.”
Through the tireless effort of his ex-wife, Rebecca, and other advocates, in 2018 Arizona passed H.B. 2502, also known as the Officer Craig Tiger Act. It provides first responders additional treatment after being involved in a traumatic on-the-job incident. It also improved the evaluation protocol and requires departments to track and report the usage of such services to better understand the prevalence of PTSD.
Much more needs to be done
Arizona took one positive step. Some states haven’t done that. Other states have done more. What is needed is a national response.
State workers’ compensation laws vary as to whether psychological injuries are generally covered, covered under only limited circumstances, or not covered at all. Do you know whether you’d be covered?
In 2018, Washington state addressed cumulative PTSD with legislation providing that police, firefighters and emergency medical technicians are eligible for workers’ compensation benefits for \PTSD caused by repeat exposure to trauma and stress.
Do you know what treatment your department’s medical benefits provide for psychological trauma? Do you know what diagnosis might be required before any treatment is available?
PTSD can be difficult to diagnose. Part of the reason is the lack of record-keeping and research. The challenge of diagnosis can make it difficult for an officer to obtain a disability pension. In the absence of definitive tests for PTSD, police brass express concern about fraud and that one such pension award would open floodgates. The same could be said of back injuries but that doesn’t exclude them from pension benefits.
Disability from psychological injury related to a single traumatic event or cumulative trauma is as real as a gunshot wound or repetitive motion injury. Officers thusly injured while protecting and serving deserve medical benefits and treatment, workers’ compensation, disability leave and pensions where appropriate.
The Canadian province of Ontario recognized that when they passed legislation creating a presumption that PTSD diagnosed in first responders is work-related. Under the Supporting Ontario's First Responders Act, the presumption provides faster access to Work Safety and Insurance Board (WSIB) benefits and timely treatment. Once a first responder is diagnosed with PTSD by either a psychiatrist or a psychologist, the claims process is expedited, without the need to prove a causal link between PTSD and a workplace event.
The diagnostic challenges of PTSD in the U.S. are not insurmountable. But legislators and departments will have to recognize that a diagnosed psychological injury – like a physical injury – is deserving of treatment and benefits.