Did work or some other type of trauma cause a firefighter paramedic to develop post-traumatic stress disorder (PTSD)? The answer to that question is the key to whether he receives workers’ comp benefits.
Royce Munker worked for the City of Norfolk in the Department of Fire-Rescue for 18 years. He worked as a firefighter paramedic for 17 years, and then was a fire inspector for a year.
After being an inspector for a year, Munker was told he’d be reassigned as a firefighter paramedic. The news caused him to suffer a panic attack for which he sought medical treatment.
During his years as a firefighter paramedic, Munker said he responded to “a lot of bad calls.” He saw decomposing and charred bodies of adults, babies and animals, and shooting victims with “blood everywhere,” and on one call had a knife pulled on him.
Munker also participated twice in post-Hurricane Katrina relief efforts. On one trip he participated as an individual. On the second one he was part of a federal Disaster Medical Assistance Team. The City allowed, but didn’t require, its employees to participate in relief efforts as part of DMAT. Munker says during both trips he performed “EMS, paramedic work.”
While assisting in post-hurricane relief efforts, Munker said he saw bodies and coffins floating in the water. He was also threatened by a looter with a gun.
After hearing that he would go back to firefighter paramedic work, Munker saw a licensed clinical social worker and a psychiatrist. In the course of seeing them, both said Munker suffered from PTSD due to his work as a firefighter paramedic, including his post-hurricane relief work.
Munker filed a request for workers’ comp benefits, specifically, lifetime medical benefits and temporary total disability.
A deputy of the Virginia Workers’ Compensation Commission (WCC) found Munker suffered from PTSD but failed to prove it was due to his work. The deputy found Munker’s PTSD was “based on work-related exposure to traumatic events as well as exposures to traumatic events outside of his employment, including his service providing post-Hurricane Katrina relief.” In other words, Munker didn’t prove his PTSD didn’t result from causes outside of work.
The full WCC reversed the deputy’s decision. The Commission said while Munker had suffered other personal trauma, his medical providers said his PTSD was caused by work – including participating in Hurricane Katrina relief. “But for [Munker’s] training as a paramedic, he would not have been called to serve in that rescue effort,” the WCC wrote.
The City of Norfolk asked a state appeals court to reverse the Commission’s decision.
Is his PTSD an occupational disease?
The Virginia Supreme Court had previously ruled that PTSD can be compensable under workers’ comp, if it can be shown it’s an occupational disease.
The City of Norfolk argued that in Munker’s case, PTSD wasn’t an occupational disease, but rather a non-compensable ordinary disease of life because he was exposed to traumatic events outside of work. His employer argued that Munker’s exposure to other traumatic events, including in his family life and childhood, demonstrated his exposure to traumatic events occurred outside of his employment.
The appeals court rejected that argument. It noted the opinions of the social worker and psychiatrist that Munker’s work experiences caused his PTSD.
The City also argued Munker’s work in post-Katrina relief efforts wasn’t working for his employer.
The Commission had found Munker would not have assisted with post-Katrina relief efforts “but for” his training as a paramedic and that the traumas he experienced there were related to his firefighter paramedic work.
However, the appeals court found:
“The Commission did not make the specific determination that his service post-Hurricane Katrina was ‘the work or process’ that he had ‘been engaged’ in, namely, labor as a firefighter paramedic.”
The appeals court reversed the decision and remanded the case for the WCC to determine whether Munker’s post-Katrina relief effort was the same “work or process” of a firefighter paramedic. Munker says it was. It’s now up to the Commission to decide if it agrees with him.
(City of Norfolk v. Royce Munker, Court of Appeals of VA, No. 1058-17-1, 1/9/18)