West Virginia Code
Article 4. Disability and Death Benefits
§23-4-1f. Certain Psychiatric Injuries and Diseases Not Compensable; Definitions; Legislative Findings; Terms; Report Required

(a) Except as provided by this section, for the purposes of this chapter, no alleged injury or disease may be recognized as a compensable injury or disease which was solely caused by nonphysical means and which did not result in any physical injury or disease to the person claiming benefits. Except as otherwise provided in this section, it is the purpose of this section to clarify that so-called mental-mental claims are not compensable under this chapter.
(b) For the purposes of this section:
(1) "First responder" means a law enforcement officer, firefighter, emergency medical technician, paramedic, and emergency dispatcher;
(2) "Post-traumatic stress disorder" means a disorder that meets the diagnostic criteria for post-traumatic stress disorder specified by the American Psychiatric Association in the Diagnostic
and Statistical Manual of Mental Disorders, fifth edition, or a later edition as adopted by rule of the insurance commissioner; and
(3) "Licensed mental health provider" means a psychiatrist, psychologist, licensed professional counselor, licensed marriage and family therapist, or licensed social worker who is qualified to treat post-traumatic stress disorder.
(4) "Employer" means any entity that controls, consistent with the provisions of West Virginia law relating to an employment relationship, the paid or volunteer employment of a first responder eligible for benefits under this section.
(c) The Legislature finds that post-traumatic stress disorder is a unique medical condition. Although it may manifest itself as a psychiatric condition that would be otherwise precluded from workers compensation coverage, post-traumatic stress disorder is an occupational hazard for first responders, similar to members of the military serving in combat. The Legislature further finds that because first responders are required to expose themselves to traumatic events during the course of their employment and thus are at a recognized higher risk of developing post-traumatic stress disorder, and because of the severe nature and debilitative effects of post-traumatic stress disorder, it is the moral obligation of the state to permit coverage to this class of individuals for their work-related disease.
(d)(1) Post-traumatic stress disorder suffered by a first responder may be recognized as a compensable occupational disease under 23-4-1(f) of this code when:
(A) The Employer has elected to provide coverage for post-traumatic stress disorder as an occupational disease; and
(B) A diagnosis has been made by a licensed psychiatrist that the first responder suffered from post-traumatic stress disorder due to exposure to an event or events that occurred in the course of and resulting from the first responders paid or volunteer covered employment: Provided, That the provisions of this section shall apply only to a post-traumatic stress disorder diagnosis made on or after July 1, 2021, or the first day of the employers next workers compensation insurance policy or self-insurance program term for which post-traumatic stress disorder coverage has been purchased or elected, whichever is later.
(2) While the diagnosis must be made by a licensed psychiatrist, mental health treatment consistent for a post-traumatic stress disorder diagnosis may be offered by a licensed mental health provider other than the diagnosing psychiatrist.
(3) A diagnosis of post-traumatic stress disorder under this section shall not include consideration of any layoff, termination, disciplinary action, or any similar personnel-related action taken in good faith by an employer.
(4) Benefits for a post-traumatic stress disorder diagnosis made under this section are contingent upon the employer electing to provide coverage for post-traumatic stress disorder from its workers compensation insurance carrier or to provide for it through its self-insurance program, whichever is applicable.
(5) The receipt of benefits is contingent on a claim being made within three years from and after a licensed psychiatrist has made the claimant aware of a post-traumatic stress disorder diagnosis in accordance with this section.
(e) Any employer that elects to offer coverage to first responders for post-traumatic stress disorder under this section shall report post-traumatic stress disorder claims data to the Offices of the Insurance Commissioner directly or via the employers private workers compensation insurance carrier, whichever is applicable, beginning July 1, 2021, or from the first day of the employers next workers compensation insurance policy or self-insurance program term, which provides such elective coverage, whichever is later.
(f) The Offices of the Insurance Commissioner shall report annually on claims data related to post-traumatic stress disorder claims for first responders to the Joint Committee on Volunteer Fire Department and Emergency Medical Services beginning January 1, 2022.
(g) The amendments made to this section during the 2021 regular session of the Legislature to recognize post-traumatic stress disorder as a compensable injury subject to the provisions of this section shall expire on July 1, 2026, unless extended by the Legislature.

Structure West Virginia Code

West Virginia Code

Chapter 23. Workers' Compensation

Article 4. Disability and Death Benefits

§23-4-1. To Whom Compensation Fund Disbursed; Occupational Pneumoconiosis and Other Occupational Diseases Included in Injury and Personal Injury ; Definition of Occupational Pneumoconiosis and Other Occupational Diseases; Rebuttable Presumption for C...

§23-4-1a. Report of Injuries by Employee

§23-4-1b. Report of Injuries by Employers

§23-4-1c.§23-4-1c. Payment of Temporary Total Disability Benefits Directly to Claimant; Payment of Medical Benefits; Payments of Benefits During Protest; Right of Commission, Successor to the Commission, Private Carriers and Self-Insured Employers to...

§23-4-1d. Method and Time of Payments for Permanent Disability

§23-4-1e. Temporary Total Disability Benefits Not to Be Paid for Periods of Correctional Center or Jail Confinement; Denial of Workers' Compensation Benefits for Injuries or Disease Incurred While Confined

§23-4-1f. Certain Psychiatric Injuries and Diseases Not Compensable; Definitions; Legislative Findings; Terms; Report Required

§23-4-1g. Weighing of Evidence

§23-4-2. Disbursement Where Injury Is Self-Inflicted or Intentionally Caused by Employer; Legislative Declarations and Findings; &Quot;deliberate Intention" Defined

§23-4-3. Schedule of Maximum Disbursements for Medical, Surgical, Dental and Hospital Treatment; Legislative Approval; Guidelines; Preferred Provider Agreements; Charges in Excess of Scheduled Amounts Not to Be Made; Required Disclosure of Financial...

§23-4-3b. Creation of Health Care Advisory Panel

§23-4-3c. Suspension or Termination of Providers of Health Care

§23-4-4. Funeral Expenses; Wrongfully Seeking Payment; Criminal Penalties

§23-4-5. Benefits for First Three Days After Injury

§23-4-6. Classification of and Criteria for Disability Benefits

§23-4-6a. Benefits and Mode of Payment to Employees and Dependents for Occupational Pneumoconiosis; Further Adjustment of Claim for Occupational Pneumoconiosis

§23-4-6b. Occupational Hearing Loss Claims

§23-4-6c. Benefits Payable to Certain Sheltered Workshop Employees; Limitations

§23-4-6d. Benefits Payable to Part-Time Employees

§23-4-7. Release of Medical Information to Employer; Legislative Findings; Effect of Application for Benefits; Duty of Employer

§23-4-7a. Monitoring of Injury Claims; Legislative Findings; Review of Medical Evidence; Recommendation of Authorized Treating Physician; Independent Medical Evaluations; Temporary Total Disability Benefits and the Termination Thereof; Mandatory Acti...

§23-4-7b. Trial Return to Work; Insurance Commissioner to Develop Rules

§23-4-8. Physical Examination of Claimant

§23-4-8a. Occupational Pneumoconiosis Board; Composition; Term of Office; Duties; Quorum; Remuneration

§23-4-8b. Occupational Pneumoconiosis Board; Procedure; Autopsy

§23-4-8c. Occupational Pneumoconiosis Board; Reports and Distribution Thereof; Presumption; Findings Required of Board; Objection to Findings; Procedure Thereon; Limitations on Refilings; Consolidation of Claims

§23-4-8d. Occupational Pneumoconiosis Claims Never Closed for Medical Benefits With Exception of Settled Claims

§23-4-9. Physical and Vocational Rehabilitation

§23-4-9b. Preexisting Impairments Not Considered in Fixing Amount of Compensation

§23-4-10. Classification of Death Benefits; "dependent" Defined

§23-4-11. To Whom Death Benefits Paid

§23-4-12. Application of Benefits

§23-4-13. Effect of Abandonment of Spouse

§23-4-14. Computation of Benefits

§23-4-15. Application for Benefits

§23-4-15a. Nonresident Alien Beneficiaries

§23-4-15b. Determination of Nonmedical Questions; Claims for Occupational Pneumoconiosis; Hearing

§23-4-16. Jurisdiction Over Case Continuous; Modification of Finding or Order; Time Limitation on Awards; Reimbursement of Claimant for Expenses; Reopening Cases Involving Permanent Total Disability; Promulgation of Rules

§23-4-16a. Interest on Benefits

§23-4-17. Commutation of Periodical Benefits

§23-4-18. Mode of Paying Benefits Generally; Exemptions of Compensation From Legal Process

§23-4-20. Postmortem Examinations

§23-4-21. Severability

§23-4-22. Permanent Disability Evaluations; Limitations; Notice

§23-4-23. Permanent Total Disability Benefits; Reduction of Disability Benefits; Reduction of Benefits; Application of Section; Severability

§23-4-24. Permanent Total Disability Awards; Retirement Age; Limitations on Eligibility and the Introduction of Evidence; Effects of Other Types of Awards; Procedures; Requests for Awards; Jurisdiction

§23-4-25. Permanent Total Disability Benefits; Reduction of Disability Benefits for Wages Earned by Claimant