Ascellus Blog

Texas First Responders in Latest School Shooting Have Access to PTSD Coverage

June 6, 2018

A law on the books less than a year could provide much needed help in the wake of the latest tragic school massacre. Gov. Greg Abbott signed legislation that provides workers’ compensation coverage to first responders who suffer from work-related Post Traumatic Stress Disorder (PTSD). It took effect last September.

Texas last year joined a small but growing list of states that recognize the potentially debilitating effects such an event can have on some first responders. It means police, firefighters, emergency personnel and other responders will be able to get the care they need to get on with their lives. Ultimately, it is good news not only for the workers and their families, but their employers and the public as well.

The Tragedy
A 17-year old student armed with a shotgun and a .38 caliber handgun is alleged to have killed eight students and two teachers during the melee at a high school about 30 minutes outside Houston. Texas deputies were reported to have been in a 25-minute shootout before the student was taken into custody.

Authorities said a retired Houston police officer who served as a resource officer at the school confronted the gunman. He sustained a gunshot wound to the arm and was among the injured taken to local hospitals.

The motive for the shooting is unclear. But students said the gunman yelled “woo hoo” as he fired on his classmates. The suspect is being held on charges of capital murder of multiple people and aggravated assault on a public servant.

The Law
It’s interesting that in proposing the legislation last year supporters noted that suicides among first responders in Texas were on the rise. They also said the care available to first responders at that time was offered through employee assistance programs, where general practitioners who are not qualified as PTSD specialists would evaluate the person’s condition and provide resources for treatment. The bill’s sponsor also said that in order to receive treatment for PTSD the first responder had to claim mental impairment, which could be grounds for dismissal from their jobs and could carry a negative stigma.

Supporters said that expanding benefits for specialized trauma care to first responders would better equip the workers to do their jobs and increase overall public safety.
The law requires first responders to meet specific criteria for PTSD as specified by the American Psychiatric Association. They would have to show it “results in impairment of a person’s functioning in the person’s community, employment, family, school or social group.” The event would have had to occur in the course and cope of the person’s employment and “the preponderance of the evidence” must indicate the event “was a substantial contributing factor of the disorder.”

Meanwhile, the National Council of Insurance Legislators is at least looking into the issue. Members of NCOIL’s Workers’ Compensation Committee recently heard a presentation on the topic. Whether that may lead to model legislation for states is unknown right now.

PTSD and First Responders
The majority of people who are exposed to traumatic events may have intense reactions, but generally don’t suffer long-lasting symptoms. But a fraction of people — including first responders — develop PTSD. Getting them the right treatment as quickly as possible is imperative for a good outcome.

Shock, anger, nervousness, fear and guilt may worsen to the point the person cannot live normally. When these reactions continue beyond one month, there’s a good chance PTSD can develop if they are not treated. Failing to treat people at that point can result in lifelong issues for the worker and major expense for the employer and insurer.

There is no exact percentage of people who develop PTSD after a tragedy. Estimates range anywhere from 6 percent to 35 percent. Much of it depends on preventive techniques they’ve been taught, as well as psychosocial factors they may have. Catastrophic thinking, fear avoidance, external locus of control, depression, past trauma and low self-efficacy are among the factors that influence how one reacts to tragedy.

Within three days of a tragedy the exposed worker should consult with a specialist who can access his physical and psychological states. Most people affected need just a few trauma recovery sessions to return to function. Those identified as having PTSD should be provided with interventions that have been shown to be effective.

Employers and others can help first responders who have been exposed to tragedies by giving them appropriate social support. Families and coworkers can actually help prevent the onset of PTSD by showing their commitment to assisting the person.

First responders are routinely faced with catastrophic situations. But large-scale shootings, especially involving children are not part of a normal day’s work. Those who handle these events should be armed with all the psychological and physical protection they need to keep the rest of us safe.

Integrated Medical Case Solutions (Ascellus) is a national network of Health Providers in Psychology that delivers cognitive behavioral therapy (CBT) for chronic pain, trauma and insomnia across the country for the workers’ compensation industry.

For additional information, contact us at, or Please join our LinkedIn group, COPE with Pain at

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Ascellus bridges the gap between mental and physical health to accelerate recovery for our nation's workforce. By connecting the workers' compensation industry with our expert behavioral care and evidence-based treatments, we deliver high-quality outcomes, helping injured workers reemerge with increased strength, purpose and resilience in the workplace.