PTSD Funding & Reimbursement Policy
Kentucky Fire Commission Policy
Post-Traumatic Stress Injury and Post-Traumatic Stress Disorder
Funding and Reimbursement Program
Policy number: 1
A. Funding
(1) One million two hundred fifty thousand dollars ($1,250,000) in each fiscal year shall be made available from the fund for a program to reimburse out-of-pocket expenses for the care and treatment of full-time career and volunteer firefighters affected by post-traumatic stress injury or post-traumatic stress disorder.
(2) Upon exhaustion or termination of funding, reimbursement benefits under this policy shall cease.
B. Eligibility
(1) An individual shall be eligible for reimbursement benefits pursuant to this policy if the individual:
(a) Is a current volunteer or full-time professional firefighter in the Commonwealth of Kentucky; and
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- Has been diagnosed by a licensed mental health professional with post-traumatic stress injury or post-traumatic stress disorder pursuant to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders; and
- Such post-traumatic stress injury or post-traumatic stress disorder has been caused by an event or an accumulation of events that occurred in the course and scope of the firefighter’s position as a volunteer or full-time professional firefighter in the Commonwealth of Kentucky; or
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(b) Was a volunteer or full-time professional firefighter in the Commonwealth of Kentucky within the past five (5) years; and
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- While a volunteer or full-time professional firefighter in the Commonwealth of Kentucky, or within five (5) years of leaving his or her position as a volunteer or full-time professional firefighter in the Commonwealth of Kentucky, was diagnosed by a licensed mental health professional with post-traumatic stress injury or post-traumatic stress disorder pursuant to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders; and
- Such post-traumatic stress injury or post-traumatic stress disorder has been caused by an event or an accumulation of events that occurred in the course and scope of the firefighter’s position as a volunteer or full-time professional firefighter in the Commonwealth of Kentucky; and
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(c) Submits to the Kentucky Fire Commission a completed:
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- Post-Traumatic Stress Disorder Reimbursement Application form;
- Substitute W-9 form;
- Certification of Post-Traumatic Stress Injury or Post-Traumatic Stress Disorder Diagnosis form;
- Authorization to Obtain and Review Medical Records Related to Diagnosis of Post-Traumatic Stress Injury or Post-Traumatic Stress Disorder form; and
- HIPPA Compliant Authorization for the Release of Patient Information Pursuant to 45 C.F.R. § 164.508 form.
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C. Reimbursement
(1) Once the eligibility requirements of Section B of this policy have been satisfied, after seeking care or treatment for post-traumatic stress injury or post-traumatic stress disorder a qualifying individual may submit to the Kentucky Fire Commission corresponding receipts for the following out-of-pocket expenses for such care or treatment paid by the qualifying individual, or by someone on behalf of the qualifying individual, for reimbursement from the funds specifically allocated in the Kentucky Fire Commission's budget for post-traumatic stress injury or post-traumatic stress disorder care or treatment:
(a) Initial diagnosis;
(b) Counseling/Therapy;
(c) Medication;
(d) Mental health facility expenses;
(e) In Patient Treatment; and
(f) Out Patient Treatment.
(2) The qualifying individual, or someone on behalf of the qualifying individual, shall pay any out-of-pocket expenses for the post-traumatic stress injury or post-traumatic stress disorder care or treatment before submitting receipts for reimbursement.
(3) Post-traumatic stress injury or post-traumatic stress disorder that arises solely from a legitimate personnel action, such as transfer, promotion, demotion, or termination, shall not be considered a compensable injury.
(4) No later than thirty (30) days after the out-of-pocket expenses for which reimbursement is sought are paid, or the corresponding care or treatment has been provided, whichever occurs later, a qualifying individual seeking reimbursement shall submit to the Kentucky Fire Commission:
(a) All insurance payment receipts for the post-traumatic stress injury or post-traumatic stress disorder care or treatment for which reimbursement is sought;
(b) A completed Post-Traumatic Stress Disorder Voucher; and
(c) All receipts for out-of-pocket expenses for post-traumatic stress injury or post-traumatic stress disorder care or treatment which have been paid by the qualifying individual, or by someone on behalf of the qualifying individual, and for which reimbursement is sought.
(5) Notwithstanding Subsection (4) of this Section, a qualifying individual may seek reimbursement for out-of-pocket expenses for post-traumatic stress injury or post-traumatic stress disorder care or treatment that was provided between July 1, 2020 and the date this policy is approved by the Kentucky Fire Commission, so long as the documents set forth in Subsection (4)(a-c) of this Section are submitted to the Kentucky Fire Commission within thirty (30) days of the date this policy is approved by the Kentucky Fire Commission.
(6) Failure to satisfy the requirements of Subsections (4) or (5) of this Section within the applicable thirty (30) day deadline shall result in a denial of such out-of-pocket expenses for which reimbursement is sought.
D. Time Limitations and Cap for Reimbursement Benefits
(1) A qualifying individual shall only be eligible for reimbursement benefits pursuant this policy for such post-traumatic stress injury or post-traumatic stress disorder care or treatment that was provided on or after July 1, 2020.
(2) Beginning at the time all requirements of Section B of this policy have been satisfied, there shall be a maximum limit of twelve (12) months for reimbursement benefits pursuant to this policy.
(3) Reimbursement benefits for each qualifying individual pursuant to this policy shall not exceed $50,000 unless:
(a) A written request for additional benefits is submitted to the Kentucky Fire Commission by the qualifying individual, in which the dollar amount of additional reimbursement benefits requested is identified; and
(b) The Financial Department of the Kentucky Fire Commission determines that the requested additional reimbursement benefits are available pursuant to Section A of this policy.
Approved by the Kentucky Fire Commission and Effective: October 14, 2020
