Why don’t Montana first responders get workers’ compensation coverage for post-traumatic stress disorder (PTSD)? This is a question lawmakers across the state are asking, and now some are trying to turn it from a hypothetical into reality.
Montana Senate Bill 394 was proposed in the 2025 Montana legislative session. Its intent is to allow first responders diagnosed with PTSD to file a workers’ comp claim and receive benefits akin to those they’d receive for a physical work-related injury. The bill indicates that PTSD would be considered a compensable occupational disease if it arose out of the course and scope of employment.
Importantly, the bill was passed in the 2025 legislative session but was vetoed by Montana Governor Greg Gianforte. However, there is strong public support and potential for reintroduction in a future session. The governor’s office indicated that he is willing to work with stakeholders to come up with alternatives for addressing PTSD among emergency personnel.
Why should PTSD be covered under Montana workers’ compensation?
As you might know, Montana workers’ compensation benefits cover injuries or illnesses that happen while a person is performing tasks related to their job. It could be an injury on a specific worksite, or anywhere, as long as it’s in the course of the individual doing their job. These benefits include medical treatment costs and lost wages related to the illness or injury. The typical types of injuries that workers’ compensation covers can include broken bones, back injuries, or other traumatic physical events at work.
However, PTSD isn’t “stress.” It’s not sadness. It’s a mental disorder that can be caused by the emotional and psychological toll of repeatedly witnessing distressing events on the job. It’s real, and it affects every aspect of a person’s life. First responders—including firefighters, police officers, EMTs, and other emergency personnel, routinely see human suffering, life-threatening situations, and violent or sudden deaths. Over time, these experiences can lead to PTSD.
PTSD is a serious medical condition that can affect mood, sleep, memory, and the ability to work and enjoy life. Unlike a sprained ankle or back injury, PTSD often doesn’t appear like a visible wound. However, the impact can be even more debilitating. The discussion around Senate Bill 394 recognized that reality under Montana’s workers’ compensation laws.
Senate Bill 394
Senate Bill 394 would allow first responders diagnosed with PTSD to file a workers’ compensation claim and receive benefits. The bill defined key terms and established that PTSD would be considered a compensable occupational disease. The bill includes these key points:
- A clear definition of “first responder.” This includes firefighters, police officers, county detention center employees, and other professionals who respond to emergency calls.
- Recognition of PTSD as a work-related injury, if diagnosed according to the standard criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
- Inclusion in the Montana workers’ compensation system under existing laws, which include eligibility for medical care and wage-loss benefits tied to PTSD.
Supporters of Senate Bill 394
The bill was sponsored by Sen. Cora Neumann (D-Bozeman) and gained support from other legislators representing districts with active first responder communities.
Proponents argued that first responders face extraordinary stress, repeatedly witnessing human tragedy, death, and violence. These experiences can accumulate over time and result in real psychological harm. Several lawmakers who previously served as firefighters or police officers shared powerful personal stories about calls they responded to and how those memories continue to affect their lives.
Advocacy groups representing firefighters and similar professions supported the measure, arguing that timely access to mental health care could save lives by preventing resignations, chronic suffering, and suicide. Suicide is a significantly higher risk in first responder populations than in the general public.
These groups argued that PTSD is a legitimate injury that deserves protection, and that recognizing PTSD in workers’ compensation encourages early access to treatment, which reduces long-term suffering and costs.
Concerns and opposition to Senate Bill 394
The bill wasn’t welcomed by everyone. Opposition came largely from business groups, local government advocates, and insurance interests concerned about the potential cost implications of expanding coverage. The Montana Chamber of Commerce and the Billings Chamber of Commerce both communicated with the governor and lawmakers during the legislative session, urging caution. They stressed that expanding workers’ compensation coverage could increase premiums for local governments and private employers, ultimately affecting taxpayers and budgets.
A representative from the Montana Self-insurers Association had concerns that additional coverage could strain local government finances. This wasn’t about PTSD, per se, but about the fact that when benefits increase, costs typically follow.
Other legislators were concerned about singling out first responders for PTSD eligibility, citing fairness and potential legal issues. Their comments ranged from worries about unequal treatment among workers to questions about whether PTSD should be addressed through workers’ comp or other systems.
Future of Montana PTSD legislation
Although Gov. Gianforte vetoed the bill in 2025, he acknowledged the challenges and sacrifices that first responders face. Ultimately, however, he shared some of the opponents’ concerns that PTSD isn’t limited to first responders, for instance. He said that other professions, like healthcare workers and social workers, also experience trauma. He was concerned that broadening workers’ comp coverage for PTSD for first responders would create unintended costs and legal complications.
However, the governor’s office is willing to work on an alternative solution for addressing PTSD among emergency personnel.
There are a couple of potential paths this legislation could take from here:
- Reintroduced in a future session. The bill could be revised to address the opponents’ and governor’s concerns. Legislators could narrow the scope, redefine terms, or adjust how benefits are paid. The revised legislation could be reintroduced as early as 2027.
- Alternative approaches. There are proposals for other systems outside traditional workers’ compensation benefits to cover PTSD treatment for first responders. For example, other states have models that include separate mental health programs administered by local health systems.
As awareness of mental health challenges among first responders grows, community members, mental health professionals, and other advocates are likely to join this conversation. Public input and constituent advocacy could sway lawmakers in future legislative sessions.
Even though the bill did not become law in 2025, it did put a spotlight on PTSD as a legitimate occupational concern for first responders. Broadly, it could reflect a cultural shift in how we view workplace injuries.
Recognizing mental health challenges like PTSD as part of workers’ compensation isn’t out-of-the-box thinking anymore; it’s part of a national trend toward more inclusive worker protections.
If you are a first responder struggling with symptoms of PTSD, or you’re supporting someone in this situation, there are available resources. Mental health professionals, peer support networks, and community organizations specialize in helping individuals cope with work-related trauma, even if workers’ compensation doesn’t yet cover the condition in Montana. And, if you need to file a workers’ compensation claim (for any work-related injury), you can contact the team at Murphy Law Firm. We’re going to be watching this—and all workers’ compensation legislation—closely and will be ready to handle these claims if and when it’s signed into law.
If you have any questions about what is covered under Montana workers’ compensation and what your legal rights are, contact us anytime for a free consultation.