For injuries dated on or after January 1, 2019, Minnesota law presumes that a police officer’s, firefighter’s, or dispatcher’s PTSD came from the job. You’d think that would make these claims easy.
It hasn’t. Not even close. In October 2025 the Minnesota Department of Labor and Industry put out a 222-page study of PTSD claims, prepared by University of Minnesota researchers working with the Department. Its finding: insurers “issued an initial denial of primary liability for more than 90% of all PTSD claims from 2014 to 2023.” Over the same years, the initial denial rate for all non-COVID claims never topped 20 percent.
And the presumption didn’t move the number. The report found that the initial denial rate for workers in presumption occupations “did not decrease after the rebuttable presumption came into effect in 2019 and remained high in 2020.” From 2017 on, presumption workers’ PTSD claims were initially denied at a higher rate than PTSD claims from workers outside those occupations.
So the presumption is real. It just won’t stop the first letter from saying no. What it changes is what your employer has to prove after that, and the Minnesota Supreme Court has been spelling that out since 2022.
Who gets the presumption
The comp act has covered PTSD as a “mental impairment” since a 2013 amendment. Before that, as the supreme court put it in 2019, “a worker could not recover for PTSD under the Workers’ Compensation Act.” The presumption came in 2018, in Minn. Stat. § 176.011, subdivision 15(e). It covers you if you were employed on active duty as:
a licensed police officer; a firefighter; a paramedic; an emergency medical technician; a licensed nurse employed to provide emergency medical services outside of a medical facility; a public safety dispatcher; a correctional officer or security counselor employed by the state or a political subdivision at a corrections, detention, or secure treatment facility; a sheriff or full-time deputy sheriff of any county; or a member of the Minnesota State Patrol
If you’re on that list and you’re diagnosed with PTSD “and had not been diagnosed with the mental impairment previously,” then the PTSD “is presumptively an occupational disease and shall be presumed to have been due to the nature of employment.”
Two catches. If you’ve been diagnosed with PTSD before, the presumption doesn’t apply. And the statute says the condition “is not considered an occupational disease if it results from a disciplinary action, work evaluation, job transfer, layoff, demotion, promotion, termination, retirement, or similar action taken in good faith by the employer.” Trauma on the job counts. Good-faith discipline and personnel decisions don’t.
The diagnosis is the claim
Under subdivision 15(d), “mental impairment” means a diagnosis of PTSD by a qualifying licensed professional, and PTSD means the condition as described in “the most recently published edition of the Diagnostic and Statistical Manual of Mental Disorders” from the American Psychiatric Association. No qualifying diagnosis, no claim.
And who counts as qualifying just changed. For dates of injury before October 1, 2026, the diagnosis has to come from a licensed psychiatrist or psychologist. The 2026 Legislature added a third option, a “psychiatric mental health nurse practitioner”, for dates of injury on or after October 1, 2026. Laws 2026, chapter 103, section 8, signed May 18, 2026.
That change is bigger than it sounds. The DLI report flagged “the shortages of mental and behavioral health care providers, particularly in rural areas”. If you can’t get in to see a psychiatrist or psychologist, you don’t have a claim yet, however bad it’s gotten. For injuries dated on or after October 1, 2026, a qualifying nurse practitioner’s diagnosis counts too.
The court has also been clear about what the DSM requirement doesn’t mean. In Smith v. Carver County, a Carver County deputy had a PTSD diagnosis from one licensed psychologist and a no-PTSD opinion from another. The Workers’ Compensation Court of Appeals had told compensation judges to check each expert’s report against the DSM themselves. In other words, do the diagnosing. The supreme court reversed. Subdivision 15(d), it held, “does nothing more than require that a diagnosis of PTSD in a workers’ compensation case be done by a licensed psychiatrist or psychologist based on the latest version of the DSM.” And the line the court repeated in 2024: “the DSM is a guideline for medical and health professionals, not a checklist for judges.” Smith v. Carver County, 931 N.W.2d 390, 397–98 (Minn. 2019).
Smith lost. His claim arose in 2016, before the presumption took effect; the judge found the employer’s psychologist more persuasive, and the supreme court reinstated that decision. That’s a PTSD claim without a presumption: two experts, and the judge picks one.
In 2024 the court added a wrinkle. A compensation judge may look at the DSM criteria when deciding which expert is more persuasive, but “judges are applying the law—not diagnosing patients.” Tea v. Ramsey County, No. A23-1207, slip op. at 14 (Minn. Apr. 17, 2024).
What the presumption actually buys you
With the presumption, the battle of experts stops being a coin flip. The employer has to rebut, and the statute says how: the presumption “may be rebutted by substantial factors brought by the employer or insurer.”
The supreme court’s 2022 decision in Juntunen v. Carlton County did the heavy lifting on what that means, and the court quoted it again in 2025 and 2026. As the court recounted it in July 2026, Juntunen held that the presumption “is rebuttable but only by substantial proof to the contrary,” that the “employer must make a strong showing,” and that “the employer faces a higher burden than in a case in which no presumption applies.” Rowe v. City of Minneapolis, No. A24-1465, slip op. at 19 (Minn. July 22, 2026) (quoting Juntunen v. Carlton County, 982 N.W.2d 729, 741 (Minn. 2022)).
It also settled what triggers the presumption: “an employee need only present a diagnosis for the presumption to apply, not that the diagnosis is determined by a compensation judge to be more credible or persuasive than any competing diagnosis offered by an employer.” Id. at 12 n.8 (quoting Juntunen, 982 N.W.2d at 740). Your diagnosis gets you in the door. Then your employer has to push you back out with substantial factors.
How an employer rebuts, after Rowe
The court went further on July 22, 2026, in Rowe. A Minneapolis officer of about 25 years had a PTSD diagnosis. The City’s psychologist examined him and concluded he didn’t meet the PTSD criteria in the DSM-5, which by then was no longer the current edition; the DSM-5-TR had come out. The Workers’ Compensation Court of Appeals held that the only way to rebut the presumption was an independent psychological evaluation under the current DSM, set aside the compensation judge’s finding for the City, and found the City hadn’t rebutted the presumption.
The supreme court reversed. Its holding: “an IPE is not the sole way for an employer to rebut the presumption. The statute and our case law allow an employer to rebut the presumption through any number of ‘substantial factors.’” Rowe, slip op. at 21. An employer’s examination based on an outdated DSM isn’t excluded as a matter of law; the compensation judge may consider it. And rebuttal might not require examining the worker at all. The court’s examples include “an expert opinion undermining the methodology of, or pointing out errors in, the expert opinion diagnosing the employee with PTSD.” Id. at 20.
After Rowe, your claim gets won or lost on the quality of your diagnosis. Does the professional qualify under the statute? Does the report tie your symptoms to the current DSM? Can it hold up when another expert takes it apart on paper?
The court left one door open. In a footnote in Rowe, it noted that while Juntunen indicated the presumption applies to the diagnosis itself and not just causation, “it is unclear whether the presumption also applies to the PTSD diagnosis such that an employer has a ‘higher burden’ to rebut the diagnosis.” Id. at 12 n.9. The court said that open question “may have significant implications for an employer attempting to refute a PTSD diagnosis.” Then it left it for another day.
The denial letter is where employers get into trouble
If you’re a first responder with a PTSD claim, know this part cold. Minnesota sets rules for how an employer denies, and breaking them costs money.
Under § 176.221, subdivision 1, a denial of a reportable injury generally has to be filed with the commissioner and served on the employee within 14 days after the employer has notice or knowledge of the injury. And the notice “must state in detail the facts forming the basis for the denial and specific reasons explaining why the claimed injury or occupational disease was determined not to be within the scope and course of employment”. For PTSD in a presumption occupation, subdivision 15(e) adds that substantial factors known to the employer at the time of denial “shall be communicated to the employee on the denial of liability.”
Many stakeholders told the DLI researchers that “denial notifications often lack sufficient detail about the reasons for denial and the evidence supporting that decision.” In their telling, the no often shows up without the why. That gap has a price. Section 176.225, subdivision 1, lets a compensation judge award an additional amount “of up to 30 percent” of the total compensation award when an employer has “frivolously denied a claim”, and it defines “frivolously” as “without a good faith investigation of the facts or on a basis that is clearly contrary to fact or law.”
Peterson v. City of Minneapolis, decided July 16, 2025, shows what that looks like. A Minneapolis officer of 22 years, a SWAT sergeant, had passed two pre-employment psychological exams that found no significant emotional problems. A licensed psychologist diagnosed him with PTSD in June 2021. In September 2021 the City denied, claiming he had a history of mental health conditions from before his employment. The court noted that “The City did not investigate Peterson’s claim at that time.” The compensation judge found the denial frivolous and awarded a 30 percent penalty, the Workers’ Compensation Court of Appeals affirmed, and the supreme court affirmed the penalty. Peterson v. City of Minneapolis, 23 N.W.3d 582 (Minn. 2025), slip op. at 3–6, 23–26. Two justices dissented on that part of the decision.
The City argued that 14 days was too short to rebut a presumption. The court answered with Juntunen: “The Legislature determined that employees suffering from PTSD need timely access to medical care, and the PTSD presumption puts the onus on employers to quickly resolve such claims.” Id., slip op. at 25 (quoting Juntunen, 982 N.W.2d at 743).
One more 2026 change points the same way. For dates of injury on or after October 1, 2026, the window in which an employer that started paying can stop by filing a denial grows from 60 days to 90. Laws 2026, chapter 103, section 12. More time to investigate. Also more time with no excuse for not investigating.
Where the comp claim isn’t the whole story
Section 176.031 makes the employer’s liability under the comp statute “exclusive and in the place of any other liability” to the worker for the injury. I wrote about that exclusive-remedy rule, and its exceptions, at /news/minnesota-workers-compensation-exclusive-remedy-176-031/. But the claims next to it are real. Under § 176.82, anyone “discharging or threatening to discharge an employee for seeking workers’ compensation benefits” is liable in a separate civil action, which I covered at /news/minnesota-workers-compensation-retaliation-176-82/. When someone other than the employer is legally responsible for the harm, § 176.061 lets the worker sue that party, and the employer may deduct what the worker recovers from benefits payable under the statute’s formula; that’s at /news/minnesota-naig-settlement-subrogation-176-061/. And if you’re hiring a comp lawyer, the fee rules have their own statute, which the same 2026 law amended; I covered it at /news/minnesota-workers-compensation-attorney-fees-176-081/.
For a police officer, there’s often a disciplinary file running at the same time. The statute’s exclusion for good-faith discipline can drag that file into the PTSD case whether anybody wants it there. I wrote about the records rules for peace-officer discipline at /news/minnesota-peace-officer-discipline-626-89/.
The supreme court says the presumption puts the onus on employers to resolve these claims quickly. The numbers say the first answer is mostly no. After that first no, it comes down to two pieces of paper: your diagnosis and their denial letter.
Madgett Law, LLC
Madgett Law, LLC handles the civil claims that sit next to a Minnesota workers’ compensation claim: retaliation and wrongful discharge under § 176.82, third-party claims against someone other than the employer, and the subrogation and coverage questions that decide what an injured worker keeps. See our general litigation practice, then send us a message.
Sources: Minn. Stat. § 176.011, subd. 15(a) (occupational disease; good-faith employer actions), subd. 15(d) (mental impairment; most recent DSM), subd. 15(e) (presumption; covered occupations; no prior diagnosis; rebuttal by substantial factors; communication on denial; good-faith employer actions); Laws 2018, ch. 185, art. 5, § 1 (presumption effective for dates of injury on or after January 1, 2019); Laws 2026, ch. 103, § 8 (adding psychiatric mental health nurse practitioners, dates of injury on or after October 1, 2026), § 9 (amending § 176.081, subd. 9), and § 12 (60-day period becomes 90 days, same effective date); Minn. Stat. § 176.221, subd. 1 (14-day denial; contents of denial notice); Minn. Stat. § 176.225, subd. 1 (penalty up to 30 percent; “frivolously” defined); Minn. Stat. § 176.031 (exclusive liability); Minn. Stat. § 176.82, subd. 1 (retaliatory discharge); Minn. Stat. § 176.061, subd. 5(a)–(b) (third-party actions; employer deduction); Smith v. Carver County, 931 N.W.2d 390, 395–98 (Minn. 2019); Tea v. Ramsey County, 5 N.W.3d 114 (Minn. 2024), No. A23-1207, slip op. at 14–15 (Apr. 17, 2024); Peterson v. City of Minneapolis, 23 N.W.3d 582 (Minn. 2025), No. A24-1205, slip op. at 3–6, 23–26 (July 16, 2025) (Moore, III, and Thissen, JJ., concurring in part and dissenting in part); Rowe v. City of Minneapolis, No. A24-1465, slip op. at 2–3, 12 & nn.8–9, 19–21 (Minn. July 22, 2026) (quoting Juntunen v. Carlton County, 982 N.W.2d 729, 740–43 (Minn. 2022)); Minnesota Department of Labor and Industry and University of Minnesota, Evaluating PTSD claims in Minnesota’s workers’ compensation system: Findings and recommendations (Oct. 2025), pp. 9–10, 12, 130. This article is general information about Minnesota law, not legal advice. Reading it does not create an attorney–client relationship, and no outcome is promised or implied.