What Is Act 121 of 2024?

On October 29, 2024, Pennsylvania enacted Act 121, a landmark amendment to the Workers’ Compensation Act that significantly changes how first responders access benefits for Post-Traumatic Stress Injury (PTSI). Effective October 29, 2025, the law removes the long-standing requirement for claimants to prove “abnormal working conditions” to qualify for psychological injury benefits related to PTSI.

Here are the key components of the new law:

• Eligibility: Applies to firefighters, police officers, emergency medical technicians (EMTs), and other designated first responders.
• Qualifying Traumatic Events: Under this new standard, the PTSI must have resulted from a “qualifying traumatic event,” which is defined in the Act as 5 enumerated events, including: (1) incidents involving serious bodily injury or death, (2) mass casualty events, (3) crime scene investigations, (4) cases involving injured or exploited minors; and (5) involving an immediate threat of the life of the claimant or other individual.
• Benefit Limits: Workers’ compensation benefits for PTSI under this standard are capped at 104 weeks.
• Diagnosis Requirement: Must be made by a licensed psychologist or psychiatrist.
• Filing Deadlines: Claims must be filed within three years of diagnosis, and the injury must have occurred within five years prior to the law’s effective date.
• Exclusions: PTSI resulting from employment actions (such as disciplinary action, job performance, or termination) are excluded from the Act.

This change represents a major step forward in recognizing the mental health challenges faced by first responders, providing a clearer and more attainable path to benefits while maintaining fiscal safeguards for municipalities. However, when first presented to the General Assembly, the legislation proposed suffered from a level of breadth and generality that made us concerned about the fiscal and administrative sustainability of the legislation. Most importantly to our members, there was concern that the proposed language could have resulted in significantly higher insurance premiums, which would have impacted the allocation of local tax dollars.

DVT’s Role in Crafting Act 121

Delaware Valley Trusts (DVT) played an active role in shaping Act 121 to balance expanded benefits with financial sustainability for local governments. Notably, DVT worked closely with its lobbyists, municipal associations (PML, PSATS, PSATC, PSAB, CCAP), and state legislators to negotiate critical amendments. These key contributions included:

• Defined Traumatic Events: Ensured the law ties eligibility to specific traumatic exposures rather than broad interpretations.
• Benefit Caps: Advocated for a two-year limit on benefits to control costs.
• Diagnosis Standards: Required evaluations by a licensed psychologist or psychiatrist.
• Delayed Effective Date: Secured a one-year implementation window to allow municipalities and insurers time to adjust premiums.

While these contributions helped ensure the Act accounted for the financial and administrative responsibility placed on municipalities, not all requested changes were accepted, and certain ambiguities may lead to litigation. These include: (1) whether this new standard will apply to PTSI claims under the Heart and Lung Act; and (2) whether claimants will be eligible for additional benefits under the “abnormal working condition” standard after the 104-week benefits has been exhausted.

Act 121 and the Impact on Member Rates

DVWCT rates for the 2026 coverage term have already been established and will not be affected by this recent legislation (pending rate approval from the Pennsylvania Department of Labor & Industry). However, the Pennsylvania Compensation Rating Bureau (PCRB) has issued preliminary guidance regarding changes in their loss costs effective April 1, 2026.

PCRB loss costs serve as the foundation for determining workers’ compensation premium rates in Pennsylvania. Commercial insurers use these loss costs to establish their rates, incorporating additional amounts for expenses and profit. While DVWCT develops its own loss funding in consultation with its actuary, the Trust relies on the PCRB loss cost figures as a benchmark to help allocate premium contributions across various rate classes. The PCRB has indicated the following adjustments in loss costs as a result of this legislation:

• 807 – Ambulance Service: 12.7% increase
• 985 – Police or Paid Firefighters: 3.0% increase
• 993 – Volunteer Ambulance Corps: 13.0% increase
• 994 – Volunteer Fire Company: 5.9% increase

Members with exposure in these class codes noted above are expected to experience similar rate adjustments. At this time, it is premature for the Trust’s actuary to quantify the overall financial impact on DVWCT’s loss funding. As actual PTSI loss experience emerges, these results will influence future loss projections and will be incorporated into the actuary’s ongoing analysis of the underlying claim data.

Please note that these revised loss costs will not affect DVWCT member rates until the 2027 coverage term.

Key Takeaways for Members

Regardless, the DVWCT Claims team is armed and ready to administer PTSI claims for first responders under this new standard.  The law does not create an automatic presumption that PTSI is work-related, first responders must still demonstrate that their PTSI is directly related to the qualifying traumatic event while on duty. DVWCT will verify that the PTSI diagnosis was rendered by a licensed physician or psychologist and the causal connection between the event and the mental health condition.  If medical records support eligibility for modified duty, the claims specialist will work with employer on return to work with appropriate accommodations.

However, by removing the “abnormal working condition” requirement, municipalities should strive to find more proactive ways in addressing mental health issues before they escalate, potentially reducing long-term disability claims. In addition, members should review their policies, trainings, and cost control measures to help mitigate financial risk.  Members are encouraged to enhance wellness programs that address mental health, resilience, and stress management. Promote resources such as employee assistance programs (EAPs), peer support, and confidential counseling services.

As always, if you have any questions or concerns, our would like additional information, please do not hesitate to reach out our General Counsel, Marie Wade, or Interim DVWCT Claim Manager, Linda Bengera, directly.