Presumption Laws: What they Mean for Firefighters Facing Cancer

In recent years, the number of risks firefighters take in their daily jobs have become evident. Beyond the obvious fire and smoke, firefighters are extremely vulnerable to toxic exposure, such as that emanating from asbestos dust and fibers.

In a report from the Centers of Disease Control (CDC), researchers found that firefighters had much higher rates of cancer diagnoses, as well as deaths generally associated with cancer, compared to the general public. The study also found there were twice as many firefighters diagnosed with Mesothelioma .

Cancer is one of the leading causes of death among firefighters today largely due to occupational exposure. Because of these rising health risks, many states have adopted presumption laws to help firefighters facing cancer diagnoses like Mesothelioma more easily receive workers’ compensation benefits. However, there are still more than a dozen states that have not adopted such laws; moreover, those states where such laws are enacted may place limitations on firefighters' rights.

How Presumption Laws Work

Presumption laws shift the burden of proof from one party, in this case the firefighters, to those who would oppose in court. Presumption laws for firefighters with heart or lung diseases have been in place for many years, though cancer presumption laws have become more prominent within the last decade or so.

Currently, some 37 states have a varied definition of cancer presumption laws in place. Some states, like Colorado, list specific types of cancer or affected body systems (i.e. digestive system, akin, etc) for coverage. At present, Arizona is the only state to mention Mesothelioma specifically for coverage. Many states offer a general definition, stating any exposure to a "known carcinogen" as defined by the International Agency for Research on Cancer (IARC) qualifies.

In addition to the types of cancers and conditions covered by these laws, state laws will delineate other differing eligibility criteria. For example, states may require a minimum number of years of service, which typically ranges from 3 to 12 years. States, generally, also mandate that the firefighter had a physical exam prior to the start of their service that showed no presence of cancer. Many of the state laws also have a clause to refute claims for individuals with a history of smoking or use of tobacco products.

Firefighters that fit the eligibility criteria in these states with cancer presumption laws have the potential to receive a number of benefits. Firefighters may receive paid medical expenses, death benefits for surviving family members, and/or a higher disability pension.

Limitations for Firefighters

While the majority of states have these laws in place now, there are still many that have tried and failed to get such legislation passed. Florida and Montana introduced bills earlier this year that were both defeated, as has been the case in similar efforts in the past.

Firefighters in these states will have a much harder time receiving workers’ compensation benefits. These individuals would need to prove that a particular toxin at a particular fire caused their cancer or condition - a feat that can be nearly impossible. Further compounding the problem, researchers on both the city and county levels have questioned the link between fighting fires and cancer.

Many governments also oppose such legislative changes, citing the additional costs associated with these laws. Fire service in general can be quite costly for a municipality and presumption laws can add costs that go beyond the budget.

Many officials are concerned about rising insurance rates, however, research has shown that post-enactment of Pennsylvania laws in 2011 only 62 claims have been presented without any major change in cost or premiums. In spite of the fact that these laws will likely add to the number of workers’ compensation claims and payments, researchers have not been able to clearly determine how much financial impact these laws may have on a community.

Even in the states where presumption laws have been enacted, volunteer firefighters are often not covered. In fact, the majority of states with these laws only cover full-time paid firefighters, leaving part-time or voluntary members of the force without coverage.

Progress Being Made

There is still much to understand about the multitude of conditions and cancers firefighters face as a result of their work but progress is slowly being made. More states are gradually passing their own presumption laws. This year, in fact, Ohio officially signed into law their own cancer presumption laws which went into effect in April. Their eligibility entails at least six years of service and exposure to a carcinogen classified by the IARC, with several other clauses in place. Hopefully this new law will benefit many firefighters who have bravely served and are currently serving in the state and more states will follow suit.

On a national level, more work is being done to also better understand the conditions firefighters face and hopefully better protect them. Just last month, the U.S. House of Representatives passed a bill that would require the CDC to develop a registry of firefighters who develop cancer. This Firefighter Cancer Registry Act would provide $2 million dollars in funds from 2018 to 2022 to allow the CDC to gather and analyze data including if the firefighter was career or voluntary; years of service; types of incidents they responded to; and the cancer they developed.

The data from this study could be used to hopefully improve the current equipment being used; safety protocols in place; and prevention techniques to better protect firefighters from these carcinogens leading to cancer diagnoses. Though the bill still needs to pass the Senate and be signed into law by President Trump, the unanimous passage in the House of Representatives is quite promising.