The National Institute for Occupational Safety and Health (NIOSH) research points to an increased risk of some types of cancers for firefighters. To better understand these findings on a larger scale, the agency established the National Firefighter Registry for Cancer.
This research strains the event-based way workers’ compensation claims are traditionally evaluated. One example is a firefighter diagnosed at age 52 after twenty years of twelve-hour shifts at fires. There are no records of the exposures, no air monitoring, and no record of the smoke’s composition on any particular night.
Claims examiners usually ask which specific event caused the illness, which is often impossible to answer when the exposure built up over years instead of on a single day.
The Standard Model Was Built for a Different Kind of Injury
Workers’ compensation was designed around certain events. A ladder slips, a machine catches a hand, and a back goes out lifting a pallet. These incidents often have details like a date and a place. Often, a supervisor documents these accidents, making claims more straightforward.
Like any other workers’ compensation claims, police and fire employees encounter claims related to single incidents like torn knees from chasing suspects, shoulders injured while lifting equipment, back injuries from extrications, and burns or falls at an emergency site. Principles behind such claims are relatively simple.
The problem comes with cumulative injuries and illnesses, which are slow to onset and develop over time. These injuries take years, or even decades, to develop, and most of these are heart conditions and conditions like cancer. There is also the potential for hearing loss, and psychological trauma can develop from traumatic emergency calls.
There is no day on which these injuries developed. Most compensation systems have difficulty recognizing cumulative injuries and illness because there is no particular event, such as a slip and fall, that resulted in these conditions.
With no single day to point to, these claims tend to rest on the full record of a career, including years of service and medical history. Local attorneys, like Hickory workers’ compensation attorney D. Brad Collins, are among those who handle that kind of claim. Such attorneys often work in general injury practices located in the same communities as the departments.
The Same Diagnosis, Two Very Different Cases
State lines matter so much to the extent that two firefighters can receive similar diagnoses at similar times and find themselves in completely opposite positions regarding how much proof they have to offer.
Statutory compensation for these claims differs immensely, particularly as legislatures attempt to resolve causation issues by writing presumptions into their compensation statutes. This variety includes which conditions are compensated, whether certain first responder occupations such as police are included, how many years of service are required, whether volunteers qualify, and whether psychological conditions qualify at all.
National generalizations about these issues are of limited use. A firefighter who reads an article about what a claim is worth may be reading about a state other than their own.
Practices representing public employees often write state-specific material for that reason, explaining how workers’ compensation for police and firefighters works under a single state’s rules.
What a Presumption Actually Does
New Jersey’s 2019 first responder legislation is an example of what that presumption can look like. It applies to eligible first responders who were exposed to cancer-causing chemicals, radiation, or radioactive materials and developed an illness or injury, or died, potentially because of that exposure.
There is a rebuttable presumption that the first responder’s injury, illness, or death is compensable under New Jersey law unless the employer proves by a preponderance of the evidence that there was no such causal connection. A similar provision applies to firefighters with seven or more years of service who are diagnosed with cancer (including leukemia) and also relies on a preponderance of the evidence.
In the absence of this rule, firefighters bear the burden of proving that their job duties directly caused their disease. Instead, the employer must show that fighting fires did not cause the disease. The burden of proof shifts from the firefighter to the employer.
This is a problem when science establishes the risk but can’t determine which shifts are responsible for the elevated risk. A presumption does not decide who wins. It decides who loses when the evidence runs out, which in this category is most of the time.
A Federal Program Sits Alongside the State One
Public safety officers have access to something most workers do not, and it runs entirely separately from any state claim.
The Public Safety Officers’ Benefits Program, administered by the Bureau of Justice Assistance, provides death and education benefits to survivors of fallen law enforcement officers, firefighters and other first responders who died in the line of duty. This program also provides disability benefits to eligible officers who are permanently and totally disabled by catastrophic injuries incurred in the line of duty.
That description includes the word “catastrophic.” This program is not a supplement to an ordinary compensation claim. It is not available for the kinds of injuries that make up most of the caseload. It is a narrow federal program for the worst outcomes, with its own application process, its own definitions, and its own determinations.
Departments also have pension disability systems with separate criteria, so a single career-ending injury can set three separate processes in motion, including a state compensation claim, a federal benefits claim, and a pension disability claim. None is bound by what the others decide.
Research on this work keeps arriving faster than legislatures can respond, so presumption laws have been rewritten often and are likely to be rewritten again. What a police officer or firefighter can recover therefore depends less on what happened to them than on when their legislature last reviewed the question. That is a notable feature of the system, and it is an accurate summary of how recovery works.
