Workers' Compensation Claims for Conditions Presumed to Be Occupational Diseases Among Firefighters in Washington State, 2000–2017

Abstract

Objective: Occupational disease presumption laws for firefighters are common, yet little is known about the workers' compensation claims filed for them. Methods: We identified Washington State's workers' compensation claims for conditions covered by presumption among firefighters during 2000 to 2017, and described them by disease type and claim characteristics. Claim rates for specific cancers were compared with statewide incidence rates using the Washington State cancer registry. Results: Firefighters filed 330 claims for conditions covered by presumption (heart problems, 43%; cancer, 35%; respiratory disease, 15%; and infectious diseases, 8%), with acceptance rates varying by disease and insurer type. Cancer claims were associated with the highest claim costs and time loss. Conclusions: This study provides necessary baseline data to understand the impact of presumption laws on workers' compensation systems, and can inform future decisions presumption law expansions for firefighters.

The Relative Burden of Occupational Injuries and Illnesses in Firefighters: An Analysis of Washington Workers’ Compensation Claims, 2006–2020

“…Characterizations of cancer and other illnesses that are legally-presumed to be occupational diseases in WA firefighters have been previously described in detail [6]. Therefore, while claims for these conditions are included in the data (counted in the total frequencies; included in the "all other" category in the presentation of results by injury type), most of these conditions are not examined separately in this analysis.…”

“…While these descriptive analyses provide valuable insight for injury prevention and intervention activities and additional research, linking the WA employment records for firefighters to other data sources to better capture chronic illnesses and diseases with long latency, such as cancers [6], would be valuable. There is a need to better understand the injury, illness, and fatality rates in volunteer firefighters, and efforts should be made to characterize their experience.…”

“…Despite these data, in WA, interest in preventing musculoskeletal disorders emerged indirectly from proactive efforts to control firefighter exposure to carcinogens. Like many states in the US, Washington State considers certain medical conditions to be legally presumed as occupational diseases for the purposes of workers' compensation, including specific cancers, respiratory disease, certain heart problems, specific infectious diseases, and posttraumatic stress disorder (PTSD) [6]. Periodic updating of WA's firefighter presumption law transitioned legislative interest from not only providing compensation for firefighters with specified disease outcomes, but to provide workers' compensation incentives and grants to fire departments for adoption of best practices [7] to prevent carcinogen exposure.…”