Presumptive Workers Comp Benefits for Firefighters and Other First Responders

Where there’s smoke, there’s … cancer?

Many states already have in place or are considering passing workers compensation provisions that presume that if a firefighter contracts certain diseases, they were caused by on-the-job conditions. So under a presumption it’s much easier for firefighters to receive benefits when they contract a disease during their career.

You might think that these presumptions would increase the number of claims and the overall cost of workers compensation to the system. And you would be correct. But just how many additional claims and how much extra cost is a tough thing to predict. Also, will there be unintended consequences?

NCCI seeks to provide regulators, carriers, and other system stakeholders with guidance on how proposed legislation could impact costs in a given state. With a number of firefighter (or more generally, first responder) presumption bills under consideration across the country, NCCI took on the research.


What we found was that the accuracy of making an estimate is highly challenging, affected by factors such as:

  • Many firefighters work for self-insured municipalities that are not required to report data to NCCI, so only a portion of firefighter claim history is available
  • Published studies on the link between firefighting and certain diseases draw varying conclusions
  • The nature of the proposed bills varies from state to state on key factors, such as the diseases covered (e.g., cancer, heart disease … even PTSD), restrictions, and the employer’s ability to rebut
  • An array of other factors such as volunteer vs. career and judicial interpretation of laws

The study also raised important questions, such as:

  • How will the long-term latency of such claims affect the industry’s ability to accurately gauge the impact?
  • Will an increase in costs drive some self-insured risks to the residual market?
  • If the presumption is applied retroactively, will this result in unfunded liabilities?

Take a deeper dive into these and other interesting findings by reading the full report on

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