Cancers in Firefighters and Fire Investigators
- Occupational Diseases
- Application Date
- This policy applies to decisions made on or after November 4, 2009.
- Chronic Exposures
- Cancers in Firefighters and Fire Investigators
- Document No.
Primary cancers of the brain, bladder, kidney, colon/rectum, ureter, esophagus, and primary-site non-Hodgkin’s lymphoma and three specified leukemias are prescribed cancers under Ontario Regulation 253/07 as amended by Ontario Regulation 423/09 (the Regulation) for the purposes of subsection 15.1 (4) of the Workplace Safety and Insurance Act (the Act).
If a full-time, part-time or volunteer firefighter or a fire investigator suffers from and is impaired by one of these prescribed cancers and meets the conditions related to duration of employment and age outlined in the Regulation, the disease is presumed to be an occupational disease due to the nature of the worker’s employment, unless the contrary is shown.
This policy applies to
- workers who are full-time or volunteer firefighters as defined in Section 1 of the Fire Protection and Prevention Act, 1997
- part-time firefighters, defined as a worker who is a firefighter and is not a volunteer or full-time firefighter
- fire investigators, defined as
- a worker to whom the Fire Marshal appointed under subsection 8(1) of the Fire Protection and Prevention Act, 1997 has delegated the duty to investigate the cause, origin and circumstances of a fire, or
- a worker who was an inspector appointed under subsection 2(4) of the Fire Marshals Act before that Act was repealed by the Fire Protection and Prevention Act, 1997.
For the purpose of the policy, the term "firefighter" refers to a full-time firefighter, a part-time firefighter or a volunteer firefighter.
This policy does not apply to forest or wildland firefighters.
A medical diagnosis of non-Hodgkin’s lymphoma, one of the three specified leukemias, or cancer originating from the specified organ is required for adjudication of claims under this policy. The prescribed cancers listed in the Regulation are listed below with their World Health Organization classification numbers.
|Prescribed Cancer||ICD-9 Code*||Description of ICD-9 Code||ICD-10 Code*||Description of ICD-10 Code|
|1. Primary-site brain cancer||191||Malignant neoplasm of the brain||C71||
Malignant neoplasm of the brain
Excludes: cranial nerves and retrobulbar tissue
|2. Primary-site bladder cancer||188||Malignant neoplasm of the bladder||C67||Malignant neoplasm of the bladder|
|3. Primary-site kidney cancer||189||Malignant neoplasm of the kidney and other and unspecified urinary organs||C64||Malignant neoplasm of the kidney|
|C65||Malignant neoplasm of the renal pelvis|
|4. Primary-site colorectal cancer||153||Malignant neoplasm of the colon||C18||Malignant neoplasm of the colon|
|C19||Malignant neoplasm of the rectosigmoid junction|
|154||Malignant neoplasm of the rectum, rectosigmoid junction and anus||C20||Malignant neoplasm of the rectum|
|C21||Malignant neoplasm of the anus and anal canal|
|5. Primary non-Hodgkin’s lymphoma (NHL)||200||Lymphosarcoma and reticulosarcoma||C82||Follicular (nodular) NHL|
|202||Other malignant neoplasm of lymphoid and histiocytic tissue (i.e. nodular lymphoma)||C84||Peripheral and cutaneous T-cell lymphomas|
|C85||Other and unspecified types of NHL (i.e. lymphosarcoma)|
|6. Primary acute myeloid leukemia, Primary acute lymphocytic leukemia, Primary chronic lymphocytic leukemia||205.0||Acute myeloid leukemia||C92.0||Acute myeloid leukemia|
|204.0||Acute lymphocytic leukemia||C91.0||Acute lymphocytic leukemia|
|204.1||Chronic lymphocytic leukemia||C91.1||Chronic lymphocytic leukemia|
|7. Primary-site ureter cancer||189.2||Malignant neoplasm of the ureter||C66||Malignant neoplasm of the ureter|
|8. Primary-site esophageal cancer||150||Malignant neoplasm of the esophagus||C15||Malignant neoplasm of the esophagus|
*International Statistical Classification of Diseases (Ninth and Tenth Revisions).
Prescribed Duration of Employment
Firefighters and fire investigators with the minimum years of eligible Ontario service for the prescribed cancer are presumed to have a work-related occupational disease. The eligible years of service is the sum of all employment periods as a firefighter or fire investigator from the date of hire until the date of diagnosis. If a worker serves in more than one capacity as a full-time, part-time or volunteer firefighter or fire investigator in the same period, this period will only be counted once towards the eligible years of service. For cancer of the colon or rectum (i.e., colorectal cancer), there is an additional requirement of obtaining the medical diagnosis of disease prior to age 61.
The date of diagnosis is not necessarily the same as the date of accident. For occupational diseases
- the date of accident is the date of earliest evidence of documented medical attention
- the date of diagnosis is the date of earliest medical documentation that establishes the worker’s diagnosis.
|Prescribed Cancer||Duration of Firefighting Employment|
|1. Primary-site brain cancer||10 years|
|2. Primary-site bladder cancer||15 years|
|3. Primary-site kidney cancer||20 years|
|4. Primary-site colorectal cancer||10 years (diagnosed prior to 61st birthday)|
|5. Primary non-Hodgkin’s lymphoma||20 years|
6. Primary acute myeloid leukemia
Primary chronic lymphocytic
Primary acute lymphocytic
|7. Primary-site ureter cancer||15 years|
|8. Primary-site esophageal cancer||25 years|
The Presumption and its Rebuttal
This policy is based on O. Reg. 253/07 as amended by O. Reg. 423/09 which provides a presumption that the prescribed cancers are work-related occupational diseases. To qualify for this presumption, workers must meet the inclusion criteria of this policy, and must have been
- diagnosed with a prescribed cancer, and
- diagnosed after the prescribed minimum employment duration (and diagnosed prior to age 61 in the case of colorectal cancer), and
- diagnosed with that cancer on or after January 1, 1960.
Workers not meeting the inclusion criteria, and those excluded from this policy, will have their claims determined on their individual merits.
The presumption may be rebutted if it is established that the employment was not a significant contributing factor to the occurrence of the cancer.
Decision Making In Earlier Time Periods
Workers or their survivors may refile previously denied claims, or present new claims, with no time restrictions other than a requirement that the date of disease diagnosis is on or after January 1, 1960.
This policy applies to decisions made on or after November 4, 2009.
This document replaces 23-02-01 dated December 13, 2007.
Workplace Safety and Insurance Act, 1997, as amended by the Workplace Safety and Insurance Amendment Act (Presumptions for Firefighters), 2007
Sections 2(1), 15, 15.1(4), 15.1(5), 15.1(6), 15.2, 94, 183
O.Reg. 253/07 as amended by O. Reg. 423/09
Board of Directors
#4(j) (i), December 17, 2009, Page 7070