Cancers in Firefighters and Fire Investigators

Document sections:| Law | Guidelines | References |

Law

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.

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Guidelines

Inclusion

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  • a worker who was an inspector appointed under subsection 2(4) of the Fire Marshals Act before that Act was repealed by the Fire Protection and Prevention Act, 1997.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.

Exclusion

This policy does not apply to forest or wildland firefighters.

Prescribed Cancers

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
			C83	Diffuse 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.

The Regulation prescribes the following minimum durations of employment:

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       leukemia     Primary acute lymphocytic     leukemia	15 years
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.

Application Date

This policy applies to decisions made on or after November 4, 2009.

Document history

This document replaces 23-02-01 dated December 13, 2007.

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References

Legislative Authority

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

Minute

Board of Directors
#4(j) (i), December 17, 2009, Page 7070

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