Cancers in Firefighters and Fire Investigators

Policy

If a firefighter or a fire investigator is diagnosed with a prescribed cancer on or after January 1, 1960, and meets the employment duration and additional criteria for the prescribed cancer, then the disease is presumed to be an occupational disease due to the nature of the worker’s employment, unless the contrary is shown.

Purpose
The purpose of this policy is to outline the prescribed cancers and the circumstances under which they will be presumed to be work-related occupational diseases, as set out in the applicable Regulation.
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
  • workers who:
    • are employed by a band council and assigned to undertake fire protection services on a reserve [band council and reserve are defined in the Indian Act (Canada)], or
    • provide fire protection services on a reserve, either voluntarily or for a nominal consideration, honorarium, training or activity allowance
  • 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
    • who was an inspector appointed under subsection 2(4) of the Fire Marshals Act before that Act was repealed by the Fire Protection and Prevention Act, 1997, or
    • who is employed by a band council and assigned to investigate the cause, origin and circumstances of a fire on a reserve.

For the purpose of this 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.

Presumption

The presumption provides that the prescribed cancers are occupational diseases presumed to occur due to the nature of the worker’s employment as a firefighter or fire investigator, unless the contrary is shown. To qualify for this presumption, workers must meet the inclusion criteria of this policy, and also must have been:

  • diagnosed with a prescribed cancer
  • diagnosed after the prescribed minimum employment duration, 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.

Prescribed cancers

A medical diagnosis of non-Hodgkin’s lymphoma, multiple myeloma, 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 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 brain C71

Malignant neoplasm of brain

2. Primary-site bladder cancer 188 Malignant neoplasm of bladder C67 Malignant neoplasm of bladder
3. Primary-site kidney cancer 189.0 Malignant neoplasm of kidney, except pelvis C64 Malignant neoplasm of kidney, except renal pelvis
189.1 Malignant neoplasm of renal pelvis C65 Malignant neoplasm of renal pelvis
4. Primary-site colorectal cancer 153 Malignant neoplasm of colon C18 Malignant neoplasm of colon
C19 Malignant neoplasm of rectosigmoid junction
154 Malignant neoplasm of rectum, rectosigmoid junction, and anus C20 Malignant neoplasm of rectum
C21 Malignant neoplasm of anus and anal canal
5. Primary non-Hodgkin’s lymphoma (NHL) 200 Lymphosarcoma and reticulosarcoma C82 Follicular lymphoma
C83 Non-follicular lymphoma
202 Other malignant neoplasms of lymphoid and histiocytic tissue C84 Mature T/NK-cell lymphomas
C85 Other and unspecified types of NHL
6. Primary acute myeloid leukemia, Primary acute lymphocytic leukemia, Primary chronic lymphocytic leukemia 205.0 Acute myeloid leukemia C92.0 Acute myeloblastic leukemia
204.0 Acute lymphoid leukemia C91.0 Acute lymphoblastic leukemia
204.1 Chronic lymphoid leukemia C91.1 Chronic lymphocytic leukemia of B-cell type
7. Primary-site ureter cancer 189.2 Malignant neoplasm of ureter C66 Malignant neoplasm of ureter
8. Primary-site esophageal cancer 150 Malignant neoplasm of esophagus C15 Malignant neoplasm of esophagus
9. Primary-site breast cancer 174 Malignant neoplasm of female breast C50 Malignant neoplasm of breast
175 Malignant neoplasm of male breast
10. Multiple myeloma 203.0 Multiple myeloma C90.0 Multiple myeloma
11. Primary-site testicular cancer 186 Malignant neoplasm of testis C62 Malignant neoplasm of testis
12. Primary-site prostate cancer 185 Malignant neoplasm of prostate C61 Malignant neoplasm of prostate
13. Primary-site lung cancer 162 Malignant neoplasm of trachea, bronchus, and lung C33 Malignant neoplasm of trachea
C34 Malignant neoplasm of bronchus and lung
14. Primary-site skin cancer 172** Malignant melanoma of skin C43 Malignant melanoma of skin
173 Other malignant neoplasm of skin C44 Other malignant neoplasms of skin
15. Primary-site ovarian cancer 183.0 Malignant neoplasm of ovary C56 Malignant neoplasm of ovary
16. Primary-site cervical cancer 180 Malignant neoplasm of cervix uteri C53 Malignant neoplasm of cervix uteri
17. Primary-site penile cancer 187.1-187.4 Malignant neoplasm of penis (specifically 187.1, prepuce; 187.2, glans penis; 187.3, body of penis; 187.4, penis, part unspecified) C60 Malignant neoplasm of penis

*International Statistical Classification of Diseases (Ninth and Tenth Revisions).
**The presumption does not apply to melanoma in situ.

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, whether consecutive or non-consecutive. If a worker served 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 band council firefighters and fire investigators, the eligible years of service are those employment periods as described above during which the band council had WSIB coverage, in addition to any periods served in another capacity as defined by the Fire Protection and Prevention Act, 1997.

The minimum durations of employment for the prescribed cancers are listed below.

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
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
9. Primary-site breast cancer 10 years
10. Multiple Myeloma 15 years
11. Primary-site testicular cancer 10 years
12. Primary-site prostate cancer 15 years
13. Primary-site lung cancer 15 years
14. Primary-site skin cancer 15 years
15. Primary-site ovarian cancer 10 years
16. Primary-site cervical cancer 10 years
17. Primary-site penile cancer 15 years

Additional criteria

In addition to the above criteria, for:

  • primary-site colorectal cancer, a diagnosis must be obtained prior to the age of 61 years
  • primary-site lung cancer, the worker must not have smoked a tobacco product in the 10 years prior to diagnosis.

NOTE

For the purpose of this policy, the date of diagnosis is used to determine whether the worker meets the requirements of the presumption (e.g., calculation of duration of employment). Once entitlement is established in a claim, benefits and services generally flow from the date of accident/injury, which may be an earlier date. For more information, see 11-01-04, Determining the Date of Injury.

Time Limits

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 diagnosis is on or after January 1, 1960.

Application date

This policy applies to decisions made on or after July 1, 2018.

Document History

This document replaces 23-02-01 dated January 1, 2017.

This document was previously published as:
23-02-01 dated January 4, 2016 
23-02-01 dated April 27, 2015
23-02-01 dated January 2, 2015
23-02-01 dated July 7, 2014
23-02-01 dated February 23, 2010
23-02-01 dated February 11, 2008
23-02-01 dated October 12, 2004
16-02-02 dated June 15, 1999.

References

Legislative Authority

Workplace Safety and Insurance Act, 1997, as amended
Sections 2(1), 15, 15.1(4), 15.1(5), 15.1(6), 15.2, 94, 183

O.Reg. 253/07 as amended

Minute
Administrative #1, July 3, 2018, Page 561