Cancers in Firefighters and Fire Investigators - Archived April 27, 2015

Policy

If a full-time, part-time or volunteer firefighter or a fire investigator suffers from and is impaired by one of the prescribed cancers described below, and meets the conditions related to duration of employment and age outlined in the applicable Regulation, the disease is presumed to be an occupational disease due to the nature of the worker’s employment, unless the contrary is shown.

Prescribed cancers include:

  • primary cancers of the brain, bladder, kidney, colon/rectum, ureter, esophagus, testis, breast, prostate
  • primary non-Hodgkin’s lymphoma,
  • multiple myeloma and
  • three specified primary leukemias

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.

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    • a worker who was an inspector appointed under subsection 2(4) of the Fire Marshals Act before that Act was repealed by the Fire Protection and Prevention Act, 1997.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, 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 listed in the Regulation are listed below with their World Health Organization classification numbers.

Prescribed CancerICD-9 Code*Description of ICD-9 CodeICD-10 Code*Description of ICD-10 Code
1. Primary-site brain cancer191Malignant neoplasm of the brainC71Malignant
neoplasm of the brain Excludes: cranial nerves and retrobulbar tissue
2. Primary-site bladder cancer188Malignant neoplasm of the bladderC67Malignant neoplasm of the bladder
3. Primary-site kidney cancer189Malignant neoplasm of the kidney and other and unspecified urinary organsC64Malignant neoplasm of the kidney
C65Malignant neoplasm of the renal pelvis
4. Primary-site colorectal cancer153Malignant neoplasm of colonC18Malignant neoplasm of the colon
C19Malignant neoplasm of the rectosigmoid junction
154Malignant neoplasm of rectum, rectosigmoid junction and anusC20Malignant neoplasm of the rectum
C21Malignant neoplasm of the anus and the anal canal
5. Primary non-Hodgkin’s lymphoma (NHL)200Lymphosarcoma and reticulosarcomaC82Follicular (nodular) NHL
C83Diffuse NHL
202Other malignant neoplasm of lymphoid and histiocytic tissue (i.e. nodular lymphoma)C84Peripheral and
cutaneous T- cell lymphomas
C85Other and
unspecified types of NHL (i.e. lymphosarcoma)
6. Primary acute myeloid leukemia, Primary acute lymphocytic leukemia, Primary chronic lymphocytic leukemia205.0Acute myeloid leukemiaC92.0Acute
lymphocytic leukemia
204.0Acute lymphoid leukemiaC91.0Acute
lymphocytic leukemia
204.1Chronic lymphoid leukemiaC91.1Chronic
lymphocytic leukemia
7. Primary-site ureter cancer189.2Malignant neoplasm of the ureterC66Malignant neoplasm of the ureter
8. Primary-site esophageal cancer150Malignant neoplasm of the esophagusC15Malignant neoplasm of the esophagus
9. Primary-site breast cancer174Malignant neoplasm of female breastC50Malignant neoplasm of breast
175Malignant neoplasm of male breast
10. Multiple myeloma203Multiple myelomaC90Multiple myeloma
11. Primary-site testicular cancer186Malignant neoplasm of testisC62Malignant neoplasm of testis
12. Primary-site prostate cancer185Malignant neoplasm of prostateC61Malignant neoplasm of prostate

*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 CancerDuration of Firefighting Employment
1. Primary-site brain cancer10 years
2. Primary-site bladder cancer15 years
3. Primary-site kidney cancer20 years
4. Primary-site colorectal cancer10 years (diagnosed prior to 61st birthday)
5. Primary non-Hodgkin’s lymphoma20 years

6. Primary acute myeloid leukemia
Primary chronic lymphocytic leukemia
Primary acute lymphocytic leukemia

15 years
7. Primary-site ureter cancer15 years
8. Primary-site esophageal cancer25 years
9. Primary-site breast cancer10 years
10. Multiple myeloma15 years
11. Primary-site testicular cancer10 years
12. Primary-site prostate cancer15 years

The Presumption and its Rebuttal

This policy is based on O. Reg. 253/07 as amended by O. Reg. 423/09 and O. Reg. 113/14 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 January 1, 2015.

Document history

This document replaces 23-02-01 dated  July 7, 2014.

This document was previously published as:
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 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 and O. Reg. 113/14

Minute

Administrative
#5, November 7, 2014, Page 519

This policy was archived on April 27, 2015