Firefighters are the unsung heroes of our communities, rushing into danger to protect lives and property. These brave men and women face not only immediate risks but also long-term health hazards from exposure to toxic substances. The silent killer of cancer stalks firefighters long after the flames are extinguished, a grim reminder of their selfless service.
In Tennessee, the law recognizes the pitfalls of this grave injustice and recognizes “presumptive coverage” for a handful of long-term health conditions – including cancer. This legislation acknowledges the inherent risks of the profession and provides crucial support to those who sacrifice so much. As we explore this vital issue, we must ask ourselves: don’t those who protect us deserve protection in return?
Why “Presumptive Coverage” Matters for Firefighters
When we think of the risks of firefighters, most people immediately think of the direct impact of fire, smoke, and crumbling buildings: crushed bones, burns, or a punctured lung can usually be directly attributed to a specific incident during a certain shift.
Unfortunately, not all dangers faced by firefighters are as clear-cut. This profession also faces one of the nation’s highest rates of cancer, heart disease, and even mental health issues. But these are usually chronic diseases that take years to develop – and therefore, traditional legislation on occupational hazards usually overlooks them.
And yet, we now know that fire safety equipment secretes large amounts of PFAS (per- and poly-fluoroalkyl substances), which are known carcinogens. Without presumptive coverage, a firefighter who has been diagnosed with cancer must then prove that they contracted it due to prolonged and unusual exposure to a toxic agent.
Presumptive coverage laws eliminate the need for exhausting battles with bureaucracy during an already challenging time. Instead, they place the onus on insurers, who now have to present evidence that it didn’t.
Presumptive Coverage in Tennessee: What’s Covered and When
For Tennessee firefighters, most protections for on-the-job injuries are outlined in Title 7 of the Tennessee Code. This bill specifies that any first responders employed by the State government or any municipal corporation within the state can receive a maximum benefit of $250,000 in worker’s compensation. This benefit can be awarded as a one-time payout, or in annual installments of $50,000 for five consecutive years.
When it comes to long-term health hazards, current legislation protects firefighters who contract “cancers caused by chemical exposure,” as well as PTSD and blood-borne infections.
Here, we should highlight the wording of the cancer presumption benefit, which specifies that this condition will be presumed as contracted on the job unless the contrary is shown by competent medical evidence.
As of early 2024, Tennessee also recognizes Post-Traumatic Stress Disorder as an occupational hazard, although its presumptive coverage is significantly more restricted. According to the latest version of the James Samples Act, this benefit will apply to firefighters who:
- Witnessed the death of a minor
- Witnessed a death that involved serious bodily injury
- Witnessed a fellow responder, co-worker, or family member come to harm while responding to a call
Firefighters who develop PTSD after such an incident will have their treatment covered as an occupational injury, and will be deemed eligible for temporary disability over it. Fire departments that offer mental health resiliency training to their employees will be eligible for special grants, which will help foot the financial burden of this coverage.
Finally, any emergency rescue workers employed by their municipal corporation (rather than a local hospital), and who contract HIV or Hepatitis B during their service, will also be covered. However, they will need to document first that they repeatedly responded to calls that involved contamination with bodily fluids.
But What’s Missing?
Although much more advanced than neighboring states, the current Legislation in Tennessee drops the ball in one key aspect: Volunteers. In the Volunteer State, presumptive coverage laws only recognize compensation for full or part-time employees of municipal corporations. Volunteer firefighters, on the other hand, are still left unprotected.
