US Senate backs firefighter cancer PSOB expansion in National Defense Authorization Act

NDAA adds PSOB presumption for firefighter cancer

The National Defense Authorization Act (NDAA) passed by Congress includes statutory text titled the Honoring Our Fallen Heroes provision, which amends the federal Public Safety Officers’ Benefits programme.

The change is set out in Section 1098 of the bill and adds a new subsection on “exposure-related cancers” to the PSOB law.

For firefighters, the provision directly addresses occupational cancer linked to repeated exposure to carcinogens encountered during emergency response, training and post-incident activities.

The statutory presumption recognises firefighter cancer as a potential line-of-duty injury for PSOB purposes when the eligibility conditions set out in the law are met.

What the bill changes in law

The bill states that “the exposure of a public safety officer to a carcinogen shall be presumed to constitute a personal injury” sustained in the line of duty and resulting in death or permanent and total disability, if the statutory conditions are met.

The bill defines “carcinogen” as an agent classified by the International Agency for Research on Cancer (IARC) under Group 1 or Group 2A and “reasonably linked to an exposure-related cancer”.

Eligibility time limits in the statute

The presumption applies if the exposure occurred while the public safety officer was engaged in a line of duty action or activity.

The bill states the public safety officer must have begun serving “not fewer than 5 years before the date of the diagnosis” with an exposure-related cancer.

The bill states the officer must be diagnosed “not more than 15 years after the public safety officer’s last date of active service”.

The bill states the exposure-related cancer must “directly and proximately” result in death or permanent and total disability.

When the presumption does not apply

The bill includes an exception stating that the presumption “shall not apply” if competent medical evidence establishes the carcinogen exposure “was not a substantial contributing factor” in the death or disability.

Cancers listed in the bill

The bill defines “exposure-related cancer” as a list that includes bladder cancer, brain cancer, breast cancer, cervical cancer, colon cancer, colorectal cancer, esophageal cancer, kidney cancer, leukemia, lung cancer, malignant melanoma, mesothelioma, multiple myeloma, non-Hodgkins lymphoma, ovarian cancer, prostate cancer, skin cancer, stomach cancer, testicular cancer and thyroid cancer.

The definition also includes “any form of cancer that is considered a WTC-related health condition” under the World Trade Center Health Program statute.

The bill also includes “any form of cancer added” through future updates.

Updates, evidence base and petitions

The bill requires that “from time to time but not less frequently than once every 3 years” the Director must review the definition of exposure-related cancer and update it where appropriate.

The bill states updates must be based on competent medical evidence showing significant risk to public safety officers from engagement in public safety activities.

The bill lists examples of evidence sources that may inform updates, including recommendations, risk assessments and scientific studies by the National Institute for Occupational Safety and Health, the National Toxicology Program, the National Academies of Sciences, Engineering, and Medicine and the International Agency for Research on Cancer.

The bill also states that any person may petition the Director to add a form of cancer to the definition, with a 180-day referral requirement for petitions that satisfy the content standard described in the statute.

Backdated applicability and claim window

The bill states the amendment applies to claims predicated on the death of a public safety officer on or after 1 January 2020 where the death is the direct and proximate result of an exposure-related cancer.

The bill also states it applies to a disability claim filed on or after 1 January 2020 where the disability is the direct and proximate result of an exposure-related cancer.

The bill adds that an individual seeking to file a claim predicated on the amendment is allowed to do so “within 3 years of the date of enactment”.

IAFC welcomes inclusion in the NDAA

Fire Chief Trisha L. Wolford, President and Board Chair of the International Association of Fire Chiefs, said: “The IAFC is grateful to see the Honoring Our Fallen Heroes Act included in the NDAA and on its way to being signed into law.

“This long-overdue reform ensures that the families of fire, law enforcement, and EMS personnel who die or become disabled from occupational cancer receive the federal benefits they deserve.

“By including occupational cancers in the Public Safety Officers’ Benefits program, Congress is honoring the sacrifices made by our fallen heroes and standing firmly with the families they leave behind.

“We commend the bipartisan champions, including Representatives Mary Gay Scanlon and Carlos A. Gimenez, the bill’s House sponsors, and Senators Amy Klobuchar and Kevin Cramer, the bill’s Senate sponsors, who advanced this critical measure and thank lawmakers in both chambers for their commitment to our nation’s fire and EMS personnel.”

IAFF calls it a turning point for PSOB

General President Edward Kelly, International Association of Fire Fighters, said: “We know the devastation occupational cancer has brought to our profession.

“When a fire fighter dies from job-related cancer, that is a line-of-duty death – and it is long past time the federal government recognized that truth.

“Congress’s passage of the Honor Act marks a significant turning point.

“This legislation ensures our fallen are honored, and their families are not left behind.”

Kelly added: “This was a truly bipartisan effort, and I want to thank those lawmakers on Capitol Hill – both Republican and Democrat – who stood with us on this critical legislation.

“I also want to thank President Trump, whose support was crucial in passing what is easily one of the most impactful pieces of legislation in our union’s history.”

Relevance for fire and safety professionals

Fire and rescue leaders, occupational health teams and HR functions may want to brief staff on the statutory time limits, particularly the five-year minimum service requirement before diagnosis and the 15-year limit after the last date of active service.

Departments supporting bereaved families may want to check how the bill’s applicability language linked to 1 January 2020 interacts with the additional three-year filing window tied to the date of enactment.

Services with exposure recording systems may also want to review how the bill defines carcinogen and how the PSOB presumption can be rebutted through competent medical evidence, as this will shape the documentation expected in claims.

This article was informed by the bill text and statements from the International Association of Fire Chiefs and the International Association of Fire Fighters.