Cancer and Chronic Illness Presumptions in Workers’ Compensation


Cancer is known to affect 40% of the population at some point in their lifetime, with men facing a slightly higher risk than women, according to the National Cancer Institute. While many elements play into the development of cancer including age, lifestyle, diet, genetics and environment; one's workplace can also be a factor in a cancer diagnosis. High-risk occupations for cancer include first responders, airline pilots, construction workers, and military members. Even white-collar jobs with prolonged sitting can increase risk with higher blood pressure, blood sugar, and an overall sedentary lifestyle. As research evolves on work-related cancers, state and federal authorities have utilized the workers' compensation system to enhance protections for workers most at risk of cancer from their work-related duties.  

IWP's newest whitepaper gives readers an overview of current and proposed cancer presumptions amongst U.S. states. The whitepaper focuses on occupations more at risk of developing cancer, primarily first responders. While most states have cancer protections/presumptions for first responders, each piece of legislation can range significantly in coverage allotted and vary in qualifications as well as restrictions. Judicial implications are also reviewed in this piece displaying certain states' interpretations of how the statutes are read and understood.


Since 2021, over 20 states have enacted or proposed legislation for cancer presumptions. These presumptions would allow certain workers who suspect their illness is primarily from their job duties to qualify for workers' compensation benefits with a lower burden of proof standard. Some examples include:

  • Arizona, Maine, and Oregon recently passed cancer protections for female firefighters. In a historically male-dominated occupation adding female-related cancers to each state’s presumption list provides more comprehensive coverage.
  • Washington state approved a cancer presumption for nuclear waste workers, straying outside the first responder category.
  • California lawmakers are mulling a presumption for healthcare staff which already received approval from the state senate.

 The effects of covid-19 have prompted statehouses nationwide to reconsider existing presumption laws. However, state presumptions operate in their own unique fashion requiring certain conditions be met to qualify. Some common eligibility standards include:

• A minimum of five years' service with some states like Wisconsin requiring ten.
• Age limits are also enforced as several states don't allow claims from those over the age of 65.
• Cancers or chronic disease compensability vary from state to state. Some states will cover only a specific set of cancers.

Workers' compensation gives workers in high-risk categories, particularly first responders, some enhanced coverage. Unfortunately, the coverage qualifications can be significantly limited at times, leaving out several workers affected by cancer. Workers at higher risk of cancer should look to their state statutes and policies to understand how their state interprets cancer presumptions. 


Read the White Paper

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