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Cancer: “On-the-Job” Injuries and Workers’ Compensation

Discussion of provisions SB17-214 subsection 13 regarding treatment as on the job illness or injury

There is definitely confusion surrounding this issue so we will clarify our understanding. The issue seems to come up when the phrase “ON-THE-JOB INJURY OR ILLNESS” is taken only in reference to one sentence and outside the context of the whole legislation.

In its entirety Section 13 specifically states that “This Subsection (13) does not affect any determination as to whether the cancer is covered under the “Workers’ Compensation Act of Colorado Articles 40 to 47 of Title 8.” This, in and of itself, should be enough clarity. The complete wording is:

(13) FOR THE PURPOSE OF EMPLOYER POLICIES AND BENEFITS, A CANCER DIAGNOSIS IS TREATED AS AN ON-THE-JOB INJURY OR ILLNESS. THIS SUBSECTION (13) DOES NOT AFFECT ANY DETERMINATION AS TO WHETHER THE CANCER IS COVERED UNDER THE “WORKERS’ COMPENSATION ACT OF COLORADO”, ARTICLES 40 TO 47 OF TITLE 8.

The Colorado Division of Workers’ Compensation added the above highlighted wording specifically to protect this employer designation of “treated as an on-the-job” from being interpreted as work-related for the purposes of workers’ compensation. This is simply a “condition of payment” agreed to by the employer for the sake of argument as reflected in the title of this subsection. The only purpose of the phrase “ON-THE-JOB INJURY OR ILLNESS” in the statute is to ensure that firefighters do not lose the Line of Duty benefit from their employers that are currently held. This Line of Duty benefit is a short term disability treatment typically associated with such an incident, and it varies from one department to another and ranges from nothing to one year’s salary. This subsection does not change Colorado workers’ compensation statute unlike Section 2 below.

As stated, this portion of the legislation does take cancer for firefighters out of WC:

SECTION 2. In Colorado Revised Statutes, 8-41-209, add (4) as follows: 8-41-209. Coverage for occupational diseases contracted by firefighters. (4) AN EMPLOYER WHO PARTICIPATES IN THE VOLUNTARY FIREFIGHTER CANCER BENEFITS PROGRAM CREATED IN PART 4 OF ARTICLE 5 OF TITLE 29 IS NOT SUBJECT TO THIS SECTION UNLESS THE EMPLOYER ENDS PARTICIPATION IN THAT PROGRAM.

By joining the Trust, fire operations no longer have any liability under the 2007 presumption law. To reemphasize, cancer classified as an “ON-THE-JOB INJURY” in Subsection 13 has no bearing given cancer’s exclusion from WC by law. Disease, as a general rule, is not covered by WC except where it can be proven to be work related. If cancer were not excluded from WC, health carriers would have to cover it the same way they did in 2006, and be subject to bad faith claims as they have no basis for denial. The new legislation was built on the premise that employers agreed to certain concessions in exchange for firefighters giving up their rights under the 2007 WC presumption statute:

  • There would be no investigation to determine the cause of the cancer because neither the employer nor the firefighter is conducting an investigation.
  • Employers agree to treat cancer as “in the line of duty,” even though it is debatable. This “Condition of Payment” as stated in the statute is part of the agreement, and does not change the previous WC statute nor does it constitute the burden of proof required under that statute.

A review of one health benefits carrier’s policy exclusions states:

Workers’ Compensation of Employer’s Liability. Financial responsibility for Services for any illness, injury, or condition, to the extent a payment or any other benefits, including any amount received as a settlement (collectively referred to as “Financial Benefits”) is provided under any workers’ compensation or employer’s liability law. We will provide Services even if it is unclear whether you are entitled to a Financial Benefit, but we may recover Charges for any such Services from the following sources

  1. Any source providing a Financial Benefit or from whom a Financial Benefit is due.
  2. You, to the extent that a Financial Benefit is provided or payable or would have been required if you had diligently sought to establish your rights to a Financial Benefit under any workers’ compensation or employer’s liability law.

Under the new legislation, firefighters are spared an invasive inquiry into their personal medical, family, and lifestyle histories to determine the source of the disease. Additionally, firefighters need to be aware that this is not workers’ compensation, but rather coverage that pays out-of-pocket expenses due to a covered cancer diagnosis.

We hope you find this discussion helpful. Please let me know where further clarification can be made. We would like to have this discussion distributed to all interested parties as we understand several of the self-insured share the same concerns.

For a printable version of this discussion, click here.

Discussion of provisions SB17-214 subsection 13 regarding treatment as on the job illness or injury There is definitely confusion surrounding this issue so we will clarify our understanding. The issue seems to come up when the phrase “ON-THE-JOB INJURY OR ILLNESS” is taken only in reference to one sentence and outside the context of the […]

Revised Combined Heart and Cancer Trust Agreement

Since the passing of the Voluntary Cancer Award Program bill earlier this May, the CFH Trust is proud to present the new Revised Combined Heart and Cancer Trust Agreement, which includes the Resolution as well as a checklist for your convenience. Please note that this is prerequisite paperwork to join the heart and/or cancer program, and must be adopted by the Member Governing Body.

Trust Agreement (IGA)

If you have any questions, please contact Mr. Lei Shi toll free at 1-844-769-6650 or directly at 503-943-6649 or email him at [email protected].

Since the passing of the Voluntary Cancer Award Program bill earlier this May, the CFH Trust is proud to present the new Revised Combined Heart and Cancer Trust Agreement, which includes the Resolution as well as a checklist for your convenience. Please note that this is prerequisite paperwork to join the heart and/or cancer program, […]

Governor Hickenlooper Signs Voluntary Cancer Award Program Bill

On May 3, Governor Hickenlooper signed Senate Bill 17-214 during a ceremony in his office. The bill, which had passed the House and Senate unanimously, was the result of more than two years of meetings, discussions, and legislative crafting by a multitude of partners. This new statute will enable the CFH Trust to create a first of its kind program to deliver rapid cancer benefits to firefighters suffering from one of five covered types of cancer: brain, digestive, genitourinary, hematological, and skin.

This program will allow participating fire departments to opt in to the Trust’s new Cancer Program and releases them from the 2007 presumptive cancer statute. This will allow fire departments to reign in workers’ compensation costs while delivering more timely payments to firefighters. In every regard, this is a win for firefighters and fire departments alike. We would like to take this opportunity to thank all contributors for their tireless work and spirit of cooperation in this historic accomplishment.

Going Forward

This news raises a lot of questions regarding how the Trust’s program will operate, and how workers’ compensation providers will respond. Here are a few fast facts to consider for now:

  • The program’s target start date is July 1, 2017, which mirrors the existing Heart Program’s coverage term.
  • Each program will work independently with no requirement to join both.
  • The Trust’s official name will be changed to the Colorado Firefighter Heart and Cancer Benefits Trust (CFHC Trust).
  • While it is not yet known what other workers’ compensation providers will do, the Colorado Special Districts Property and Liability Pool (CSD Pool) will be offsetting 100% of the cost of this coverage for members of its Workers’ Compensation program. For more information regarding this, contact the CSD Pool.
  • Visit this page for additional updates as they become available.
  • Please visit the FAQ for further information
On May 3, Governor Hickenlooper signed Senate Bill 17-214 during a ceremony in his office. The bill, which had passed the House and Senate unanimously, was the result of more than two years of meetings, discussions, and legislative crafting by a multitude of partners. This new statute will enable the CFH Trust to create a […]

Mediterranean Diet Believed to Drastically Reduce Cardiovascular Disease and Cancer

It’s been known for some time now that the Mediterranean diet offers a whole host of health benefits. The food mostly consists of whole-grain bread, vegetables, fruits, beans, and nuts with fish as the primary source of protein. The diet strays away from red meats and processed foods, and several studies in the past decade have produced results suggesting lowered levels of “bad” cholesterol (LDL), decreased risk of metabolic syndrome and unhealthy weight gain.1

It is important to note that some of these studies focused on the firefighter population specifically, and this is due to the reported high prevalence of cardiovascular disease with that profession. In October 2016, in collaboration with Tufts University, the National Institute of Public Safety Health, and the US Department of Homeland Security, the Harvard School of Public Health is conducting a study with the purpose of “[lowering] firefighters’ risks for [cardiovascular disease] and cancer by successfully getting more firefighters and their families to adopt and incorporate the healthy eating principles behind the Mediterranean diet.” The estimated completion date is set for October of 2018, and the study is still open to volunteers who wish to participate. You can view the full eligibility requirements and further details on the study itself here. It is interesting to note that the Harvard Public School of Health conducted a similar study with firefighters back in 2014. The results were generally positive and suggest adherence to the diet may be in our firefighters’ best interests.

Sources: 1. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0087539#s3It’s been known for some time now that the Mediterranean diet offers a whole host of health benefits. The food mostly consists of whole-grain bread, vegetables, fruits, beans, and nuts with fish as the primary source of protein. The diet strays away from red meats and processed foods, and several studies in the past decade […]

Calcium Supplements Potentially Increase Risk of Heart Disease

According to a recent study conducted by researchers from John Hopkins University, Indiana University, UCLA Medical Center, and other institutions, people who take calcium supplements may be at greater risk of heart disease. Published in the Journal of the American Heart Association, the study suggests that calcium supplements contribute to plaque build up in the aorta and arteries, essentially obstructing blood flow 1. This particular build-up is known to cause heart attacks.

The exigency behind this particular study came from previous research on the effects of calcium supplements on the human body. Researchers have found mounting evidence that the body metabolizes calcium supplements differently than calcium-rich foods such as dairy products or vegetables; instead of accumulating in bones, calcium supplements seem to accumulate in muscle and soft tissue 2. Based on their findings, researchers highly recommend people seeking to supplement their calcium intake to discuss it with their physicians first.

You can view the study in its entirety here.

Sources:
  1. http://www.hopkinsmedicine.org/news/media/releases/calcium_supplements_may_damage_the_heart
  2. https://www.washingtonpost.com/national/health-science/calcium-supplements-may-raise-risk-of-heart-disease/2016/10/17/a80285fe-9215-11e6-9c52-0b10449e33c4_story.html?utm_term=.afe127a6f77f
According to a recent study conducted by researchers from John Hopkins University, Indiana University, UCLA Medical Center, and other institutions, people who take calcium supplements may be at greater risk of heart disease. Published in the Journal of the American Heart Association, the study suggests that calcium supplements contribute to plaque build up in the […]