This page offers answers to frequently asked questions about what is specifically covered under this program and how to obtain coverage.
Q: What conditions qualify for benefits?
A: “Heart and Circulatory Malfunction” refers only to a sudden and serious malfunction of the heart and circulatory system as occurs in a diagnosis of coronary thrombosis, cerebral vascular accident, myocardial infarction, and cardiac arrest. Heart and Circulatory Malfunction does not refer to conditions such as hypertension and angina.
Q: What are the coverage restrictions?
A: In order to be covered, an employee must have:
- 5-years continuous service as a firefighter
- Medical exam prior to a heart condition that would have reasonably found the condition
- Discovery of a covered condition within 48-hours of a work event
Q: Can I cover all of my firefighters?
A: Every firefighter is eligible for coverage eventually. In order to be eligible for coverage, a firefighter must fall into one of two criteria:
- Career Firefighters with 5 or more continuous years of service with any employer in a full-time capacity (1,600 hours served or more)
- Volunteer or Part-Time Firefighter with 5 or more continuous years of service with the same employer
Even with this, note that only coverage for career firefighters is eligible for reimbursement from DOLA. Your department can elect to cover Volunteers and Part-Time firefighters and carry the cost for that coverage.
Q: What are the coverage offsets?
A: The coverage is offset in two ways:
- Coverage is offset by any other employer paid disability plan such as workers’ compensation, FPPA, Social Security Disability, or retirement plan
- If a firefighter is a smoker, benefit levels are reduced by 25%
Q: What is the employer responsible for?
A: The statute requires a $250,000 Claim Limit inclusive of all payments. Payments will apply as follows:
- $4,000 award where medical analysis reveals a “Heart or Circulatory Malfunction” exists and, where applicable, any one of the next three conditions are also present:
- $1,500 per week up to seven weeks for Emergency Room visit with admittance for less than 48-hours for a “Heart or Circulatory Malfunction”
- $2,000 per week for up to 25 weeks for Emergency Room visit with admittance for more than 48-hours for a covered “Heart or Circulatory Malfunction”
- $2,500 payment up to a maximum of 80 weeks for a covered “Heart or Circulatory Malfunction” that prohibits a firefighter from returning to employment to a position that the firefighter is trained for, or could reasonably be trained to perform
- $25,000 Rehabilitative Employment services relating to “Heart or Circulatory Malfunction”
- $10,000 Cosmetic Disfigurement resulting from a “Heart or Circulatory Malfunction”
- $25,000 Accelerated Benefit is an advanced payment if the firefighter’s illness is terminal (not additional funds)
- Any disputes that cause a legal action
Q: How can coverage be purchased?
A: The Colorado Firefighter Heart and Circulatory Benefits Trust is being formed through Intergovernmental Agreement (IGA) by Colorado public entities to cover the required benefits of CRS 29-5-302. The projected cost is $175 per firefighter. Each entity’s Board of Directors must adopt a resolution to join the Trust, sign the IGA, and remit funds prior to coverage inception. A Contribution Proposal and IGA with a member resolution will be sent to all known eligible employers of firefighters who qualify for this coverage. If information is not received by December 1, 2014, please contact us for the information.
Q: How does the Reimbursement Work?
A: See the Reimbursement information page for more information.
