Will Virginia Join the First Responder Presumption Parade?

13 Jan, 2020 Bob Wilson


This past December, findings of a Joint Legislative Audit and Review Commission (JLARC) study that reviewed Virginia’s Workers’ Compensation System and Disease Presumptions was released. To no one’s surprise, the study found that “too often information about workers compensation is unclear, confessing that recommendations and several changes should be made to the current laws.” It also found that “even with protective gear, firefighters are exposed to carcinogens.” 

It recommended that brain and testicular cancers should be added to the list that qualify firefighters for workers compensation. It also suggests that the state make it easier for firefighters to prove they were exposed to toxins.

Oh, my. Who could have seen this coming? 

There has been a tremendous surge in the establishment of automatic presumption laws for first responders across the country in the past couple years. This is especially true for firefighters. In many states, a broad range of conditions, from a variety of cancers to cardiovascular conditions, are now automatically covered for people in these roles. In many cases the benefit coverage for first responders is 24/7; a heart attack while cleaning a garage, fishing or even having sex can automatically qualify for workers’ compensation benefits in some states. 

Many people believe that firm and established science is behind the political decisions that implement these types of benefits. The reality, however, in many cases is that the emotional argument for supporting those on the front line of emergencies carries more weight. Firefighters don’t have better science behind their argument for benefits. They have better lobbyists than other groups.

Even the JLARC study that is recommending expanded coverage (available here) in Virginia fails to offer substantive research that definitively establishes connections between workplace exposures and causation of specific diseases. It admits that “research is mixed on the extent of a causal connection between firefighting and the 10 existing and proposed cancer presumptions.” It continues with: 

Although mixed, the existing research is sufficient to support a plausible connection between firefighting and the cancers currently included as presumptive diseases in the Code of Virginia. A plausible connection also exists between firefighting and three cancers that House Bill 1804 (2019) proposed adding to Virginia’s statute: colon, testicular, and brain cancer. Among these three, the evidence of a link between firefighting and colon cancer is the least strong but still plausible according to epidemiological research. 

OK, so there is a plausible, possible, potential connection between firefighter workplace activities and getting some type of cancer somewhere in or on your body. And even though there is even less evidence of a connection to colon cancer, it should still be included.

Because a commission of non-medical people chooses to move forward without definitive science to back up their recommendations. The report points out that current requirements in Virginia to establish cancer presumptions are unreasonably burdensome and not supported by science. 

The same could be said toward the automatic presumption argument. Plausibility is not proof of anything.   

There will be some who take me to task on this viewpoint. They will point out that strong plausibility’s are enough indication to support a proactive view on benefits for these conditions. It should be noted that the study also states that the risk of cardiovascular disease for public sector employees increases with years of service. That is absolutely true. Highly plausible. And wholly inaccurate when used out of context.

The risk of cardiovascular disease increases for EVERYONE with years of service. It even increases for those who are not engaged in any service or are completely unemployed. Sitting at my desk for years in a sedentary job has increased my risk of cardiovascular disease, but that doesn’t mean my job is to blame. 

It means I have gotten older, and with that aging the risk of cardiovascular disease increases. As a private sector employee, it means I am on my own. A public sector employee in many states now has coverage not afforded lesser souls. It is not so much science that is driving this phenomenon as it is politics. 

Nonetheless, it appears that Virginia is bound on the path of other states in the establishment of a two-tier benefits system; one that provides benefits largely based on job title alone.  

And we shouldn’t find that a plausible arrangement at all. 


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