{"id":4900,"date":"2020-03-21T14:18:39","date_gmt":"2020-03-21T18:18:39","guid":{"rendered":"https:\/\/joemillerinjurylaw.com\/?p=4900"},"modified":"2020-05-26T13:46:17","modified_gmt":"2020-05-26T17:46:17","slug":"the-details-behind-the-jlarc-study-on-virginia-firefighters-and-presumptions","status":"publish","type":"post","link":"https:\/\/joemillerinjurylaw.com\/the-details-behind-the-jlarc-study-on-virginia-firefighters-and-presumptions\/","title":{"rendered":"The Details Behind the JLARC study on Virginia Firefighters and Presumptions"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">The JLARC\u2019s review of Virginia\u2019s <a href=\"https:\/\/joemillerinjurylaw.com\/practice-areas\/workers-compensation\/\">workers\u2019 compensation<\/a> laws focused on a variety of issues including the relationship between firefighting and 10 different types of cancer to determine what presumptions should apply. They study was performed by epidemiologists at <\/span><a href=\"http:\/\/jlarc.virginia.gov\/pdfs\/other\/JHU_Consultant_Report.pdf\"><span style=\"font-weight: 400;\">Johns Hopkins University\u2019s Bloomberg School of Public Health<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">We discussed some of these issues in a <\/span><a href=\"https:\/\/joemillerinjurylaw.com\/occupational-disease-for-first-responders\/\"><span style=\"font-weight: 400;\">previous article<\/span><\/a><span style=\"font-weight: 400;\">. The general findings of the study were as follows:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Current presumptions.<\/b><span style=\"font-weight: 400;\"> 40 states have presumptions for firefighting and cancer. 34 states have presumptions for firefighting and heart disease. 15 states have presumptions for law enforcement and heart disease.<\/span><\/li>\n<li style=\"font-weight: 400;\"><a href=\"https:\/\/law.lis.virginia.gov\/vacode\/title65.2\/chapter4\/section65.2-402\/\"><b>Virginia\u2019s current presumptions<\/b><\/a><b> for first responders<\/b><span style=\"font-weight: 400;\">:<\/span>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Cancer. There are presumptions for breast, leukemia, ovarian, pancreatic, prostate, rectal, and throat cancer<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">There are proposed exemptions, as of 2019, for brain cancer, colon cancer, and testicular cancer<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">There was another proposed exemption for post-traumatic stress syndrome (PTSD)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Cardiovascular disease<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Respiratory disease. Workers generally don\u2019t\u2019 seek to establish this presumption.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Infectious disease. Workers generally don\u2019t seek to establish this presumption.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">83 studies on cancer, heart disease, respiratory disease, and PTSD among firefighters and police officers were analyzed and evaluated for quality and bias.<\/span><\/p>\n<h3><b><i>The findings of the John Hopkins University study<\/i><\/b><\/h3>\n<p><span style=\"font-weight: 400;\">The epidemiologists made the following findings regarding the validity of Virginia\u2019s current and proposed cancer presumptions:<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Johns Hopkins University epidemiologists determined that the best available evidence provides some support for most of Virginia\u2019s current and proposed cancer presumptions.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Firefighters are exposed to carcinogens. Firefighters can\u2019t fully avoid exposure to these carcinogens \u2013 even when they are wearing protective gear.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Every type of fire releases toxic and carcinogenic substance<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">To what extent firefighters are exposed to these carcinogens depends on many factors. The main exposure routes are inhaling these toxins and skin absorption of the carcinogens.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The study found that the firefighters had an increased risk of the following types of cancer:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Prostate cancer<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Throat cancer<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Brain cancer (proposed in 2019)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Leukemia<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Rectal cancer<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Testicular cancer (proposed in 2019)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The Johns Hopkins study did not have enough evidence on the following cancer types:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Colon cancer (proposed in 2019)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Pancreatic cancer<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Breast cancer<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">No research was done on ovarian cancer. This is interesting, since pancreatic cancer and breast cancer are specifically listed in <\/span><a href=\"https:\/\/law.lis.virginia.gov\/vacode\/title65.2\/chapter4\/section65.2-402\/\"><span style=\"font-weight: 400;\">VA Code 65.2-402 ( C )<\/span><\/a><span style=\"font-weight: 400;\"> among those cancers to be presumed to be an occupational disease. As mentioned in a previous article on this subject, the mention of pancreatic cancer is inherently contradictory since it is really impossible to know what caused any pancreatic cancer based on our current state of scientific knowledge.\u00a0<\/span><\/p>\n<h3><b><i>Cancers which should be added to the firefighter presumption lists<\/i><\/b><\/h3>\n<p><span style=\"font-weight: 400;\">The JLARC report, based on the John Hopkins study, recommended that worker\u2019s compensation laws in Virginia create presumptions for the following cancer types:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Brain cancer<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Testicular cancer<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The reports added that colon cancer could be added to the list though the evidence for adding it wasn\u2019t as strong as the other two cancer types.<\/span><\/p>\n<h3><b><i>Recommendations by the JLARC regarding current cancer presumptions for firefighters<\/i><\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Current cancer presumptions which should be maintained or could be subject to a sunset provision depended on the following:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">\u201cBetter data on firefighting-cancer associations will be available after new National Firefighter Registry is fully implemented.\u201d<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">\u201cThe General Assembly could maintain all current cancer presumptions in statute, including those with less scientific evidence, but add a sunset provision. Cancers with weaker scientific evidence to support occupation-disease associations could be removed if new scientific evidence does not increase support for including them.\u201d<\/span><\/li>\n<\/ul>\n<h3><b><i>Costs for adding the three extra cancer presumptions \u2013 brain cancer, testicular cancer, and colon cancer<\/i><\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Enactment of <\/span><a href=\"https:\/\/www.billtrack50.com\/BillDetail\/1001058\"><span style=\"font-weight: 400;\">Virginia House bill 1804<\/span><\/a><span style=\"font-weight: 400;\"> (which adds several cancer presumptions) for firefighter should result in just about six new compensable workers\u2019 compensation claims yearly &#8211; though the five year total is expected to be high.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Insurance premiums for workers\u2019 compensation for firefighters are expected to rise $269 in the first year.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The insurance premium for the Line of Duty Act (LODA) are expected to rise $61 \u201cper FTE in the first year.\u201d<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\u201cSome additional liability would be created for firefighters no longer working with an employer and still within statute of limitations.\u201d<\/span><\/p>\n<h3><b><i>Additional JLARC firefighting presumptions<\/i><\/b><\/h3>\n<p><span style=\"font-weight: 400;\">The JLARC also found that the \u201crequirements to establish cancer presumptions for firefighters are unreasonably burdensome and appear counter to the purpose of the presumption.\u201d This is the same comment I had made in my <\/span><a href=\"https:\/\/joemillerinjurylaw.com\/occupational-disease-for-first-responders\/\"><span style=\"font-weight: 400;\">previous article on this subject<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Most disputed claims by firefighters for Virginia workers\u2019 compensation benefits \u2013 between 2019 to 2018 \u2013 found that the firefighter would not be entitled to benefits \u2013 in large part because of the failure to prove exposure to the right substance.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Of the 20 firefighter\/cancer cases heard during that timeframe:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">13 (65%) did not prove toxic exposure or a disability resulting from the cancer and denied benefits<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">4 (20%) were denied benefits for other reasons<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">4 (20%) did meet the occupational illness requirements and were awarded benefits<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The \u201cpresumption covers firefighters who have had \u201ccontact with toxic substance encountered in line of duty.\u201d A big part of the reason for these denials was that firefighters were required to \u201cprove exposure to <\/span><b>specific carcinogen<\/b><span style=\"font-weight: 400;\"> suspected to cause their particular type of cancer.\u201d\u00a0 \u201cOf 16 cases heard by VWC in which firefighters did not meet all requirements, the firefighter did not meet the toxic exposure requirement in seven.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The Johns Hopkins scientists found that:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">\u201cDocumenting exposure to carcinogens is extremely difficult and costly. Virginia firefighters are not equipped with technology to measure exposure\u201d because the technology is expensive and requires expertise.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The strict requirements are \u201c<\/span><b>counter to the purpose of presumption<\/b><span style=\"font-weight: 400;\">, which is to relieve firefighters of need to prove work caused their disease.\u201d<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The study found that it would be sufficient if firefighters were required to show exposure to hazardous conditions that, in turn, exposed them to carcinogens.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another finding by the JLARC study was that Virginia\u2019s requirement for 12 years of continuous service was not supported by scientific evidence (studies have shown that less service time could cause cancer) and was the highest in the country (the next highest was 20 years). In fact, there is case law that says that assuming there is sufficient proof that a firefighter has a type of cancer caused by exposure to known cancer-causing toxins that match up to that cancer, he or she need only prove ONE SINGLE EXPOSURE to a fire to prove there was sufficient exposure.\u00a0 In that context, the 12 continuous years of service makes little sense.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Virginia workers\u2019 compensation lawyer Joe Miller Esq. has been fighting aggressively for injured workers and workers who suffer occupational illnesses \u2013 for more than 31 years. He understands how dangerous firefighting, policing work, and other types of first response work are. For help with any illness claim based on your work, please phone Joe Miller, Esq., at <\/span><b><a href=\"tel:\/\/888-694-1671\" title=\"888-694-1671\">888-694-1671<\/a><\/b><span style=\"font-weight: 400;\">\u00a0or use my online <\/span><a href=\"https:\/\/joemillerinjurylaw.com\/contact-us\/\"><span style=\"font-weight: 400;\">contact form<\/span><\/a> <span style=\"font-weight: 400;\">to speak with a strong advocate.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The JLARC\u2019s review of Virginia\u2019s workers\u2019 compensation laws focused on a variety of issues including the relationship between firefighting and 10 different types of cancer to determine what presumptions should apply. They study was performed by epidemiologists at Johns Hopkins University\u2019s Bloomberg School of Public Health.\u00a0 We discussed some of these issues in a previous &#8230; <\/p>\n<p class=\"read-more-container\"><a title=\"The Details Behind the JLARC study on Virginia Firefighters and Presumptions\" class=\"read-more button\" href=\"https:\/\/joemillerinjurylaw.com\/the-details-behind-the-jlarc-study-on-virginia-firefighters-and-presumptions\/#more-4900\" aria-label=\"Read more about The Details Behind the JLARC study on Virginia Firefighters and Presumptions\">Read More<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","footnotes":""},"categories":[10,97,31],"tags":[],"uagb_featured_image_src":{"full":false,"thumbnail":false,"medium":false,"medium_large":false,"large":false,"1536x1536":false,"2048x2048":false},"uagb_author_info":{"display_name":"Joe Miller","author_link":"https:\/\/joemillerinjurylaw.com\/author\/jmiller\/"},"uagb_comment_info":0,"uagb_excerpt":"The JLARC\u2019s review of Virginia\u2019s workers\u2019 compensation laws focused on a variety of issues including the relationship between firefighting and 10 different types of cancer to determine what presumptions should apply. They study was performed by epidemiologists at Johns Hopkins University\u2019s Bloomberg School of Public Health.\u00a0 We discussed some of these issues in a previous&hellip;","_links":{"self":[{"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/posts\/4900"}],"collection":[{"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/comments?post=4900"}],"version-history":[{"count":0,"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/posts\/4900\/revisions"}],"wp:attachment":[{"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/media?parent=4900"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/categories?post=4900"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/tags?post=4900"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}