Ask any firefighter how they believe they will die, and they are unlikely to say by fire. They know they are far more likely to die of something that destroys the body much slower: cancer.
Firefighters do not have to enter a burning building to inhale the hazardous chemical substances in plumes of smoke, such as benzene, formaldehyde or asbestos. If not adequately cleaned, chemicals on gear or equipment can also quickly contaminate vehicles, the fire station or a firefighter’s home, leading to dangerous contact with the skin even after work is done.
Maine law recognizes that firefighters are at higher risk of certain types of cancers than the general population. That’s why it assumes that firefighters who develop specific cancers and meet other requirements got sick as a result of their employment, entitling them to workers’ compensation benefits to cover their medical costs or lost wages.
That is, unless their employer challenges the idea that the employee got cancer in the line of work, setting up the potential for a protracted fight during a time of illness. Newly produced data show that a challenge is almost always what firefighters with cancer are getting.
Over the past decade, all but one of the 34 Maine firefighters who submitted cancer claims saw their employers oppose their request for benefits, according to the Maine Workers’ Compensation Board. The initial denials required firefighters to sometimes wait many months before their claims were ultimately determined to be valid.
The process gave employers an almost one-in-three chance of winning but not because the firefighters pushed back. Rather, of the 33 firefighters between Jan. 2013 and March 2023 who faced a challenge from their employer, nine then walked away, resulting in no payment.
Another 18 ultimately won payment, and six are still in the dispute resolution process at the workers’ compensation board.
The data came to light after James Pineau of Orono filed a public records request for the information with the board. He wanted to see the numbers, he said, after his brother, who has served at a number of Maine fire departments over 30 years, received an immediate denial of benefits after being diagnosed with colorectal cancer. Pineau has watched the adversarial process play out for his brother, who declined an interview and to be named since he is appealing the denial of his claim.
Many firefighters view the presumption of benefits in Maine law as an empty promise.
The denials are “insulting to the fire service and the sacrifice that those men and women have put in,” said Jared Willey, president of the Bangor Professional Firefighters Association IAFF Local 772. “You’ve dedicated your mind, body and soul. You have bled for the community … and when you need the community or you need the city to now back you and invest in you, [they] run away, denying the claim, hoping you bow your head and walk away.”
Generally, the process works this way, said John Rohde, executive director of the Maine Workers’ Compensation Board: Employees injured on the job must report it to their employer, which, for firefighters, is usually a municipality. The employer then lets their insurer know. Many municipalities get their workers’ compensation coverage through the Maine Municipal Association. The association declined an interview.
If the employee is seeking benefits for time lost from work, the insurer must make a payment or deny the claim within 14 days. Insurers can deny claims while they investigate medical records. They can also later voluntarily pay claims that they initially denied.
Many municipal employers may balk at the idea of incurring costs that could get passed on to property taxpayers. The annual direct cost of a single workers’ compensation claim for cancer is estimated at an average of about $163,000, according to the Occupational Safety and Health Administration’s injury estimator tool. What employers actually pay depends on their insurance policy.
Pineau questioned why the process allows insurers to deny without evidence. His brother’s benefits were denied through a “notice of controversy” because there was “no causal relationship and no medical evidence of injury.” That means there wasn’t documentation showing the cancer was connected to his employment. But his brother had not yet been asked to provide any evidence.
“What I would love to see is you get a letter … saying, ‘We have received your claim for workers’ compensation. We would like you to submit evidence.’ But they immediately get a notice of controversy,” Pineau said.
Maine law states there is a “rebuttable presumption” that firefighters contracted cancer in their job, but they still have to meet certain criteria to qualify for workers’ compensation benefits.
They need to have worked as a firefighter for at least five years. Eleven different cancers are covered. They have to affirm that their cancer is not likely to be inherited and that they have had no substantial exposures to carcinogens other than through firefighting. Firefighters also must have been tested previously to establish a baseline for when they did not have cancer.
As Rohde explained it, the “rebuttable presumption” in law shifts the burden of proof, so the employee doesn’t have to prove the cancer is work related. Rather the employer has to prove it’s not.
Disproving a cancer claim can take awhile. In one instance recalled by Willey, with the Bangor department’s union, it took two years for a longtime firefighter with brain cancer to win benefits, and he died.
“It’s a long, drawn-out process. They don’t treat it anything like breaking a leg on duty,” he said.
There are steps fire departments can take to increase firefighters’ odds of winning a cancer claim, but they are more likely to be pursued by bigger departments with full-time firefighters.
For instance the Bangor Fire Department gives their employees the option to be tested to confirm they are clear of cancer, to establish the required baseline in case they ever need to file a cancer claim. It’s paid for by the city, Willey said.
But smaller towns, with volunteer firefighters, are less likely to pay for cancer screenings, putting the onus on individual firefighters to take the step themselves. Getting tested without symptoms isn’t always covered by health insurance, especially for those who have not reached a certain age, Willey said.
“The odds of most municipalities being able to afford physicals for volunteer firefighters to establish that baseline are extremely unlikely. It really comes down to the educational piece,” said William St. Michel, executive director of the Maine Fire Chiefs’ Association and former chief of Durham Fire and Rescue.
To qualify for the presumption, firefighters must have a history of regularly responding to fires or other emergency calls. But if firefighters don’t keep track of specific activities, or don’t have a detailed job description, it can be harder to show later on that they were likely exposed to potential carcinogens while doing their work, Michel said.
It’s become such an issue that there are now phone apps to help firefighters document each exposure, in the event they one day develop cancer and begin a new type of fight.
