Presumptive Coverage : AFFES Q + A
Presumptive Coverage Staff Q&A’s, October 29, 2024 (**New** See Q&A’s 10-15):
Presumptive Cancers and Heart Injuries
What is meant by presumptive coverage?
On May 1, 2024, Ontario Regulation 253/07 (the Regulation) was amended to extend existing presumptive coverage for designated cancers and heart injuries to Wildland Firefighters and Wildland Fire Investigators. This means that if a Wildland Firefighter or Fire Investigator is diagnosed with a presumptive cancer or sustained a heart injury and meets all other relevant criteria for the cancer or heart injury, the illness/injury is presumed to be work-related, unless proven otherwise.
Presumptive coverage reduces time and complexity for individuals filing claims, making it easier for Wildland Firefighters and Fire Investigators to access WSIB benefits and services.
However, if a claim does not qualify for the presumption, it is then determined on its individual merits (i.e., case-by-case basis).
Why are Wildland Firefighters and Investigators being included in the presumptive coverage now?
Recent scientific sources, such as the July 2023 report by the International Agency for Research on Cancer (IARC) on occupational exposure as a firefighter, do not distinguish between Wildland Firefighters and municipal firefighters. A growing body of research has shown that firefighters, including Wildland Firefighters, are at increased risk of developing certain cancers.
Which staff are eligible for presumptive coverage?
Former and current MNRF employees who meet the definition of either “Wildland Firefighter” or “Wildland Fire Investigator” in the Regulation and have been diagnosed with one of the presumptive cancers, or sustained a heart injury, on or after January 1, 1960, and meet all other relevant criteria (e.g. minimum of 10-20 years employment depending on the presumptive cancer) are eligible for presumptive coverage.
I am currently employed as a Wildland Firefighter or Wildland Fire Investigator and have a pending WSIB claim for one of the presumptive cancers or a heart injury. What happens with my claim?
Any pending claims that are eligible for presumptive coverage (see Q3 above) will be decided by the WSIB based on the new rules set out in the Workplace Safety and Insurance Act and the Regulation.
For any questions related to a specific claim, please call the WSIB at 1-800-387-0750, Monday to Friday 7:30 a.m. to 5 p.m., and your inquiry will be directed to the appropriate WSIB decision-maker.
I am currently employed as a Wildland Firefighter or Wildland Fire Investigator and have a previously denied WSIB claim for one of the presumptive cancers or a heart injury. What happens in this case?
Any previously denied claims that are eligible for presumptive coverage (see Q3 above) will be reconsidered based on the new rules set out in the Workplace Safety and Insurance Act and the Regulation. The WSIB will review any past claims where a decision may need to be reconsidered based on the expanded coverage. The WSIB will reach out to you about your claim.
If you do not hear from the WSIB, feel free to call the WSIB at 1-800-387-0750, Monday to Friday 7:30 a.m. to 5 p.m., and your inquiry will be directed to the appropriate WSIB decision-maker.
What are the prescribed circumstances for heart injuries?
Section 3 of the Regulation sets out that a worker must have sustained a heart injury while, or within 24 hours of,
(a) attending a fire scene in the performance of their duties or
(b) actively participating in a training exercise that is related to duties and that involves a simulated fire emergency.
What are the presumptive cancers and the minimum duration of employment prior to diagnosis for the presumptive diseases?
The presumptive cancers and minimum durations of employment for the list of presumptive diseases are listed below:
Presumptive Cancer
Duration of Firefighting Employment Prior to Diagnosis**
Primary-site brain cancer - 10 years
Primary-site bladder cancer - 15 years
Primary-site kidney cancer - 20 years
Primary-site colorectal cancer - 10 years
Primary non-Hodgkin’s lymphoma - 20 years
Primary acute myeloid leukemia - 15 years
Primary chronic lymphocytic leukemia - 15 years
Primary acute lymphocytic leukemia - 15 years
Primary-site ureter cancer - 15 years
Primary-site esophageal cancer - 15 years
Primary-site breast cancer - 10 years
Multiple Myeloma - 15 years
Primary-site testicular cancer - 10 years
Primary-site prostate cancer - 15 years
Primary-site lung cancer - 15 years
Primary-site skin cancer - 15 years*
Primary-site ovarian cancer - 10 years
Primary-site cervical cancer - 10 years
Primary-site penile cancer - 15 years
Primary-site pancreatic cancer - 10 years
Primary-site thyroid cancer - 10 years
If I meet the eligibility criteria, is it still possible that the presumption could be rebutted?
Yes, it is possible that Wildland Firefighters or Wildland Fire Investigators who meet all the applicable criteria for the presumption could be rebutted.
For heart injuries, the presumption may be rebutted by the WSIB if the adjudicator determines that the employment was not a significant contributing factor to the heart injury.
For occupational cancers, the presumption may be rebutted by the WSIB if the adjudicator determines that the Wildland Firefighter or Wildland Fire Investigator either had negligible exposure or was never exposed to the hazards of a fire scene, or the employment was not a significant contributing factor.
I am a current employee and I am worried about my health now that we know that there is a potential risk for occupational cancer or heart injuries. Who can I talk to or what safety precautions are being taken to support me?
If you have any concerns, you are encouraged speak with your manager. Additionally, the Employee and Family Assistance Program (EFAP) offered through TELUS Health, also provides all OPS employees with 24/7 professional, confidential support services including counseling, programs and resources to the employee and eligible dependents at no cost to the Employee and they can be connected anytime at 1-833-371-1662.
Please know that the ministry takes the health and safety of all staff very seriously and is working continually to ensure the safety of all staff. If you have any questions, please speak with your manager.
Presumptive Post-Traumatic Stress Disorder (PTSD) **NEW**
10. What legislation was amended to expand presumptive PTSD to Wildland Firefighters and Wildland Fire Investigators?
As part of the Working for Workers 5 package which received Royal Assent on October 28, 2024, section 14 of the Workplace Safety and Insurance Act (WSIA) was amended to include Wildland Firefighters and Wildland Fire Investigators to the list of workers eligible for presumptive coverage for PTSD. (**Please note, it may take some time for the changes to be reflected online)
I am a Wildland Firefighter or Wildland Fire Investigator with a PTSD diagnosis—will the presumption apply to my claim?
In order to be eligible for the presumption, a Wildland Firefighter or Wildland Fire Investigator must have been a worker for at least one day on or after October 28, 2022 (This is called ‘transition day’ which is defined as the day that is 24 months before the day that the Bill receives Royal Assent (RA)).
If the worker:
Is a Wildland Firefighter or Wildland Fire Investigator at the time of filing the claim, the diagnosis must have been made on or after October 28, 2022.
Ceased being a Wildland Firefighter or Wildland Fire Investigator on or after October 28, 2024, then the diagnosis must have been made on or after October 28, 2022 but no later than 24 months after the worker ceased to be a Wildland Firefighter or Wildland Fire Investigator.
Ceased being a Wildland Firefighter or Wildland Fire Investigator on or after October 28, 2022 but before October 28, 2024 then the diagnosis must have been made on or after October 28, 2022 and no later than 24 months after October 28, 2024.
I am a Wildland Firefighter or Wildland Fire Investigator with a PTSD diagnosis. When must I file my claim to be considered under the presumption?
Claims related to PTSD diagnoses made on or after October 28, 2022, but before October 28, 2024 must be filed within six months of October 28, 2024.
For diagnoses made on or after October 28, 2024, claims must be filed within six months of the date of diagnosis.
I am a Wildland Firefighter or Wildland Fire Investigator with a pending WSIB claim for PTSD. What happens with my claim?
Any pending claims that are eligible for presumptive coverage will be decided by the WSIB based on the rules set out in the Workplace Safety and Insurance Act, as amended by Bill 190 (“Working for Workers 5 Act”).
For any questions related to a specific claim, please call the WSIB at 1-800-387-0750, Monday to Friday 7:30 a.m. to 5 p.m EST., and your inquiry will be directed to the appropriate WSIB decision-maker.
I am a Wildland Firefighter or Wildland Fire Investigator with a previously denied claim for PTSD. What happens in my case?
Previously denied claims for PTSD are not eligible for refiling.
Who can I speak with if I have further questions?
Employees who have further questions about the recent changes should speak with their manager. If employees have questions about the WSIB claims process or a specific claim please call the WSIB at 1-800-387-0750, Monday to Friday 7:30 a.m. to 5 p.m EST.
Notes:
*The Working for Workers 5 Act (Bill 190) includes a provision to reduce the minimum duration of employment prior to diagnosis of primary-site skin cancer from 15 to 10 years. This provision, if passed, will come into force on proclamation at a later date. The date for proclamation has not yet been determined.
The Following is added by OPAWF authors for your reference from WSIB sources. It was not included in the email to all staff.
** WSIB Defines Years of service as: “For wildland firefighters employed by a Ministry contractor, the eligible years of employment are those employment periods as described above during which the employer had WSIB coverage and an active contract for services with the Ministry, in addition to any other periods of employment as a firefighter or fire investigator. (A worker employed by a Ministry contractor qualifies as a wildland firefighter only for those periods when their employer had an active Ministry contract.)”.
The WSIB statement on terms of service does not clarify if it means that so long as you work on a Fireline or have an exposure then that year counts towards your years required, or if it is a summative of your time served with the AFFES, but not your time on hiatus (similar to your pension). For more information please see:https://www.wsib.ca/en/operational-policy-manual/cancers-firefighters-and-fire-investigators
