Federal firefighters score major health care win in defense bill

Federal firefighters will for the first time automatically qualify for compensation benefits when they are diagnosed with certain types of cancer.

A provision to award the firefighters presumptive benefits was quietly included in the National Defense Authorization Act (NDAA), which Congress passed at the end of last year.

The NDAA included the provision through a bill called the Federal Firefighters Fairness Act, which was crafted in the Senate by Sens. Tom Carper (D-Del.) and Susan Collins (R-Maine).

The law applies to firefighters who work for federal agencies and respond to emergencies on public lands or military installations.

Carper, who has pushed for legislation to make it easier for federal firefighters to file compensation claims since 2007, told The Hill he was “elated” with the passage of the bill.

“These brave men and women put themselves in harm’s way to save lives and protect our public lands—and if they contract an illness or disease on the job, we owe it to them to make sure they get the help they need,” the senator said in a statement.

In the House, California Democratic Reps. Salud Carbajal and Mark Takano, as well as Republican Reps. Don Bacon (Ill.) and Brian Fitzpatrick (Pa.), sponsored the legislation.

There are thousands of federal firefighters in the U.S. who work for federal agencies, including the U.S. Forest Service and the Department of Defense (DOD). About 7,500 firefighters work for the DOD at various installation bases, according to the International Association of Fire Fighters (IAFF), which represents about 3,500 of them.

The IAFF said there are about 100 claims annually that would be covered by the act. 

The DOD firefighters are often exposed to perfluoroalkyl and polyfluoroalkyl substances (PFAS) — known as "forever chemicals" because of how long they take to break down — that have been used in firefighting gear and firefighting foam used in emergencies.

Historically, 95 percent of federal firefighters' workers compensation claims for cancer-related diagnoses and medical treatments have been denied, according to the IAFF — even as it has become a leading cause of death for the responders.

The new NDAA provision amends the Federal Employee Compensation Act to award federal firefighters with the presumptive benefit that a cancer-related disability or death was the result of their work — similar to a major change passed last year for military veterans who have been exposed to burn pits. 

IAFF General President Edward Kelly said the legislation was long overdue, applauding the federal government for “righting a wrong.”

“With the passage of the NDAA, firefighters diagnosed with cancers and their families will have the financial protection that municipal and state firefighters in the United States have had for decades,” he told The Hill.

Mike Jackson, who was diagnosed with testicular cancer in 2021 and has worked as a federal firefighter for more than a decade, called the legislation a “life-changer.”

Jackson, 45, said when he first became a firefighter, he “did not have a clue” about the dangers involved. 

“I don’t think anybody could forecast that cancer was going to turn into our number one killer,” he said.

Knowing he was likely exposed to cancerous chemicals at the Fort Myers, Va., military base where he has worked since 2010, Jackson filed a claim with the Department of Labor (DOL) in November 2021 and was evaluated by a doctor.

But his claim was denied because the cancer diagnosis could not be tied to his work as a firefighter, he said. Jackson, who has a wife and two kids, described his home life as chaotic in the months following his diagnosis.

“My wife was in shambles,” he said.

Luckily, doctors removed Jackson's tumor soon after he reported complications, and he was insured, as his medical bills climbed to more than $100,000. But he wouldn’t get approval for worker’s compensation until a secondary DOL review in June 2022 reversed the decision denying his claim.

Jackson said other firefighters in his line of work have not been as lucky, noting he just talked with a former co-worker on Thursday to guide him through the process of a cancer diagnosis as a federal firefighter.

“I know what my struggles were and my struggles are very minimal compared to what some of these guys are going through now and in the future,” he said.

The NDAA provision lists more than a dozen cancer-related illnesses — including colorectal cancer, esophageal cancer, kidney cancer, leukemia and lung cancer — that are eligible for presumptive benefits.

While it doesn’t include other cancers primarily affecting women, including breast cancer, those could be added to the list over the years if more research supports it, according to a Senate Democratic aide involved in crafting the legislation.

The NDAA provision also includes language to phase out current firefighting gear as PFAS-free alternatives become available, and creates a minimum staffing standard for responding to emergencies, which will reduce exposure for individual firefighters. The IAFF said many facilities have not staffed firefighters adequately for emergencies.

PFAS exposure on military bases has been widely documented for years, especially for the firefighting foam, which is now used only in the biggest emergencies. 

But exposure to the forever chemicals through the inner and outer layers of firefighting or bunker gear is a relatively new finding that many firefighters are not fully aware of, according to Jackson, the firefighter from Virginia.

Kelly, the IAFF president, said the NDAA provision was a big step forward, but stressed it was important to continue minimizing exposure to carcinogens.

"The PFAS in our bunker gear is actually poisoning us," said Kelly. "The fight over PFAS in our society is really a generational one. It doesn't just impact firefighters, it impacts our grandchildren."

The Defense Department, which did not respond to a request for comment on this story, faced a bipartisan call from more than 40 senators in September to increase testing and remediation efforts of PFAS exposure at military bases.

The U.S. Forest Service, whose federal firefighters are also covered under the NDAA provision, said it was conducting a literature review to estimate the exposure of carcinogens in the wildland fire environment. The federal agency said there is a "growing awareness of the impacts of the environmental hazards faced by our wildland fire community."

Bacon, who was among the sponsors of the provision, said federal firefighters “put their lives on the line and constantly expose themselves to toxic substances and deadly fumes.”

“This is the least we can do to protect those who protect us,” he said in a statement to The Hill.