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Maryland Workers’ Compensation: Firefighter disease presumptions

Firefighters face exposure to toxic chemicals, substances and gases on a regular basis when they run toward danger on all of our behalves. Maryland law presumes that when they get certain diseases in particular circumstances, Workers’ Compensation benefits will be awarded. 

Firefighter occupational disease presumptions: Heart and lung conditions 

The law provides that a paid or volunteer firefighter is “presumed to have an occupational disease … suffered in the line of duty … compensable” by Workers’ Compensation if these diagnoses cause partial or total disability or death: 

  • Heart disease
  • Hypertension
  • Lung disease


The same eligibility presumption applies to certain cancer diagnoses in some circumstances: 

  • Leukemia, or prostate, throat, non-Hodgkin’s lymphoma, testicular, rectal, multiple myeloma, brain or breast cancer “caused by contact with a toxic substance … encountered in the line of duty”
  • Ten years of fire-fighting service in the department of current service
  • Condition prevents the person from performing his or her normal fire-fighting duties 

Related matters 

For the presumption to apply to a diagnosis under either category, a volunteer firefighter, before he or she started duty, must have “met a suitable standard of physical examination.” 

In some cases, the presumptions may apply even if a firefighter develops a covered illness in retirement. 

The law also provides that benefits received pursuant to these presumptions are stacked on top of retirement benefits, so both are received (subject to a cap). Otherwise, only one could be received in a period of dual eligibility. 

In any given claim, the employer, usually a city, municipality or other local government, may choose to oppose the firefighter’s presumption, so legal counsel is important in these cases. 

Policy behind the presumption 

The Baltimore Sun recently published an extensive article about the Maryland firefighter presumptions. The piece describes both sides of a debate over this law. Some argue that it is expensive for taxpayers to pay these claims and that in a given case it may not be possible to prove a link the covered cancer or illness to the actual work of firefighting. Some point to conflicting studies. 

However, the point of a presumption is that when proof is difficult, the law gives the benefit of the doubt to a party for policy reasons. Firefighters put themselves in danger to protect members of our community. This law recognizes that we are going to be on their side when they come down with catastrophic illnesses that could be the result of their brave actions. 

Maryland is not alone in this choice. According to the Sun, over 30 other states have similar Workers’ Compensation presumptions for firefighters.

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