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September 2, 2011

An Accidental Disability Pension for Leukemia?

Patrick Laverty

I appreciate firefighters for the job they do. I have friends who are firefighters on various departments around the state and I try to ask them lots of questions to better understand their job. I can also appreciate the fact that it is a job that can lead to permanent disability through injuries sustained on the job. I could even buy that the job can lead to certain types of cancer, lung cancer not the least of which. However, I do wonder about leukemia as a result of being on the job. Former Providence Fire Chief George Farrell was awarded a full tax-free disability pension by the Providence Pension Board as a result of his leukemia.
The vote to award the tax-free pension was 5-4, as the board debated their own rules.

The city Law Department opined that in order for Farrell to receive an accidental-disability pension, three physicians must agree that the leukemia, which at last word was in remission, renders him totally and permanently disabled from doing the job of fire chief. One of the three physicians who examined Farrell said he could return to work on medication.

I don't understand what's not clear about "three physicians must agree". One disagreed, so isn't that enough to disqualify the claim? The article doesn't explicitly state it, but based on a comment from one pension board member, it would appear that the board's lawyer also believes the doctors must be unanimous.

"We totally disregarded our attorney," Hull complained.

The other part that is curious to me is just in the title of this pension, it is an "accidental disability pension". That says to me that the claim must be based on some accidental event. I don't know that leukemia is caused by such a thing. This type of pension should be awarded when the injury is a direct result of being on the job.

As a side note, the chief was already receiving a standard pension and filed a claim for the accidental disability pension, possibly in part because it comes with a better health care plan. That is an understandable desire for someone with cancer, and I do hope Mr. Farrell makes a full recovery from the disease.

Comments

I thought the article I read said there was a 'presumption of cancer' clause in the contract. Basically, if they get cancer, it's presumed to be from on-the-job activities.

Posted by: mangeek at September 2, 2011 12:52 PM

If there really is the presumption that all cancer is work-related, then that is an insane and corrupt policy. Most people have heart problems or get cancer at some point in their life. Half of my family has gotten cancer, and none of them were firefighters. Would they all get disability pensions if they had been? Even if a doctor on the panel says they can continue work? There should exist the opposite presumption, that it is not work-related, unless they can prove it beyond a preponderance of the medical evidence or some other low but fair standard that allows for some uncertainty.

$20 internet currency says that a certain red-faced Providence Fire Department captain completely misses the point and starts raging in the comments section yet again about carcinogens in smoke, etc.

Posted by: Dan at September 2, 2011 2:21 PM

"and starts raging in the comments section yet again about carcinogens in smoke, etc."

That's exactly why I said I would even find lung cancer to be understandably caused by the job. I don't know if studies have been done directly linking other types of cancers to the profession of firefighting, especially with eliminating any other external factors that could contribute as well.

Posted by: Patrick at September 2, 2011 2:32 PM

The presumptive cancer clause is an additional thank you from the taxpayers for hazardous duty obligations. Some disagree with it, most don't.

Posted by: michael at September 2, 2011 4:26 PM

Michael:

I wouldn't mind such a rule if we can also prohibit firefighters from smoking, chewing, and other habits that are known to cause cancer.

If that is the rule, great. If not, it's too one-sided and needs to be changed or eliminated.

BTW, I mean prohibiting those habits whether at work or in their private lives.

Posted by: John at September 2, 2011 4:33 PM

Patrick, my apologies, I forgot to welcome you to the contributors list, best wishes, I always respect your views and enjoy your writing.

Also, how many get these cancers happen before age 60? That is the period firefighters in Providence are covered for. i understand everybody knows family and friends who have and have died from cancer, but most of those cases I would imagine occurred after the age of sixty.

John, valid point, a healthy lifestyle should be a prerequisite for any job related cancer disability benefits.

Posted by: michael at September 2, 2011 4:43 PM

Thank you Michael, similar sentiments here.

As far as the "age 60" thing goes, wouldn't that imply that if a retired firefighter gets cancer at 65, the contract is saying "you didn't get it from the job" but if he got it at 55, the contract says "you got it on the job"? In spite of the fact that very few firefighters are still working at 55.

Posted by: Patrick at September 2, 2011 5:22 PM
The presumptive cancer clause is yet another thank you, on top of many, from the bought-and-paid-for politicians and union-majority labor board. Rational -thinking taxpayers oppose it, but most RI residents simply let their emotions control them or don't care.

Fixed that for you, Michael. Nice appeal to popularity fallacy, by the way.

I don't think some here fully *appreciate* the implications of shifting the burden of proof to the municipality to disprove a disability. This sort of thing is unheard of in legitimate civil law.

Posted by: Dan at September 2, 2011 6:31 PM

"John, valid point, a healthy lifestyle should be a prerequisite for any job related cancer disability benefits."

It's actually not a valid point, nor is your own. Valid points require logic and logic dictates that disability should be awarded only in the event that the worker can demonstrate, at least beyond a preponderance of the evidence standard, that the condition is work-related and they are unable to return to work. Loosening these common sense prerequisites or shifting the burden of proof as a "thank you" makes no logical sense because the prerequisites have nothing to do with punishment or reward, they are safeguards for accuracy and fairness. External factors like smoking, drinking habits, and weight should of course be considerations in determining whether that initial burden of proof is met, but making it a "prerequisite" makes no sense because an unhealthy individual could still get a work-related disease.

Good laws serve a rational purpose and are narrowly tailored to serve that purpose. An alien concept in Rhode Island, apparently.

Posted by: Dan at September 2, 2011 6:58 PM

I presume I'm the "certain red-faced Providence Fire Department Captain".

I won't debate Dan...it's useless.

Cancer is presumed to be job-related until retirement (whatever age that may be but not beyond 60). Like it or not FF's need that clause to be exactly as is. No one can ever prove where their cancer came from (at least not at this point in time). No pension board would award a disability pension for cancer if not forced to by the letter of the law.

Also, like it or not, FF's are routinely exposed to carcinogens and sometimes directly exposed with proper documentation to that fact. Without the presumption of cancer clause many have been denied even with documentation of repeated exposures.

The general public bitches when someone is smoking in their general area.

As for smoking or other tobacco products, if a member uses tobacco after June of 2008(?) - whenever the presumptive clause went into effect he/she is disqualified from filing a disability pension on the grounds of cancer.

All that being said I disagree with the awarding of the disability pension in this case for the reason that he (in his position) is nothing more than an office worker - he has been for the last 15 years.

Posted by: Tom Kenney at September 2, 2011 7:39 PM

"Like it or not FF's need that clause to be exactly as is."

No, they don't. There are a number of different ways this issue could be handled fairly, logically, and responsibly. This is not one of them. It's a totally illogical clause grounded in emotion and corrupt political paybacks.

"No one can ever prove where their cancer came from (at least not at this point in time)."

Yes, they can. They can do it based on a preponderance of the evidence standard. It's an extremely low burden to meet, and it's exactly how all cancer-related lawsuits are handled for the "little people" who don't run around with helmets and badges and have militaristic titles.

"No pension board would award a disability pension for cancer if not forced to by the letter of the law."

Plainly false, because a pension board just did. In fact, the law stated that they should deny this individual a pension and they went ahead and did it anyway. And if that were the case, the problem would be with the pension board, not the contract.

"Also, like it or not, FF's are routinely exposed to carcinogens and sometimes directly exposed with proper documentation to that fact. Without the presumption of cancer clause many have been denied even with documentation of repeated exposures."

They can present their evidence. If they can't prove that their disability is more likely than not work-related, then, emotional appeals aside, why do they deserve anything? Are you saying that the entire tort system is unfair and there should be a presumption that the plaintiff should recover in any cancer case? If not, how do you distinguish the two situations? You can't. Your argument is grounded in the theology of Firefighter Exceptionalism and has no logical basis.

"The general public bitches when someone is smoking in their general area."

It's unpleasant, but I'd be okay with it if I were being paid $30-40/hr + health care + pension, etc.

The medical science is much more inconclusive than you make it out to be, FYI. Studies conflict as to whether firefighters are any more likely to develop cancer, and they live longer on average.

Posted by: Dan at September 2, 2011 8:41 PM

I saw on television, just tonight, a statistic claiming that half of all men will develop cancer in their lifetime, and one third of women will get it.

So near as I can tell, chances are that if a firefighter gets cancer, it's statistically likely that firefighting had nothing to do with it, unless were talking lung cancer for a non-smoking individual.

Posted by: swamper at September 2, 2011 11:09 PM

Studies have actually consistently found that firefighters have no higher incidence of lung cancer.

Posted by: Dan at September 2, 2011 11:23 PM

Dan I just did a quick google search and found dozens of studies showing higher camcer rates of many types in fire fighters. We can all cherry pick facts like you.

Posted by: Ron coouch at September 3, 2011 9:08 AM

[[[[ Studies conflict as to whether firefighters are any more likely to develop cancer, and they live longer on average. ]]]]

[[[[ Studies have actually consistently found that firefighters have no higher incidence of lung cancer. ]]]]


For those following this, the person who quoted the preceding statements is absolutely lying. He is making false statements based on nothing but his ignorance and his desire to be right.

Posted by: Tom Kenney at September 3, 2011 9:21 AM

"As far as the "age 60" thing goes, wouldn't that imply that if a retired firefighter gets cancer at 65, the contract is saying "you didn't get it from the job" but if he got it at 55, the contract says "you got it on the job"? In spite of the fact that very few firefighters are still working at 55."

Exactly, which is why I'm pushing for legislation that states that if a firefighter contracts cancer of any kind at any time in his life it will be presumed job related.

Just kidding. All I know is that in the ten years I was riding the engine and ladder companies I was exposed to 1000 times more toxic chemicals than I am now as a Rescue Lieutenant. I've got a different set of exposure problems now that are not covered by any contracts. Last week I stuck myself with a dirty needle while working a code in a bouncing truck on a thirty year old heroin addict. I don't know if he has HIV, Hepatitis C or anything else, but if he does I have a good chance of having it as well, as does my wife. The week before I had a guy directly from Africa in the rig who told me when we arrived at the hospital ten minutes into our contact that he tested positive for TB. TB is highly contagious especially in a closed, unventilated space, kind of like an ambulance.

Smaller concerns, smaller and crawly actually are the bedbug infestation and cockroach problem. The little critters pass through patients to us, and breed like mad.

At least we have a presumptive cancer clause in our contract, doesn't cover everything, but every little bit helps.

Posted by: michael at September 3, 2011 10:20 AM

"No pension board would award a disability pension for cancer if not forced to by the letter of the law."

Doesn't the letter of the law say that THREE doctors have to agree that you can't work anymore to get put on disability pension? Didn't only TWO doctors came to this conclusion? Didn't the board award it anyway?

The issue here isn't the cancer presumption, that's a minor detail. The issue is the board going around their own rules to do something that they shouldn't be able to do. This is institutional in Rhode Island; boards, committees, and the entire legislature (sans Rod Driver when he was around) deciding to ignore the rules and do what they want to anyways.

So Mr. Kenney, how would you feel if a board unilaterally decided that your health insurance contribution would go up, even though you had a contract that said it wouldn't, because that's the situation the taxpayers are in right now.

Posted by: mangeek at September 3, 2011 10:47 AM

@ mangeek,

I agree with you 100%.

Posted by: Tom Kenney at September 3, 2011 10:53 AM

FYI mangeek, from what I understand 4 of the 5 votes in the affirmative re:Farel's pension came from the City's reps not from the union and labor and retiree side.

Posted by: Tom Kenney at September 3, 2011 12:29 PM

For somebody who constantly claims to take the high road instead of arguing, Tom Kenney sure does a lot of arguing. I guess you really can have your cake and eat it too.

I won my bet from earlier in the thread. The caped crusader never lets us down by jumping into a thread with irrelevancies, absolutist statements, and fallacies galore.

If he ever acknowledged a single problem with his department, now that would be worth paying attention to. I think the earth would have to reverse rotation first. An organization that admits no faults or room for improvement has zero credibility.

Posted by: Dan at September 3, 2011 3:05 PM

The sad part of this story is not the presumption of cause but the pig that thought a regular pension wasn't enough. The pig that apparently was able to do his job before he went into remission but some how can't do it know. The pig that probably hasn't entered a burning building in a decade. The pig that should be an embarrassment to the men and women for who he should have been setting an example. The pig that just cast an even greater shadow over the already beat up reputation of real fire fighters.

Posted by: Max Diesel at September 3, 2011 9:13 PM

Thanks for antagonizing and bringing this down three levels, Max.

Posted by: mangeek at September 4, 2011 1:29 AM

My point is that even if 100% of all firefighters got cancer, and even if half the force comprised of women, then at least 4 of the 10 would of the claims would be invalid based on the statistical analysis (425/1000 Americans get cancer at some point in their lives). Remember that's with 100% cancer rate with a force employing women at the same rate as men. The real denial rate should be much higher than 4 of 10 claims.

Has any firefighter ever been denied the disability benefit for having cancer? It would seem logical, to me anyways, that half of the men's claims and two thirds of the women's claims would be rejected based on the natural occurance of this horrible disease/condition.

How it's determined who gets awarded the disability pension and who doesn't is where it gets complicated. But it's not like the newbies don't know what they're getting into. There are many who strongly tout the increased risk here, and they may very well be right about it. The rookies are not going in blind. It's the whole risk/reward thing. Most of these guys do the job out of the love and thrill of the job. If not the case, we wouldn't have such a strong volunteer corps across the country. What is it, 71% volunteer FF (NFPA) in USA?

I would liken the whole cancer disability thing to smoking for 30 years and blaming big tobacco for breathing problems, or drinking a six pack daily for decades and then blaming the brewmasters for liver failure. It's the whole risk/reward thing.

But it can be concluded with 100% certainty that all cancer is NOT caused by firefighting.

Posted by: swamper at September 4, 2011 8:09 AM

[[[[ Has any firefighter ever been denied the disability benefit for having cancer? ]]]]

Yes, many have been denied before the presumptive clause - actually, ALL have been denied prior to the presumptive clause. Some have been denied since the presumptive clause based on conflicting reports from doctors, such as in this case.

[[[[ But it can be concluded with 100% certainty that all cancer is NOT caused by firefighting. ]]]]

I agree. However, it's not something that can be debated in a logial manner - number of years service - documented exposures - lack of exposures outside the job, etc. It has become a 100% or 0% issue.

Posted by: Tom Kenney at September 4, 2011 8:17 AM

What's the point of debating if logic is damnned?

If it's 100% or 0%, then I'd have to side with the zero based on the statistics coupled with the men and women being armed with the knowledge of the inherent risk associated with doing the job.

What the percentage denied since the presumptive clause took effect is really where we're at. Does it come anywhere near 42.5%? Again, that would be the right number if every single firefighter contracted cancer and half of them were women.

Nothing divides people better than the all or nothing mentality. Pick one side or the other. Why does it have to be a 100% or 0% issue?

Posted by: swamper at September 4, 2011 9:02 AM

Does anyone know how much this clown's pension was bumped with and without the disability after coming back as chief?

Posted by: Max Diesel at September 4, 2011 9:17 AM

Can a single person here explain to me why firefighters should get a legal presumption in their favor while the entire rest of the United States must meet a preponderance of the evidence burden for cancer claims?

Let's just call it for what it is - these people enjoy a manufactured "hero" status and the political game is rigged in their favor, so logic goes out the window and they get a pass. If not, then please, please explain to me why they are different than any other person bringing a cancer claim against Big Pharma, the oil companies, the U.S. military, etc. I would love to hear your explanation. Michael, Tom Kenney, et al - please step right up and defend the indefensible.

Posted by: Dan at September 4, 2011 9:34 AM

Because our jobs regularly put us, knowingly in direct exposure with countless numbers of toxins and carcinogens. Public safety demands this. We take on the risk with the understanding that if something should happen to us that our families will not be completely devastated financially.

No one can prove one way or the other how or when they recieved the exposure that eventually caused their cancer. By requesting a disability pension for cancer we are not like the consumer with a "preponderance of the evidence" burden. We were put in this position because our job requires us to do so, not out of any personal choice.

Posted by: Tom Kenney at September 4, 2011 10:49 AM

"By requesting a disability pension for cancer we are not like the consumer with a "preponderance of the evidence" burden. We were put in this position because our job requires us to do so, not out of any personal choice."

Tom, your logic is so bad that it actually stings my brain. It is exactly the same issue, whether it's for another of many jobs that involves exposure to carcinogens or various kinds of tort claims. The issue of choice has absolutely nothing to do with the standard of proof required for establishing a legally sufficient proximate causal link between exposure and the disease. Your argument is totally nonsensical and irrelevant and hasn't demonstrated why firefighters need to be treated "specially" in this case. It's directly analogous to other claims.

Again, you're just resorting to this Firefighter Exceptionalism dogma where you assert that everything firefighting-related is fundamentally different than other situations and firefighters need special rules that treat them favorably compared with everyone else. I wouldn't mind your piss-poor logic so much if it ever meant that due to "special circumstances of the job" firefighters would require less compensation, but by some funny coincidence it always happens to result in the taxpayers getting hosed.

Posted by: Dan at September 4, 2011 1:54 PM

Not surprisingly the above posted poster is against giving firefighters their due when it comes to exposures. Not demanding to be called heroes. Not demanding exhorbitant wages. But rather simply be acknowledged at having a higher rate of exposures than the average Joe Blow.

Not surprising at all...yet he's failed to show how he knows so much about my job and my exposures.

Posted by: Tom Kenney at September 4, 2011 2:52 PM

Can we get a firefighter in here with basic reading comprehension skills? I feel like I'm in two different conversations that were spliced together. Not only does Tom fail to address any of my points, he completely mistates the argument I am making and goes on a tirade against an idea nobody is pushing here. I am precisely in favor of firefighters getting their due - when have I ever said differently?

Tom - stick to putting out fires, you are a pitiful spokesman. Your heart is in the right place, but you have a hard time keeping your thoughts in order.

Posted by: Dan at September 4, 2011 4:12 PM

You fail to show a "basic understanding" of the real world of politics. The Prov Retirement Board, with a majority under mayoral and council control, will not give a disability pension to a firefighter unless the presumptive clause is absolute. Period. What don't you understand about that?

Posted by: Tom Kenney at September 4, 2011 4:24 PM

Some of us still believe in fair and principled governance rather than the spoils system your union and the politicians play for keeps, Tom. Two wrongs don't make a right in my book - maybe that makes me an idealist.

Posted by: Dan at September 4, 2011 5:07 PM

I think the confusion stems from three doctors, two opinions, with one saying returning to work is possible with the aid of medication. How then could this disability pension have been awarded without the required unamimous opinion?

Posted by: swamper at September 4, 2011 5:25 PM

@swamper,

I'm not in support of Farel's pension primarily for that exact reason.

What I'm fighting over with Dan is his insistance that firefighters should not have a presumptive clause stating that any cancer is assumed job-related.

Any disability request would still need to pass other requirements such as three doctors agreeing that the patient cannot function at his job anymore.

Posted by: Tom Kenney at September 4, 2011 5:34 PM

Tom-Agent Orange is recognized as causing about 11 presumptive diseases-I already had one cancer from it-lymphoma,but later I developed oral cancer(never chewed or dipped snuff)and funny thing is,that if it was a little lower down,like larynx or somesuch,it is presumptive.Mine,being on my tongue and floor of the mouth,isn't considered AO related.
What I'm saying is that firefighters,being exposed to smoke and various toxins,may justifiably be presumptive on certain cancers,but not all.
Suppose a firefighter got melanoma.how could that be linked?

Posted by: joe bernstein at September 4, 2011 9:45 PM

Joe,

That's true but there are many types of cancer that show a higher % in FF's but not necessarily enough (for the bean counters) to make everyone agree that they should be presumptive. There are many that are in high enough percentages that most would agree are presumptive.

If there were a way to categorize these cases fairly, based on actual numbers, I'd be ok with that. Our present system has fluctuated from no cancers covered, to all cancers covered, back to no cancers and finally back to all cancers. It's been an all or nothing battle for us.

Those in the fire service (as would be the case for career military personnel) skew the numbers in the research by what they call the "healthy worker effect". This is because FF's or active military personnel are generally in better health than the general population. They need to be in order to do their jobs. This tends to skew the numbers against presumptive clause arguements.

Posted by: Tom Kenney at September 5, 2011 8:09 AM

"Those in the fire service (as would be the case for career military personnel) skew the numbers in the research by what they call the "healthy worker effect"."

This is actually just another example of what actual experts and researchers call confirmation bias. Tom Kenney starts out with the assumption that most firefighter cancer is work-related (he "wants" to believe this, whether it is true or not) and then when the numbers turn out weaker than hoped, he goes fishing for excuses to explain it all away and maintain his theory.

This instance is particularly bad because it involves a number of stacking unscientific assumptions:
1. Firefighters are "healthier" than average (whatever that means), and
2. Being "healthier" reduces their cancer rates from what they "should" be (whatever that means).

It also glosses over the very important scientific issue of what a valid control group would be and ignores any possible counter-explanations (1. Firefighters are almost all men, 2. Do firefighters drink and smoke more than average? I'm guessing yes, but we don't know) etc.

Basically, Tom Kenney has a religion (Firefighter Exceptionalism) that gives him personal meaning, and for anything that is either unknown, unprovable, or inconvenient to his dogma, he has an overeager explanation to sell to you in defense of it. It's the logical equivalent of a Bible-thumper telling you that the devil put evolutionary fossils in the ground to trick you.

Now listen to him tell you how I "hate firefigthers" or some such thing and how none of these totally valid points, that any responsible researcher would point out, matter.

Posted by: Dan at September 5, 2011 10:52 AM

I didn't make up "healthy worker effect", look it up as it pertains to firefighter injuries, illness and fatalities.

Dan thinks he's a scientist now.

He can't even say that FF's have more exposures to these carcinogens due to our exposure to smoke, toxins and deisel fumes. Who's being honest?

Posted by: Tom Kenney at September 5, 2011 11:32 AM

I don't know about scientist; I do have an engineering degree.

I never denied your point about exposures, Tom. It's just not relevant to my scientific and legal arguments about burden of proof. If you don't understand why, please ask somebody else to explain it to you.

Posted by: Dan at September 5, 2011 5:19 PM