HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/HB 557 Fire Investigator Cancer Treatment Benefits
SPONSOR(S): Government Operations Subcommittee, Salzman & others
TIED BILLS: IDEN./SIM. BILLS: CS/SB 838
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Insurance & Banking Subcommittee 17 Y, 0 N Herendeen Luczynski
2) Government Operations Subcommittee 16 Y, 0 N, As CS Roth Toliver
3) Appropriations Committee 23 Y, 0 N Lee Pridgeon
4) Commerce Committee 20 Y, 0 N Herendeen Hamon
SUMMARY ANALYSIS
In 2019, the Legislature created a special benefit package for firefighters suffering from certain types of cancer,
because studies have demonstrated a link between firefighting and cancer. The special benefit package is an
alternative to filing a workers’ compensation claim, which requires proof that workplace exposures are the
cause of a firefighter’s occupational disease. Like firefighters, fire investigators sustain significant exposure to
hazardous vapors, gases and particles that are known to contribute to chronic health conditions, including
cancer; however, fire investigators are not eligible for the special benefit package.
The special benefit package provides that firefighters who are diagnosed with certain types of cancer are
eligible for a one-time payment of $25,000 and employer-sponsored health insurance, including reimbursement
for any deductible, co-payment, or co-insurance costs the firefighter incurs for the treatment of cancer. To
qualify for these benefits, a firefighter must: (1) have been working full-time as a firefighter, for a government
employer, for at least 5 continuous years; (2) have not used tobacco products for at least the 5 years prior to
the cancer diagnosis; and (3) have not been employed in any other position which is proven to create a high
risk of cancer during the 5 years prior to the cancer diagnosis.
Employment-sponsored health benefits must be made available for 10 years after the firefighter terminates
employment, so long as the firefighter is not subsequently re-employed as a firefighter.
If a firefighter becomes disabled or dies due to cancer, the employer must consider the cancer diagnosis as an
injury or illness incurred in the line of duty. This makes the firefighter eligible for line-of-duty disability retirement
benefits and also makes surviving family members eligible for line-of-duty death benefits.
The number of Florida-certified fire investigators working full-time for state and local governments, including
special fire districts, is unclear. The Florida State Fire College has certified 1,740 fire investigators since 2005,
and about half of these people also hold certifications as firefighters. The State Fire Marshal employs 104 fire
investigators; 86 of these fire investigators are Florida-certified or in the process of becoming certified.
The bill amends the definition of “firefighter” to include Florida-certified fire investigators, making fire
investigators eligible for the special benefit package related to a cancer diagnosis. The costs to provide the
enhanced benefits under s. 112.118, F.S., must be borne by the employer.
The bill has an indeterminate significant negative fiscal impact on state and local governments, which are
responsible for the cost of the special benefit package. See Fiscal & Analysis & Economic Impact Statement.
The effective date of the bill is July 1, 2022.
This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives .
STORAGE NAME: h0557h.COM
DATE: 2/24/2022
 FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Present Situation
Firefighters Face an Increased Risk of Cancer
A two-part study by the Centers for Disease Control and Prevention/National Institute for Occupational
Health and Safety (NIOSH) concluded that firefighters have a nine percent greater risk of being diagnosed
with cancer – and a 14 percent greater risk of dying from cancer – than the general population of the
United States.1
The study was launched in 2010 and reviewed records of nearly 30,000 career firefighters who served in
Chicago, Philadelphia, and San Francisco fire departments between 1950 and 2009.2
 In 2013, researchers reported statistically significant mortality and incidence rates of cancers of the
esophagus, intestine, lung, kidney, and oral cavity, as well as increased mesothelioma for
firefighters compared with the general population, and excess risk of bladder and prostate cancer at
younger ages.3
 In 2015, researchers reported that the risk of developing lung cancer and leukemia increases with
exposure to smoke and hazardous chemicals that are released from burning materials, asbestos,
and diesel exhaust.4
In 2018, the federal government directed the Centers for Disease Control to create a National Firefighter
Registry that, with voluntary participation from firefighters, will track cancer and occupational risk factors to
help researchers and the medical community better understand the causes of disease and death among
firefighters.5
Special Benefit Package for Firefighters in Lieu of Workers’ Compensation Benefits
The Legislature took action in 2019 by creating s. 112.1816, F.S.6 Instead of seeking benefits through the
workers’ compensation system,7 where the employee must prove that workplace exposures caused
cancer, a firefighter diagnosed with certain types of cancer is entitled to certain benefits. An affected
firefighter may receive a one-time cash payment of $25,000 and a guarantee that their employer-
sponsored health insurance will continue while the firefighter remains on the job and for 10 years after the
firefighter terminates employment, so long as the firefighter is not subsequently re-employed as a
firefighter. The employer must reimburse the firefighter for any deductible, co-payment, or co-insurance
costs paid for the treatment of cancer.
1 Centers for Disease Control and Prevention/National Institute for Occupational Health and Safety, Findings from a Study
of Cancer among U.S. Fire Fighters, cdc.gov/niosh/pgms/worknotify/pdfs/ff-cancer-factsheet-final-508.pdf (last visited
Feb.18, 2022).
2 Id.
3 Centers for Disease Control and Prevention/National Institute for Occupational Health and Safety, Mortality and cancer
incidence in a pooled cohort of US firefighters from San Francisco, Chicago and P hiladelphia (1950− 2009),
http://www.cdc.gov/niosh/firefighters/pdfs/OEM_FF_Ca_Study_10-2013.pdf (last visited Feb. 18, 2022).
4 Centers for Disease Control and Prevention/National Institute for Occupational Health and Safety, Exposure–response
relationships for select cancer and non-cancer health outcomes in a cohort of US firefighters from San Francisco, Chicago
and Philadelphia (1950–2009), https://stacks.cdc.gov/view/cdc/34054, (last visited Feb. 18, 2022).
5 Centers for Disease Control and Prevention/National Institute for Occupational Health and Safety, National Firefighter
Registry, https://www.cdc.gov/niosh/firefighters/registry.html (last visited Feb. 18, 2022).
6 Ch. 2019-21, Laws of Fla.
7 See ch. 440, F.S.
STORAGE NAME: h0557h.COM PAGE: 2
DATE: 2/24/2022
 Every state board, commission, department, division, bureau, agency, county, municipality, or other
political subdivision of the state that employs firefighters,8 including fire control districts, must make these
benefits available to firefighters who are employed on a full-time basis. There are approximately 650 state-
employed firefighters currently covered by the State Risk Management Trust Fund (SRMTF). 9
Eligibility Requirements
To be eligible, a firefighter must be diagnosed with one of the following types of cancer: bladder cancer,
brain cancer, breast cancer, cervical cancer, colon cancer, esophageal cancer, invasive skin cancer,
kidney cancer, large intestinal cancer, lung cancer, malignant melanoma, mesothelioma, multiple myeloma,
non-Hodgkin’s lymphoma, oral cavity and pharynx cancer, ovarian cancer, prostate cancer, rectal cancer,
stomach cancer, testicular cancer, and thyroid cancer. 10 Additionally, the firefighter:
 Must have been employed by his or her employer for at least 5 continuous years;
 Must not have used tobacco products for at least the 5 years preceding the cancer diagnosis; and
 Must not have been employed in any other position in the 5 years preceding the cancer diagnosis
which is proven to create a higher risk for any cancer. 11
Line-of-Duty Disability Retirement and Death Benefits
Many firefighters are members of the Florida Retirement System (FRS), which provides retirement benefits
to 980 participating employers, including all state and county government agencies, school boards, state
universities and community colleges, as well as many cities and special districts.12 Firefighters who are
members of the FRS are included in a special risk class whose members receive enhanced benefits, due
to the unique challenges and risks of their jobs.13
Municipalities and special fire districts that do not participate in the FRS offer retirement plans that are
secured by the Firefighters’ Pension Trust Fund (FPTF)14, which must meet minimum requirements
established by the Division of Retirement of the Department of Management Services. 15
When a firefighter diagnosed with cancer qualifies for the $25,000 cash payment and health benefits, the
employer must consider a firefighter’s cancer diagnosis as an injury incurred in the line of duty. 16
If the firefighter becomes totally and permanently disabled by cancer, the firefighter is entitled to a line-of-
duty retirement,17 as follows:
 Under the FRS, a line-of-duty disability retirement results in payment of 65 percent of the
firefighter’s average final compensation for the remainder of his or her life; 18
8 S. 112.191(1)(a), F.S.
9 Florida Department of Financial Services (DFS), Agency Analysis of 2022 CS/House Bill 557, p. 1 (Feb. 7, 2022).
10 S. 112.1816(1)(a), F.S.
11 S. 112.1816(2), F.S.
12 Department of Management Services, Division of Retirement, Florida Retirement System Pension Plan and other State
Administered Systems, Comprehensive Annual Financial Report FY 2019-2020, p. 8, Annual Reports / Publications /
Retirement / Workforce Operations / Florida Department of Management Services - DMS (myflorida.com) (last visited
Feb. 18, 2022).
13 S. 121.0515, F.S.
14 S. 175.041, F.S.
15 Ss. 175.021, and 175.351, F.S.; also see Department of Management Services, Municipal Police and Fire
Plans/Overview, Overview / Municipal Police and Fire Plans / Local Retirement Plans / Retirement / Workforce Operations
/ Florida Department of Management Services - DMS (myflorida.com) (last visited Feb. 18, 2022).
16 S. 112.1816(2)(b), F.S.
17 S. 112.1816(3), F.S.
18 Department of Management Services, supra note 12, at 39. Under s. 121.091(4)(b), F.S., an employee is totally and
permanently disabled if he or she cannot render useful and efficient service as an officer or employee.
STORAGE NAME: h0557h.COM PAGE: 3
DATE: 2/24/2022
  Under the FPTF, a line-of-duty disability retirement results in payment of at least 42 percent of the
firefighters’ average monthly compensation for the remainder of his or her life; 19 and
 If the firefighter did not participate in a retirement plan, the employer must pay 42 percent of the
firefighters’ most recent annual salary, for life.20
If the firefighter dies due to cancer or the treatment of cancer, the firefighter’s beneficiary is entitled to line-
of-duty death benefits,21 as follows:
 Under the FRS, a line-of-duty death benefit provides a lifetime monthly benefit equal to the
firefighter’s salary at death to the surviving spouse. If the spouse dies, the benefit is paid on behalf
of the member’s dependent children until the youngest reaches age 18, and the benefit may be
extended until the youngest child reaches age 25 if the child is unmarried and a full-time student.22
 State law does not require a line-of-duty death benefit for the FPTF. However, if a firefighter with 10
years of service dies prior to retirement, the firefighter’s beneficiary receives either early or normal
retirement benefits for 10 years.23
 If the firefighter did not participate in a retirement plan, the employer must provide a death benefit of
at least 42 percent of the firefighters’ most recent annual salary to the beneficiary, for at least 10
years.24
Additionally, the firefighter’s beneficiary is eligible for a death benefit of $75,000. 25
The employer is required to pay the costs of the special benefit package without increasing employee
contributions to a retirement plan.26
Workers’ Compensation Benefits
A firefighter who declines the special benefit package may instead file a claim for workers’ compensation
benefits. Workers’ compensation is a no-fault system that provides medical benefits and compensation for
lost wages when an employee is injured or killed in the course of employment.
The Employee Must Demonstrate Causation
In addition to on-the-job injuries, employers may be required to pay compensation for lost wages or furnish
benefits (such as medical care, medical devices, attendant care) if an occupational disease causes
disablement, is due to the nature of the employee’s occupation, and the employee contracted the disease
during the course of his or her employment.27 In general, occupational diseases are compensable if:
 A condition peculiar to the occupation causes the disease;
 The employee contracts the disease on the job;
 The job presents a particular hazard of the disease;
 The incidence of the disease is substantially higher in the occupation than in the public;
 The nature of the employment was a major contributing cause of the disease; and
 Epidemiological studies show that exposure to the specific substance involved, at the levels to which
the employee was exposed, may cause the precise disease sustained by the employee.28
19 S. 175.191, F.S., states that an employee is totally and permanently disabled if he or she cannot render useful and
efficient service as a firefighter and is likely to remain so disabled continuously and permanently.
20 S. 112.1816(3)(b), F.S.
21 S. 112.1816(3)(a), F.S
22 Department of Management Services, supra note 12, at 39.
23 S. 175.201, F.S.
24 S. 112.1816(3)(b), F.S.
25 S. 112.191(2)(a), F.S.
26 S. 112.1816(5), F.S.
27 Ss. 440.09 and 440.151, F.S.
28 S. 440.151(2), F.S.
STORAGE NAME: h0557h.COM PAGE: 4
DATE: 2/24/2022
 Thus, under the workers’ compensation system, a firefighter suffering from cancer must show a causal
relationship between the diagnosis of cancer and his or her work as a firefighter to receive medical benefits
and compensation for lost work time.
Temporary Disability
Disability is defined as the incapacity to earn wages the employee was receiving at the time of injury. 29 It is
a measure of the earning capacity that is lost as a result of a work-related injury.30 Disability may be
temporary or permanent, and partial or total.31
When an authorized doctor declares an injured employee to be temporarily but totally disabled, the
employee is eligible for up to 260 weeks (5 years) of disability benefits.32
Injured workers who earn less than the statewide average weekly wage 33 are paid two thirds of their
average weekly salary, typically beginning on the 8th day after the employee loses time from work.34 The
minimum payment is $20 per week and the maximum payment is 100 percent of the statewide average
weekly wage; thus, payments to injured workers who earn more than the statewide average weekly wage
are capped at the statewide average weekly wage that was in effect on the date of injury. 35
Temporary disability benefits end when the injured worker’s doctor indicates that the employee can work in
some capacity and the employee returns to work, or when the employee reaches the maximum medical
improvement and the carrier has paid 5 years of benefits.36
Total and Permanent Disability
When an employee is totally and permanently disabled after the date of maximum medical improvement,
the employee who is not able to work in any job, for any employer, must be paid 66 2/3 percent of the
employee’s average weekly wage at the time of injury, or up to 100 percent of the statewide average
weekly wage, until age 75, or until the end of the injured workers’ life if the injury prevented the worker from
working sufficient quarters to be eligible for Social Security disability. 37
An order of compensation may require lifetime medical benefits for a catastrophic injury. Additionally,
people who are disabled prior to age 65 are eligible for Medicare.38 If a totally and permanently disabled
worker receives Social Security disability benefits, the federal benefit may offset some or all of the benefits
paid by the workers’ compensation system.39
Death Benefits
29 S. 440.02(13), F.S.
30 Metropolitan Stevedore Co. v. Rambo, 521 U.S. 121 (1997).
31 S. 440.15, F.S.
32 S. 440.15(2)(a), F.S., limi