BIG CHANGES FOR FIREFIGHTER OCCUPATIONAL CANCER

BIG CHANGES FOR FIREFIGHTER OCCUPATIONAL CANCER
On December 18, 2026, President Donald Trump signed into law H. Amdt. to S. 1071, The 2026 National Defense Authorization Act (NDAA). The NDAA authorizes annual funding levels for the U.S. Armed Forces and sets expenditures for the Department of Defense (DoD). Also included in this bill was the “Honoring our Fallen Heroes Act”.
Why is this important for the fire service? Well, the Honoring Fallen Heroes Act enables certain occupational cancers to be eligible for coverage under the Public Safety Office’s Benefit Program (PSOB). The U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Assistance’s (BJA) Public Safety Officers' Benefits (PSOB) Program provides death and education benefits to survivors of fallen law enforcement officers, firefighters and other first responders, and disability benefits to officers catastrophically injured in the line of duty.
Simply put, the surviving family members of firefighters who have died from certain occupational cancers is now considered LODD and are now eligible for death benefits through PSOB, providing certain parameters are met.
We have long known that firefighting in today’s synthetically material-based world brings increased exposure to deadly toxins and an enhanced chance for firefighters to contract certain occupational related cancers. And while some states have recognized this and included certain cancers in their statewide indemnification programs, Georgia not being one of those, until now the PSOB Federal Benefit has not recognized occupational cancer as a covered causation.
WHO’S COVERED?
Once a bill like this is signed into law, the Department of Justice, Office of Justice Programs, will have to take the basic outline of the bill and develop rules and regulations to ensure the benefit process adheres to their long-standing legal requirements. Additionally, they will have to work out some of the terminology and definitions that are not specifically identified in the legislation. This may take some time.
As noted, it will be some time before all of the rules and regulations associated with the bill are published, however the key points of the legislation are pretty basic: First and foremost, the benefit is retroactive to January 1, 2020. Secondly, the firefighter must have been serving as a public safety officer (the PSOB official term for firefighter) for not fewer than 5 years at the time of the cancer diagnosis. Basically, if the firefighter had been serving for not less than 5 years at the time of their diagnosis and died after January 1, 2020, the family may be eligible for the death benefit.
Additionally, this legislation goes beyond the normality that you are no longer covered by PSOB LODD benefits once you retire; the legislation covers firefighters for 15 years after their last day of active service as a public safety officer. Now, we’ll have to wait to see what the term “Active Service” means once the rules and regulations are completed. At this point, it is unclear whether this pertains only to those who ride fire trucks, or to all firefighters regardless of their assignment within the department.
As with all PSOB coverage, there is an exemption also: “The presumption shall not apply if competent medical evidence establishes that the exposure of the public safety officer to the carcinogen was not a substantial contributing factor in the death or disability of the public safety officer”.
Otherwise, if the firefighter were to die in an off-duty traffic accident, they would not be considered eligible for the benefit just because they had been diagnosed with one of the identified cancers. To be eligible, the cancer is going to have to be identified as the cause of death.
WHAT’S COVERED?
The legislation currently identifies 20 specific cancers and any form of cancer that is considered a WTC-Related Health Condition under section 3312(a) of the Public Health Service Act.
- bladder cancer.
- brain cancer.
- breast cancer.
- cervical cancer.
- colon cancer.
- colorectal cancer.
- esophageal cancer.
- kidney cancer.
- leukemia.
- lung cancer.
- malignant melanoma.
- mesothelioma.
- multiple myeloma.
- non-Hodgkins’s lymphoma.
- ovarian cancer.
- prostate cancer.
- skin cancer.
- stomach cancer.
- testicular cancer.
- thyroid cancer.
Furthermore, the legislation defines a review process that may take place no less than every 3 years to potentially add additional cancers that are not currently covered but now considered a fire service-related occupational cancer.
THE SURGE
The addition of occupational cancers into the PSOB Program is huge! The inclusion of heart attacks in 2003 for firefighters was the first recognition that occupational hazards exist beyond that of just trauma. While this increased the opportunity for many more firefighters’ families to potentially receive the death benefit, the process of applying for benefits was not well known, cumbersome and extremely slow, and it took several years to work out the issues in the process to make it untroublesome. Again in 2020 the PSOB recognized COVID19 as an occupational hazard and began covering certain deaths related to COVID19. However, this process went much faster and many more claims were filed and much quicker than before. In fact, COVID19 claims more than doubled the PSOB’s annual claim numbers in the first year alone, as you can imagine, overwhelming the PSOB staff. The PSOB did a great job of augmenting their current full-time staff with contractors and at the peak of COVID19 claims they had over 25+ staff members working to process claims.
Unfortunately, due to circumstances in which they do not control, the PSOB has not been able to maintain the surge levels of staffing and what was already a slow process has even slowed more. And with the general consensus being that the initial influx of cancer related benefit applications will be immense, the key take away here is patience!
Fire service leadership at the national level has been watching this legislation and plans are in the works to assist the fire service nationwide in the application process once the rules and regulations are worked out. Organizations like the National Fallen Firefighters Foundation (NFFF) through their Local Assistant State Team (L.A.S.T.) program, The International Association of Firefighters (IAFF) and the Firefighter Cancer Support Network are all working to establish a surge in individuals that are available to assist individuals and departments with the benefit application process.
THE BENEFIT
Again, as with all PSOB benefit applications there are some very specific guidelines that will come into play. First, we’ll discuss the beneficiary: The PSOB rules and regulations are very specific in who is eligible to receive the benefit, regardless of the firefighter or survivors’ wishes; If there is just a surviving spouse and no children, then the spouse would receive the entire benefit. If there are surviving children and the firefighter is not married, then the benefit would be divided equally between the children. If there is a surviving spouse and children, then the spouse would get 50% of the benefit and the other 50% would be divided equally between the children. If the firefighter is not survived by either a spouse or children, then the hierarchy continues to a beneficiary listed on a PSOB identified beneficiary form or department sponsored life insurance plan on file with the department. Then it goes to surviving parents in equal shares, and then lastly, adult children in equal shares. Determining eligibility is a major portion of the application process and requires a good deal of documentation.
As with all things PSOB, the benefit amount is also very specific. The amount of the PSOB benefit changes each October. The current amount is $ 461,656.00. While we will have to wait for the rules and regulations to identify the benefit amount for the applications of those firefighters who died before October 2025, I suspect the benefit will be the identified benefit for the year of death. Once an application has worked its way through the process and has been approved, the benefit is paid out in a one-time payment and is non-taxable.
There are also education benefits potentially available for those survivors who have been approved for the main benefit. This requires an additional application process that is much less cumbersome and time consuming compared to the initial application.
Additionally, there is an appeals process for those claims that are denied. According to a recent audit, about 35% of the claims filed are denied due to not meeting the criteria. Of those who appealed about 21% are eventually approved.
WHAT’S NEXT?
While it will be some time before the PSOB rules and regulations are completed and they are ready to start accepting Cancer Death related claim applications, there are things the surviving family members can start doing today in preparation.
As mentioned, the normal family demographic determination process will certainly still apply. This means each application will include the identity of all of the immediate family members, i.e. spouse, ex-spouse, children, stepchildren, adopted children, deceased spouse or children, etc. And provide proof of such will be required. The required documentation will include marriage certificates for those married. Divorce Decrees for all divorces of the firefighter and their current spouse, birth certificates for all children, court orders for adopted children and any other identifying legal paperwork.
Again, while not clearly identified yet by published rules and regulations, supporting documentation of the firefighter’s current work status, date of employment or date of retirement will also be required. This information will more than likely be included in the “Statement of Circumstances” which is the responsibility of the employing department. All of the previously identified assisting agencies and their representatives can and will help generate this document.
Additionally, records such as the death certificate indicating the cause of death, and medical records identifying the type of cancer and diagnosis date will also most certainly be required.
Families that believe they may be eligible for this benefit can start today by gathering these documents and having them ready for the application process. Having to wait on required documentation significantly slows down the application process. Having all the required documentation in hand when the application is filed provides the biggest opportunity for a efficient approval process.
I would also note that the PSOB Benefit Application process, while greatly improved over the last few years, is still lengthy and somewhat cumbersome. There are pitfalls and must have documentation that is not necessarily intuitive. Having the assistance of someone who is trained and experienced in the process will provide the best opportunity for smooth and expedient application processing.
For more information or assistance with filing an application for benefits, contact one of the organizations identified above.
Dennis Thayer



