Workers Comp Claims for California Firefighters Injured at Work

There are special rules for California firefighters who are injured at work.

These rules give firefighters additional workers compensation benefits and make it easier for them to get benefits for medical conditions that might not be considered work injuries if they were in another job.

It is important to understand:

  1. Who is considered a firefighter
  2. The additional benefits a firefighter can receive
  3. How those benefits fit with the general rules related to work injuries

In this article, our California personal injury lawyers will explain:

1. What special California workers' compensation benefits do firefighters receive?

Workers' compensation benefits provide medical, temporary disability, permanent disability and death benefits. There are two special rules that give firefighters additional benefits:

  • When a firefighter is injured and unable to work, he or she can receive one year of full salary in lieu of disability benefits, which are only two-thirds of one's salary.1
  • When a firefighter has a medical condition listed below it is presumed that it is a work injury. He gets the benefit of the doubt as to the cause of your injury that an injured worker in another industry may not get. This also allows him to receive medical treatment and disability benefits that other injured workers may not get.2

The Labor Code defines “firefighter” differently for each set of benefits. Each of these situations are addressed below.

2. Payment at full salary under Labor Code section 4850 when a firefighter is unable to work due to a work injury

Firefighters who qualify for full-salary benefits include city, county, or district firefighters.3 These benefits are often referred to as “4850 benefits.”

This does not include telephone operators, clerks, stenographers, machinists, mechanics, or other people whose function does not include active firefighting and prevention services.4

A firefighter is entitled to one year of full salary “4850 benefits” if he or she is unable to work due to a work injury.5

Workers in other industries would only receive temporary or permanent disability payments.

Temporary disability is when you cannot work and still require treatment. Temporary disability benefits are limited to two-thirds of your salary and capped at a certain amount.

Permanent disability is when your condition is not going to change, and you have permanent loss of ability. Permanent disability benefits are capped at $290 a week.

The “4850 benefits” benefits are not taxable.6

After the one-year period, firefighters are entitled to receive temporary disability benefits if he or she still can't work.7

A firefighter cannot receive “4850 benefits” and disability benefits at the same time.8

2.1 Do “4850 benefits” count toward other disability benefits you can receive?

Any injured worker is entitled to 104 weeks of “aggregate disability payments” within a five-year period of each injury.9 This means that you are limited to two years of temporary disability benefits for your injury. These are the benefits that replace your salary when you can't work.

Aggregate disability payments include the one-year full salary benefits that firefighters get under Labor Code section 4850.10

In other words, a California firefighter can get one year of “4850 benefits” at full salary and one year of temporary disability benefits at two-thirds of your salary totaling two years of aggregate disability benefits.

Example: Michelle is a firefighter injured on duty. She is off work for one year and gets the full-salary “4850 benefits.” She continues to miss work for another year and gets temporary disability benefits at two-thirds her weekly salary.

Michelle is still unable to work even light or modified duty, and tries to claim further temporary disability benefits, saying that she is entitled to 104 weeks of temporary disability.

She is denied another year of temporary disability because the full salary 4850 benefits count toward the 104 weeks.

2.2 How does retirement affect “4850 benefits”?

The “4850 benefits” terminate at the time of a California Public Employees Retirement System (CALPERS) retirement. This is the case even if you have not used up your year of benefits.11

2.3 What happens if there's a delay in the insurance company paying “4850 benefits”?

You should receive your “4850 benefits” within two weeks of being unable to work. An unreasonable delay of “4850 benefits” can cause a penalty of up to 25% of the amount delayed under Labor Code Section 5814.12

Example: Ryan, a firefighter, is injured on the job and taken off work by his doctor. Because he is a firefighter he is eligible for “4850 benefits”. He can receive full pay for one year. Based on a salary of $78,000 a year, Ryan earns $1,500 a week. As benefits are paid every two weeks, he is paid $3,000 every two weeks in “4850 benefits.”

Because these benefits are not taxed Ryan will receive more money in his pocket than if he was working.

If Ryan were not a firefighter he would only receive two-thirds of his average weekly wage or $1,000, and be paid $2,000 every other week.

If Ryan continues to miss work after receiving one year of full-salary 4850 benefits, his benefits after the first year will be lowered to the $2,000 payments for up to another 52 weeks.

3. Medical conditions that are presumed to be work related when you are a firefighter

For this section a firefighter is a “person engaged in providing firefighting services who is an apprentice, volunteer, or employee on a partly paid or fully paid basis.”13 It can be a trainee.14

It includes anyone who works for:

  • a city, county, district, or any other municipality
  • the University of California or California State University
  • the Department of Forestry and Fire Protection
  • county forestry or firefighting department
  • a fire department that serves the U.S. Department of Defense
  • a fire department that serves NASA
  • fire and rescue coordinators that work for the Office of Emergency Services15

Medical conditions that are presumed to come from working as a California firefighter also include:

  • cancer16
  • pneumonia17
  • heart trouble18
  • a blood-borne infectious disease19
  • a biological or chemical agent20
  • meningitis21

If a firefighter develops cancer, he or she has to show that he was exposed to a carcinogen while working, and there is a reasonable link between the carcinogen and the type of cancer.22

A carcinogen is defined as anything identified by the International Agency for Research on Cancer (IARC).23

High blood pressure, arteriosclerosis, or an abnormal echocardiogram are examples of heart trouble.24 Therefore, high blood pressure with no other symptoms can be considered heart trouble.25

Example: Linda is a firefighter who testified to two specific instances of exposure to benzene and diesel fuel. She develops breast cancer and was found to have a work-related cumulative trauma injury.

Linda is entitled to this even though she had a breast cancer gene and the evaluating doctor did not feel it was work-related. Even though there isn't a study showing a connection between the exposure and cancer, it does not mean the cancer isn't reasonably linked.26

Example: Jake is a firefighter and he is exposed to asbestos and later develops stomach cancer. There was not a reasonable link between the cancer and the exposure because no doctor could find any medical connection.27 Jack's cancer is not related to work, and he does not get any California workers' compensation benefits.

A firefighter can claim these injuries after he stops working. For each year of service, he has three months after he stops working to claim a work injury. This continues up to a maximum of 5 to 10 years depending upon the condition.

Example: Alan has worked for the fire department for ten years. Alan can claim a heart injury from work up to 30 months after he stops working. This is because for each year of service, he is allowed three extra months to claim this injury.

Alan claims a heart injury two years after he stops working and is entitled to benefits.

3.1 Can your employer get out of paying for some of your disability?

In a regular California workers' compensation injury, the employer is only responsible for the portion of the injury caused by work.28 However in the case where one of the above presumptions apply to a California firefighter, the entire injury is presumed to be from work.29

Even if you have a pre-existing condition, there is no apportionment.30

This entitles you to get a larger permanent disability award because there is no reduction for any part that is not related to work.

Example: Dave is a firefighter. A doctor found an injury to his heart. The doctor said that 40% of his heart injury existed prior to Dave becoming a firefighter. Even though this may be true, all of Dave's injury is considered to be from work.

Dave's workers comp settlement could have been reduced by 40% if not for this rule.

Remember as well that you can always appeal a denial of workers compensation benefits in California

4. Other rules that benefit California firefighters

Any firefighter who is injured or dies while performing duties as a firefighter, even if not for his employer, is said to have a work injury.31 32

The spouse of a firefighter who dies is eligible to continue to receive health insurance benefits. Alternatively, she can receive a lump sum survivor benefit. Also, any children can receive health benefits until they turn 21.33

A dependent of a firefighter killed or totally disabled in the line of duty is also entitled to a scholarship.34

5. How do I take advantage of the special rules for firefighters?

All the special rules for firefighters are contained in the California Labor Code. Insurance companies are aware of these benefits when you file a claim for California workers' compensation benefits and complete the necessary workers comp forms. They should notify you that you qualify for them.

However, being aware of your rights as a California firefighter is important to receive the benefits you deserve.

Legal References

  1. Cal. Lab. Code § 4850

  2. Cal. Lab. Code § 3212

  3. Cal. Lab. Code § 4850(b)(2)

  4. Cal. Lab. Code § 4850(c)(4)

  5. Cal. Lab. Code § 4850

  6. https://www.irs.gov/publications/p525#en_US_2017_publink1000229331

  7. Cal. Lab. Code § 4853

  8. Cal. Lab. Code § 4854

  9. Cal. Lab. Code § 4656

  10.  County of Alameda v. Workers' Comp. Appeals Bd. (Knittel) (2013) 213 Cal. App. 4th 278, 286

  11.  City of Martinez v. Workers' Comp. Appeals Bd. (2000) 85 Cal. App. 4th 601, 614

  12.  Gage v. Workers' Comp. Appeals Bd. (2016) 6 Cal. App. 5th 1128, 1135

  13. Cal. Lab. Code § 3211.5

  14. 86 Ops. Cal. Atty. Gen. 123, 126

  15. Cal. Lab. Code § 3212.1(a)

  16. Cal. Lab. Code § 3212.1(d)

  17. Cal. Lab. Code § 3212

  18. Id.

  19. Cal. Lab. Code § 3212.8

  20. Cal. Lab. Code § 3212.85

  21. Cal. Lab. Code § 3212.9

  22. Cal. Lab. Code § 3212.1(b)

  23. Id.

  24. Muznik v. Workers' Comp. Appeals Bd. (1975) 51 Cal. App. 3d 622, 636-637

  25. Muznik, at p. 638

  26. County of Ventura v. WCAB (2010) 75 Cal. Comp. Cases 513

  27. Riverview Fire Protection Dist. v. Workers' Comp. Appeals Bd. (1994) 23 Cal. App. 4th 1120

  28. Cal. Lab. Code § 4663

  29. Department of Corrections & Rehabilitation v. Workers' Comp. Appeals Bd. (2008) 166 Cal. App. 4th 911, 920

  30. Department of Corrections & Rehabilitation, at p. 917

  31. Cal. Lab. Code § 3600.1

  32. Cal. Lab. Code § 3600.4

  33. Cal. Lab. Code § 4856

  34. Cal. Lab. Code § 4709

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