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Schedule B Item 5 Firefighters/Heart Injury or Disease
2000/06/05-01
THE WORKERS' COMPENSATION BOARD OF BRITISH COLUMBIA
RESOLUTION OF THE PANEL OF ADMINISTRATORS
RE: Schedule B Item 5 Firefighters/Heart Injury or Disease
WHEREAS:
Pursuant to Section 82 of the Workers Compensation Act, RSBC 1996, Chapter 492 and amendments thereto (the "Act") the Panel of Administrators (the "Panel") must approve and superintend the policies and direction of the Workers' Compensation Board (the "Board"), including policies respecting compensation, assessment, rehabilitation and occupational safety and health, and must review and approve the operating policies of the Board;
AND WHEREAS:
Pursuant to Section 6(4)(a) of the Act the Panel of Administrators, on behalf of the Board may, on the terms and conditions and with the limitations which are deemed adequate and proper, amend Schedule B of the Act;
AND WHEREAS:
Pursuant to Section 1 of the Act the Panel of Administrators, on behalf of the Board may, by regulation of general application, designate or recognize a disease as an "occupational disease";
AND WHEREAS:
The Board's current policy dealing with compensation for "Heart Conditions" is provided in Section 30.70 of the Rehabilitation Services and Claims Manual (the "RSCM");
AND WHEREAS:
The Terms of Reference of the Occupational Disease Advisory Committee state that "when assessing occupational causation of disease, the Committee shall be guided by the Protocol for the Assessment of Medical/Scientific Information, adopted by the Industrial Disease Standing Committee of the Board of Governors of the WCB on March 2, 1993."
THE PANEL OF ADMINISTRATORS RESOLVES THAT:
- Pursuant to Section 6(4)(a) of the Act, Item 5 of Schedule
B to the Act is repealed and a corresponding Regulation is to
be deposited with the Registrar of Regulations in such form as may be
required by the Registrar.
- Pursuant to Section 1 of the Act, "Heart Disease"
is added to the list of occupational diseases in Section 1 of BC Regulation
71/99, the Occupational Disease Recognition Regulation, and a corresponding
Regulation is to be deposited with the Registrar of Regulations in such
form as may be required by the Registrar.
- Section 26.03 of the RSCM is amended as shown in Appendix A.
- Section 30.70 of the RSCM is amended as shown in Appendix B.
- Section 15.15 of the RSCM is adopted as published policy as
shown in Appendix C.
- As a consequential amendment, Item 5 of Appendix 2 of the RSCM
is amended as shown in Appendix D.
- The Board's Research Secretariat facilitate/sponsor further research,
within a 5-10 year timeframe, into the relationship between heart injury
and disease and/or any specific sub-type of heart injury or disease
and the occupational exposures of firefighters and other emergency workers.
- Once the results of such research are available, the Board through
its governing body, in consultation with the Occupational Disease Advisory
Committee, will determine whether heart injury and/or disease or any
heart injury and/or disease subtype should be added to Schedule B.
- If the decision is to add any heart injury and/or disease to Schedule
B that has been removed by way of this Resolution, claims made by firefighters
for such condition(s), which were disallowed in the period from the
effective date of this Resolution, shall be reconsidered in accordance
with the new Schedule B language.
- Training specific to the adjudication of claims made by firefighters
for heart injury and disease in relation to the policy set out in Appendix
C will be provided, on an expedited basis, to Board Officers who adjudicate
such claims.
- The above amendments to Schedule B, to the Occupational Disease Recognition Regulation, and to Sections 26.03, 30.70 and Appendix 2 of the RSCM, and the adoption of Section 15.15 of the RSCM shall be effective 90 days after deposit of the above Regulations with the Registrar of Regulations. The amendments shall apply only to those claims where the initial application for compensation has been received by the Board on or after the effective date of such amendments.
DATED at Richmond, British Columbia, June 5, 2000.
By the Workers' Compensation Board
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APPENDIX A
(Additions in Bold, Deletions in Strikethrough)
#26.03 Recognition by Regulation of General Application
The Board may designate or recognize a disease as an occupational disease "by regulation of general application" (Section 1). In these circumstances, the Board designates or recognizes a disease as an occupational disease but without specifying that it is peculiar to or characteristic of a particular process, trade or occupation. The desired institutional memory is thus less specific. The Board has designated or recognized the following as occupational diseases by regulation:
Bronchitis
Campylobacteriosis (Diarrhea caused by Campylobacter)
Carpal Tunnel Syndrome
Chicken Pox
Cubital Tunnel Syndrome
Disablement from Vibrations
Emphysema
Epicondylitis (Lateral and Medial)
Food Poisoning
Giardia Lamblia Infestation
Head Lice (Pediculosis Capitis)
Heart Disease
Herpes Simplex
Hypothenar Hammer Syndrome
Infectious Hepatitis
Legionellosis
Lyme Disease
Meningitis
Mononucleosis
Mumps
Plantar Fasciitis
Radial Tunnel Syndrome
Red Measles (Rubeola)
Ringworm
Rubella
Scabies
Serum Hepatitis
Shigellosis
Staphylococci Infections
Stenosing Tenovaginitis (Trigger Finger)
Streptococci Infections
Thoracic Outlet Syndrome
Toxoplasmosis
Typhoid
Vinyl Chloride Induced Raynaud's Phenomenon
Whooping Cough
Yersiniosis
It is important to distinguish between designation or recognition of an occupational disease under Section 6(4)(b) or by regulation of general application, and the addition of a disease to Schedule B under Section 6(4)(a). Where the Board concludes that a disease is more likely to occur in connection with a particular employment covered by the Act than elsewhere, it may be added to Schedule B (see #26.01). On the other hand, where the Board concludes that a disease is sometimes due to the nature of a particular employment covered by the Act, but it does not appear that the disease is more likely to occur in connection with that employment than elsewhere (it is not something specific to that employment), the Board may designate or recognize the disease under Section 6(4)(b) or by regulation of general application without the rebuttable presumption afforded by inclusion in Schedule B.
Several of the above contagious diseases are not likely to be ". . . due to the nature of any employment in which the worker was employed . . ." except for hospital employees, or workers at other places of medical care.
The authority under the Act to designate or recognize a disease under Sections 6(4)(a), 6(4)(b) or by regulation of general application rests with the Governors.
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APPENDIX B
(Additions in Bold, Deletions in Strikethrough)
#30.70 Heart Conditions
Heart attacks Heart-related conditions which arise out
of and in the course of a person's employment and which are attributed
to a specific event or cause or to a series of specific events or causes
are generally treated as personal injuries. They are therefore adjudicated
in accordance with the policies set out in Chapter 3. If the cardiac
heart-related condition of a worker who is not employed as a
firefighter is one involving a gradual onset and is not attributed
to a specific event or cause or to a series of events or causes, the claim
will be considered as an occupational disease adjudicated
under Section 6 of the Act. (See #15.10 and #15.15).
The following entry is found in Schedule B.
Description of DiseaseDescription of Process or IndustryHeart injury or disease
including heart attack,
cardiac arrest or
arrhythmia, disease of
the pericardium, heart
muscle or coronary arteries.Where the worker is employed as a
firefighter.
The result of this provision is that, where the worker is employed
as a firefighter, claims for heart attacks or other heart or related conditions
are treated as claims for occupational disease.
The meaning of this provision in Schedule B, in conjunction with Section
6(3), is that where a worker has suffered an injury to or disease of the
heart (including heart attack) while employed as a firefighter (but not
necessarily engaged in the act of fighting a fire at the time the condition
becomes a manifest disability), then the Board must conclude that the
injury or disease was due to the nature of that employment, unless the
contrary is proved (see #26.21 regarding the rebuttable presumption).
If the evidence is more heavily weighted in favour of a conclusion that
it was something other than the employment that caused the heart injury
or disease, then the contrary will be considered to have been proved and
the claim, on that basis, could properly be disallowed.
The term "firefighter" is limited to workers whose actual
duties involve the fighting of fires where they are likely to be exposed
to smoke, fumes, gases, vapours and other by-products of combustion. Workers
who are employed in the firefighting industry who are not in fact actively
fighting fires are not "employed as a firefighter" for the purposes
of Schedule B. For example, the following workers would not be
considered to be employed as a firefighter:
- a fire prevention officer (who does not attend fire scenes during or after dousing);
- a dispatcher;
- a person who maintains firefighting equipment; or
- a fire lookout;
unless the actual duties of such workers also involve the fighting
of fires or unless such worker had immediately before the condition became
manifest been transferred or rotated to that position from one involving
fighting fires.
The fact that a worker's job description requires them to fight fires
if called upon to do so does not in itself make the worker a firefighter
for this purpose. The test is whether the worker was actively employed
to attend and to fight fires at or immediately before the date of disablement
from the heart injury or disease.
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APPENDIX C
(Additions in Bold, Deletions in Strikethrough)
#15.15 Firefighters and Heart Injury
The physical tasks involved in extinguishing fires and performing related rescue and hazardous materials responses expose firefighters to risks that are often unique to their profession. In this section the term "firefighter" refers to workers whose actual duties involve extinguishing fires and/or performing related rescue and hazardous materials duties. This section does not apply to workers employed in the firefighting profession who do not perform such duties. Evidence that a worker's job description includes the performance of such duties does not in itself render the worker a firefighter for the purposes of this section.
If during or within twenty-four hours immediately following attending a fire, rescue, or hazardous materials response the firefighter experiences:
- the onset of chest pain, collapse, cardiac arrest, or death due to myocardial infarction (heart attack); or
- the onset of symptoms, collapse, cardiac arrest, or death associated with an episode of acute cardiac arrhythmia;
a strong inference will arise that such condition was caused by the employment where during the course of attending such fire, rescue, or hazardous materials response the firefighter was exposed to:
- an intense physical effort sufficient to cause significantly increased heart rate and arterial blood pressure, or
- high temperatures and/or the wearing of personal protective equipment that significantly affected the firefighter's ability to thermo-regulate or that caused the firefighter to undergo intense physical effort, or
- environments containing asphyxiants such as carbon monoxide, carbon dioxide, or hydrogen cyanide, and that are likely to have produced oxygen deficiency in that firefighter.
The commencement of such twenty-four hour period begins when the firefighter leaves the scene of the fire, rescue, or hazardous materials response. Against this inference must be weighed any evidence which suggests that such cardiac condition is due to non-occupational factors. However, it is recognized that in rare cases the onset of symptoms associated with such cardiac condition may first occur between twenty-four and forty-eight hours following the above-described occupational exposure(s). Where the onset of such symptoms first occur more than twenty-four hours after the firefighter leaves the scene of the fire, rescue, or hazardous materials response, consideration is given to any evidence which may account for such delay in onset. In particular, consideration is given to all relevant clinical records, including hospital reports, that document the worker's condition.
Generally, the Board will determine that the firefighter's condition is not causally associated with the employment where the onset of symptoms, collapse, cardiac arrest, or death due to the above-described cardiac condition occurs:
- more than forty-eight hours following the time when the firefighter left the scene of such fire, rescue or hazardous materials response; or
- during or immediately following the performance of non-occupational activities that are likely to have caused the firefighter to experience significantly altered cardiovascular or respiratory function.
Against this inference must be weighed any evidence which supports the claim.
Where one of the above-described conditions is determined to be compensable, the Adjudicator must determine whether the worker was suffering from a pre-existing or underlying condition such as coronary artery disease. See #15.00, #15.10 and #30.70. Time loss and health care expenses that are solely attributable to treatment of the pre-existing or underlying condition through such interventions as angioplasty, coronary bypass and/or medications, are compensable only in circumstances where the pre-existing or underlying condition is compensable. Consideration will also be given to proportionate entitlement under Section 5(5) and to relief of costs under Section 39(1)(e) of the Act (also see #113.20 and #115.30).
See #7.10 regarding volunteer members of a fire brigade.
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APPENDIX D
Appendix 2 of the RSCM -- Occupational Diseases Listed in Schedule B
(Additions in Bold, Deletions in Strikethrough)
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Where there is prolonged exposure to dusts, fumes or mists containing nickel or the dusts of hard woods. |
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Where there is exposure to vinyl chloride monomer. |
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Where there is exposure to:
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Where there is repeated exposure to respirable organic dusts. |
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Where there is excessive exposure to a gas, vapour, mist, fume or dust of a chemical or other material ordinarily causative of respiratory irritation. |
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Where there is exposure to the fume of zinc or other metals. |
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Where there is exposure to high concentrations of fluorine or fluorine compounds in gaseous or particulate form. |