PRESUMPTION FOR PUBLIC EMPLOYEES WHO RISK LIFE OR HEALTH
Certain employees of public or government agencies have jobs which, by their very nature, carry a greater potential for sustaining a certain type of injury or acquiring a certain type of medical condition. In many of these cases, the Labor Code contains presumptions of industrial injury for the protection of this special class of employees that put themselves in harm’s way for our protection and/or to provide us with other essential services.
These presumptions cover such medical conditions as heart trouble, tuberculosis, cancer, pneumonia, hernias, low back injuries, certain infectious diseases (including COVID), and meningitis, amongst others. When these presumptions apply, the injured employee is entitled to all benefits afforded to them by the workers’ compensation laws of the State of California. This includes disability payments, medical treatment, hospital and surgical care, and in the most tragic of cases – death benefits.
Typically when we think of employees that fall within these special categories, we think of firefighters or law enforcement officers. It is important to note, however, that not all such employees are afforded these presumptions. There are strict criteria that must be met for the presumption to apply – that is, an assumption or conclusion that their medical conditions and/or injury is work-related.
In order to obtain the benefit of one of these presumptions, the medical condition or injury must develop or manifest itself during a period when that employee was in the service of the qualifying agency. This does not require the employee to actually be “at work” at the time they develop a condition or injury. They are considered in the service of their employer from the date they are brought into service through the date of termination of that service, whether voluntary (e.g. retirement) or otherwise. This means that the presumption can also apply during periods of vacations, sick time, weekends, etc. – such that if one of these special public employees had a heart attack while on vacation or on a weekend, it still could be presumed work-related.
It is also important to note that even when the presumption renders an injury work-related, it is a rebuttal presumption. This means that if there is sufficient other evidence to show that the medical condition or injury was caused by an incident, occurrence or exposure that was not work-related, the presumption may disappear based upon the weight of the evidence.
For example, if you had a firefighter that had a heart attack on a weekend that was presumed compensable initially, but other evidence surfaced that he had a very loud, aggressive or even physical altercation with a family member or friend unrelated to work that immediately preceded the heart attack – that might be enough to overcome the presumption typically afforded to firefighter.
We will provide additional examples of presumptions related to special conditions and injuries to certain classes of public employees in a future blog.