BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2253
                                                                  Page  1

          Date of Hearing:   April 7, 2009

                           ASSEMBLY COMMITTEE ON INSURANCE
                                 Jose Solorio, Chair
                  AB 2253 (Coto) - As Introduced:  January 16, 2010
           
          SUBJECT  :   Workers' compensation: cancer presumption

           SUMMARY  :   Extends the statute of limitations on the existing  
          cancer presumption for safety employees to a period of time  
          equal to one year for each year of service.  Specifically,  this  
          bill  : 

          1)Extends, from three months per year of service to one year per  
            year of service, the period of time after termination of  
            service during which cancer is presumed to be work-related.

          2)Extends the five-year cap that modifies the one year for one  
            year of service formula to a fifteen-year cap. 

          3)Specifies that the provision of law establishing the cancer  
            presumption may be cited as the William Dallas Jones Cancer  
            Presumption Act of 2009.

           EXISTING LAW  

          1)Provides for a comprehensive system of workers' compensation  
            benefits for injuries that occur during the course of  
            employment.

          2)Provides that for specified safety employees (firefighters and  
            peace officers) cancer is presumed to have arisen during the  
            course of employment.

          3)Requires the Workers' Compensation Appeals Board (WCAB) to  
            find that the cancer is employment-related unless the employer  
            proves that the cancer is not related to employment.

          4)Specifies that for the presumption to apply, the safety  
            officer must be in service at the time the cancer manifests  
            itself, or, if the employee has separated from the employer,  
            the statute of limitations has not expired.  The statute of  
            limitations is different for each employee, based on a formula  
            that grants three months for each year of service to that  
            employer, with the period commencing on the last date actually  








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            worked.

          5)Provides that, regardless of the time period for the statute  
            of limitations calculated using the three months per year of  
            service formula, in no case shall the statute of limitations  
            be more than 5 years from the date last worked by the employee  
            for that employer.

           FISCAL EFFECT  :   Undetermined, but see Comment 4, below.

           COMMENTS  :   

           1)Purpose  .  According to the author, in the course of performing  
            their job-related duties, firefighters and other public safety  
            personnel routinely come into contact with materials known to  
            cause various types of cancer.  Since the original cancer  
            presumption statute was enacted over two decades ago, research  
            and anecdotal information reveal that some industrially-caused  
            cancers actually manifest themselves well-beyond the existing  
            60 month statute of limitations given the complex synergistic  
            effects of multiple compound exposures, as well as the rapidly  
            growing introduction of new chemicals and industrial compounds  
            into our environment.  Consequently, there is a critical need  
            to strike the cap in current law.

           2)Rationale for presumption  .  Many factors play a role in the  
            development of cancer, while the importance of these factors  
            is different for different types of cancer.  A person's risk  
            of developing a particular cancer is influenced by a  
            combination of factors, some of which include one's exposure  
            to cancer-causing agents in their environment, as well as  
            their exposure to cancer-causing agents in the workplace.  In  
            many cases, these factors act together or in sequence to cause  
            cancer.

          According to the US Department of Health and Human Services, the  
            time from genetic cellular change to the development of cancer  
            is called the latency period. A latency period can be 10 years  
            or as long as 30 years or more, which means that some cancers  
            diagnosed today may be due to genetic changes that occurred in  
            the cells some time ago.

            Further, in November 2006, the Journal of Occupational and  
            Environmental Medicine found that firefighters have  
            significantly elevated rates of four types of cancer: multiple  








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            myeloma, non-Hodgkin's lymphoma, prostate, and testicular  
            cancer.

            According to the sponsors of the bill, the California  
            Professional Firefighters, the original purpose of the  
            presumption, which was enacted over 20 years ago, was to  
            recognize that it was probable that many cancers that  
            afflicted safety officers were job-related, but due to the  
            passage of time during the latency period, it was difficult to  
            prove that relation to the job.

            Recent scientific developments, however, have shown that the  
            original statute of limitations provision is contrary to the  
            purposes of the presumption.  Several of the cancers most  
            closely associated with the firefighters and their profession  
            have a latency period longer than 60 months.  For example, a  
            review of The Risk of Cancer in Firefighters by Anne L Golden,  
            PhD, Steven B Markowitz, PhD, and Philip J Landrigan, MD, MSc,  
            as published in 1995 in the Occupational Medicine: State of  
            the Art Reviews, reveals that the latency period for most of  
            the relevant cancers associated with exposure to chemical  
            carcinogens is likely to be at least three or four decades.

           3)William Dallas Jones  .  William "Dallas" Jones was a dedicated  
            firefighter in Los Angeles County for nearly 35 years.  The  
            passion and professionalism with which he conducted his duties  
            as President for Los Angeles County Firefighters Local 1014  
            and later as Secretary/Treasurer for California Professional  
            Firefighters made him highly qualified to lead the state  
            Office of Emergency Services as Director from 1999-2004.   
            During his time at OES, Dallas responded to and was on the  
            ground during a myriad of emergencies, including the  
            devastating fire storms in 2003 that engulfed Southern  
            California.  After leaving that post, he continued his work by  
            returning as Secretary-Treasurer for the California  
            Professional Firefighters, even after he was diagnosed with  
            cancer in 2007.  He ultimately succumbed to cancer when it  
            claimed his life in 2008.

           4)Prior Legislation  .  AB 128 (Coto) of 2009 proposed an  
            extension of the cancer presumption similar to what is  
            proposed by this bill.  However, AB 128 did not cap the  
            "one-year for one-year of service" formula for the statute of  
            limitations at the fifteen year time frame proposed by this  
            bill.  Thus, presumably, the costs identified by the  








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            Appropriations Committee for AB 128 are greater than the costs  
            that would be associated with this bill.  According to the  
            Assembly Appropriations Committee Analysis of AB 128, that  
            bill would have generated General Fund costs in excess of $300  
            million.  AB 128 was held on suspense.

           5)Opposition  .  A number of public entities and associations of  
            public entities are opposed to the bill.  (See list below.)   
            They cite a 2004 WCAB ruling that held that the public  
            employer must, in order to rebut the cancer presumption,  
            "explicitly demonstrate that medical or scientific research  
            has shown that there is no reasonable inference that exposure  
            to known carcinogen or carcinogens is related to [the cancer]  
            or causes the development of the cancer."  They conclude that  
            this standard makes it virtually impossible to rebut the  
            presumption, and that therefore the bill makes any cancer any  
            safety officer ever contracts compensable through the workers'  
            compensation system.

          Opponents note that the cancer presumption applies to any  
            cancer, and that the risk of cancer in the general population  
            greatly increases with age.  They provide an example of a  
            25-year-old person who works for 25 years, then retires - a  
            not uncommon scenario in fire and police work.  This person  
            would have the benefit of the cancer presumption until the age  
            of 65, when the general risk of cancer is substantially  
            increased.

           6)Costs associated with workers' compensation cancer presumption  
            claims  :  

              a)   Medical expenses  .  While many retired safety officers  
               have employer-provided health insurance, there are still  
               medical expenses associated with turning the cancer into a  
               workers' compensation case.  Usually, CalPERS or other  
               pension fund-related health program treats workers'  
               compensation as primary, so even though the public employer  
               is paying premiums to the plan, the medical expenses must  
               be paid directly.  For those not in public medical plans,  
               the public employer would become primary.

              b)   Death benefits  .  Death benefits of up to $290,000,  
               depending on the number of dependents a cancer victim has,  
               are payable by the public employer, plus weekly payments of  
               over $950 per week for the support of minor dependents  








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               until they reach the age of 18.

              c)   Temporary and permanent disability payments.   For those  
               safety officers still in the labor market, the normal range  
               of temporary and permanent disability benefits, including  
               "4850" time (providing full salary replacement for one  
               year, an enhancement over regular temporary disability  
               benefits), would be provided.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California Association of Highway Patrolmen (sponsor)
          California Nurses Association
          California Professional Firefighters (sponsor)
          California State Employees Association (CSEA)
          CDF Firefighters Local 2881 (Co-sponsor)
          Kern County Firefighters Union, Inc.
          Marin Professional Firefighters
          Monrovia Firefighters - Local 2415
          Orange County Professional Firefighters' Association
          Peace Officers Research Association of California (PORAC)
          Union City Firefighters - Local 1946
           
          Opposition 
           
          California Association of Joint Powers Authorities
          California Coalition on Workers' Compensation
          California Special Districts Association
          California State Association of Counties
          CSAC Excess Insurance Authority
          Howard Jarvis Taxpayers Association
          Los Angeles County
          Orange County Board of Supervisors
          Regional Council of Rural Counties

           
          Analysis Prepared by  :    Mark Rakich / INS. / (916) 319-2086