Extending presumptive coverage for post-traumatic stress disorder
How do the recent legislative changes impact presumptive coverage for post-traumatic stress disorder?
As of October 28, 2024, presumptive coverage for post-traumatic stress disorder (PTSD) now extends to include both wildland firefighters and wildland fire investigators in certain circumstances.
We are updating our policy to reflect these legislative changes. Until then, all decisions related to affected claims will be based on the new legislation.
When did this take effect?
These changes took effect on October 28, 2024.
What do I need to do if I already submitted a related claim?
If you have already submitted a claim for PTSD, you do not need to take any action. We will call you about any legislative changes that affect your claim.
If I received a PTSD diagnosis before October 28, 2024, when do I need to submit a claim to be considered under presumptive coverage?
If you are a wildland firefighter or wildland fire investigator and received a PTSD diagnosis on or after October 28, 2022, but before October 28, 2024, you must submit a claim before April 28, 2025, to be considered under presumptive coverage.
Change to coverage for esophageal cancer
How does this change impact how you adjudicate claims for firefighters and fire investigators with esophageal cancer?
Now we can process and adjudicate firefighter and fire investigator claims for esophageal cancer by presuming it's work related if you have been a firefighter or fire investigator for 15 years, instead of 25 years.
This means if a person has been a firefighter or fire investigator for at least 15 and is diagnosed with esophageal cancer, we will presume that their illness is work related. This gives them faster and easier access to the benefits and support they need.
When does this take effect?
These changes took effect on May 1, 2024.
What do I need to do if I already submitted a related claim?
If you have already submitted a claim for esophageal cancer, you do not need to take any action. We will call you about any legislative changes that affect your claim.
Will decisions on past claims be reconsidered based on the expanded coverage?
We are reviewing any past claims where we may need to reconsider the decision based on the expanded coverage. We’ll reach out to these people about their claim.
Coverage for wildland firefighters and fire investigators
What does the extended presumptive coverage for wildland firefighters and fire investigators mean?
As of October 28, 2024 presumptive coverage for post-traumatic stress disorder extends to include both wildland firefighters and wildland fire investigators in certain circumstances.
We’re updating our policy to reflect these legislative changes. All decisions related to affected claims will be based on the new legislation, until the policy is updated.
As of May 1, 2024, presumptive coverage for cancers and heart injuries was extended to include both wildland firefighters and wildland fire investigators. We have updated our policy for cancer and for heart injuries in firefighters and fire investigators.
Coverage for pancreatic and thyroid cancers
Why is presumptive cancer coverage being expanded?
The Ontario government announced an expansion of presumptive cancer coverage for eligible firefighters and fire investigators to include pancreatic and thyroid cancers.
When does this expansion take effect?
These changes took effect on June 29, 2023.
Who is eligible for this expanded coverage?
The expanded presumptive coverage is for firefighters and fire investigators employed in those jobs for 10 or more years who have been diagnosed with pancreatic and thyroid cancers. The coverage is retroactive to January 1, 1960. You can read more about presumptive cancer coverage, including existing coverage for certain other cancers.
Could claims that were previously not allowed now be eligible for benefits?
Yes, in some cases a claim that was previously not allowed may now be eligible to receive benefits under the expanded presumptive coverage. We are proactively reviewing previous claims to identify any that we may need to reconsider.
What types of cancer are covered in this expansion?
This expanded presumptive coverage applies to pancreatic and thyroid cancers for eligible firefighters and fire investigators. For other cancers that may be covered by existing presumptive coverages, see our Cancers in Firefighters and Fire Investigators Policy.
Information for employers of firefighters and fire investigators
When will I know the cost of the claim(s) affected by this?
Costs vary based on the facts of each specific case. We will make every effort to provide a preliminary estimation of the claim cost as soon as we are able. You will know the exact cost of any impacted claims when a decision on the claim has been made.
What payment options are available to me?
Please email employeraccounts@wsib.on.ca or call us at 1-800-387-0750, Monday to Friday 7:30 a.m. to 5 p.m. if you need support with your WSIB account.