First Responder Presumptive Coverage

Answer:

We were recently doing a presentation before a local union, and we were asked how presumptions differ from a regular workers’ compensation injury. Presumptions are unique in the law in that it shifts the burden from the injured worker to the carrier. What that means is once you’ve met the elements of the presumption, the burden then falls on the carrier to prove that it’s not work-related.

For example, if an individual has a heart attack and is a first responder, they’re entitled to the heart presumption if they meet the four criteria of the protected class, the protected condition, they have a qualifying pre-employment physical, and they have a disability within a definition of workers’ compensation. If they’ve met those four criteria, those four elements, they’ve proved their case and it then falls upon the employer carrier to rebut that presumption with either competent substantial or clear and convincing evidence of a non-work-related cause. If you have a presumptive case and would like to discuss your options, please call us at Oliver and Fox and I’ll be happy to explore those options.