Presumptive Disability Law in Georgia

Presumptive Health Initiative

CODE PART:

CHAPTER 3. LOCAL FIRE DEPARTMENTS GENERALLY
ARTICLE 2. MINIMUM REQUIREMENTS
§ 25-3-23. General requirements; equipment and clothing; insurance

TITLE 45. PUBLIC OFFICERS AND EMPLOYEES

CHAPTER 9. INSURING AND INDEMNIFICATION OF PUBLIC OFFICERS AND EMPLOYEES

ARTICLE 5. LAW ENFORCEMENT OFFICERS, FIREMEN, PRISON GUARDS, AND PUBLICLY EMPLOYED EMERGENCY MEDICAL TECHNICIANS

PART 1. GEORGIA STATE INDEMNIFICATION FUND

  • 45-9-85. Payment of indemnification for death or disability; procedure for making payments; appeal

Georgia Legislative Website

DESCRIPTION:

    1. A legally organized fire department shall provide and maintain sufficient insurance coverage on each member of the fire department to pay claims for injuries sustained en route to, during, and returning from fire calls or other emergencies and disasters and scheduled training sessions.
      1. As used in this paragraph, the term:
        1. ‘Cancer’ means bladder, blood, brain, breast, cervical, esophageal, intestinal, kidney, lymphatic, lung, prostate, rectum, respiratory tract, skin, testicular, and thyroid cancer; leukemia; multiple myeloma; or non-Hodgkin’s lymphoma.
        2. ‘Firefighter’ means a firefighter as defined in Code Section 25-4-2.
        3. ‘Volunteer’ means a volunteer as defined in Code Section 25-4-2.
      2. On and after January 1, 2018, a legally organized fire department shall provide and maintain sufficient insurance coverage on each member of the fire department who is a firefighter to pay claims for cancer diagnosed after having served 12 consecutive months as a firefighter with such fire department. Such insurance benefits shall include at minimum the following:
        1. A lump sum benefit of $25,000.00 subject to limitations specified in the insurance contract and based on severity of cancer and payable to such firefighter upon submission to the insurance carrier or other payor of acceptable proof of diagnosis by a physician board certified in the medical specialty appropriate for the type of cancer involved that there are one or more malignant tumors characterized by the uncontrollable and abnormal growth and spread of malignant cells with invasion of normal tissue and that:
          1. Surgery, radiotherapy, or chemotherapy is medically necessary;
          2. There is metastasis; or
          3. The firefighter has terminal cancer, is expected to die within 24 months or less from the date of diagnosis, and will not benefit from, or has exhausted, curative therapy; or
        2. A lump sum benefit of $6,250.00 subject to limitations specified in the insurance contract and based on severity of cancer and payable to such firefighter upon submission to the insurance carrier or other payor of acceptable proof of diagnosis by a physician board certified in the medical specialty appropriate for the type of cancer involved that:
          1. There is carcinoma in situ such that surgery, radiotherapy, or chemotherapy has been determined to be medically necessary:
          2. There are malignant tumors which are treated by endoscopic procedures alone;
          3. There are malignant melanomas; or
          4. There is a tumor of the prostate, provided that it is treated with radical prostatectomy or external beam therapy; and(ii) Payable as a result of a specific injury or illness to begin six months after
            disability and submission to the insurance carrier or other payor of acceptable proof
            of disability precluding service as a firefighter and continuing for up to 36 consecutive monthly payments:
            (I) A monthly benefit equal to 60 percent of the member’s monthly salary as an employed firefighter with the fire department or a monthly benefit of $5,000.00, whichever is less; or
            (II) If the member is a volunteer, a monthly benefit of $1,500.00. The benefit under subdivision (I) or (II) of this division, as applicable, shall be subordinate to any other benefit actually paid to the firefighter for such disability from any other source, not including insurance purchased solely by the firefighter, and shall be limited to the difference between the amount of such other paid benefit and the amount specified under subdivision (I) or (II) of this division, as applicable.
      3. The combined total of all benefits received by any firefighter under subdivisions (B)(i)(I) and (B)(i)(II) of this paragraph during his or her lifetime shall not exceed $50,000.00.
      4. With the exception of the benefit under subdivision (B)(ii)(I) of this paragraph, any person who was simultaneously a member of more than one fire department at the time of diagnosis shall not be entitled to receive benefits under this paragraph from or on behalf of more than one of such fire departments. In the event a volunteer of one fire department is simultaneously employed by another fire department, the fire department for which such person is a volunteer shall not be required to maintain the coverage on such volunteer otherwise required under this subsection during the period of such employment. Any member who receives benefits under division (ii) of subparagraph (B) of this paragraph may be required to have his or her condition reevaluated; in the event any such reevaluation reveals that such person has regained the ability to perform duties as a firefighter, then his or her benefits under division (ii) of subparagraph (B) of this paragraph shall cease. Benefits under said division shall also cease upon the death of such person. A member who, after at least one year as a firefighter, departs from employment, ceases to be an active volunteer, or retires shall be entitled to continue his or her coverages under this paragraph through a continuation or conversion to individual coverage. The departing member shall be responsible for payment of all premiums.
      5. In addition to any other purpose authorized under Chapter 8 of Title 33, county governing authorities and municipal governing authorities may use proceeds from county and municipal taxes imposed under said chapter for purposes of providing insurance pursuant to this paragraph.
      6. Funds received as premiums for the coverages specified in this paragraph shall not be subject to premium taxes under Chapter 8 of Title 33.
      7. The computation of premium amounts by an insurer for the coverages under this paragraph shall be subject to generally accepted adjustments from insurance underwriting.
  2. The Georgia Firefighter Standards and Training Council shall be authorized, by rules and regulations, to adopt such rules and regulations as are reasonable and necessary to implement the provisions of this Code section and to establish and modify minimum requirements for all fire departments operating in this state, provided that such requirements are equal to or exceed the requirements provided in subsections (a) and (b) of this Code section

45-9-85. Payment of indemnification for death or disability; procedure for making payments; appeal

(a) As used in this Code section, the term:

(1) “Nonroutine stressful or strenuous physical activity” means actions that are not clerical, administrative, or nonmanual in nature.

(2) “Public safety officer” means a law enforcement officer, firefighter, emergency medical technician, emergency management rescue specialist, state highway employee, or prison guard.

(3) “Work related activity” means, while in the line of duty:

(A) Engaging in a situation involving nonroutine stressful or strenuous physical activity related to law enforcement, fire suppression, rescue, hazardous material response, emergency medical services, prison or jail security, disaster relief, or any other emergency response as classified by the commission; or

(B) Participating in a training exercise involving nonroutine stressful or strenuous physical activity.

(b) Indemnification shall be paid under this article as follows:

(1) In the case of a partial permanent disability suffered in the line of duty by a public safety officer, the eligible disabled person may elect payment of $35,000.00 paid in equal monthly installments for five years or a lump sum of such amount reduced to its present value upon the basis of interest calculated at the rate of 6 percent per annum;

(2) In the case of a total permanent disability suffered in the line of duty by a public safety officer, the injured person may elect to receive a payment of $75,000.00 paid in equal monthly installments for five years or a lump sum of such amount reduced to its present value upon the basis of interest calculated at the rate of 6 percent per annum;

(3) (A) In the case of death suffered in the line of duty by a public safety officer, payment shall be made to:

(i) The surviving unremarried spouse;

(ii) The surviving children who are under the age of 19 or, if a student enrolled in an institution of postsecondary education at the time of such death, under the age of 24; or

(iii) Individuals not otherwise provided for under this subparagraph who are the dependents of the spouse or deceased person as shown in the spouse’s or deceased person’s most recent tax return.

(B) In the case of organic brain damage suffered in the line of duty by a law enforcement officer, firefighter, emergency medical technician, emergency management specialist, state highway employee, or prison guard, payment shall be made to the legal guardian of the organically brain damaged person.

(C) The surviving unremarried spouse, dependents, or the legal guardian may elect to receive payment in a lump sum payment of $150,000.00 paid in equal monthly installments for five years or a lump sum of such amount reduced to its present value upon the basis of interest calculated at the rate of 6 percent per annum; or

(4) A heart attack, stroke, or vascular rupture suffered by a public safety officer shall be presumed to qualify such public safety officer under this subsection if the heart attack, stroke, or vascular rupture:

(A) Commenced:

(i) While such public safety officer was performing work related activity;

(ii) While such public safety officer was on duty after performing work related activity; or

(iii) Not later than 24 hours after performing work related activity; and

(B) Directly or proximately resulted in the death or partial or permanent disability of the public safety officer, unless competent medical evidence established that the heart attack, stroke, or vascular rupture was not related to the work related activity or was directly or proximately caused by something other than the mere presence of cardiovascular disease risk factors