Regulators across the country started 2026 off strong, introducing several bills that have the potential to impact workers’ comp. One notable trend is that so far six states have introduced bills that could expand presumptions for certain health conditions and occupations, facilitating workers’ compensation eligibility for high-risk roles.
Arizona House Bill 2204 was introduced, which would create a PTSD presumption for first responders – in this case covering peace officers, firefighters, paramedics, emergency medical care technicians, and public safety telecommunicators – if their condition arises from a work-related trauma. Several qualifying traumatic incidents are listed in the bill.
Florida House Bill 813 and Senate Bill 984 were introduced, which would update current cancer presumptions for firefighters by requiring a one-time $25,000 payment upon diagnosis and extend benefits for up to 10 years post-employment. If enacted, these bills would go into effect July 1, 2026.
Illinois House Bill 4226 would expand rebuttable presumptions currently available for certain medical first responders to hospital security guards who have completed at least five years of service. The presumption covers:
- Any condition or impairment of health of which results directly or indirectly from any bloodborne pathogen, including staph infection, lung or respiratory diseases, tuberculosis, or cancer
- Hernia
- Hearing loss
If enacted the bill would go into effect on January 1st of the following year.
Kentucky House Bill 26 would expand the definition of "injury" to include psychological injuries that are not a direct result of physical injuries for police officers, firefighters, emergency medical services personnel, front-line staff members as defined by KRS 61.315, or members of the National Guard.
As for defining psychological injuries, the bill notes that such injuries must be the result of a work-related event or cumulative work-related stress that is extraordinary and unusual in comparison to pressures and tensions experienced by the average employee across all occupations. Furthermore, such an event cannot be related to disciplinary action, work evaluation, job transfer, layoff, demotion, termination, or similar actions. The bill also notes that if a defined first responder is diagnosed with PTSD within three years of the last active date of employment then there shall be a rebuttable presumption.
Maryland Senate Bill 90 would recognize hypertension as an occupational disease for firefighters and medical responders, creating a presumption when these workers have at least two years of service and meet other
Pennsylvania House Bill 2087 would extend workers’ compensation coverage to volunteer firefighters and EMTs injured during fundraising activities. If enacted, this bill would go into effect 60 days after enactment.
Virginia House Bill 130 would expand existing cancer presumptions that apply to firefighters and public safety employees to sheriffs, deputy sheriffs. The existing presumption covers leukemia and cancers of the pancreas, prostate, rectum, throat, ovary, breast, colon, brain, testicle, bladder and thyroid. However, for colon, brain, or testicular cancer, the presumption shall not apply for any individual who was diagnosed with such a condition before July 1, 2020. For bladder or thyroid cancer, the presumption shall not apply for any individual who was diagnosed with such a condition before July 1, 2023.
Washington Senate Bill 5882 would extend current PTSD presumptions to correctional facility workers and allow them to file claims up to five years post-employment. If enacted, this bill would go into effect January 1, 2027.
Expanded presumptions may affect the types of conditions covered under workers’ compensation, some of which involve medication management. Healthesystems monitors these changes to support appropriate medication therapy and compliance with state requirements.
For ongoing coverage of the latest legislation and policy updates impacting workers' comp, visit the Healthesystems Advocacy & Compliance page for our weekly Regulatory Recap.
