State legislatures across the country filed many bills in 2026 seeking to create or expand workers’ comp presumptions, and though many did not pass, several notable bills were enacted.
This level of legislative activity across the country indicates that this trend will likely continue, which has the potential to expand claim eligibility for various occupational illnesses, which could impact workers’ comp programs down the road.
PTSD
Wisconsin Assembly Bill 651 was signed into law, expanding PTSD‑only workers’ comp claim eligibility for certain first responders, including part‑time and volunteer firefighters and emergency medical responders.
Virginia House Bill 1313 expanded the state’s existing PTSD presumption for first responders, clarifying that PTSD incurred by a law-enforcement officer or firefighter, an incident or exposure without any accompanying physical injury occurring in the line of duty on or after January 1, 2027, is a qualifying event, as defined in the bill.
Meanwhile, several other bills made progress in their states but did not pass. This includes:
- Connecticut House Bill 5279 which would have expanded an existing PTSD presumption for first responders to include witnessing a serious physical injury that does not result in death, disfigurement, loss of a vital body part or function, or permanent disfigurement
- Florida Senate Bill 774 which would have expanded the state’s existing first responder mental-injury presumption to include 911 dispatchers
- Idaho Senate Bill 1425 which proposed the addition of coroners, “medicolegal” death investigators, and qualifying coroner employees to the list of first responders eligible for workers’ comp benefits for post-traumatic stress injuries
- New Jersey Senate Bill 3662 which would have created a task force to study and provide recommendations regarding pandemic-related post-traumatic stress disorder in first responders, health care professionals, and other frontline workers
- Vermont Senate Bill 306 which would have extended the state’s existing PTSD presumption to include 911 dispatchers, public safety dispatchers, emergency operators, and other “first responder in communications” roles
Cardiovascular Conditions
Maryland House Bill 347 now establishes that certain firefighters, firefighting instructors, rescue squad members, advanced life support unit members, and members of the Office of the State Fire Marshal suffering from hypertension are presumed to have an occupational disease that is compensable under workers' compensation law and are presumed to be disabled if certain requirements are met.
Additionally, South Carolina House Bill 3163 was signed into law, expanding workers’ comp presumptions for firefighters to include stroke, while also broadening presumption eligibility to cover conditions that arise during training, rescue activity, or within 24 hours of strenuous duty. This bill excludes administrative roles.
However, Arizona House Bill 2679 did not pass, which would have strengthened the state’s existing presumption for heart‑related, perivascular, and pulmonary conditions occurring within 24 hours of a known exposure event by raising employers’ rebuttal requirements by prohibiting them from citing factors like age, family history, or lifestyle to rebut claims.
Cancer
Florida Senate Bill 984 was enacted, which enhances firefighter cancer benefits by requiring continued death benefits for certain beneficiaries after a firefighter’s death tied to cancer, reinforcing existing presumptive cancer protections.
At the moment, Arizona Senate Bill 1215 is still in progress and could change the existing cancer presumption to list out specific cancer types that can be covered by workers’ comp as occupational diseases. Of note, this cancer presumption currently covers “adenocarcinoma or mesothelioma of the respiratory tract,” which has been interpreted in such a way to allow for the denial of adenocarcinoma claims that are not of the respiratory tract. The proposed language changes would make it so that such claims could be accepted.
Many other states proposed expansions to cancer presumptions which did not make it through the legislative process, including:
- Colorado Senate Bill 184 which would have significantly expanded the list of cancers covered for firefighters under the current presumption law
- Hawaii House Bill 2387 which would have significantly expanded the currently existing cancer presumption for firefighters, and cover additional types of cancer
- Vermont House Bill 661 which would have expanded the state’s existing cancer presumption for firefighters to cover larynx, pharynx, and trachea cancers. Furthermore, the bill would remove the previous age‑under‑65 requirement
- Virginia House Bill 865 which would have expanded the state’s workers’ comp cancer presumption to include lung cancer and non‑Hodgkin’s lymphoma for qualifying first responders with five years of service
Parkinson’s Disease
Governor Kay Ivey signed Alabama House Bill 466 into law, which expands occupational illness presumptions for firefighters to include Parkinson’s disease. The bill includes a standard for demonstrating that Parkinson’s disease is occupational in origin in order to qualify for benefits. Firefighters must have completed three years of service and have previously passed a physical exam that showed no evidence of the disease prior to beginning service.
Furthermore, the disease must manifest itself during the period in which the firefighter is in the service of the city if the firefighter demonstrates that he or she, while employed by the city, was exposed to a known toxin that is associated with an increased risk of Parkinson's disease.
The bill will go into effect October 1st.
For ongoing coverage of the latest legislation and policy updates impacting workers' comp, visit the Healthesystems Advocacy & Compliance page for our weekly Regulatory Recap.
