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SECOND REGULAR SESSION
HOUSE BILL NO. 3096
103RD GENERAL ASSEMBL Y
INTRODUCED BY REPRESENT A TIVE ALLEN.
5373H.01I JOSEPH ENGLER, Chief Clerk
AN ACT
T o repeal sections 287.067 and 287.120, RSMo, and to enact in lieu thereof four new sections
relating to workers' compensation occupational disease presumptions for certain first
responders, with penalty provisions.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Sections 287.067 and 287.120, RSMo, are repealed and four new sections
2 enacted in lieu thereof, to be known as sections 287.067, 287.068, 287.069, and 287.120, to
3 read as follows:
287.067. 1. In this chapter the term "occupational disease" is hereby defined to mean,
2 unless a dif ferent meaning is clearly indicated by the context, an identifiable disease arising
3 with or without human fault out of and in the course of the employment. Ordinary diseases of
4 life to which the general public is exposed outside of the employment shall not be
5 compensable, except where the diseases follow as an incident of an occupational disease as
6 defined in this section. The disease need not to have been foreseen or expected but after its
7 contraction it must appear to have had its origin in a risk connected with the employment and
8 to have flowed from that source as a rational consequence.
9 2. An injury or death by occupational disease is compensable only if the occupational
10 exposure was the prevailing factor in causing both the resulting medical condition and
11 disability . The "prevailing factor" is defined to be the primary factor , in relation to any other
12 factor , causing both the resulting medical condition and disability . Ordinary , gradual
13 deterioration, or progressive degeneration of the body caused by aging or by the normal
14 activities of day-to-day living shall not be compensable.
EXPLANA TION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law . Matter in bold-face type in the above bill is proposed language.
15 3. An injury due to repetitive motion is recognized as an occupational disease for
16 purposes of this chapter . An occupational disease due to repetitive motion is compensable
17 only if the occupational exposure was the prevailing factor in causing both the resulting
18 medical condition and disability . The "prevailing factor" is defined to be the primary factor ,
19 in relation to any other factor , causing both the resulting medical condition and disability .
20 Ordinary , gradual deterioration, or progressive degeneration of the body caused by aging or
21 by the normal activities of day-to-day living shall not be compensable.
22 4. "Loss of hearing due to industrial noise" is recognized as an occupational disease
23 for purposes of this chapter and is hereby defined to be a loss of hearing in one or both ears
24 due to prolonged exposure to harmful noise in employment. "Harmful noise" means sound
25 capable of producing occupational deafness.
26 5. "Radiation disability" is recognized as an occupational disease for purposes of this
27 chapter and is hereby defined to be that disability due to radioactive properties or substances
28 or to Roentgen rays (X-rays) or exposure to ionizing radiation caused by any process
29 involving the use of or direct contact with radium or radioactive properties or substances or
30 the use of or direct exposure to Roentgen rays (X-rays) or ionizing radiation.
31 6. (1) Disease of the lungs or respiratory tract, hypotension, hypertension, or disease
32 of the heart or cardiovascular system, including carcinoma, may be recognized as
33 occupational diseases for the purposes of this chapter and are defined to be disability due
34 to exposure to smoke, gases, carcinogens, inadequate oxygen, of paid firefighters of a paid
35 fire department or paid police of ficers of a paid police department certified under chapter 590
36 if a direct causal relationship is established, or psychological stress of firefighters of a paid
37 fire department or paid peace of ficers of a police department who are certified under chapter
38 590 if a direct causal relationship is established.
39 (2) Cancer or any heart-rel ated, perivascular , or pulmonary disease or other
40 r elated condition contracted by a fir efighter or fir e investigator shall be presum ed to be
41 an occupational disease, as pr ovided under section 287.068.
42 7. Any employee who is exposed to and contracts any contagious or communicable
43 disease arising out of and in the course of his or her employment shall be eligible for benefits
44 under this chapter as an occupational disease.
45 8. W ith regard to occupational disease due to repetitive motion, if the exposure to the
46 repetitive motion which is found to be the cause of the injury is for a period of less than three
47 months and the evidence demonstrates that the exposure to the repetitive motion with the
48 immediate prior employer was the prevailing factor in causing the injury , the prior employer
49 shall be liable for such occupational disease.
50 9. (1) (a) Posttraumatic stress disorder (PTSD), as described in the Diagnostic and
51 Statistical Manual of Mental Health Disorders, Fifth Edition, published by the American
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52 Psychiatric Association, (DSM-5) is recognized as a compensable occupational disease for
53 purposes of this chapter when diagnosed in a first responder , as that term is defined under
54 section 67.145.
55 (b) Benefits payable to a first responder under this section shall not require a physical
56 injury to the first responder , and are not subject to any preexisting PTSD.
57 (c) Benefits payable to a first responder under this section are compensable only if
58 demonstrated by clear and convincing evidence that PTSD has resulted from the course and
59 scope of employment, and the first responder is examined and diagnosed with PTSD by an
60 authorized treating physician, due to the first responder experiencing one of the following
61 qualifying events:
62 a. Seeing for oneself a deceased minor;
63 b. W itnessing directly the death of a minor;
64 c. W itnessing directly the injury to a minor who subsequently died prior to or upon
65 arrival at a hospital emer gency department, participating in the physical treatment of, or
66 manually transporting, an injured minor who subsequently died prior to or upon arrival at a
67 hospital emer gency department;
68 d. Seeing for oneself a person who has suf fered serious physical injury of a nature
69 that shocks the conscience;
70 e. W itnessing directly a death, including suicide, due to serious physical injury; or
71 homicide, including murder , mass killings, manslaughter , self-defense, misadventure, and
72 negligence;
73 f. W itnessing directly an injury that results in death, if the person suff ered serious
74 physical injury that shocks the conscience;
75 g. Participating in the physical treatment of an injury , including attempted suicide, or
76 manually transporting an injured person who suff ered serious physical injury , if the injured
77 person subsequently died prior to or upon arrival at a hospital emer gency department; or
78 h. Involvement in an event that caused or may have caused serious injury or harm to
79 the first responder or had the potential to cause the death of the first responder , whether
80 accidental or by an intentional act of another individual.
81 (2) The time for notice of injury or death in cases of compensable PTSD under this
82 section is measured from exposure to one of the qualifying stressors listed in the DSM-5
83 criteria, or the diagnosis of the disorder , whichever is later . Any claim for compensation for
84 such injury shall be properly noticed within fifty-two weeks after the qualifying exposure, or
85 the diagnosis of the disorder , whichever is later .
287.068. 1. This section and section 287.069 shall be known and may be cited as
2 the "Missouri Fir efighter Occupational Disease Pr otection Act".
3 2. For the purposes of this section, the following terms mean:
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4 (1) "Cancer", any condition of cancer affecting the skin or the central nervous,
5 lymphatic, digestive, hematologic, urinary , skeletal, oral, br east, testicular ,
6 genitourinary , liver , or pr ostate system including, but not limited to, bladder cancer ,
7 brain cancer , brea st cancer , cervical cancer , chr onic lymphocytic leukemia, chro nic
8 myelogenous leukemia, colon cancer , esophageal cancer , invasive skin cancer or
9 melanoma, kidney cancer , liver cancer or hepatocellular carc inoma, lung cancer ,
10 lymphatic or hematopoietic cancer or lymphoma, mesothelioma, multiple myeloma,
11 non-Hodgkin's lymphoma, oral cavity and pharyngeal cancer , ovarian cancer , pr ostate
12 cancer , rec tal cancer , testicular cancer , thyro id cancer , pancr eatic cancer , and any other
13 condition of cancer that may be caused by or res ult fr om exposure to extr eme heat,
14 inhalation, chemical fumes, smoke, particles, toxic gases, ingestion, radiation, or known,
15 suspected, or unknown carcin ogens;
16 (2) "Fire investigator", a person who is or was employed full-time by a
17 municipality , fir e pr otection district, or state agency and who is trained in and
18 r esponsible for determining the origin, cause, and development of a fir e or explosion.
19 This term shall include a ret ired fir e investigator;
20 (3) "Fir efighter", any person who is a paid or ret ired fir efighter or a volunteer
21 fir efighter employed by a political subdivision as an employer as defined under this
22 chapter or otherwise serving as a member or officer of a fir e department, fir e protecti on
23 district, or other fir efighting organization of a political subdivision who is or was
24 r egularly assigned to hazardous duty including, but not limited to, fir e suppr ession,
25 emergency medical res ponse, hazardous materials res ponse, or technical res cue
26 operations;
27 (4) "Regularly assigned to hazardous duty", assigned to duty that requi res the
28 fir efighter or fir e investigator to be involved in fir e suppr ession, fir e investigation,
29 emergency medical res ponse, hazardous materials res ponse, technical res cue, or other
30 duties that expose the individual to smoke, carcin ogens, toxic substances, or other
31 occupational hazards inher ent to fir efighting or fire investigation;
32 (5) "V olunteer fir efighter", a person having principal employment other than as
33 a fir efighter but who r egularly serves or served a fir e department, fir e protecti on
34 district, or other fir efighting organization of a political subdivision for the purpose of
35 the pr evention or control of fir e without regul ar salary or wages, but may rec eive
36 nominal compensation, stipends, or reim bursement for services ren dered . This term
37 shall include a ret ired volunteer fir efighter .
38 3. Cancer contracted by a fir efighter or fir e investigator shall be presum ed to be
39 an occupational disease if:
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40 (1) The fir efighter or fir e investigator successfully passed a physical examination
41 befor e employment and the examination did not indicate evidence of cancer . In the case
42 of a fir efighter , the physical examination r eceived under this subdivision shall be
43 r easonably aligned with the National Fire Pr otection Association Standard on
44 Compr ehensive Occupational Medical Pr ogram for Fir e Departments (NFP A 1582);
45 (2) The fir efighter or fir e investigator was r egularly assigned to hazardous duty
46 for a minimum of five years;
47 (3) The fir efighter or fir e investigator was exposed to an agent, whether known
48 or unknown, classified by the International Agency for Research on Cancer , or any
49 successor organization, as a gro up 2 or 2A car cinogen or classified as a cancer -causing
50 agent by the American Cancer Society , the American Association for Cancer Resear ch,
51 the Agency for Healthcar e Resear ch Quality , the American Society of Clinical Oncology ,
52 the National Institute for Occupational Safety and Health, or the United States National
53 Cancer Institute; and
54 (4) The cancer diagnosis occurr ed during the fir efighter's or fir e investigator's
55 employment or within ten years following the last date of employment as a fir efighter or
56 fir e investigator . The statute of limitations for an occupational disease as pr ovided
57 under this chapter shall begin to run fr om the date of diagnosis or death, whichever
58 occurs first, provi ded the diagnosis or death occurs within the ten-year period under
59 this subdivision.
60 4. For the purpose of calculating the five-year period under subdivision (2) of
61 subsection 3 of this section:
62 (1) T ime spent in training, whether paid or unpaid, shall be counted toward the
63 five-year minimum r equir ement; and
64 (2) Service with multiple fir e departments or fir e districts may be aggr egated to
65 meet the five-year req uirement, pr ovided the fir efighter or fir e investigator submits
66 appr opriate documentation.
67 5. Notwithstanding subsection 3 of this section, fir efighters and fir e investigators
68 ar e not requi red to identify specific car cinogens to which they were exposed or to pr ove
69 a direct causal link between a known carci nogen and the particular cancer diagnosed
70 beyond establishing that the fir efighter or fir e investigator was exposed to known
71 car cinogens during his or her service or period of employment.
72 6. Any heart-r elated, perivascular , or pulmonary injury or death of a fir efighter
73 or fir e investigator shall be pre sumed to be an occupational disease if:
74 (1) The fir efighter or fir e investigator passed a physical examination before
75 employment that did not indicate evidence of a heart-r elated, perivascular , or
76 pulmonary disease, condition, or injury . In the case of a fir efighter , the physical
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77 examination receiv ed under this subdivision shall be reas onably aligned with the
78 National Fir e Pr otection Association Standard on Compreh ensive Occupational Medical
79 Pr ogram for Fir e Departments (NFP A 1582); and
80 (2) The fir efighter or fir e investigator was exposed to a documented, work-
81 r elated incident and the heart-r elated, perivascular , or pulmonary injury or death
82 occurr ed within twenty-four hours after exposur e and was reas onably r elated to the
83 exposur e.
84 7. The pr esumptions pr ovided in this section may be re butted only by clear and
85 convincing evidence establishing that a nonoccupational cause was the independent,
86 primary , and exclusive cause of the cancer , heart-r elated condition, perivascular
87 condition, or pulmonary condition, such that the condition would have occurr ed in the
88 absence of any occupational exposure or work-related event encounter ed in the course
89 of the fir efighter's or fir e investigator's employment duties.
90 8. The burden of pr oof to r ebut the pr esumptions established in this section shall
91 be on the employer or the employer's workers' compensation insurance carrier .
92 9. This section shall apply to all fir efighters and fir e inspectors, as defined under
93 this section, of all public, private, and volunteer fir e departments, fir e protecti on
94 districts, or other fir efighting organizations of all political subdivisions and any other
95 political subdivisions employing fir e investigators.
96 10. The section shall apply only to claims filed on or after the effective date of
97 this section.
98 1 1. The prov isions of this section shall not apply r etro actively to claims that wer e
99 finally adjudicated prior to the effective date of this act.
100 12. Nothing in this section shall be construed to limit or res trict any other
101 benefits available to fir efighters or fir e investigators under this chapter or any other
102 pr ovision of law .
287.069. 1. Insurance carriers, self-insur ed employers granted authority by the
2 division to self-insure, third-party administrators, and workers' compensation pools
3 pr oviding coverage for fir efighters and fir e investigators shall compile and report to the
4 division claim and claim res erve information for cancer -r elated claims filed by or on
5 behalf of fir efighters and fir e investigators.
6 2. The division shall compile and make available to the department of commer ce
7 and insurance, department of public safety , insurance carriers, and r ecognized rating
8 organizations authorized under this chapter the claim-r elated information.
9 3. Cancer -r elated claim and claim re serve information to be r eported shall
10 include:
11 (1) The type of cancer diagnosed;
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12 (2) The date of diagnosis;
13 (3) The date the claim was filed;
14 (4) The date the claim was accepted or denied;
15 (5) The basis for denial, if denied;
16 (6) The total amount paid or res erved for medical benefits;
17 (7) The total amount paid or res erved for indemnity benefits;
18 (8) The curr ent status of the claim; and
19 (9) Any other information r equir ed or deemed necessary by the division to fulfill
20 the requ irem ents under this section.
21 4. The information r equir ed to be reported to the division under the pr ovisions
22 of subsection 3 of this section shall be consider ed a closed filing, shall be confidential,
23 and shall not be subject to the req uirements of chapter 610.
24 5. The division shall pre pare and publish an annual r eport summarizing the data
25 collected under subsection 3 of this section regard ing pr esumed cancer claims under
26 section 287.068. Such r eport shall include, at minimum, the following information:
27 (1) The number of claims filed during the preced ing fiscal year;
28 (2) The number of claims accepted and paid during the pr eceding fiscal year;
29 (3) The number of claims denied during the preced ing fiscal year;
30 (4) The number of active or pending claims as of the date of the repo rt; and
31 (5) The cost rel ated to claims described under subsection 3 of this section.
32 6. The division shall publish and submit the report r equir ed under subsection 1
33 of this section befor e August 28, 2028, and an updated r eport every two years ther eafter ,
34 to each of the following:
35 (1) The speaker and the minority leader of the house of r epresent atives;
36 (2) The pr esident pr o tempor e and the minority leader of the senate;
37 (3) The Missouri Association of Fir e Chiefs or its successor organization;
38 (4) The Fir e Fighters Association of Missouri or its successor organization; and
39 (5) The Missouri Municipal League or its successor organization.
287.120. 1. Every employer subject to the provisions of this chapter shall be liable,
2 irrespective of negligence, to furnish compensation under the provisions of this chapter for
3 personal injury or death of the employee by accident or occupational disease arising out of
4 and in the course of the employee's employment. Any employee of such employer shall not
5 be liable for any injury or death for which compensation is recoverable under this chapter and
6 every employer and employees of such employer shall be released from all other liability
7 whatsoever , whether to the employee or any other person, except that an employee shall not
8 be released from liability for injury or death if the employee engaged in an af firmative
9 negligent act that purposefully and dangerously caused or increased the risk of injury . The
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10 term "accident" as used in this section shall include, but not be limited to, injury or death of
11 the employee caused by the unprovoked violence or assault against the employee by any
12 person.
13 2. The rights and remedies herein granted to an employee shall exclude all other
14 rights and remedies of the employee, the employee's spouse, parents, personal
1 5 representatives, dependents, heirs or next kin, at common law or otherwise, on account of
16 such injury or death by accident or occupational disease, except such rights and remedies as
17 are not provided for by this chapter .
18 3. No compensation shall be allowed under this chapter for the injury or death due to
19 the employee's intentional self-inflicted injury , but the burden of proof of intentional self-
20 inflicted injury shall be on the employer or the person contesting the claim for allowance.
21 4. Where the injury is caused by the failure of the employer to comply with any
22 statute in this state or any lawful order of the division or the commission, the compensation
23 and death benefit provided for under this chapter shall be increased fifteen percent.
24 5. Where the injury is caused by the failure of the employee to use safety devices
25 where provided by the employer , or from the employee's failure to obey any reasonable rule
26 adopted by the employer for the safety of employees, the compensation and death benefit
27 provided for herein shall be reduced at least twenty-five but not more than fifty percent;
28 provided, that it is shown that the employee had actual knowledge of the rule so adopted by
29 the employer; and provided, further , that the employer had, prior to the injury , made a
30 reasonable ef fort to cause his or her employees to use the safety device or devices and to obey
31 or follow the rule so adopted for the safety of the employees.
32 6. (1) Where the employee fails to obey any rule or policy adopted by the employer
33 relating to a drug-free workplace or the use of alcohol or nonprescribed controlled drugs in
34 the workplace, the compensation and death benefit provided for herein shall be reduced fifty
35 percent if the injury was sustained in conjunction with the use of alcohol or nonprescribed
36 controlled drugs.
37 (2) If, however , the use of alcohol or nonprescribed controlled drugs in violation of
38 the employer's rule or policy is the proximate cause of the injury , then the benefits or
39 compensation otherwise payable under this chapter for death or disability shall be forfeited.
40 (3) The voluntary use of alcohol to the percentage of blood alcohol suff icient under
41 Missouri law to constitute legal intoxication shall give rise to a rebuttable presumption that
42 the voluntary use of alcohol under such circumstances was the proximate cause of the injury .
43 A preponderance of the evidence standard shall apply to rebut such presumption. An
44 employee's refusal to take a test for alcohol or a nonprescribed controlled substance, as
45 defined by section 195.010, at the request of the employer shall result in the forfeiture of
46 benefits under this chapter if the employer had suf ficient cause to suspect use of alcohol or a
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47 nonprescribed controlled substance by the claimant or if the employer's policy clearly
48 authorizes post-injury testing.
49 (4) Any positive test result for a nonprescribed controlled drug or the metabolites of
50 such drug from an employee shall give rise to a rebuttable presumption, which may be
51 rebutted by a preponderance of evidence, that the tested nonprescribed controlled drug was in
52 the employee's system at the time of the accident or injury and that the injury was sustained in
53 conjunction with the use of the tested nonprescribed controlled drug if:
54 (a) The initial testing was administered within twenty-four hours of the accident or
55 injury;
56 (b) Notice was given to the employee of the test results within fourteen calendar days
57 of the insurer or group self-insurer receiving actual notice of the confirmatory test results;
58 (c) The employee was given an opportunity to perform a second test upon the original
59 sample; and
60 (d) The initial or any subsequent testing that forms the basis of the presumption was
61 confirmed by mass spectrometry using generally accepted medical or forensic testing
62 procedures.
63 7. Where the employee's participation in a recreational activity or program is the
64 prevailing cause of the injury , benefits or compensation otherwise payable under this chapter
65 for death or disability shall be forfeited regardless that the employer may have promoted,
66 sponsored or supported the recreational activity or program, expressly or impliedly , in whole
67 or in part. The forfeiture of benefits or compensation shall not apply when:
68 (1) The employee was directly ordered by the employer to participate in such
69 recreational activity or program;
70 (2) The employee was paid wages or travel expenses while participating in such
71 recreational activity or program; or
72 (3) The injury from such recreational activity or program occurs on the employer's
73 premises due to an unsafe condition and the employer had actual knowledge of the
74 employee's participation in the recreational activity or program and of the unsafe condition of
75 the premises and failed to either curtail the recreational activity or program or cure the unsafe
76 condition.
77 8. Mental injury resulting from work-related stress does not arise out of and in the
78 course of the employment, unless it is demonstrated that the stress is work related and was
79 extraordinary and unusual. The amount of work stress shall be measured by objective
80 standards and actual events.
81 9. A mental injury is not considered to arise out of and in the course of the
82 employment if it resulted from any disciplinary action, work evaluation, job transfer , layoff ,
83 demotion, termination or any similar action taken in good faith by the employer .
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84 10. The ability of a firefighter to receive benefits for psychological stress under
85 section 287.067 shall not be diminished by the provisions of subsections 8 and 9 of this
86 section.
87 1 1. (1) An employer or employer's insurance carrier shall file an answer or
88 r esponsive pleading to a claim under the pr ovisions of section 287.068 within thirty days
89 of re ceiving notice fr om the division acknowledging recei pt of the claim. Failur e to
90 timely res pond shall creat e a r ebuttable presum ption that the delay or r ejection was
91 unr easonable. The question of delay or rej ection and the reas onableness of the cause
92 shall be determined by an administrative law judge or the commission in accordance
93 with the facts.
94 (2) If an employer or insurance carrier unr easonably rej ects or delays a claim
95 for benefits under the pro visions of section 287.068 that qualifies for presum ptive
96 coverage, the employer or insurance carrier shall be assessed a penalty equal to five
97 times the amount of benefits that were unrea sonably reje cted or delayed, up to a
98 maximum amount of fifty thousand dollars.
99 (3) The penalty assessed under this subsection shall be paid to the claimant in
100 addition to any other benefits or compensation awarded.
101 (4) The pr ovisions of this subsection shall apply to all claims filed on or after the
102 effective date of section 287.068.
✔
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