OCCUPATIONAL DISEASE PENSION AWARD NOT A CATASTROPHIC INJURY UNDER PSEBA

Transcription

1 May 24, 2017 For any questions or comments you might have regarding this newsletter, please feel free to contact: MUNICPAL LAW GROUP Authored By: Scott F. Uhler OCCUPATIONAL DISEASE PENSION AWARD NOT A CATASTROPHIC INJURY UNDER PSEBA (312) sfuhler@ktjlaw.com Qualifying for Occupational Disease Disability Pension Due to Work as a Firefighter Not Catastrophic Injury That Would Entitle Employee to Continuing Health Insurance Benefits Under PSEBA The Supreme Court has held that eligibility for continuing health insurance benefits under the Public Safety Employee Benefits Act ( PSEBA ) must be due to a catastrophic injury resulting in a line -of-duty disability pension concluding that an injury resulting only in an occupational disease disability pension (under section of the Pension Code) does not qualify as such a catastrophic injury for PSEBA benefits. A summary of the decision is set forth herein. A full copy of the decision is available at the following link: Inside This Issue Link to Decision 1 Summary of Decision 2-5 Facts Issue SupremeCourt/2016/ pdf Analysis.. 2-5

2 SUMMARY OF DECISION FACTS This case involved the application for and award of an occupational disease disability pension to a firefighter in the City of Rockford. The Pension Board found that the firefighter qualified for an occupational disease disability pension as a firefighter with at least 5 years of creditable service who was unable to perform his duties due to heart disease resulting from his service as a firefighter. The medical evidence before the Pension Board showed the firefighter s medical condition (cardiomyopathy) resulted from the performance of his duties as a firefighter. When the firefighter s continued access to health insurance benefits through the City expired 3 years later, he applied for PSEBA continuing health insurance benefits. PSEBA provides lifetime City paid health insurance benefits for a public safety employee, spouse, and children when the employee is catastrophically injured or killed in the line of duty. The firefighter asserted that the Pension Board s decision awarding him an occupational disease disability pension for his heart disease due to his work as a firefighter served to establish he suffered a catastrophic injury due to his employment as required by PSEBA. ISSUE The Court stated that the primary issue in the matter was whether the award of an occupational disease disability pension under section of the Pension Code also demonstrated that the firefighter suffered a catastrophic injury within the meaning of section 10(a) of PSEBA. Both the circuit court and appellate court ruled for the firefighter. The Supreme Court reversed and ruled for the City. ANALYSIS The Supreme Court noted that PSEBA provides in relevant part: (a) An employer who employs a full-time law enforcement, correctional or correctional probation officer, or firefighter, who, on or after the effective date of this Act suffers a catastrophic injury or is killed in the line of duty shall pay the entire premium of the employer s health insurance plan for the injured employee, the injured employee s spouse, and for each dependent child of the injured employee until the child reaches the age of majority or until the end of the calendar year in which the child reaches the age of 25 if the child continues to be dependent for support or the child is a full-time or part-time student and is dependent for support. 2

3 Occupational Disease Pension Award Not a Catastrophic Injury Under PSEBA (cont d.) (b) In order for the law enforcement, correctional or correctional probation officer, firefighter, spouse, or dependent children to be eligible for insurance coverage under this Act, the injury or death must have occurred as the result of the officer s response to fresh pursuit, the officer or firefighter s response to what is reasonably believed to be an emergency, an unlawful act perpetrated by another, or during the investigation of a criminal act. 820 ILCS 320/10 (West 2008). The firefighter argued that the requirements for an occupational disease disability pension under section of the Pension Code are essentially the same as those for a line-of-duty disability pension under section and that an occupational disease disability pension award under section of the Pension Code qualified as a line-of-duty disability pension because his heart disease arose during and because of his employment as a firefighter and is therefore a catastrophic injury within the meaning of PSE- BA. The Court held that a public safety employee does not establish a catastrophic injury under PSEBA by just demonstrating an injury as a firefighter or during the course of employment as a firefighter. Rather, the employee must prove an injury resulted in a line-ofduty disability pension under section of the Pension Code. 3

4 The Court noted that qualifying for an occupational disease disability pension under section does not equate to a line-of-duty disability pension under section 4-110, emphasizing that section (line-of-duty pension) provides: If a firefighter, as the result of sickness, accident or injury incurred in or resulting from the performance of an act of duty or from the cumulative effects of acts of duty, is found *** to be physically or mentally permanently disabled for service in the fire department, so as to render necessary his or her being placed on disability pension, the firefighter shall be entitled to a disability pension ***. A firefighter shall be considered on duty while on any assignment approved by the chief of the fire department, even though away from the municipality he or she serves as a firefighter, if the assignment is related to the fire protection service of the municipality. 40 ILCS 5/4-110 Section , providing for an occupational disease disability pension, however establishes different standards for a pension award: The General Assembly finds that service in the fire department requires firefighters in times of stress and danger to perform unusual tasks; that firefighters are subject to exposure to extreme heat or extreme cold in certain seasons while performing their duties; that they are required to work in the midst of and are subject to heavy smoke fumes, and carcinogenic, poisonous, toxic or chemical gases from fires; and that these conditions exist and arise out of or in the course of employment. An active firefighter with 5 or more years of creditable service who is found unable to perform his or her duties in the fire department by reason of heart disease, stroke, tuberculosis, or any disease of the lungs or respiratory tract, resulting from service as a firefighter, is entitled to an occupational disease disability pension during any period of such disability for which he or she has no right to receive salary. Any active firefighter who has completed 5 or more years of service and is unable to perform his or her duties in the fire department by reason of a disabling cancer, which develops or manifests itself during a period while the firefighter is in the service of the fire department, shall be entitled to receive an occupational disease disability benefit during any period of such disability for which he or she does not have a right to receive salary. In order to receive this occupational disease disability benefit, (i) the type of cancer involved must be a 4

5 For any questions or comments you might have regarding this newsletter, please feel free to contact: Chicago Office 20 N. Wacker Drive, Ste Chicago, IL T: (312) F: (312) Orland Park Office S. Ravinia Ave., Ste 10 Orland Park, IL T: (708) F: (708) Occupational Disease Pension Award Not a Catastrophic Injury Under PSEBA type which may be caused by exposure to heat, radiation or a known carcinogen as defined by the International Agency for Research on Cancer and (ii) the cancer must (and is rebuttably presumed to) arise as a result of service as a firefighter. 40 ILCS 5/ (West 2008). The Court went on to indicate that other, similar occupational disease disability provisions required service for a specific number of years, reflecting the intention to compensate firefighters for diseases generally contracted from repeated exposure to those hazardous conditions regularly faced by firefighters. Line-of-duty disability pensions on the other hand apply to conditions or injuries suffered due to an identifiable act or acts of duty, without reliance on or reference to a certain number of service years of service. The Court stated the General Assembly clearly established different eligibility standards for a line-of duty and an occupational disease pension. The injuries result from and arise under differing circumstances. A section (line-of-duty) pension is premised on a disability resulting due to a specific act or acts of duty. A section pension is different, relying on firefighters work under hazardous circumstances and providing benefits if a firefighter suffers one of the covered diseases after repeated exposure to such conditions over a prescribed time period. This newsletter is not to be construed as legal advice or a legal opinion under any circumstance. The contents are solely intended for general informative purposes, and the readers of this newsletter are strongly urged to contact their attorney with regard to any concepts discussed herein. This newsletter may be deemed advertising under the laws of the Supreme Court of Illinois Klein, Thorpe and Jenkins, Ltd. The Supreme Court clarified that it had already defined the term catastrophic injury in PSEBA very specifically to solely the line-of-duty disability provision in section of the Pension Code and that the General Assembly did not demonstrate any intent to expand the definition of catastrophic injury to include disability pension awards under other sections of the Pension Code. Bremer v. The City of Rockford, 2016 IL (12/30/16) 5