What are Presumptive Industrial Injuries?

The California Worker’s Compensation system provides certain presumptions regarding the causation of an injury or illness for certain public employees. A presumption is a legal concept where the burden of proof automatically shifts from one party to another. In the legal world, the burden of proof is typically imposed on the injured worker to prove their case. However, California’s Worker Compensation system eliminates this standard by providing certain presumptions for certain public employees, whereby the burden of proof is automatically imposed upon the employer. If a presumption applies, the employer has the initial burden of proving that the injury was not caused by the employees’ job. It is important to note that, even if a presumption does not apply to you, you may still be entitled to Workers’ Compensation benefits relating to the injuries and conditions listed below.

What injuries or conditions are covered by a presumption?

The following injuries and conditions are presumed to be industrially related:

• Heart Trouble
• Hernia
• Pneumonia
• Cancer
• Tuberculosis
• Blood-Borne Infectious Diseases & Methicillin-Resistant Staphylococcus Aureus (MRSA)
• Injuries from Exposure to Biochemical Substances
• Meningitis
• Lyme Disease
• Low Back (Law Enforcement Officers only)
• Post-Traumatic Stress Disorder

Note that each of these presumptions apply to different classes of public employees, and also have their own criteria.  See California Labor Code Sections 3212 – 3213.2 for an extensive list and explanation of all presumptions discussed.

Heart Trouble Presumption

What is the Heart Trouble Presumption?
Heart trouble has been defined as “any affliction to, or additional exertion of, the heart caused directly to that organ or the system to which it belongs, or to it through interaction with other inflicted areas of the body.” Muznik v. WCAB (1975) Thus, any trouble to the heart that develops or manifests during employment is presumed to be industrially caused, unless controverted by other evidence. However, the employer may not overcome the heart presumption by attributing the heart injury to any disease existing prior to the development or manifestation.   The only way that the employer may overcome the heart presumption is by showing through substantial medical evidence that some contemporaneous non work-related event was the sole cause of the heart trouble.

Some examples of conditions held to constitute heart trouble by the Workers’ Compensation Appeals Board include left ventricular hypertrophy, atrial enlargement, atherosclerosis, valvular lesions, scarring caused by viral infections, coronary artery disease, myocardial infarctions, arrhythmias, atrial fibrillation, cardiomyopathy and mitral valve prolapse.

High blood pressure and hypertension alone, without actual heart involvement, does not trigger the presumption.

Who Does the Heart Trouble Presumption Apply to?
The heart trouble presumption applies to the following public employees:

• Members of city, county, or municipal fire department
• Members of the Forestry and Fire Protection who are engaged in active firefighting
• Members of the law enforcement division at the Wildlife Protection Branch who are engaged in active law enforcement
• Members of the Department of Fish and Game who are engaged in active law enforcement
• Officers and employees at the Department of Corrections who have custodial or supervisory duties
• Officers and employees at the Department of the Youth Authority who have group supervision duties
• Parolees or peace officers defined by Penal Code 830.5 that have custodial or supervisory duties of wards, inmates, or parolees, and have served at least 5 years
• CHP officers designated as a peace officers under VC 2250.1(a) who have graduated from a certified academy and who have been regular, full-time employees for at least 5 years
• University of California Fire Department employees who are on a regular, full-time salary and non-probationary basis
• University of California Police Department employees who have graduated from a certified academy and who a defined as a peace officer under Penal Code 830.2
• Police Officers for a city, municipality, CHP, Sheriffs, Deputy Sheriffs, Inspectors or Investigators a District Attorney’s office, who have been employed with a regular, full-time salary for at least 5 years and are defined as peace officers under Penal Code 830.1, 830.2, or 830.3
• Department of Justice employee’s that fall within the “state safety” class and are employed on a regular, full-time salary
• Every officer employed at the Atascadero State Hospital

Hernia Presumption

What is the Hernia Presumption?
California’s Labor Code does not define the term “hernia.” However, the court has noted that a “hernia” is a broad term for “protrusion of tissue or an organ through an abnormal opening in the body cavity that normally contains it.” City of San Diego v. WCAB (Stanley) (1997)). Generally considered to apply to all types hernias, including hiatal hernias.

Who Does the Hernia Presumption Apply to?
The hernia presumption applies to the following public employee’s:

• Members of a fire department, including lifeguards, of any county forestry or firefighting department
• Active firefighters at the Department of Forestry and Fire Protection
• Members of a sheriff’s office
• Members of a district attorney’s staff of inspectors and investigators
• Members of a city, county, or municipal police department
• Members of a city, county, or municipal fire department
• Active firefighters at the Department of Forestry and Fire Protection
• Members of the warden service for the Wildlife Protection Branch of the Department of Fish and Game, who are engaged in active law enforcement
• University of California Fire Department employees who are employed with a regular, full-time salary and non-probationary basis
• Department of Justice employee’s that fall within the “state safety” class and are employed on a regular, full-time salary

Pneumonia Presumption

What is the Pneumonia Presumption?
Pneumonia is an infection that inflames the air sacs in one or both lungs. These air sacs fill with fluid and may cause coughing, fever, chills, and difficulty breathing. This presumption applies to pneumonia contracted from the workplace, but also to pneumonia secondary to an underlying condition or infection. A specific type of pneumonia need not be identified, nor does it limit the applicability of the presumption. In one case, the court found that Valley Fever was pneumonia for the purposes of applying this presumption. Board of Administration v. IAC (Cheda) (1961)

Who Does the Pneumonia Presumption Apply To?
The pneumonia presumption applies to the following public employee’s:

• Members of a fire department, including lifeguards, of any county forestry or firefighting department
• Active firefighters at the Department of Forestry and Fire Protection
• Members of the warden service for the Wildlife and Protection Branch of the Department of Fish and Game, who are engaged in active law enforcement
• CHP officers designated as a peace officers under VC 2250.1(a) who have graduated from a certified academy and who have been regular, full-time employees
• University of California Fire Department employees who are on a regular, full-time salary and non-probationary basis
• University of California Police Department employees who have graduated from a certified academy and who a defined as a peace officer under Penal Code 830.2
• Members of a police department, sheriffs, deputy sheriffs, and inspectors or investigators in a district attorney’s office, who are defined as peace officer under Penal Code 830.1, 830.2, and 830.3 and employed with a regular, full-time salary
• Department of Justice employee’s that fall within the “state safety” class and are employed on a regular, full-time salary
• Department of Justice employee’s that fall within the “state safety” class and are employed on a regular, full-time salary
• Officers and employees at the Department of Corrections who have custodial or supervisory duties of inmates or parolee
• Officers at the Department of Youth Authority, who are defined as peace officers under Penal Code 830.5 and who have custodial or supervisory duties of wards or parolee’s

Meningitis Presumption

What is the Meningitis Presumption?
Meningitis is a virus that causes inflammation of the membranes surrounding the brain and spinal cord. This presumption applies to meningitis in itself, and to other injuries caused by the virus or medical procedures causing injury as a result of the meningitis. However, a positive test for meningitis typically must be shown in order for this presumption to apply.

Who Does the Meningitis Presumption Apply To?
The meningitis presumption applies to the following public employee’s:

• Members of a police department, sheriff’s office, and fire department
• Members of any county forestry or firefighting department
• CHP officer’s
• County probation officer’s
• Inspector’s and investigators in a district attorney’s office
• Peace officers for the Department of Corrections who have custodial or supervisory duties over inmates or parolee’s
• Peace officers for the Department of Youth Authority who have custodial or supervisory duties of wards or parolee’s
• Peace officers of local agencies as defined by Penal Code 830.5

All of the above must be employed on a regular, full-time salary, and does not apply to employees whose principal duties consist of clerical work.

Cancer Presumption

What is the Cancer Presumption?
This presumption applies to all types of cancer. However, to be entitled to this presumption, the employee must prove that:

(1) identify the primary site of the cancer;

(2) that the cancer developed or manifested during a period of service to the department or unit; and

(3) that the employee was exposed to a carcinogen while in service, as defined by the International Agency for Research on Cancer, or the California Department of Industrial Relations.

To activate this presumption, a medical expert must determine the development or manifestation of the specific cancer. This often raises the “latency period” issue, as some cancers may start developing and/or manifesting before, during, or after employment periods, which often used by the employer to attempt overcome the cancer presumption.

To overcome this presumption, the employer must show, by preponderance of the evidence and with medical probability, that there is no reasonable link between the employee’s exposure to a known carcinogen during the employment and development or manifestation of the cancer. The employer cannot overcome this by merely showing a lack of evidence establishing a reasonable link between the carcinogen and the cancer. Rather, the employer must affirmatively establish that no reasonable link exists.

Who Does the Cancer Presumption Apply To?
The cancer presumption applies to the following public employee’s:

• Active firefighters, whether voluntary, partly, or fully paid, for the following:
• Certified, active firefighting members that serves a U.S. Department of Defense
• Active firefighters for fire departments serving NASA
• Peace officers defined by Penal Code 830.1, 830.2(a), and 830.37(a)(b), who are primarily engaged in law enforcement
  • Penal Code 830.1 includes specified sheriff’s, deputy sheriff’s, local police officers, attorney general and Department of Justice employee’s
  • Penal Code 830.2(a) includes CHP officers
  • Penal Code 830.37(a)(b) includes certain arson investigators
• Chief, Senior, and regular coordinators for the fire and rescue services at the Office of Emergency Services

The court has held that a police officer who carried weapons and had duties of public law enforcement as defined by Penal Code 830.33, may be entitled to this presumption. An acting Deputy Sheriff, a correctional deputy for a county, and an investigator for the district attorney’s office, have also been entitled to this presumption.

Peace officers under Penal Code 830.6 are not entitled to this presumption, nor are peace officers working for a school district under Penal Code 830.32, correctional officers employed by the California Department of Corrections & Rehabilitation, and county probation officers.

Skin Cancer Presumption For Lifeguards

What is the Skin Cancer Presumption?
This presumption specifically applies to certain lifeguard’s for skin cancer only.

Who Does the Skin Cancer Presumption Apply To?
The skin cancer presumption applies to lifeguards who are employed by a city, county, district, employees from the Department of Parks and Recreation, or other municipal entity. To be entitled to this presumption, the lifeguard must be employed for more than 3 consecutive months in a calendar year. 

Tuberculosis

What is the Tuberculosis Presumption?
Tuberculosis is caused by a specific bacterium that primarily attacks the lungs but can also attack other bodily organs and functions. For this presumption to apply, the employer may require the employee to be tested for the condition.

Who Does the Tuberculosis Presumption Apply To?
The tuberculosis presumption applies to the following public employee’s:

• Members of a police department for a city or county
• Members of a sheriff’s office for a city or county
• Members of a fire department for a city, county, or district, or other public agency
• CHP members
• Inspector’s or investigators for a district attorney’s office whose duties consist of active law enforcement, or that work in a prison, or jail
• Active firefighters for the Department of Forestry and Fire Protection
• Members of any county forestry or fire department
• Peace officers for the Department of Corrections, who have custodial or supervisory duties of inmates or parolees
• Correctional officers employed by a public agency
• Peace officers employed by the Department of Youth Authority who have custodial or supervisory duties of wards or parolees
• Peace officers of local agencies as defined by Penal Code 830.5

All of the above employee’s must be employed on a regular, full-time salary, and does not apply to employee’s whose principal duties consist of clerical work.

Blood-Borne Infectious Disease and MRSA Presumption

What is the Blood-Borne and MRSA Presumption?
Blood-borne pathogens are microorganisms such as viruses and bacterium that are carried and transmitted primarily through blood, causing disease in humans. There are many different blood-borne pathogens, some of which include malaria, hepatitis, HIV/AIDS. Blood-borne viruses are typically contracted through contact with infected bodily fluids. On the other hand, MRSA is a staphylococcal bacterial infection that is resistant to antibiotics and can also be contacted by open skin or wounds.

This presumption for blood-borne diseases extends following termination for 3 calendar months for each full year of service, but for no longer than 5 years after termination of service. The MRSA presumption extends for 90 days following termination of service, with the 90-day period starting on the last day actually worked.

Who Does the Blood-Borne and MRSA Presumption Apply To?
This presumption applies to the following public employee’s:

• Members of a sheriff’s office for a city, county, or other municipal agency
• Members of a police or fire department for a city, county, or other municipal agency
• Peace officers as defined by Penal Code 830
• Active firefighters for the Department of Forestry and Fire Protection
• Active firefighters for any county forestry or firefighting unit

All of the above classes of employees are entitled to this presumption whether they are voluntary, partly, or fully paid. None of the above classes of employee’s need be full-time or certified by their respective agencies.

Injury from Exposure to Biochemical Substance Presumption

What is a Biochemical Substance for the Purposes of Worker’s Compensation?
For the purposes of worker’s compensation in California, a biochemical substance is defined as “any biological or chemical agent that may be used as a weapon of mass destruction, including but not limited to, any chemical warfare agent, weaponized biological agent, or nuclear radiological agent” as defined in Penal Code 11417. (Labor Code Section 3212.85).

A “weapon of mass destruction” for the purposes of this presumption, includes the above, and restricted biological agents, intentional release of industrial agents via weapons, aircraft, vessel, or vehicles. Intentional use of a dangerous or hazardous material that is generally used for an industrial or commercial purpose, such as tear gas and mace, is considered a weapon of mass destruction for worker’s compensation purposes.

A “destructive weapon” means to use with the intent of causing widespread bodily injury or death, by means of fire, explosion, or release of a chemical, biological, or radioactive agent.

What is the Exposure to a Biochemical Presumption?
When a public employee is exposed to any of the biochemical substances discussed above, any injury, illness, or death caused by such exposure is presumed to be recoverable.

Who Does the Exposure to a Biochemical Presumption Apply To?
This presumption applies to the following public employee’s:

• Peace officers as defined by Penal Code 830.1 and 830.5
• Members of a fire department for a city, county, or other municipal agency
• University of California fore department employees
• California State University fire department employees
• Members of the Department of Forestry and Fire Protection
• Members of any other county forestry or firefighting department

All of the above classes of employees are entitled to this presumption whether they are voluntary, partly, or fully paid.

Lyme Disease Presumption

What is the Lyme Disease Presumption?
Lyme Disease is a vector-borne disease in the form of a bacteria that is transmitted to humans by the bites of infected ticks. Common symptoms of infection include fever, headaches, fatigue, and a skin rash. If left untreated, the infection can spread to the joints, heart, and nervous system. Some forms of Lyme Disease may be treated with antibiotics.

When a public employee is diagnosed with Lyme Disease, any injury or illness is presumed to be recoverable, but may be overcome by the employer is there is no reasonable link between the employee’s work duties and history and the Lyme Disease.

Who Does the Lyme Disease Presumption Apply To?
The Lyme Disease presumption applies to the following employee’s:

• Peace officers as defined by Penal Code 830.1(b) and 830.2(e),(f), and (g)
• Corps members as defined by Public Resources Code 14302
• Other classified employees of the California Conservation Corps

Low Back Injury Presumption for Law Enforcement Officers

What is a Lower Back Impairment for Purposes of This Presumption?
Low back injuries are presumed to be work-related for certain public employees.

For this presumption to apply, the injured officer must have been employed for at least 5 years and show that he or she was required to wear a duty belt as a condition of their employment. A “duty belt” means a belt used for the purpose of holding a gun, handcuffs, baton, and other items related to law enforcement.

The lower back presumption extends for a period of 3 calendar months for each full year of the requisite service, but does not exceed 5 years after the last date actually worked in the specified capacity.

What Officer’s Does the Lower Back Presumption Apply To?
The lower back presumption applies to the following employees:

• Members of a police department for a city or county
• Members of a sheriff’s office of a county
• Peace officers employed by CHP
• Peace officers employed by the University of California

Post-Traumatic Stress Disorder

What is the PTSD Presumption?
PTSD is a mental health condition that is triggered by the witnessing or experiencing of a traumatizing event. There is a presumption for injuries to certain state and local peace officers and firefighting personnel for injuries occurring on or after January 1, 2020.

For the presumption to apply, the employee must have worked for at least 6 months with the department or unit, and the PTSD must have developed or manifested during a period of employment with that particular department or unit. The covered employee is entitled to all compensation for hospital, surgical, medical, disability, and death benefits.

This presumption extends to a covered employee following termination of employment for a period of 3 calendar months for each full year of the required service, but for no longer than 5 years after the last date actually worked.

Who Does the PTSD Presumption Apply To?
The PTSD presumption applies to the following employees:

• Active firefighters, whether voluntary, partially, or fully paid, for fire departments of a city, county, district, or other municipal agency
• Active firefighters, whether voluntary, partially, or fully paid, for the fire department of the University of California and California State University
• Active firefighters, whether voluntary, partially, or fully paid, for the Department of Forestry and Fire Protection
• Active firefighters, whether voluntary, partially, or fully paid, for any county forestry or firefighting department or unit
• Certified, active firefighters for a fire department servicing a U.S. Department of Defense installation
• Active firefighting members of a fire department that serve NASA and who adhere to specified training standards
• Specified peace officers who are primarily engaged in active law enforcement
• Fire and rescue service coordinators who work for the Office of Emergency Services