Relating To Workers' Compensation Medical Benefits.
Summary
SB828 amends Hawaii’s workers’ compensation law to expand and clarify medical benefits for firefighters diagnosed with certain cancers and related diseases. The bill revises section 386-21.9, Hawaii Revised Statutes, so that a firefighter with at least five years of service who has a compensable claim for a covered cancer or disease remains entitled to workers’ compensation medical care, services, and supplies unless the employer proves the condition was not associated with firefighting duties.
The bill broadens the list of covered conditions to include adenocarcinoma or mesothelioma of the respiratory system, cancer of the buccal cavity, colon, pharynx, and thyroid, and malignant melanoma, while retaining coverage for other specified cancers such as leukemia, multiple myeloma, and non-Hodgkin lymphoma. It also sets a payment floor and ceiling for medical care tied to the Medicare Resource Based Relative Value Scale applicable to Hawaii, requiring employer liability for at least 110 percent and no more than 150 percent of the listed fees.
Impact
SB828 would expand the scope of presumptive workers’ compensation medical coverage for firefighters under Hawaii law and modify the evidentiary standard by allowing employers to rebut coverage only by proving the disease was not related to firefighting duties. It would affect section 386-21.9 and the administration of medical benefits for covered firefighters, while also establishing a specific reimbursement range for covered medical services based on Medicare fee schedules.
Sentiment
The available voting history shows strong support for the bill at each committee stage, with unanimous or near-unanimous passage: 5-0 in both Senate Public Safety, Intergovernmental and Military Affairs and Senate Labor and Technology, and 13-0 in Senate Ways and Means. The overall sentiment appears favorable, reflecting broad legislative agreement on expanding protections for firefighters with occupational cancers.
Contention
The main policy issue is the balance between expanding benefits for firefighters and preserving an employer’s ability to contest causation. The bill shifts the burden toward employers by requiring them to prove a cancer or disease was not associated with firefighting duties, which may be a point of concern for employers and insurers. Another notable feature is the use of Medicare-based fee limits for medical reimbursement, which could affect provider payments and workers’ compensation costs. No committee transcript objections are available in the provided record, and the recorded votes suggest little overt opposition.