module 9 part 1

Question 2

What is a presumption in workers’ compensation law?

Answer 2

A legal rule that assumes a condition is work-related if certain criteria are met, shifting the burden to the employer/insurer to disprove.

Question 3

Why are presumptions important?

Answer 3

They make it easier for employees (especially certain job classes) to prove work-relatedness, speeding benefit access.

Question 4

Mnemonic for presumption concept

Answer 4

“ASSUME → SHIFT” — Law assumes work link until employer shifts burden.

Question 5

What happens if a presumption applies?

Answer 5

The employer must provide substantial evidence to rebut the presumed work-relatedness.

Question 6

Are presumptions automatic?

Answer 6

No — the injured worker must meet eligibility requirements (job class, exposure, time worked).

Question 7

Which workers most often benefit?

Answer 7

Public safety (firefighters, peace officers), some health care workers, first responders.

Question 8

Key public safety presumption conditions?

Answer 8

Heart disease, hernia, pneumonia, tuberculosis, certain cancers, COVID-19, PTSD (for specified roles).

Question 9

What is the heart disease presumption?

Answer 9

Heart trouble developing during employment for firefighters/peace officers is presumed work-related.

Question 10

How can employers rebut heart presumption?

Answer 10

Must show substantial non-industrial cause (e.g., documented pre-existing heart disease unrelated to work).

Question 11

Mnemonic for heart presumption

Answer 11

“HEART HERO” — Heroes get heart coverage unless clearly disproved.

Question 12

What is the cancer presumption?

Answer 12

Cancer in firefighters/peace officers presumed work-related if exposure to carcinogens is reasonably linked.

Question 13

Time requirement for cancer presumption?

Answer 13

Must have worked the required years (often ≥5 years of exposure service).

Question 14

What is the tuberculosis (TB) presumption?

Answer 14

TB for firefighters/peace officers is presumed industrial if contracted during service.

Question 15

Time limit to claim TB presumption?

Answer 15

Usually 3 months after last exposure while employed in covered capacity.

Question 16

What is the pneumonia presumption?

Answer 16

Pneumonia in firefighters/peace officers presumed industrial if developed during duty.

Question 17

What is the hernia presumption?

Answer 17

Hernias in certain safety workers presumed work-related unless clear non-industrial cause shown.

Question 18

What is the COVID-19 presumption?

Answer 18

COVID-19 infection during active duty (especially health & safety) presumed work-related for specified dates.

Question 19

COVID presumption time rules?

Answer 19

Applies if positive test within 14 days of working during covered emergency period.

Question 20

What is the PTSD presumption?

Answer 20

PTSD in firefighters/peace officers from 2020 legislation presumed work-related if diagnosed by qualified mental health professional.

Question 21

Duration of PTSD presumption coverage?

Answer 21

Extends for up to 5 years after last employment in qualifying role.

Question 22

Mnemonic for safety psych presumption

Answer 22

“PTSD = PROTECT THOSE SAVING DAY.”

Question 23

Why do presumptions often have time caps?

Answer 23

To balance fairness — limit liability to exposures closely tied to employment period.

Question 24

What must QME do when presumption applies?

Answer 24

Acknowledge presumption, but still analyze medical facts; may support or rebut if clear non-work cause.

Question 25

Can presumptions be rebutted?

Answer 25

Yes — by showing **substantial medical evidence** that non-industrial causes outweigh work link.

Question 26

What is “substantial evidence” standard?

Answer 26

Must be reasonable, credible medical evidence with factual basis — not speculation.