Understanding Cancer in Workers’ Compensation
The Overlooked Risk: Cancer in the Workplace
Cancer affects 40% of the population at some point in life, and while we often think of lifestyle factors—like smoking, diet, and genetics—your job can also be a risk factor. Certain occupations, including firefighters, construction workers, military personnel, miners, law enforcement, and even nail technicians, are exposed to carcinogens that increase their risk.
For employees diagnosed with cancer, the challenges go beyond health concerns—they face lost work time, medical bills, extended leave, and financial burdens. But if their cancer is linked to workplace exposure, workers' compensation may apply.
What Types of Cancer Qualify for Workers' Comp?
Workers’ comp eligibility depends on workplace exposure to specific carcinogens. Here are five cancers commonly linked to occupational hazards:
Lung Cancer – Exposure to asbestos, silica dust, or industrial chemicals.
Skin Cancer – Caused by long-term exposure to UV rays or toxic chemicals.
Mesothelioma – Directly linked to asbestos, common in construction and manufacturing.
Bladder Cancer – Associated with prolonged contact with industrial dyes and solvents.
Leukemia – Linked to benzene, found in oil, manufacturing, and chemical industries.
The Challenge: Proving It’s Work-Related
One major hurdle is proving that cancer stemmed from workplace exposure—especially since it can take years to develop. Employees filing for workers’ comp must:
✔ Document their diagnosis and treatment history.
✔ Obtain medical records linking cancer to work conditions.
✔ Seek legal support to navigate the claim process.
To address this, nearly all states have laws that provide presumptive coverage, ensuring that employees with certain occupational exposures are automatically presumed to have developed cancer as a result of their job.
The Financial Toll of Cancer
Cancer treatment is expensive, and studies show that 22.5% to 64% of working-age cancer survivors experience financial distress due to medical bills. This strain affects treatment adherence, quality of life, and overall health outcomes.
The objective for every payer/PBM is to ensure that employees diagnosed with work-related cancer receive proper medical care and clinical support.
Why This Matters for Employers & Insurers
Workers’ comp isn’t just about insurance—it’s also about protecting employees and streamlining care. Payers and PBMs play a vital role in ensuring:
Access to appropriate care including specialty medications—Delays can worsen health outcomes.
Efficient claim processing—Cancer treatment is lengthy, and delayed claims increase costs.
Support for employees—Providing help during a health crisis fosters loyalty, morale, and retention.
Cancer is tough—but navigating workers’ comp shouldn’t be. By addressing workplace risks and supporting affected employees, we can improve both clinical support and health outcomes for workers.
By Julia Bieurance
PharmD Candidate (P4)
For questions, e-mail pharmd@prodigyrx.com
Sources
1. https://www.cancer.gov/about-cancer/understanding/statistics
2. https://www.cancer.gov/about-cancer/causes-prevention/risk