Firefighters puzzled by N.S. delay in expanding cancer compensation coverage

Billy Marr is heading back to hospital Wednesday to have another piece of his liver removed. The Halifax firefighter has been undergoing treatment since a routine colonoscopy discovered cancer in his rectum 16 months ago.

Marr said he knew the minute the scope images flashed on the screen during the Aug, 18, 2020, examination that something was wrong.

"I looked at the gastroenterologist and I'm like, 'That's not good,' and he looked at me and said, 'No, it's not,'" recalled Marr, 44, who has been off work since that appointment to undergo treatments or recover from them.

Despite all that, Marr considers himself fortunate because colorectal cancer is covered as a workplace injury or disease by Halifax Regional Fire & Emergency, and it is one of six cancers the province's Workers' Compensation Board presumes are related to firefighting work.

What he worries about are firefighters facing a host of other cancers that do not receive presumptive coverage under Nova Scotia's workers' compensation rules, including several suffered by female firefighters.

Many provinces now cover more than a dozen types of cancer, but Nova Scotia is still looking at whether breast, ovarian and cervical cancers, along with nine others, should be added to the list.

In 2020, the Department of Labour even consulted firefighters about the change, but cabinet has not changed the regulations to expand the list of presumptive cancers. 

"We need to change the legislation," Marr said in the dining room of his Dartmouth, N.S., home. "We need to protect those people.

"How can you expect people to lay their lives on the line on a regular basis if you're not going to look out for them?"

Having a cancer on the presumptive list, which was originally established in 2003, speeds up the compensation process for a firefighter and means less red tape. Firefighters whose cancers are not on the list must go through the arduous process of trying to prove their disease is related to their work in order to qualify for compensation.

Nova Scotia only extends presumptive coverage if a firefighter has brain, bladder, colon or kidney cancer, leukemia or non-Hodgkin's lymphoma. 

Manitoba, the province which has most recently expanded its list of presumptive cancers for firefighters, is adding four more types to the 14 it already covers, including thyroid and pancreatic cancer.

Retired firefighter Will Brooks wholeheartedly agrees Nova Scotia firefighters need better coverage. The former Truro, N.S., lieutenant is the founder of the Canadian Fallen Firefighters Foundation, a national organization that honours firefighters killed in the line of duty and helps support their families.

"I'm very puzzled by the delay," Brooks said in a recent interview.

The previous Liberal government said in early 2019 there was a plan to expand the list of covered cancers to 17. Brooks said both Liberal Leader Iain Rankin and Tim Houston, the current PC premier, promised to make the changes during the last election campaign.

The PC campaign platform promised to "extend prescription benefit coverage for firefighters to cover the following additional forms of cancer linked to firefighting: ureter, penile, testicular, breast, esophageal, prostate, skin, digestive tract."

According to Brooks, coverage can affect a whole host of issues for a firefighter with cancer, not the least of which is treatment.

"Nova Scotia actually had some of the very first legislation in this area but it has just remained dormant," he said. 

"If you're struggling, you pick up the phone and call 911, we come," said Marr. "That's what we do. This is our 911 call to the government.

"The longer they take to enact it, it just diminishes what we do."

Marr is scheduled for more surgery on Wednesday, as the cancer has returned to his lungs and liver. 

"I've undergone 11 rounds of chemo, five rounds of radiation. I've had one third of my liver removed," Marr said. "I've had my rectum removed, I've had a temporary ileostomy, I've had that reversed."

Premier Tim Houston said on Wednesday said his government recognizes the urgency around adding to the list of presumptive cancers. He said he anticipated it would be done in a few months.

"We will get it done and we will get it done faster than any previous government," Houston said.

Houston wouldn't say whether retroactive accommodations would be made, but said "these are all the types of things we'll have to look at."

"We want to be fair and we want to be respectful of those that get on the front lines and that's what we'll do. These are all the types of questions we are working through. But we said we'd provide the coverage and we will provide the coverage."

Since the presumptive cancer coverage was first brought into force in 2003, the Workers' Compensation Board of Nova Scotia has handled 129 claims, of which 97 have had benefits paid.