A Landmark Shift in Federal Cancer Presumption
On December 19, 2025, the Honoring Our Fallen Heroes Act was signed into law as part of the National Defense Authorization Act. This legislation represents the most significant expansion of federal cancer protections for firefighters in a generation. It fundamentally changes how the Public Safety Officers' Benefits (PSOB) program treats cancer-related line-of-duty deaths, and every active, retired, and volunteer firefighter in this country should understand what it means.
The law passed with strong bipartisan support — 312 to 77 in the House and 77 in the Senate. That margin reflects what those of us in the fire service have known for decades: the evidence linking firefighting to cancer is overwhelming, and the federal benefits system was long overdue for an update.
What the Law Actually Does
At its core, the Honoring Our Fallen Heroes Act adds 20 types of cancer to the list of conditions presumed to be job-related under the PSOB program. This is a presumptive coverage provision, meaning that eligible firefighters diagnosed with one of these cancers no longer bear the burden of proving that their specific exposures caused their disease.
Prior to this law, firefighter families seeking PSOB death benefits for cancer had to demonstrate a direct causal link between the firefighter's occupational exposures and their cancer diagnosis. In practice, this requirement was an enormous barrier. Firefighters are exposed to hundreds of carcinogens over the course of a career — in structure fires, vehicle fires, wildland fires, hazmat incidents, and even in the fire station itself. Isolating a single exposure event is often scientifically impossible.
The new law removes that requirement. If a firefighter is diagnosed with one of the 20 covered cancers, the presumption is that it was caused by their service.
Covered Cancers
The 20 cancers added to the PSOB presumption include many of the malignancies most strongly associated with firefighting exposures. While the specific list is detailed in the legislation itself, it encompasses cancers of the bladder, brain, breast, colon, esophagus, kidney, liver, lung, lymphatic system, skin (melanoma), prostate, reproductive system, stomach, thyroid, and several others identified through the body of peer-reviewed research compiled over the past two decades.
Death Benefits
Eligible families receive $461,000 or more in federal death benefits through the PSOB program. This is in addition to any state or local line-of-duty death benefits, pension survivor benefits, or life insurance proceeds. The PSOB benefit amount is adjusted annually for inflation.
It is important to note that PSOB benefits also include educational assistance for the spouses and children of fallen officers. These provisions can cover tuition, fees, and living expenses at accredited institutions.
Eligibility Requirements
The law establishes clear eligibility criteria that balance accessibility with program integrity.
- Timing of diagnosis: The cancer must be diagnosed at least 5 years after the firefighter began their service. This threshold reflects the latency period of occupational cancers — they take years or decades to develop after initial exposure.
- Post-service window: The diagnosis must occur no later than 15 years after the firefighter's last active day of service. This provision recognizes that many firefighters are diagnosed after retirement, when the cumulative effects of years of exposure finally manifest.
- Retroactivity: The law is retroactive to January 1, 2020. Families of firefighters who died from covered cancers on or after that date may be eligible for benefits, even if the death occurred before the law was signed. This is a critical provision that I encourage affected families to explore immediately.
Who Qualifies as a "Firefighter"?
The PSOB program covers career firefighters, volunteer firefighters, and members of legally organized fire departments. Federal wildland firefighters are also covered. If you carry a badge, respond to emergencies, and face the same exposures as any other firefighter, this law was written for you.
How to Apply
PSOB claims are administered by the Bureau of Justice Assistance (BJA) within the U.S. Department of Justice. The application process involves submitting documentation of the firefighter's service history, medical records establishing the cancer diagnosis, and a death certificate where applicable.
I strongly recommend that departments and unions designate a point of contact for PSOB claims. The process, while improved, still involves federal paperwork and timelines. Having someone in the department who understands the system can make a meaningful difference for grieving families navigating an already difficult time.
The PSOB program website provides application forms, FAQs, and contact information for the claims office. Families can also contact the National Fallen Firefighters Foundation for guidance and support.
Context: The Broader Legislative Landscape
The Honoring Our Fallen Heroes Act does not exist in isolation. It is part of a broader legislative effort to address the cancer crisis in the fire service. Two additional bills deserve attention.
The Federal Firefighter Cancer Detection and Prevention Act of 2025
Introduced as H.R. 2921 in the House and S. 2745 in the Senate, this legislation would establish a cancer screening and prevention program specifically for federal firefighters. It recognizes that early detection is the single most effective tool for improving cancer outcomes — a principle that applies equally to municipal and volunteer firefighters.
The FIRE Cancer Act
H.R. 1610, the Firefighter Inclusion in Relevant Early-Detection Cancer Act, would expand access to cancer screenings through existing federal health programs. Both bills complement the Honoring Our Fallen Heroes Act by focusing on prevention rather than solely on post-diagnosis benefits.
The trajectory of federal legislation is clear: Congress is moving toward comprehensive recognition that firefighting is an inherently carcinogenic occupation. The question is no longer whether firefighters face elevated cancer risks. The question is how quickly we can build systems to detect, treat, and compensate for those risks.
What This Means for Departments
Fire departments — career, combination, and volunteer — should take several immediate steps in response to this law.
- Update your personnel on the new presumption. Every firefighter in your department should know that this law exists, what it covers, and how their families would access benefits. Incorporate this into your annual training or safety stand-down.
- Review your recordkeeping. PSOB claims require documentation of service dates, assignments, and incident exposures. Departments with robust records management systems will be better positioned to support claims. Those without such systems should begin building them now.
- Strengthen your cancer prevention programs. Presumptive coverage is vital, but prevention is better. Gross decontamination on scene. Clean cab policies. Regular laundering of PPE. Annual cancer screenings. The evidence base for these practices is strong, and the cost of implementation is modest compared to the cost of losing a firefighter.
- Connect with your state's presumptive laws. Most states have some form of firefighter cancer presumption on the books. The federal law supplements but does not replace state-level protections. Understanding how the two interact is important for comprehensive coverage.
A Note on the Human Cost
I have attended more firefighter funerals than I care to count. In recent years, an increasing number of those services have been for brothers and sisters taken by cancer — not by a roof collapse or a flashover, but by the slow, relentless progression of a disease they contracted doing the job they loved.
The fire service culture has traditionally honored the dramatic line-of-duty death. The collapse. The explosion. The rescue gone wrong. These are the deaths that make the news, that fill the funeral procession for miles. But cancer kills more of us than all of those combined. It kills quietly. It kills after retirement, when the uniform is hanging in the closet and the pension checks are arriving. And for too long, it killed without recognition.
This law changes that. Not perfectly. Not completely. But meaningfully. It tells our firefighters and their families that the nation recognizes their sacrifice — all of it, including the sacrifice that doesn't show up until years after the last alarm.
Looking Ahead
The Honoring Our Fallen Heroes Act is a milestone, not a finish line. Continued advocacy is needed to fund the cancer screening programs authorized by companion legislation, to expand presumptive coverage at the state level, and to invest in the research that will drive the next generation of prevention strategies.
For those considering a career in the fire service, I want to be direct: this is a profession with real risks, including long-term health risks. But it is also a profession that is finally reckoning with those risks honestly, building protections, and fighting for the people who serve. Explore the full range of fire service careers and understand both the rewards and the realities.
To every firefighter reading this — career, volunteer, active, or retired: know your rights under this law. Talk to your union representative or your department's benefits coordinator. If you have been diagnosed with cancer, or if you have lost a loved one to cancer, explore whether this law applies to your situation. You have earned these protections.
And to the legislators who voted for this bill: the fire service thanks you. Now fund the rest of it.
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