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Workers with cancer claims in California are overwhelmingly—but not exclusively—public safety workers covered by presumptions

• There are substantial differences in worker characteristics and claim outcomes between workers with and without coverage by cancer presumptions.
• Differences across occupations in mortality, claim denials, and earnings losses suggest that presumptions exert a powerful influence on claiming behavior and have succeeded in reducing barriers to claim filing for public safety workers covered by the presumptions.

Cancer leads to substantial earnings losses for most workers, but outcomes vary widely across occupation groups

• As a proportion of their earnings, losses experienced by firefighters and peace officers with cancer claims were less severe than losses for the average injured worker who received indemnity benefits.
• No earnings losses were detected for lifeguards who filed cancer claims.

Permanent disability and death benefits are responsive to differences in earnings losses across occupation groups, but pretax wage replacement rates still vary widely across occupations

• It appears likely that differences in earnings losses across occupations reflect differences in severity of disability, as suggested by patterns of benefit receipt and mortality.

No evidence of widespread gender differences in earnings losses, disability ratings, or benefit payments within occupations was found

• Available data do not support the conclusion that women who file cancer claims experience worse labor market outcomes or systematically different levels of compensation than male workers in the same occupational groups who file cancer claims.
• Estimates were imprecise, however, due to the limited number of female workers with cancer claims.

California's workers' compensation system requires employers to provide medical care and disability (or indemnity) benefits to workers who experience workplace injuries and illnesses, including occupational cancer. The adequacy of disability benefits for workers with occupational cancer is an issue of considerable public concern. In response to concerns over potential gender bias in disability compensation, the California State Legislature has passed several bills that would have modified the disability rating process for cancer. All of these bills were vetoed by former Governor Jerry Brown.

This report was requested in Governor Brown's September 2018 veto message for Assembly Bill 749 and was commissioned by the state Department of Industrial Relations in order to inform the ongoing debate over compensation for industrial cancer in California. In this report, the authors conduct an empirical analysis of earnings losses, disability ratings, and benefit payments for occupational cancer claims in the California workers' compensation system.

This report builds on other recent RAND research on earnings losses and postinjury outcomes for workers who experience occupational injuries and illnesses in California, including a study on musculoskeletal disorders among firefighters. The intended audience consists of legislators and other policymakers in California, stakeholders with an interest in the health and safety of public safety workers, and policymakers in other states who are considering how occupational cancers should be compensated in the workers' compensation system.

• Chapter One

  Introduction

• Chapter Two

  Data and Methods for Studying Earnings Loss and Benefits Due to Occupational Cancer

• Chapter Three

  Earnings Losses and Benefit Payments for Workers with Occupational Cancer Claims

• Chapter Four

  Earnings Losses and Benefit Payments for Workers with Occupational Cancer Claims by Gender

• Chapter Five

  Conclusion and Policy Implications