The multi-state trend to propose legislation focused on providing special workers’ compensation or occupational disease coverage for first responders for conditions such as mental stress, cancer, and cardiac conditions continues in 2025. Expansion of these laws can mean greater access to care for first responders, but it can also lead to increased claims and costs for employers. The following highlight several related bills introduced in 2025 that have been recently signed into law or made it just shy of that final step.
Connecticut
Connecticut Senate Bill 1426, signed into law and effective October 1, 2025, amends the state’s Firefighters Cancer Relief Program to expand coverage to skin cancer as an additionally covered type of cancer. The law allows firefighters to receive compensation and benefits in the same amount and manner that would be provided if caused by an occupational disease that arose out of and in the course of the firefighter's employment and was suffered in the line of duty.
Tennessee
Tennessee Senate Bill 288 amends an existing firefighter cancer presumption law to add prostate, breast and pancreatic cancers to the list of covered cancers. SB 288 was signed into law and takes effect July 1, 2025.
Tennessee House Bill 310, also signed into law and effective July 1, 2025, expands the existing state post-traumatic stress disorder (PTSD) presumption to include law enforcement officers and emergency medical responders. This adds to the existing presumption law, which states that PTSD is compensable for certain firefighters. HB 310 defines "emergency medical responders" as emergency medical technicians, technician-paramedics or paramedics, and "law enforcement officers" as individuals employed by the state or a local government as members of a law enforcement agency whose primary responsibility is the prevention and detection of crime and the apprehension of offenders.
West Virginia
West Virginia House Bill 2797, a workers’ compensation bill that expands the types of professionals who may diagnose PTSD, was signed into law and is scheduled to take effect July 11, 2025. Under current law, PTSD suffered by a first responder may be recognized as a compensable occupational disease under certain conditions and must be diagnosed by a licensed psychiatrist. HB 2797 adds certified mental health nurse practitioners and certified psychiatric physician assistants as those who may diagnose PTSD in first responders. While this change addresses the PTSD diagnosis, it should be noted that the same law allows several other provider types to treat PTSD.
Montana
While Montana Senate Bill 394 passed both legislative chambers, it was ultimately not signed into law by the governor. The bill would have amended state law to specify PTSD as a new type of injury eligible for workers’ compensation benefits for certain first responders. Under the bill, a first responder must have been diagnosed with PTSD, according to the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, and the diagnosis must have found that the injury or occupational disease arose out of the course and scope of employment. The bill defined “first responder” to include a firefighter, law enforcement officer, or an emergency care provider.
MyMatrixx by Evernorth continues to track it all
MyMatrixx has tracked around 90 bills related to special or presumptive coverage for first responders in more than half of the states so far this year. The status of the bills is fluid, and by the time of this publication, others may have progressed. A comprehensive list of bills and details of their current status can be found on the Legislative and Regulatory Policy Tracker on our Statehouse Watch webpage (select “Presumptions” as the topic).
Questions on these bills or other public policy topics for our Regulatory Affairs team can be sent to MMXRegulatoryAffairs@MyMatrixx.com. For more information on policy developments in workers’ compensation impacting pharmacy across the country, please visit and bookmark Statehouse Watch at MyMatrixx.com.