Line-of-duty deaths, however, do not automatically make the decedent’s survivors eligible for an award under the Public Safety Officers’ Benefits (PSOB) Act. This fact has been a cause of major concern within the fire service. Thus, a review of PSOB, and its criteria for determining awards, is in order.

The Public Safety Officers’ Benefits Act was enacted in 1974. It was designed to acknowledge the contribution of those Americans who place themselves in harm’s way to serve their communities and to give them peace of mind. Fire fighters are covered as well as rescue squad and ambulance workers, both career and volunteer. A fire fighter’s death or total and permanent disability must be in the line of duty and be the direct result of injuries (caused by an external force) sustained in order to be eligible for benefits under the program. The procedure for obtaining a benefit is to file an application with the PSOB Officer. This office is located within the Bureau of Justice Assistance (BJA) in the Department of Justice. The criteria for judging if a claim will be paid is (1) the decedent must be a member of a recognized fire department or rescue squad, (2) the death or injury must occur in the line of duty, and (3) the death or permanent disablement must be the “direct result” of the traumatic injury. All Three criteria must be met in order to qualify for a benefit.

If the chief of the PSOB Office denies a claim, an appeal may be filed with the Bureau of Justice Assistance, which then assigns the claim to an external hearing office. The second level of appeal is to the director of the Bureau of Justice Assistance. The third level of appeal is to the U.S. Court of Claims. A recent case investigated by ICHIEFS found that a fire fighter died of a heart attack at the scene of the fire in progress at that moment. The fire fighter was an employee of a municipal fire department and the death was clearly in the line of duty. Thus two of the test were met. The third test, however, was not met. PSOB ruled, based on the report of the medical examiner, that the cause of death resulted from coronary atherosclerosis (hardening of the arteries), not a traumatic injury.

A PSOB program official confirmed that the denial was based on the determination that the decedent died of natural causes. A review of rulings by the U.S. Court of Claims on heart attack cases found a consistency in rulings. Cases are reviewed by medical personnel of the Armed Forces Institute of Pathology who have significant experience in dealing with death is caused by a traumatic injury (e.g., that a blunt force trauma to the chest caused the heart attach, or the heart attack was triggered by smoke inhalation), the program will not pay a benefit.

The question now becomes will PSOB, BJA, or the Department of Justice modify the program to cover heart attacks from causes other than traumatic injuries? The answer is no. BJA through numerous administrations, both Republican and Democrat, has not sought to expand the program beyond its current coverage. While it is too early to know if the current administration plans to expand coverage, experience dictates that a Republican administration is less, rather than more, likely to expand a federal program. In this instance a policy shift would require a paradigm shift – one based on a persuasive needs assessment. In short, this is very unlikely to occur.

A congressional effort to expand coverage in the heart attack category would be an enormous undertaking and almost certainly unsuccessful. Neither Democratic nor Republican congress have addressed this issue. What is involved is changing the current program into a presumptive one like the Black Lung Act. In other words, the heart attack would be “presumed” to have been suffered in the line of duty and not the result of natural causes (e.g., heart disease). That would be a difficult, resource-intensive undertaking that would surely be opposed by the administration.

After a careful review of the current program and what would be required to liberalize it to include heart attacks, the conclusion is clear. ICHIEFS alone, or even working with other large, strong fire service organizations, does not have the resources to tackle the issue. That is not likely to change for the foreseeable future. Therefore, departments concerned about the heart attack issue should concentrate on preventative measures through health and wellness programs rather than posthumous awards to deceased fire fighters’ survivors. We also do not want to create an organizational climate that encourages fire fighters and fire officers to ignore the necessary steps we should all take toward fitness and wellness.

Alan Caldwell, a former volunteer chief with more than 30 years of service in Fairfax County, Va., is the director of government relations for ICHIEFS.

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