Friday, January 29, 2016

2nd District Finds PSEBA Eligibility Not Automatic for Firefighter with Cardiomyopathy

The 2nd Appellate District has weighed in on the question of whether an award of a line of duty disability automatically qualifies the employee for no cost lifetime health benefits under the Public Safety Employee Benefits Act (“PSEBA”). 

To qualify for these benefits, the Act itself contains a two part test. The employee must show that he or she sustained a catastrophic injury and that it occurred as a result of the employee’s “response to what is reasonably believed to be an emergency, an unlawful act perpetrated by another or during the investigation of a criminal act.”

In the case of Bremer v. City of Rockford 2015 IL App (2d) 130920, the plaintiff was a veteran firefighter for the City who applied for a duty disability based on his diagnosis of cardiomyopathy.  During the pension board hearing,  he presented evidence that his disease was the result of many years of exposure to smoke and toxic chemicals. The pension board found that he was eligible for a disability pension as a result of his occupational disease, pursuant to the Pension Code.  He then sought lifetime insurance benefits under PSEBA.

Both parties sought summary judgment on the issue of whether the plaintiff was eligible for PSEBA benefits. The plaintiff argued that his illness of cardiomyopathy was the result of many years of responding to fires and other emergencies, as found by the pension board. The City argued that a finding of duty related disability only requires that a pension board find that the firefighter suffer from an occupational injury or illness sustained in the service of a firefighter and therefore does not fulfill the second part of the test for PSEBA eligibility. The trial court granted plaintiff’s summary judgment on the issue.

 The Appellate Court reversed, finding that the second prong of the PSEBA test is fact specific and involves a case by case analysis as to whether the events leading to the catastrophic injury resulted from one of the enumerated events. The court in this case specifically found that the pension board was only required to find whether the plaintiff’s cardiomyopathy was an occupational illness sustained in the service as a firefighter which qualified him for a duty disability pension and found that the pension board’s additional findings that plaintiff was responding to emergencies in the course of his employment was beyond their authority as a board. The court found that a separate determination on PSEBA benefits was appropriate.

This is a victory not just for the City of Rockford, but for all public sector employers who employ firefighters.  For many years now employees have sought to effectively merge the two factors for PSEBA eligibility. Given the high cost of free lifetime health insurance for an employee and their dependants, employers closely monitor eligibility.  The court here reinforced the appropriateness of an employer reaching its own  findings, independent of any made by a pension board, as to whether an employee is PSEBA eligible.