Research shows firefighters are at increased risk for developing cancer due to toxic exposures on the job, but while all 50 states and the District have created laws to provide benefits for firefighters with certain cancers, the News4 I-Team found many say the process in getting that help is fraught and the list of covered cancers is too narrow.
Before D.C. firefighter technician Steven Shipp passed away in April after developing colorectal cancer, he called for change to the system designed to protect firefighters like him.
"Our jobs should be fighting for our lives, not fighting for what we deserve," Shipp told the I-Team in February, as he recovered from invasive surgeries and intensive 52-hour chemotherapy sessions. "I'm going to die from this because of my job ... I'm not asking for anything that I don't deserve."
Shipp, a 20-year veteran of D.C. Fire and EMS, was diagnosed with cancer in January 2023, when doctors told him a large cancerous mass had spread from his appendix to his colon. Shipp said he had been working the job he loved -- driving Truck 7 out of Engine 18 -- just days before.
"I just remember my wife coming back in the recovery room, and we cried and we hugged and we just said, 'Well, you know, we're going to fight,'" he said.
But the fight they had wasn't what they expected, as they soon began a monthslong battle to get the District to recognize his cancer as connected to his service.
Under D.C. law, active duty firefighters with cancers presumed to be caused by toxic exposures (and who have served a prerequisite amount of time) are eligible for workman's compensation and, in some cases, line-of-duty death benefits. That means the District will cover their time off for treatment, their entire medical costs and, if they die from their illness, their family could receive their full annual survivor benefits. All of this, experts told the I-Team, is beyond what private insurance would cover alone.
"I thought they would just automatically do the right thing and take care of you," Shipp said. "It's a brotherhood."
But his cancer was not on D.C.'s presumptive list, which at the time covered rectal cancer, but not cancers associated with the colorectal track. Doctors diagnosed him with what's called peritoneal carcinomatosis, an advanced cancer they said likely began in his colon or appendix.
Because Shipp's cancer wasn't on the list of those presumed to be job-connected, he wasn't initially granted coverage, leaving him to use his private insurance and regular sick leave to seek treatment. But Shipp, who was given a Stage 4 diagnosis, said he was worried about so much more than that.
"Not only was I worried about living, I was worried about 20 years of my life, a paycheck, you know, my family, like, getting the honor that, you know, they deserve and I deserve," he said.
He said his oncologists wrote letters on his behalf, with supporters arguing his cancer should qualify under D.C. law as his cancer had spread throughout his colorectal track.
"And they still said, 'No, it doesn't meet the criteria,'" he said.
Sean Celestine worked with Shipp at Engine 18 for 14 years. Three days before Shipp passed away in April, Celestine was having a six-inch cancerous tumor removed from his leg.
He retired from D.C. Fire in January after he was diagnosed with sarcoma, a rare cancer not on D.C.'s presumptive list, though some studies have linked it to known carcinogens in firefighting.
"I tried to get them to rule it performance of duty -- POD -- meaning that you got this because of your job. And they said no," Celestine said.
D.C. Fire and EMS declined News4's request for an interview but said in a statement: "We stand in full solidarity with our colleagues who face life-altering health challenges. These are difficult and deeply personal circumstances, and we are committed to doing everything possible within the bounds of the law to ensure they receive care, time off, and the support they need and deserve in the most convenient process possible."
The statement continued that "where emerging evidence shows a connection between occupational exposure and illness, we support expanding the law to reflect those realities," noting the application of the presumptive law is governed by "specific statutory and medical criteria."
The News4 I-Team found stories like Shipp's and Celestine's aren't uncommon in departments across our region -- even as states continue to expand their presumptive lists.
The I-Team used public records requests to show how many local counties handled firefighters' cancer claims between 2019 and 2024.
Not including claims for chronic disease, the records show D.C. Fire approved 12 cancer claims in the past five years but told News4 they don't track how many they deny.
Fairfax County approved 18 presumptive claims but denied six in that timeframe.
Prince George's County approved 42 cancer claims and denied or deferred 10.
And Montgomery County approved 31 cases, but 42 were initially rejected.
Experts say any changes in that count likely reflect court battles that ensued following denials.
"We are seeing more and more different types of cancers and the rates of cancers among firefighters and particular types of cancer are changing," said Ken Berman, an attorney who spent decades representing firefighters and their families in cancer-related workman's compensation cases.
He has seen the evolution of presumptive disability laws related to firefighter cancer -- noting many cancers have been added over the years -- but believes many are still a step behind what firefighters are experiencing now.
"The chemicals keep changing, and so you're always a step behind this moving target," Berman said.
A 2013 federal study of almost 30,000 firefighters who served between 1950 and 2009 found they had a 14% increase in cancer-related deaths and a two-fold increase in cancers like mesothelioma.
Studies have also found links between cancer and common firefighting tools, such as turnout gear and firefighting foam, that contain forever chemicals called "PFAS," which stands for per- and polyfluoroalkyl substances.
"Just being a firefighter means it's one of the most highest risks of contracting cancer," said Ed Kelly, general president of the International Association of Fire Fighters.
According to the IAFF, cancer caused 72% of all IAFF member line-of-duty deaths in 2023. That's not including firefighters who may have died from cancer in the same time but whose deaths were not considered line of duty.
Kelly's organization is pushing for Congress to expand the Public Safety Officers' Benefits Program to provide benefits to all federal, state and local first responders who die from job-related cancer. Now, it's up to each state to decide what cancer to cover.
Kelly said he hopes the legislation will offer additional protection for firefighters regardless of where they work or live.
"You can work right over one city line, one county line, one state line, and have an entirely different set of benefits," he said, adding, "At the end of the day, these are benefits nobody wants. If I'm getting a benefit of cancer presumption, that means I have cancer."
Celestine, who after leaving Engine 18 in Capitol Hill spent several years fighting fires out of Engine 5 in Georgetown, said he believes his cancer was due to toxic exposures on the job. It's a fight he knows can be difficult to prove.
"We had firefighting foam when I was in the academy that's now been ruled cancer causing. We've had to change gear, our protective gear, because the gear we've had has been known to cause cancer," he said, adding, "There's no cancer in my family. Where else am I going to have gotten it from?"
As he prepares for another round of chemo, Celestine is appealing his denial in hopes the District will cover his medical bills and the time he took off for treatment -- the costs he incurred even outside of private health insurance.
"I want them to say, 'Yes, your cancer is a cancer that we're responsible for,' for the next person," he said, adding his cancer is "rare now, until it isn't."
After months of fighting, D.C. Fire ultimately approved Shipp's claim, and the D.C. Council eventually added several cancers, including colorectal, to the District's presumptive list.
But he said getting his reimbursements for treatments he incurred during the interim, as well as getting certain medicines or doctors approved, was overly complicated and frustrating.
At one point, Shipp said, his case manager complained he had too many doctors.
"I'm like, because I'm trying to save my life," he told News4, later adding, "I'm not going to grow old with my family because of what I did. The least they can do is treat me like a human, to treat my family with respect for what they're going to give up."
News4 asked PFC Associates, which oversees first responders' claims in the District, about those complaints.
In a statement, it said, "PFC Associates is proud to serve more than 6,000 dedicated police officers and firefighters across the District of Columbia. While we do not comment on individual patient cases, we remain committed to working closely with our patients to address any concerns throughout their care journey."
Shipp said he repeatedly tried to sit down with fire department leaders to share his story in hopes of improving the system for the future. He wasn't granted that meeting before he fell too ill to speak.
As the end drew near, he asked his best friend to deliver this message at his funeral: "I'm not bitter about anything that I went through or that happened to me. Hurt, yes. But my faith and belief in God are far too strong to be bitter. I want the process to be made better and fixed, if possible. Not for me, but for the next one of us unfortunate enough to contract this horrific disease."
Shipp was granted a line-of-duty death because of his cancer, but his family said they're still working through the process of receiving his full death benefits.
This story was reported by Tracee Wilkins and Katie Leslie, produced by Katie Leslie, and shot by News4 photographers Derrick Cheston and Carlos Olazagasti and WTVJ Miami photographer Anthony James. News4 I-Team photographer Steve Jones edited this report. WTVJ Miami executive producer Connie Fossi contributed to this report.
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