Texas rules in favor of firefighter seeking coverage for cancer treatment
The appeals panel from the Texas Department of Insurance sided with Homer Salinas over the city’s insurance carrier who denied him worker’s compensation
By Berenice Garcia
MISSION, Texas — The state reaffirmed its support of a Mission firefighter in his quest to receive insurance coverage for his cancer treatment after an appeals panel sided with him over the city’s insurance carrier who denied him worker’s compensation.
The appeals panel from the Texas Department of Insurance sided with Homer Salinas, the Texas State Association of Fire Fighters announced Tuesday, reaffirming an initial ruling in his favor earlier this year.
In September, TDI Administrative Law Judge Julio Gomez, Jr. ordered the insurance carrier, the Texas Municipal League Intergovernmental Risk Pool (TMLIRP), to pay Salinas’ denied medical care.
Gomez ruled that Salinas, who had paid for his own treatment, “sustained a compensable injury, in the form of an occupational disease.”
“We have won four rounds of this fight, but we must keep going to ensure that no sick Texas firefighters will be forced to fight both cancer and insurance red tape,” Salinas said Tuesday in a news release. “My family and I remain grateful for the amazing support of the Mission community and of firefighters around Texas.”
Salinas, who joined the Mission Fire Department as a volunteer firefighter in 2002, was diagnosed with renal cell carcinoma in October 2017.
However, his case with the Department of Insurance began after TMLIRP denied his claim in November 2017, claiming that his diagnosis was not job-related.
The TSAFF, a firefighters union, alleged that a review of Salinas’ case indicated that TMLIRP denied coverage without reviewing material pertinent to Salinas’ claim.
“The denial also contained erroneous statements and the TMLIRP administrator neglected to review essential evidence in the case,” the association said in the release.
When the denial of coverage for Salinas’ treatment was publicized earlier this year, the city of Mission vowed to take steps within the city to provide more support for its firefighters.
The city has since adopted temporary paid leave for its firefighters for illnesses “presumed to have been related to the firefighter’s line of duty.”
The policy went into effect in February and granted Salinas paid leave while he sought a final determination from TDI.
“His fight just shows that TML and city employers too often deny coverage of life-saving cancer treatment for firefighters with legitimate insurance claims,” John Riddle, TSAFF president, said in the release. “With state law clearly on our side, TSAFF and Texas firefighters will continue to fight to hold these insurers accountable.”
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