Source: US Congressional Budget Office

Bill Summary

S. 237 would expand eligibility for death, disability, and education benefits provided by the Public Safety Officer’s Benefit (PSOB) program to public safety officers and their beneficiaries if an officer dies or becomes permanently and totally disabled as a direct result of a cancer covered under the bill. S. 237 would apply retroactively to officers who die or become disabled on or after January 1, 2020. The bill would require the Department of Justice (DOJ) to review the list of cancers covered by the bill at least once every three years.

S. 237 also would extend the deadline to file a claim for benefits under the PSOB program for officers and their beneficiaries for officers who die or become permanently and totally disabled from COVID-19. Under current law, the deadline to file such a claim was May 11, 2023, when the public health emergency declared during the coronavirus pandemic ended.

Estimated Federal Cost

The estimated budgetary effect of S. 237 is shown in Table 1. The costs of the legislation fall within budget function 750 (administration of justice).

Basis of Estimate

CBO assumes that the bill will be enacted near the end of fiscal year 2025. The estimate is based on CBO’s analysis of cancer incidence and mortality among the general population of the United States and a review of the medical literature related to cancer incidence and mortality among public safety officers, including firefighters. The estimate is also based on CBO’s projections of the number of deaths among public safety officers that are likely to be related to cancer and the number of officers or their beneficiaries who apply for and receive benefits under the PSOB program.

Background

The PSOB program is administered by DOJ to provide cash benefits to federal, state, and local public safety officers and their beneficiaries in the event of death or permanent and total disability resulting from physical injuries and certain mental health conditions, such as post-traumatic stress disorder. Education benefits are also available to eligible spouses and children of officers who die or become disabled in the line of duty. Public safety officers include those working in law enforcement, firefighters, emergency management, and emergency medical services.

The program already provides benefits to World Trade Center responders and their beneficiaries who die or become disabled from cancer from exposure to a carcinogen after the terrorist attacks on September 11, 2001. CBO is unaware of the program approving any death or disability claim related to cancer that does not stem from attacks on September 11, 2001.

Eligibility Under the Bill

Under S. 237, an exposure to a carcinogen would qualify as an injury in the line of duty if an officer later dies or becomes permanently and totally disabled as a direct result of cancer. The bill would direct DOJ to presume that a qualifying injury caused the death or disability if the officer:

• Was exposed to a carcinogen while in the line of duty;
• Served for at least five years before being diagnosed with cancer; and
• Received a diagnosis of cancer within 15 years of leaving service.

The presumption would not apply if DOJ determines, based on competent medical evidence, that the exposure to a carcinogen was not a substantial factor in an officer’s death or disability.

Direct Spending

The PSOB program pays a one-time death benefit to spouses and children or other designated beneficiaries of officers who die in the line of duty. The cost of those benefits is classified in the budget as direct spending. In 2025, the one-time benefit is $448,575; under current law, that amount increases each year to account for inflation.

Cancer Claims. CBO expects that most relatives of potentially eligible officers would apply for benefits. Based on information from DOJ and other similar programs, such as the September 11th Victim Compensation Fund, CBO estimates that about 75 percent of claims for cancer-related deaths among public safety officers would ultimately result in benefits being paid to family members or designated beneficiaries. CBO expects that firefighters would account for most claims under the bill.

Using data from the Centers for Disease Control and Prevention (CDC) on cancer mortality among the general population and a review of medical literature regarding cancer incidence and mortality among firefighters, CBO estimates that, on average, about 40 claims would be filed annually over the 2025-2035 period.

S. 237 also would require benefits to be awarded for cancer deaths occurring between January 1, 2020, and the date of enactment. CBO estimates that about 200 claims would be submitted for officers who died from cancer during that period and that those claims would be filed within three years of enactment.

COVID-19 Claims. Additionally, the bill would extend by three years the deadline to file a claim for death benefits for spouses, children, or other beneficiaries of officers who die from COVID-19. Under current law, an officer is presumed to be eligible by DOJ if the officer was diagnosed with COVID-19 within 45 days of the last day of duty and medical evidence indicates that the officer had the virus or complications from the virus at the time of death. Under current law, the deadline to file such a claim was May 11, 2023, when the public health emergency related to the coronavirus pandemic was lifted. Using information from DOJ about the number of those claims it received between 2020 and 2023 and data from the CDC on COVID-19 mortality, CBO estimates that about 150 claims would be submitted for officers who die from COVID-19.

In total, CBO estimates that under the bill, about 765 claims would be filed over the 2025-2035 period. Based on the amount of time CBO estimates that it would take DOJ to process each eligible claim, CBO estimates that about 530 claims would be approved for benefits over the next decade under S. 237. (About 30 claims filed during that period would be approved after 2035.) Accounting for expected increases in inflation, CBO estimates that enacting S. 237 would increase direct spending by $255 million over the 2025-2035 period.

Spending Subject to Appropriation

By expanding the scope of qualifying deaths and injuries, S. 237 also would increase the number of claimants eligible for disability and education benefits under the PSOB program. Spending for those benefits is subject to the availability of appropriated funds. DOJ also would incur administrative costs to implement the bill. In total, CBO estimates that implanting S. 237 would cost $59 million over the 2025-2030 period (see Table 2). That spending would be subject to the availability of appropriated funds.

Disability Benefits. Under current law, the PSOB program pays benefits for permanent and total disability resulting from injuries suffered in the line of duty. Under current law, claimants receive a one-time benefit that is the same amount as the death benefit ($448,575 in 2025), which increases each year to account for inflation. In total, CBO estimates that the cost of disability benefits under S. 237 would be $24 million over the 2025-2030 period.

Cancer Claims. S. 237 would designate an exposure to a carcinogen as an injury in the line of duty if an officer later becomes permanently disabled as a direct result of cancer. Using information from DOJ about the historical number of claims, CBO expects that fewer claims for disability benefits would be filed under the bill than claims for death benefits. On that basis, CBO estimates that one claim for disability benefits would be filed for every three claims for death benefits. Additionally, based on conversations with DOJ and subject matter experts, CBO expects that most officers affected by cancer would not meet the permanently and totally disabled threshold. Based on historical approval rates for disability-related claims, CBO estimates that about 50 percent of claims for disability claims would ultimately be approved.

Under the bill, CBO estimates that about 120 claims for disability benefits related to cancer would be filed over the 2025-2030 period. Using information from DOJ about the time it takes to process each claim, CBO estimates that about 50 claims would be approved over the same period. (About 10 additional claims filed during the period would be approved after 2030.)

COVID-19 Claims. S. 237 also would extend by three years the deadline to file a claim for benefits under the PSOB program for officers who become permanently and totally disabled from COVID-19. Using data from DOJ about the number of those claims filed and approved over the 2020-2023 period, CBO estimates that under S. 237 fewer than five claims would be approved for officers who become disabled from COVID-19.

Education Benefits. Under current law, the spouse or children of a public safety officer who dies or becomes permanently disabled from physical injuries and certain mental health conditions may also be eligible for education benefits to cover tuition, fees, books, supplies and room and board. The monthly benefit for a full-time student in 2025 is $1,536; that amount is adjusted each year for inflation. Under current law, the maximum duration of benefits is 45 months of full-time education or a proportionate duration of part-time education.

Historical data from the PSOB program indicate that about three claims for education benefits have been approved for every two claims that have been approved for death and disability benefits. On that basis, CBO estimates that about 360 claims stemming from death benefits and about 50 claims stemming from disability benefits will be approved over the 2025-2030 period under S. 237. Using information about the time it takes to process claims for education benefits, CBO estimates that about 650 people will receive benefits over the 2025-2030 period under the bill. In total, CBO estimates that those benefits would cost $30 million over the 2025-2030 period. Those outlays reflect the historical spending patterns for such claims.

Administrative Costs. As discussed above, implementing S. 237 would require DOJ to review more than 150 additional claims annually under the bill. Using information from the agency about the number of staff required to process claims under current law, CBO estimates that implementing the bill would require an additional five people each year to process claims and review the list of eligible cancers at a cost of $1 million annually. In total, CBO estimates that DOJ would incur $5 million in administrative costs over the 2025-2030 period.

Uncertainty

CBO’s cost estimate for S. 237 is subject to significant uncertainty in several areas:

• Identifying public safety officers’ rate of incidence and deaths from cancer and COVID-19;
• Estimating the number of people who would be eligible to file claims for benefits under the bill;
• Calculating the proportion of claims that DOJ would determine to be eligible, which is affected by the latency periods for different cancers and other circumstances specific to each officer’s medical history and lifestyle; and
• Anticipating the timing of submissions and the amount of time required to review applications and process claims.

CBO strives for estimates that are in the middle of possible outcomes and each factor in the estimate could be higher or lower than CBO estimates. As a result, enacting the bill could result in higher or lower costs than CBO estimates.

Pay-As-You-Go Considerations

The Statutory Pay-As-You-Go Act of 2010 establishes budget-reporting and enforcement procedures for legislation affecting direct spending or revenues. The net changes in outlays that are subject to those pay-as-you-go procedures are shown in Table 3.

Increase in Long-Term Net Direct Spending and Deficits

CBO estimates that enacting S. 237 would not increase net direct spending by more than $2.5 billion in any of the four consecutive 10-year periods beginning in 2036.

CBO estimates that enacting S. 237 would not increase on‑budget deficits by more than $5 billion in any of the four consecutive 10-year periods beginning in 2036.

Mandates

The bill contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act.

Federal Costs: Jeremy Crimm

Mandates: Erich Dvorak

Estimate Reviewed By

Justin Humphrey
Chief, Finance, Housing, and Education Cost Estimates Unit

Kathleen FitzGerald 
Chief, Public and Private Mandates Unit

H. Samuel Papenfuss 
Deputy Director of Budget Analysis

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