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IAFF District 16 Online

Federal Fire Fighter Cancer and Disease Registry

In order to support the passage of federal legislation providing for coverage of certain diseases as presumptive disability the IAFF 16th District is collecting data.

Information on federal fire fighter cancer, illness and other diseases will be maintained in this database.  Other than a diagnosis, specific medical information is not maintained in the database.  The information submitted will be used to support federal fire fighter illness and disease legislation and to provide research information on fire fighter job related illnesses and diseases. The information is not available for public viewing and personally identifiable information will not be shared without consent of the persons providing information.

Information regarding former fire fighters may also be submitted.  In order to do this you must provide contact information for the fire fighters family.

This information is collected and maintained by the 16th District through this website  www.iaff16.org .

Name of person with illness or disease?*
Name of person submitting information?*
Last federal site/location the person with illness or disease worked at?*
Does the person with the illness/disease or the persons family believe the illness or disease is/was related to fire fighter duties or exposures?*
What disease/illness was medically diagnosed?*
Was a claim filed with the Office of Workers Compensation (OWCP)*
If a OWCP claim was filed was it accepted and coverage provided?
Phone number for additional information.*
Email address for additional information.*
Date*
Enter date in month/day/year format 08/17/2017

Note: * indicates required information.

 

   
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