A veteran Austin firefighter says the city has turned its back on her at the worst possible time, rejecting her workers' compensation claim after a diagnosis of stage four uterine cancer. The denial, which staff and union leaders say landed in her mailbox in November, leaves her family without a guaranteed income and key medical protections while she keeps working through treatment and gears up to fight the decision. Her case has quickly become a flashpoint for critics of how Texas handles occupational cancer claims for first responders.
According to KXAN, the firefighter, 46-year-old Suzanne La Follette, learned of her diagnosis in May 2025. She has spent 19 years with the Austin Fire Department, including 16 years riding on a fire engine. The station reports that the city, through its third-party administrator, sent a denial letter in November. Had the claim been approved, it would have covered her full salary, thousands of dollars in medical bills, and a line-of-duty death benefit.
How Texas law narrows presumptive coverage
Texas law gives firefighters a presumption that certain cancers are work-related, but that safety net is tightly drawn. The statute lists only a limited group of cancers: stomach, colon, rectum, skin, prostate, testis, and brain cancers, along with non-Hodgkin’s lymphoma, multiple myeloma, malignant melanoma, and renal cell carcinoma. Uterine cancer is not on that list.
The scope of the law was narrowed in a 2019 amendment that removed broader language tying coverage to exposure to heat, smoke, or suspected carcinogens, according to the Texas Government Code. That missing language now sits at the heart of the city's rationale for denying La Follette's claim.
Researchers track exposures and risks
While La Follette prepares her appeal, researchers are trying to catch up with the risks firefighters face on the job. UTHealth Houston is leading a statewide Texas Firefighter Cancer Study, headed by Dr. Jooyeon Hwang, that aims to measure fireground exposures, track early biological warning signs and push for cancer screening that reflects firefighters' occupational hazards.
The effort links exposure monitoring, occupational epidemiology, and screening promotion in a multi-project program to better understand cancer risk among Texas firefighters, according to the UTHealth School of Public Health. Advocates say that stronger data could eventually reshape how presumptive laws treat cancers that, like uterine cancer, are not currently written into the statute.
Union response and legal precedent
The Austin Firefighters Association has blasted the city's handling of the case, and its president has argued that officials are doing the bare minimum required by law. That criticism, along with details of La Follette's claim, appeared in KXAN, which also reported that La Follette's attorney remains optimistic about an appeal.
The dispute echoes earlier fights over cancer claims in Austin. In 2018, the city dropped a lawsuit challenging Lt. Carrie Stewart's workers' compensation claim for breast cancer after a lengthy legal battle, according to Insurance Journal. That reversal is now part of the backdrop as La Follette and the union weigh their next steps.
What comes next
Under Texas workers' compensation rules, La Follette can push her case beyond the city's third-party administrator and into the formal dispute process. Claimants can seek resolution through benefit review conferences, independent medical review, and contested case hearings before administrative law judges, procedures detailed by the Texas Division of Workers' Compensation.
The process is not quick, but it offers several chances for La Follette to challenge the denial. Her case now sits where emerging cancer science, union pressure, and state law collide, and firefighters across Texas are watching closely to see whether her fight shifts the ground under future first responder cancer claims.
