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Workers’ Compensation Law for Occupational Diseases

by | Mar 14, 2024 | Workers Compensation

What is an occupational illness? Occupational Safety and Health Administration (OSHA) defines occupational illness as an event or exposure in the work environment that either caused or contributed to the resulting condition or significantly aggravated a pre-existing condition in the employee. In this blog, let’s grasp how occupational diseases are claimed under the Workers’ Compensation Law.

Before that, let us know about medical record reviewing, a vital step in workers’ compensation claims for occupational diseases. Medical chart reviews help to anlyse the medical records of the victimised employee in detail and reflect the important medical evidence required to substantiate the claim.

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You may come across occupational diseases often presented along with occupational injuries. Workplace accidents account for occupational injuries, whereas occupational diseases occur due to exposure to hazards. However, both affect the employees and are regulated by the Workers’ Compensation Law.

As per the Bureau of Labor Statistics, 2.8 million nonfatal occupational injuries and illnesses were reported in private industry employers in 2019. Information regarding workplace injuries and illnesses is revealed by the Injuries, Illnesses, and Fatalities (IIF) program. These data are collected and reported each year by the Survey of Occupational Injuries and Illnesses (SOII) and the Census of Fatal Occupational Injuries (CFOI).

In this blog, we will scope out how occupational illness could be claimed by the Workers’ Compensation Law. Before that, it would be befitting to be aware of the Workers’ Compensation Law of the US in general.

It is a system of rules in every state that guards the employees who are harmed while performing job-related duties. It offers fixed monetary awards to the employees, thereby eliminating the need for a lawsuit against the employer. This could consume more time, and the employee, in the end, may recover nothing from the litigation.

The Workers’ Compensation Law is administered by the state and financed by the contribution of the employer. The Federal Employment Compensation Act delivers workman’s compensation for federal employees. In a few words, the Workers’ Compensation Law is an insurance program that protects both the employee and the employer.

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Common Occupational Diseases in the US

The types of occupational diseases depend upon the nature of the work and the environment to which an employee is exposed. That makes employees in certain occupations prone to occupational diseases when compared to others. According to data by the U.S. Bureau of Labor Statistics, the following industries were reported as high-risk sectors for occupational illnesses in 2019.

  • Manufacturing
  • Health care and social assistance
  • Retail trade
  • Transportation and warehousing
  • Accommodation and food service
  • Administrative and waste services
  • Professional and technical services
  • Wholesale trade
  • Construction
  • Other services, non-public administration

Let’s now check out what are the common occupational illnesses encountered by employees working in the above-mentioned sectors. These diseases cause impact the ability of the employees to work or even lead to death.

1. Occupational Illness Due to Physical Hazards

Hearing Loss, heat stroke, skin burn, illness due to atmospheric compression or decompression, Hand-Arm Vibration Syndrome (HAVS), facial disorders and retinal burns, and cataracts are some of the commonly reported occupational diseases caused by physical hazards.

2. Occupational Illness Due to Chemical Hazards

Mercury Poisoning, diabetes, skin disorders, heart diseases, inflammatory bowel disease, thyroid dysfunctions, infertility, and pregnancy abnormalities are often reported in workers frequently exposed to chemical hazards.

3. Infectious Diseases

Tuberculosis, hepatitis B and C, Human Immunodeficiency Virus (HIV), COVID-19, etc., are the common infectious diseases reported in healthcare workers and first responders.

4. Respiratory Diseases

Occupational Asthma, Chronic Obstructive Pulmonary Disease (COPD), interstitial lung disease, pleural disease, etc., are some of the respiratory diseases in coal miners, factory workers, and painters.

5. Musculoskeletal Disorders

Rotator Cuff Tendinitis, Back disorders, Carpal Tunnel Syndrome, Tenosynovitis, Tension Neck Syndrome, etc., are common among construction workers, carpenters, and data entry professionals.

6. Occupational Cancers

Lung Cancer, mesothelioma, leukemia, bladder cancer, etc., are frequently reported in workers exposed to asbestos and other carcinogenic hazards.

7. Skin Diseases

Contact dermatitis, allergic dermatitis, contact urticaria, latex allergy, etc., are reported in workers constantly exposed to certain chemicals or radiation.

The Workers’ Compensation Law for Occupational Diseases

To be considered an occupational illness under the Workers’ Compensation Law, the following criteria should be met.

  1. There should be a direct relationship between the work conditions and the disease.
  2. The disease must follow a natural incident of the work performed by the employee
  3. Employment must be the proximate cause of the illness
  4. The worker should not be equally exposed to the hazard outside of employment
  5. The illness should be incidental to the character of the business
  6. The illness should be from a risk connected with the employee’s occupation and flow from it as a natural consequence
  7. The incidence of the disease should be substantially greater in the particular industry or occupation than it is in the general population

For federal workers, the Workers’ Compensation Law demands two documents to be submitted by the employee for an occupational disease claim.

  1. A report from the physician

The medical report should contain all the necessary information about the date of examination, illness, symptoms, treatment provided, diagnostic tests, medications, etc. The report should back up the argument that the work caused the illness or aggravated the illness of the employee.

  1. A statement to prove the nature of duties and exposure of work of the employee

This statement is a signed document prepared by the employee that shoulders the medical report given by the physician. The report in detail explains the roles and responsibilities of the employee at the workplace, work timings, the hazards he is routinely exposed to, etc.

Role of a Workers’ Compensation Lawyer in the Claim

The First and foremost thing you should know when suffering from an occupational disease is to know if you have a claim or not. The illness should be recognized as an industrial injury or approved by the state’s Occupational Diseases Committee. For instance, emotional distress caused by work-related stress is excluded from claims for occupational diseases. Search out for a workers’ compensation attorney well-versed in occupational injury claims and have a case evaluation.

As per the Workers’ Compensation Law, the claim should be filed within the statute of the limitation period. The injury date may be the date you first received a diagnosis or stopped working because of the disease. Failing to file a claim before this period may stop you from making a claim. However, the statute of limitation varies between the states. The Workers’ Compensation Law in Ohio, Washington, and New York allocate two years for an employee to file an occupational injury claim. However, in situations of delayed diagnosis of the illness, an additional time period may be given to the employee to file the claim.

Workers’ compensation attorneys would be very well informed about the paper works required for the claim.  They utilize medical records, expert testimony, and other evidence to support the claim.

As initially discussed, occupational injuries and diseases are different under the law. Filing a workers’ compensation claim for an occupational disease differs from that of a workplace injury.

The Workers’ Compensation Law is relatively uncomplicated for work injuries. This is because workplace injuries are often the aftermath of accidents, and they would have a clear timeline to present. A workplace accident would have witnesses and evidence that would shoulder the workers compensation lawsuit.

Occupational diseases, on the other hand, may not be immediately symptomatic or evident. It may take even years for an occupational illness to establish, making the workers’ comp trickier. Substantiating the ‘injury date’ would be a herculean task in workers’ compensation claims for occupational diseases. In most of the cases the date on which the employee first experienced the symptom or first exposed to the hazard is considered the injury date.

Another hurdle in an occupational injury claim is in vindicating that the disease stemmed from the workplace itself.  Many of the occupational diseases have multiple causes, thereby making it hard to prove that it is work-related. Some diseases would be coupled with a family history which may add headaches to the claim.

The bitter truth about a workman’s comp is that the employer would try to defend the claim. This is to avoid paying a huge sum of workers’ compensation benefits to the employee. If the arguments and evidence are not strong, the claim may even get rejected.

Medical reports play a very crucial role in the success of the claim. The claimant should discuss in detail his routine work nature, the onset of symptoms, and the severity of the illness. This would help the physician to analyze and correlate the illness with the work.

Medical records review of the employee would be a potent asset to detangle these complications. High-quality medical chart reviews would showcase the nature of the illness, the severity of the symptoms, and the extent of damages caused by the occupational disease. Any possibility of pre-existing illness could be ruled out during the medical record review process. With all the supporting proof, workers’ compensation lawyers would be able to help the claimant with the maximum amount of compensation.

If the claim is accepted by the insurer, the employee can either accept the payment offer extended or can negotiate for a settlement like that of a personal injury claim. If a settlement is not reached, the claim will move toward a trial. If the claim is rejected by the employer, the employee could move for an appeal.

Damages Covered by the Workers’ Comp

The damages covered under an occupational illness may differ from one state to another and would be different depending upon the severity of the illness. The following are the common damages compensated.

  • Medical expenses
  • Lost wages
  • Vocational retraining
  • Disability
  • Death benefits

The Federal Black Lung Program helps workers of the mining industries with disability and death benefits for claims filed under the Black Lung Benefits Act. The Energy Employees, Occupational Illness Compensation Program, is another employee benefits program under the Energy Employees Occupational Illness Compensation Act (EEOICPA). This program guards the current and former employees of the Department of Energy from occupational illnesses like cancer or other diseases due to exposure to radiation, beryllium, or silica.

Conclusion

Medical care for a serious occupational disease would be expensive, and without workers’ compensation benefits, you may not be able to afford the treatment and your financial needs. An occupational illness may take years to bring to light; still, you are entitled to workers’ compensation for your grievances if you have the assistance of an occupational cancer lawyer.

Do not hesitate to fight for what you are owed. All you need to do is seek the legal support of a proficient workers’ compensation attorney. With supporting evidence, he would prove that your illness stemmed from the work you were engaged in. With a successful claim, you can take home deserving workers’ compensation benefits as per the law in your state.

Why should you not fight when it’s your right?

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