Skin Conditions, Skin Diseases & Workers’ Compensation: What You Need to Know

California Workers’ Compensation Law covers injuries and illnesses to one’s entire body. There are a number of Skin-Related Conditions and/or Injuries that can be work-related. Per the Centers for Disease Control, it is estimated that more than 13 million workers in the United States are potentially exposed to chemicals that can be absorbed through the skin. Dermal exposure to hazardous agents can result in a variety of occupational diseases and disorders, including Occupational Skin Diseases (OSD) and systemic toxicity.

What are Skin Conditions that can be Work-Related?

There are a large variety of Skin Conditions that may be work-related. These conditions may include Scars, Skin Grafts, Dermatitis (Contact / Allergic/ Irritant/ Frictional), Pruritus, Disfigurement, Latex Allergies, Eczema, Urticaria, Folliculitis, Nail Disorders and Skin Cancer.

What are Causes of Occupational Skin Disease?

Per the CDC, causes of Occupational Skin Diseases/Disorders include Chemical Agents, Mechanical Trauma, Physical Agents, and Biological Agents.

What are Occupational Exposures by Chemical Agents?

Per the CDC, Chemicals are the main cause of Occupational Skin Diseases and Disorders. These agents are divided into two types: Primary Irritants and Sensitizers. Primary or Direct Irritants act directly on the skin through chemical reactions. Sensitizers may not cause immediate skin reactions, but repeated exposure can result in allergic reactions. A worker’s skin may be exposed to hazardous chemicals through direct contact with contaminated surfaces, disposition of aerosols, immersion, or splashes.

What are Occupational Exposures by Physical Agents?

Physical Agents are items such as extreme temperatures (hot or cold) and radiation (UV/solar radiation.) These physical agents can result in burns, frostbite, and cancer.

What are Occupational Exposures by Mechanical Trauma?

Mechanical Traumas include friction, pressure, abrasions, lacerations and contusions (scrapes, cuts and bruises.) These agents can lead to a variety of medical problems including infections.

What are Biological Agents?

Biological Agents include parasites, microorganisms, plants and other animal materials. These agents can lead to infections, Bloodborne Diseases and Lyme Disease.

Are there any particular Occupations that are at risk for Occupational Skin Diseases?

Per CDC, workers at risk of potentially harmful exposures of the skin include, but are not limited to, those working in the following industries and sectors: Food Service, Cosmetology, Health Care, Agriculture, Cleaning, Painting, Mechanics, Printing/Lithography, and Construction.

Chemical Exposure and Skin, How do Chemicals cause Industrial Skin Injuries?

Per the CDC, Dermal Absorption is the transport of a chemical from the outer surface of the skin both into the skin and into the body. Studies show that absorption of chemicals through the skin can occur without being noticed by the worker, and in some cases, may represent the most significant exposure pathway. Many commonly used chemicals in the workplace can potentially result in systemic toxicity if they penetrate through the skin (i.e. pesticides, organic solvents). These chemicals enter the blood stream and cause health problems away from the site of entry. Therefore, injuries to the skin may also bring rise to injuries to other body systems. It is recommended that individuals with a chemical skin disorder have a complete work-up to determine if any other bodily systems are effected.

What is Dermatitis? Are there Different Types?

Occupational Contact Dermatitis can occur in a variety of ways. There is Irritant Contact Dermatitis and the other is Allergic Contact Dermatitis. Per the CDC, Contact Dermatitis, also called Eczema, is defined as an inflammation of the skin resulting from exposure to a hazardous agent. It is the most common form of reported OSD, and represents an overwhelming burden for workers in developed nations. Epidemiological data indicate that Contact Dermatitis constitutes approximately 90-95% of all cases of OSD in the United States. Common symptoms of Dermatitis include Itching, Pain, Redness, Swelling, the formation of small blisters or wheals (itchy, red circles with a white center) on the skin, and Dry, Flaking, Scaly Skin that may develop cracks.

What is Irritant Contact Dermatitis?

Irritant Contact Dermatitis (ICD) is a non-immunologic reaction that manifests as an inflammation of the skin caused by direct damage to the skin following exposure to a hazardous agent. The reaction is typically localized to the site of contact. Available data indicates that ICD represents approximately 80% of all cases of occupational contact dermatitis. ICD may be caused by phototoxic responses (e.g., tar), acute exposures to highly irritating substances (e.g., acids, bases, oxiding /reducing agents), or chronic cumulative exposures to mild irritants (e.g., water, detergents, weak cleaning agents.)

What is Allergic Contact Dermatitis?

Allergic Contact Dermatitis (ACD) is an inflammation of the skin caused by an immunologic reaction triggered by dermal contact to a skin allergen. For ACD to occur, a worker must be first sensitized to the allergen. Subsequent exposures of the skin to the allergenic agent may elicit an immunologic reaction resulting in inflammation of the skin. The reaction is not confined to the site of contact and may result in systemic responses. ACD may be caused by industrial compounds (i.e. metals, epoxy and acrylic resins, rubber additives, chemical intermediates), agrochemicals (i.e. pesticides and fertilizers), and commercial chemicals.

Are there Differences between Irritant Contact Dermatitis and Allergic Contact Dermatitis?

Per the CDC, because the symptoms and presentation of ICD and ACD are so similar, it is extremely difficult to distinguish between the two forms of Contact Dermatitis without clinical testing (e.g. patch testing). The severity of Contact Dermatitis is highly variable and depends on many factors including: Characteristics of the hazardous agent (irritant and/or allergen); Concentration of the hazardous agent (irritant and/or allergen); Duration and frequency of exposure to the hazardous agent (irritant and/or allergen); Environmental factors ( e.g., temperature, humidity); and Condition of the skin (e.g., healthy vs. damaged skin, dry vs. wet).

What is a Latex Allergy?

Per the CDC, Latex Gloves have proved effective in preventing transmission of many infectious diseases. But for some workers, exposures to latex may result in allergic reactions. Reports of such reactions have increased in recent years–especially among Health Care Workers.

What are Bloodborne Infectious Diseases and How are they Skin-Related?

Bloodborne Infectious Diseases can involve the skin. Many times, the Skin is part of the mechanism of the injury. Injured Workers can be exposed to blood through needle stick and other sharps injuries, mucous membrane, and skin exposures. These exposures to blood and other body fluids occur across a wide variety of occupations. Health Care Workers, Emergency Response and Public Safety Personnel, and other Workers.

Are there any Workers’ Compensation Laws that assist Injured Workers with Skin Injuries?

Yes. There are a variety of Workers’ Compensation Laws for which Injured Workers who have sustained skin-related injuries can take advantage of to obtain compensation. First, there are Presumptions that may be available to Safety Workers. Also, there is additional Temporary Disability benefits available for injuries involving severe burns.

What Temporary Disability Law applies to Skin Conditions?

In the case of Severe Burns, 240 compensable weeks within a period of five years from the date of the injury is payable for Total Temporary Disability benefits. This is in comparison to the 104 weeks for other industrial injuries. See Labor Code Section 4656.

What are the Presumptions that may apply with respect to Skin Conditions?

The Presumptions which may apply to Skin Disorders include Bloodborne Disease, Cancer, Lyme Disease and MRSA. See Labor Code Sections 3212.1, 3212.12, and 3212.8.

Can a Skin Disorder result in Permanent Disability?

Yes. Skin Disorders can result in Permanent Disability. Permanent Disability is assessed if there is a finding of a Whole Person Impairment per the AMA Guides. Per the AMA Guides to the Evaluation of Permanent Impairment, 5th Edition, Permanent Disability for skin conditions is any dermatological abnormality or loss that persists after medical treatment and rehabilitation and that is unlikely to change significantly in the next year, with or without treatment. See AMA Guides 5th Edition at P. 173. There is a Skin Disorder Section as well as a Facial Disorder and/or Disfigurement Section as well for assessing impairment. Also, if those Sections do not accurately represent the Injured Worker’s permanent disability, the evaluating physician is allowed to use the chapter, table, or method of assessing impairment of the AMA Guides that most accurately reflects the injured employee’s impairment. See Almaraz Guzman.

Are there any notable Workers’ Compensation Cases involving Skin Disorders?

Yes. There is a landmark case of Nielson vs. WCAB (1974) 39 C.C.C. 83. Nielson involved a bank vault teller who sustained an injury resulting in a sensitivity to nickel and copper. The bank vault teller’s disability caused by sensitivity to nickel and copper resulted in the Injured Worker’s inability to compete in the open labor market. The Court indicated that this should be a consideration when assessing the injured workers permanent disability.

If you would like a “free” consultation with a workers compensation attorney, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. They have been helping people in Central and Southern California deal with their worker’s compensation cases for 25 years. Contact us today for more information.