Firefighting, Smoke Inhalation and Workers’ Compensation: What You Need to Know

Firefighting exposes Safety Personnel to smoke inhalation. This smoke contains a large variety of substances that can cause respiratory diseases.  Fires release a large variety of items into the atmosphere. If this smoke is inhaled, it can cause damage to the lungs. The smoke generated by the heating and burning of the materials is also a factor. These substances contain toxic gases, particles, and other contaminants. Fires, depending upon where they occur, can burn both natural and synthetic materials. For example, smoke from forest or grass fires may contain more natural materials than the smoke from a warehouse fire.

What Compounds are in Smoke?

Smoke inhalation contains many different compounds. These can include the following items:

  • Carbon monoxide
  • Carbon dioxide
  • Acrolein
  • Phosgene
  • Hydrochloric acid
  • Chlorine
  • Cyanide
  • Ammonia
  • Aldehydes
  • Nitric acid
  • Nitrous oxide.

What Products Cause Toxic Smoke?

Smoke inhalation, that is toxic, can emanate from a variety of sources. These sources can include the following items:

  • Wood
  • Cotton
  • Paper
  • Petroleum products
  • Polyvinyl chloride (PVCs)
  • Plastics, refrigeration materials
  • Soot
  • Wallpaper
  • Lacquered wood

Is the nature of the Smoke Important?

Yes. The nature of the smoke is important. Data concerning the composition of the smoke, as well as the level of the exposure, is very important with respect to the assessment of an industrial injury.

How Does this Smoke Exposure Impact an Injured Worker?

 

The nature and extent of the exposure can determine the impact on the Workers’ health. Two types of exposures are Acute Exposures and Chronic Exposures.

Acute Exposure- Short-term exposure is called acute exposure By acute, it is anticipated that the individual will make a full recovery. Acute exposures can also possibly lead to respiratory symptoms.

Chronic Exposure- Continuous or repeated contact with a toxic substance over a long period of time (months or years) is considered as chronic exposure. Chronic exposure can lead to chronic respiratory responses such as bronchitis symptoms, reduction in baseline function, the excess annual decline in lung function.

Are there any special benefits from Workers’ Compensation for Firefighters and Lung Disease?

Yes. There are various evidentiary presumptions that may apply to lung disease claims. There is the Cancer Presumption. The Cancer Presumption includes Lung Cancer. Also, there is an extended total temporary disability benefit for pulmonary fibrosis or chronic lung disease to 240 weeks. See Labor Code Section 4656.

Is there an Association between Smoke Inhalation and Lung Disease?

Yes. There is “data suggest that wildland firefighting is associated with decreases in lung function and increases in airway responsiveness independent of a history of cigarette smoking.” See. The effect of smoke inhalation on lung function and airway responsiveness in wildland firefighters. Am Rev Respir Dis. 1992 Dec;146(6):1469-73.

Is there confirmation that Firefighting is a factor in lung disease?

Yes. Studies have shown and confirm “earlier reports of a chronic effect of firefighting on pulmonary function and suggest an association of this occupational with increased respiratory symptoms and disease independent of cigarette smoke.” See The effect of occupational exposure on pulmonary function: a longitudinal evaluation of firefighters and nonfirefighters. Am Rev Respir Dis. 1982 Mar;125(3):319-22.

Is there any concern when there are repeated acute exposure during firefighting?

Yes. Studies have found that “[t]he repeated acute exposures during firefighting augment the burden of a chronic airway and systemic inflammation and may eventually lead to allergic sensitization of the airways and increased incidence of rhinitis and asthma after prolonged exposure.” Acute effects of smoke exposure on airway and systemic inflammation in forest firefighters J Asthma Allergy. 2018; 11: 81–88.

Are There any Studies concerning Firefighting and Chronic Disease?

Yes. There are studies which indicate that “smoke inhalation of particulate matter and smoke during firefighting induces a local inflammatory response within the lungs and allergic sensitization, which subsequently initiates a systemic response resulting in the adverse health consequences associated with air pollution exposure.”

One study found that ”a short time of low-intensity exposure is adequate in order to generate this inflammatory procedure. Although this effect may be of minor clinical significance for young healthy firefighters, it is inevitable that susceptible subjects establish chronic cardiopulmonary disease. Awareness should be heightened among firefighters to avoid exposure and to adequately use the self-contained breathing apparatuses during operations.” See Prolonged occupational exposure leads to allergic airway sensitization and chronic airway and systemic inflammation in professional firefighters Respiratory Medicine Volume 118 2016, P. 7-14

Where Can I Get Legal Advice?

If you would like a free consultation regarding workers’ compensation, 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 26 years. Contact us today for more information.

Activities of Daily Living (ADLs) & Workers’ Compensation: What You Need to Know

California Workers’ Compensation Law provides for the assessment of Permanent Disability based upon the American Medical Association Guides to the Evaluation of Permanent Impairment 5th Edition. The AMA Guides employs an analysis of the injuries impact on Activities of Daily Living when determining the percentage of Whole Person Impairment.

The purpose of the AMA Guides, within the California framework, is to provide a Whole Person Impairment for each injured body part. This Whole Person Impairment is then placed into a formula to calculate the Injured Worker’s Permanent Disability percentage. It is that percentage which translates into monetary compensation.

This article is meant to explain what are the Activities of Daily Living, how they are analyzed, and how they can impact the assessment of the Injured Worker’s Whole Person Impairment.

Impairment Ratings and Activities of Daily Living, What is the Relationship?

Per the AMA Guides, “Impairment percentages or ratings developed by medical specialists are consensus-derived estimates that reflect the severity of the medical condition and the degree to which the impairment decreases an individual’s ability to perform common activities of daily living (ADL), excluding work.

Impairment ratings were designed to reflect functional limitations and not a disability. The whole person impairment percentages listed in the Guides estimate the impact of the impairment on the individual’s overall ability to perform activities of daily living, excluding work, as listed in Table 1-2. 4 Guides to the Evaluation of Permanent Impairment.” at Page 4.

The fact that the AMA Guides excludes consideration of work activities provides some irony to the fact that the Guides are used to compensate Injured Workers on their Workers’ Compensation cases using Activities of Daily Living. In handling these cases, there is always the concern that an Injured Worker may not be adequately compensated for their inability to perform their job.

Impairment Ratings and Activities of Daily Living are related. In certain assessments of Whole Person Impairment, there are ranges within the tables for particular medical conditions. The impact of the injury on ADLs can impact the assessment of the Whole Person Impairment by the evaluating physician. Certain tables, the ranges are not very large. On other tables, the ranges are quite large.

What are the Activities of Daily Living?

Per the AMA Guides, Activities of Daily Living “include such activities as self-care, personal hygiene, communication, ambulation, travel, sexual function, and sleep. “

How are the Activities of Daily Living broken down?

Per the AMA Guides 5th Edition, Table 1-2, See Page 599, the following are the definitions of each ADL.

Self Care:
  • Urinating
  • Defecating
  • Brushing Teeth
  • Personal Hygiene
  • Combing Hair
  • Bathing
  • Dressing Oneself
  • Eating
Communication:
  • Writing
  • Typing
  • Seeing
  • Hearing
  • Speaking
Physical Activities:
  • Standing
  • Sitting
  • Reclining
  • Walking
  • Climbing stairs
  • Hearing
  • Seeing
  • Tactile Feeling
  • Tasting
  • Smelling
Sensory function:
  • Nonspecialized Grasping
  • Lifting
  • Tactile
  • Hand Activities
  • Discrimination
Travel:
  • Riding
  • Driving
  • Flying
Sexual function:
  • Orgasm
  • Ejaculation
  • Lubrication
  • Erection
Sleep:
  • Restful
  • Nocturnal sleep pattern

How is Impairment of Activities of Daily Living evaluated?

Limitations are to be judged by the medical disorders and not by other factors. Factors such as lack of money or transportation are not to be considered when addressing ADLs. See AMA Guides.

How is the impact of Activities of Daily Living assessed?

“In the context of the individual’s overall situation, the quality of these activities is judged by their independence, appropriateness, effectiveness, and sustainability. It is necessary to define the extent to which the individual is capable of initiating and participating in these activities independent of supervision or direction.” See AMA Guides at P. 361.

Who makes the Assessment on the impact of Activities of Daily Living and How?

In workers’ compensation, the evaluating physician, either the Agreed Medical Examiner, Qualified Medical Evaluator, or Treating Physician, that make the assessment on Activities of Daily Living.

In many Qualified Medical Evaluations and Agreed Medical Evaluations, the evaluating doctors will either directly ask the injured worker or provide them written questionnaires to make such an assessment. Per the AMA Guides, “[t]he examiner must assess not simply the number of activities that are restricted but the overall degree of restriction or combination of restrictions.

For example, a person who is able to cook and clean might be considered to have marked restriction of daily activities if he or she were too fearful to leave home to shop or go to the physician’s office.” AMA Guides to the Evaluation of Permanent Impairment, 5th Edition, Page 361.

Where Can I Get Legal Advice?

If you would like a free consultation regarding workers’ compensation, 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 26 years. Contact us today for more information.

CourtCall and Workers’ Compensation: What You Need to Know

The California Worker’s Compensation System allows for parties to conduct remote court appearances where the party may appear by phone. This article is intended to discuss the nature of telephonic representation. Telephonic representation can have some advantages as well as disadvantages within the Workers’ Compensation System.

Is Telephonic Representation Ordinary?

Yes. Telephonic representation is not part of the Workers’ Compensation Appeals Board system. The WCAB partners with Courtcall which provides the system to allow for remote court appearances and telephonic representation. Parties employing Courtcall must pay a fee to Courtcall.

Why Do Attorneys Use CourtCall?

Courtcall allows for attorneys or representatives to avoid unnecessary travel, extreme traffic and harsh weather conditions. For example, during certain times of the year, some highways in California may be closed to normal traffic and prevent an in-person appearance. CourtCall can reduce the billable hours for the appearance and save the client some money. CourtCall can remove the travel time from the appearance and allows the attorney/representative to work on other matters. It also allows for more flexibility in physical appearances. For example, an attorney can appear in San Diego in the morning and Eureka in the afternoon.

What is the Purpose of Telephonic Representation?

The CourtCall system allows for lawyers and representatives to make routine workers’ compensation appearances by telephone from their offices, homes or other convenient locations. See DIR. The participants of telephonic representation are required to be on a “landline” and have access to a fax machine.

Is CourtCall Available for All Workers’ Compensation Courts and Judges?

No. Not all Workers’ Compensation Judges allow for CourtCall. Many, however, participate. The nature and extent of their participation in a particular Courtroom for Courtcalls depend on the Judge. The parties seeking to use telephonic representation must check in advance whether they are able to do so.

What Hearings Can You Appear by CourtCall?

Per the DWC (Division of Workers’ Compensation) only Mandatory Settlement Conferences, Status Conferences, and Priority Conferences are eligible for telephonic representation. CourtCall is not available for Trials, Expedited Hearings or for an unrepresented injured worker. It has only been used on occasion for Lien Conferences.

How Does Courtcall Work?

Per the DIR, the CourtCall staff coordinates and facilitates the telephonic appearances. The calling party may speak to the Judge in the presence of the other parties, or they may speak privately and directly to other parties outside of the Judge’s hearing. Fax machines at the district offices coordinate the circulation of documents among the parties.

Is there a Fee for Using CourtCall?

Yes. Courtcall is a private company and there is a charge for the service.

What is Your Experience Using CourtCall?

Overall, I have found the use of Courtcall has been a very positive experience.

At times, I have had calendar conflicts involving significant travel. Courtcall has helped me resolve these conflicts and make both appearances. Also, it has saved my offices’ considerable travel time. This saves time can be used to work on the cases rather than being stuck in traffic.

The results from the appearances have been quite satisfactory. I do not feel that the results would have been different with a physical appearance.

While I prefer not to make it a primary way of making appearances, I continue to employ it as a tool to allow for my offices to maintain quality representation. The use of Courtcall allows my offices to prevent an unnecessary delay to an injured workers’ case. For instance, before Courcall, I would have had to request a continuance from the court on particular matters. Now, the need for certain continuances have been eliminated.

How Do the Judge’s Handle Courtcall Matters?

Based upon my experience, Judges have acted extremely professional in their handling of Courtcall matters. An Injured Worker should not be too concerned that a party on their case is appearing via Courcall.

Are There Any Disadvantages in Using CourtCall?

Yes. While it had nothing to do with the actual case, there are many times that an attorney or representative will run into an attorney or representative on another case at the Workers’ Compensation Appeals Board. These incidental meetings many times result in settlement or progress being made on other cases.

Should I Be Concerned That A Party Is Appearing by CourtCall?

Yes. I would recommend a heightened awareness on behalf of an Injured Worker appearing on a matter in which CourtCall is being employed by one of the parties.

If there is settlement authority, the paperwork should be provided to you at the hearing to sign and be submitted to the Workers’ Compensation Judge for approval. There is no excuse concerning the circulation of the documents. The facsimile machine provided by CourtCall allows for the immediate circulation of documents.

In sum, there should be an insistence that your matter is treated in the same manner as if the party appearing by CourtCall was appearing in person.

Where Can I Get Legal Advice?

If you would like a free consultation regarding workers’ compensation, 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 26 years. Contact us today for more information.

Lung Diseases: Industrial Causation and Workers’ Compensation: What You Need to Know

Lung Disease

Many employees in the workplace are exposed to contaminants which can cause or contribute to lung disease. Any lung disease that is caused by or contributed to by work contaminants may entitle the worker to claim workers’ compensation benefits and medical treatment. Contaminants, which can cause injury, include fumes, gases, vapors, mists, and dust.

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Lung Diseases & Workers’ Compensation: What You Need to Know

Lung Disease

The Respiratory System is a vital system for one’s health. In many work environments, it is possible that Workers can sustain respiratory injuries. The consequences of such respiratory injuries can range from minor to serious to fatal. This article discusses the nature of industrial lung injuries. Continue reading