THE WORST WORK INJURY EVER? INJURED WORKER IN THE NEWS, #20

A Contract Worker was killed at a landfill in Florida in perhaps the most horrible way possible.

While he was using a Porta Potty, a bulldozer ran the portable bathroom and killed his co-worker.

The Bulldozer Operator and the Deceased Employee worked for the same company.   It is reported that the driver ‘… immediately exited the bulldozer and ran towards the porta potty to see if anyone was inside of it,’ the sheriff’s office spokesperson said. ‘At that time, he observed Henderson unresponsive inside the porta potty.’ dailymail.com

This tragic fact pattern will be discussed within California Law.  This fact pattern contains many issues as to whether a worker can sustain a work injury while using the facilities.  Further, is it possible for someone to be “at fault” and pursue a claim.

If A Worker Is On A Restroom Break, Are They Protected Under Workers’ Compensation?

California Workers’ Compensation Law provides for the “personal comfort doctrine.”  The “personal comfort doctrine” provides generally that compensation extends to injuries suffered while the employee is engaged briefly and during work hours in a personal act which is necessary or helpful to his comfort or convenience. (2 Hanna, op. cit., supra, § 9.03[2][a], pp. 9–3—9–31.) The personal comfort doctrine is not strictly limited to injuries suffered on the employer’s premises. ( Cf. State Comp. Ins. Fund v. Workmen’s Comp. App. Bd. (Cardoza) (1967) 67 Cal. 2d 925 [32 Cal. Comp. Cases 525, 64 Cal. Rptr. 323, 434 P.2d 619] Fremont Indemnity Co. v. Workers Comp. Appeals Bd. (1977) 69 Cal. App. 3d 170 [42 Cal. Comp. Cases 297, 137 Cal. Rptr. 847].) [**8]  Its limit is reached when the acts “are found to be departures effecting a temporary abandonment of employment. …” ( Id., at p. 928.) Olson Farms, Inc. v. Workers Compensation Appeals Bd. of California & Suzanne Shawnego, 51 Cal. Comp. Cases 107 (Cal. App. 3d Dist. March 05, 1986)

Thus, the Contract Worker would be covered when he used the restroom since he was engaged in a personal act which was for his comfort.  His family would be able to pursue a Death Benefit Dependency Claim.

What About The Bulldozer Operator Who Cause the Accident, Does He Have A Claim?

With this fact pattern and given the “no fault” nature of workers’ compensation, the Bulldozer Operator, if he sustained an emotional injury as a result of killing his co-worker, could file a claim.  It would appear that the incident may have psychiatrically traumatizing,

What If I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

MEN, DEPRESSION, SUICIDE, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Stress impacts Men and Women differently.   Studies show there are differences in the workplace.  The findings are both significant and complicated.

This article will discuss depression, suicide, the differences between men and women, and the implications with respect to workers’ compensation cases.

What Is the Psychological Diagnosis of Depression?  

 Per the American Psychiatric Association, Depression (major depressive disorder) is an illness that negatively affects how you feel, the way you think and how you act.

”Depression symptoms can include: Feeling sad or having a depressed mood, Loss of interest or pleasure in activities once enjoyed, Changes in appetite — weight loss or gain unrelated to dieting, Trouble sleeping or sleeping too much, Loss of energy or increased fatigue, Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech (these actions must be severe enough to be observable by others), Feeling worthless or guilty, Difficulty thinking, concentrating or making decisions, Thoughts of death or suicide.” APA

A depression diagnosis requires these symptoms last for an extended period of time. “Symptoms must last at least two weeks and must represent a change in your previous level of functioning for a diagnosis of depression.” APA

Which Sex Is Diagnosed Most with Depression?

 Studies show that women are diagnosed at twice the rate as men. “[c]omparatively, in Western countries, men are formally diagnosed with depression at approximately half the rate of women” (Kessler et al., 2005Wilhelm, Parker, Geerligs, & Wedgwood, 2008).” 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/1557988313490786

Note: These findings raise questions.  There is the issue of “men’s reluctance to express concerns about their mental health and reticence to seek professional health care (Emslie, Ridge, Ziebland, & Hunt, 2006Sharpe & Heppner, 1991Winkler et al., 2006).” 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/1557988313490786

In other words, men may not seek mental health treatment. Thus, there would be fewer depression diagnosis for men.

Is There a Connection Between Depression and Suicide?

Severe depression can … significantly increase the risk for suicide.  (Emslie et al., 2006Kessler et al., 2005Wilhelm et al., 2008World Health Organization, n.d.), 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/1557988313490786

Which Sex is at Most Risk of Suicide?

Men have been found to have higher rates of suicide. “[S]uicide rates are approximately four times higher in Western men than in women (Centers for Disease Control and Prevention, 2012Hawton & van Heeringen, 2009Levi et al., 2003Moller-Leimkuhler, 2003Rihmer, Belso, & Kiss, 2002Statistics Canada, 2012a2012bWasserman, 2000Wolfgang & Zoltan, 2007).” 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/1557988313490786

Thus, there is the question as to why men’s suicide rates are higher when their depression rates are lower.

Are There Suicidal Issues Related to Occupation?

The issue of suicide has multiple issues.  There is suicidal thought or ideation.  There is the act of suicide.

Studies have found high suicide rates in male-dominated workgroups. This included manual workers, farming, military and nursing.” 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/1557988313490786

Suicidal ideation is also an issue for men. Being a failed breadwinner can have an impact on suicidal thoughts. “Linkages between men’s work, depression, and suicide have also been described. Self-perceptions of being a “failed breadwinner” led older men with a history of depression to think about suicide (Oliffe, Han, Ogrodniczuk, Phillips, & Roy, 2011), whereas some middle-aged men countered suicidal ideations by focusing on work as a means of providing for their family (Oliffe, Ogrodniczuk, Bottorff, Johnson, & Hoyak, 2012. 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/1557988313490786

Is There a Connection Between Depression and Retirement?

Depressed workers are more likely to retire than nondepressed workers (Doshi, Cen, & Polsky, 2008) 1. Oliffe JL, Han CSE. Beyond Workers’ Compensation: Men’s Mental Health In and Out of Work. American Journal of Men’s Health. January 2014:45-53. doi:10.1177/155798831349078

What Does This Information Mean with Respect to Workers’ Compensation Claims?

These studies impact workers’ compensation cases in that they provide insight into the injured worker.

There studies show that there is some uniqueness for a man to file a claim for depression. These studies provide “red flags” as to certain occupations that men perform and their risk for suicide.  These studies may give some insight to employers as to whether depressed male  injured workers are going retire or return to work.  These studies show that working may assist a man’s mental state.

What If I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

 

INJURED WORKERS WAKE UP! CARRIERS AND EMPLOYERS HAVE OTHER GOALS THAN YOU: RISK MANAGEMENT AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Injured Workers need to know that the workers’ compensation system is a risk management system. Therefore, it is important to understand the nature of a risk management system.  Insurance Companies and Employers may take actions on your claim and your employment.  Therefore, understanding risk management may allow you take measures to protect yourself.

Risk Managers compile information and techniques which allow them to limit costs with respect to workers’ compensation claims.

Injured Workers and Workers should have a general understanding risk management within a work injury context. Risk Managers’ approaches in workers’ compensation claims may unfortunately impact an Injured Worker’s treatment or benefits.

This article will discuss the various factors that Risk Managers consider as important and what areas that they will address as cost-savings measures.

What Is Workers’ Compensation?  How Is It Related To Risk Management?

Workers’ Compensation was created to be insurance program that manages work injury losses or costs for employers.  The system is designed with the context that businesses and employers can be able to cover the employee injury risk and no go broke.  In other words, a work injury claim should be something that can be affordable and not bankrupt a business.

Work Injury losses and costs include indemnity payments, transactional costs such as adjusting and legal costs, and medical treatment costs.  Further, employers and insurers are also concerned with respect to reserves. Reserves are monies that are set aside to pay the expected costs on a claim.

What Is Risk Management?

Risk Management is a field which addresses aspects of insurance and loss.   Thus, with respect to industrial injuries, Risk Managers focus on both injury reduction and injury prevention.

Part of the injury reduction component includes limiting the nature and extent of injuries as well as the attending costs for the claim. This can include reducing indemnity payments as well as medical treatment.

Part of Risk Management is the ability to predict outcomes.   Therefore, knowledge of past claims and past results lays the foundation as to how to approach future claims.

What Are the Methods of Risk Management?

Risk Management methods include safety training, control banding, protective equipment safety guards, safety mechanisms on machinery, and safety barriers. Also, analyzing causes by using root cause analysis may help reduce future injury. Varacallo M, Knoblauch DK. Occupational Injuries and Workers’ Compensation Management Strategies. 2020 Aug 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29262238.

Some aspect of risk management can include workplace inspection.

What Is Risk Management’s View of the Sources of Occupational Injuries?

Risk Managers need to know what can cause injuries in the workplace.  Occupational injuries can result from physical, biological, chemical, or psychosocial hazards. Varacallo M, Knoblauch DK. Occupational Injuries and Workers’ Compensation Management Strategies. 2020 Aug 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29262238.

Thus, Risk Managers may have a goal of controlling these hazards.  In doing so, this can lead to loss prevention with respect to work injury claims.

Thus, Risk Managers may implement workplace training, rules, and regulations.

What Is Risk Management’s View as to the Types of Work Exposures That Can Cause Injury?  

Risk Managers see a variety of exposures that workers encounter in the workplace that are causative towards injuries.  Unlike sources of injury, exposures are ones that are in fact injurious in nature.  These include “noise, temperature, insect or animal bites, aerosols, blood-borne pathogens, hazardous chemicals, radiation, and occupational burnout.” Varacallo M, Knoblauch DK. Occupational Injuries and Workers’ Compensation Management Strategies. 2020 Aug 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29262238.

Thus, Risk Managers may control the amount of worker’s exposure to these items or events to prevent work injury claims.

What is Risk Management’s View as to Common Sources of Injury?

“Many injuries still occur due to poor ergonomics, manual handling of heavy loads, misuse of equipment, general hazards, and inadequate safety training.” Varacallo M, Knoblauch DK. Occupational Injuries and Workers’ Compensation Management Strategies. 2020 Aug 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29262238.

Thus, Risk Managers, to prevent injury, may implement of ergonomic work stations, training and rules for properly lifting and safety training.

What is Risk Management’s View as to the Common Types of Injuries?

“Slipping or tripping, which causes a fall are common work-related injuries, accounting for 20% to 40% of disabling occupational injuries.”  Varacallo M, Knoblauch DK. Occupational Injuries and Workers’ Compensation Management Strategies. 2020 Aug 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29262238.

Further, it should be noted that orthopedic injuries tend to be the most common medical specialty that is employed to treat industrial injuries.

What is Risk Management’s View as to the Parts of the Body Get Injured?

The most common injury is to the Upper Extremities.  They represent 50 percent of workplace injuries.   Hearing Loss also accounts for a significant amount of occupational injury claims.  Further, needle sticks are also a source of injuries as well. Varacallo M, Knoblauch DK. Occupational Injuries and Workers’ Compensation Management Strategies. 2020 Aug 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29262238.

Thus, Risk Managers may impose rest breaks, ergonomics, hearing testing, hearing protections, and proper disposal of needles to prevent work injuries.

What Is Risk Managements’ View of Age?

A Worker’s age can statistically have value to Risk Managers.

Statically, “[a]ge is perhaps the most common personal factor that predisposes a person to an increased risk of work-related injury. Workers aged 65 years and older are more likely to suffer from occupational injuries compared to their younger occupational counterparts.” Varacallo M, Knoblauch DK. Occupational Injuries and Workers’ Compensation Management Strategies. 2020 Aug 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29262238.

Additionally, older workers can make them ”at higher risk for hearing loss, visual impairment, and the use of multiple prescription medications that are linked to higher rates of work-related injuries.”

In sum, Risk Management, although there are laws against age discrimination, may be focused on the tasks that older workers perform.

Does Risk Management Have a Concern with Respect to Occupations?

Yes.  Certain occupations for which there are higher rates of work injuries.  In particular, the occupations with high rates of include farming, fishing, forestry, construction and manufacturing.  Supra.

What is Risk Management’s View with Respect to Testing Proving or Disproving Claims?

Risk Managers rely on traditional work-ups by medical providers to assess work injury claims.

The work-ups include the taking of a comprehensive history and a physical examination. Also,  a diagnostic workup should be considered. This diagnostic work-up can include, but is not limited to, radiographs, ultrasound, and advanced imaging modalities.

Risk Managers, however, have concerns with respect to MRIs.  It is noted that “while the use of magnetic resonance imaging (MRI) is often helpful in delineating the actual clinical pathology, providers should remain cognizant of the potential for overdiagnosis and the potential for treating a potentially incidental finding that is not the primary source of a patient’s current debilitating condition.” [emphasis added]

Note: This passage shows notes that allowing for medical testing can open a Pandora’s Box of liability.  An incidental finding on a MRI can lead to a claim being amended for additional body parts.

Further, it is noted that “MRI has been demonstrated previously in the literature to its known limitations in the appropriate clinical setting. For example, a 2010 study reported on the inconsistent diagnostic accuracy of wrist MRIs being obtained to identify the potential source(s) of ulnar-sided wrist pain.” Supra.

Further, “a 2017 study analyzing work-related injuries consistent with unilateral knee or shoulder injury and subsequent bilateral MRI studies being performed during the diagnostic evaluation reported that less than half of patients had degenerative and/or pathologic findings that would be considered worse than the contralateral, asymptomatic, “normal” side.”

Note: This research is Risk Management propaganda concerning MRIs.  The issue is treating symptomatic disabling body parts.  The fact that an asymptomatic body part with pathology is present should not create excuse.

What Is Risk Management’s View on Treatment?

Risk Managers view treatment with a two-fold perspective.  In the treatment setting, there is the opportunity to treat the injury. Also, there is the opportunity to analyze the work-relatedness of the claim. This can include an assessment as to the value of the claim.

“Each work-related injury is different. Thus, providers should first establish whether the injury is preexisting, directly or indirectly related to the patient’s occupational requirements and if the claim is considered to fall under the workers’ compensation system.” Varacallo M, Knoblauch DK. Occupational Injuries and Workers’ Compensation Management Strategies. 2020 Aug 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29262238.

Risk Managers note that “[t]reatment is specific to the specific condition and may include pain management modalities, physical therapy, NSAIDs, injections, and surgery.  It is important to recognize that each patient presenting with occupational-related injuries should be managed on an individual basis as not all conditions are created equal.”   This is position is true.   This position is not however adhered to during the course of workers’ compensation treatment.

Risk Managers limit claims exposure by asking providers to limit their evaluations and treatment.  This can be done by limiting authorization to treat certain body parts or what treatment will be authorized.

What Is Risk Management’s View on Surgery?

Surgeries are not necessarily viewed as beneficial from a Risk Management perspective.

“The literature supports many different types of clinical encounters the potential disparity with respect to postoperative outcomes comparing work-related injury patients compared to their non-work counterparts.”

“For example, total joint replacements are, in general, consistently reproducible procedures that yield excellent outcomes in the vast majority of patients. However, when comparing occupational-based (or workers’ compensation) patients to non-workers’ compensation control patients via matched cohort or comparative studies, the literature demonstrates the potential for a comparably inferior outcome in the former.” Varacallo M, Knoblauch DK. Occupational Injuries and Workers’ Compensation Management Strategies. 2020 Aug 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29262238.

Thus, Risk Managers may have some fear and trepidation as to authorizing surgeries due to the fact that there is the anticipation that the results may not be optimum.  As a result, Risk Managers may scrutinize and resist requests for surgery.

What Is the Risk Management’s View of Case Settlement?

Risk Managers have a concern with respect to the future medical costs. This is especially the cases with respect to older workers. It is noted that “the synergistic combination of the older population falling at work, in addition to the older population’s predisposition to these low-energy injuries, sets up the potential for an overall devastatingly morbid effect on the entire healthcare system.” Varacallo M, Knoblauch DK. Occupational Injuries and Workers’ Compensation Management Strategies. 2020 Aug 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29262238. The Risk Management perspective to include nurse practitioners as part of the diagnosis progress.

This perspective indicates that there may be an increased sense of urgency to settle older workers’ case.   This is due to the fact of the possible high medical exposure costs.   Further, Risk Managers may desire to avoid placing older workers in work setting in which they may be subject to trip and fall injuries.

What Is Risk Management’s View on Obtaining a Medical Diagnosis?

“All healthcare providers are encouraged to manage these patients individually in order to ensure the best possible outcomes.”  Varacallo M, Knoblauch DK. Occupational Injuries and Workers’ Compensation Management Strategies. 2020 Aug 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29262238. Nurse practitioners were included as part of the providers who could make the medical diagnosis. Supra.

As a representative of Injured Workers, it is my contention that diagnosis and treatment of Injured Worker should be the purview of medical doctors.  They should be the one making the diagnosis and not nurse practitioners.   The reliance on nurse practitioners is solely a cost savings measure, Improper or inadequate diagnosis by a nurse practitioner can lead to delay in a achieving a proper medical diagnosis.  This improper or inadequate diagnosis can lead to delays in both proper treatment and return to work. Therefore, while reliance on lower level practitioners for diagnosis of a condition may be perceived as cost-cutting, it may not actually be more costly in the long run.

What Is Risk Management’s View Concerning “Return-to-Work?”

Yes. Risk Managers recognize that there are “return to work” issues for Injured Workers. I attended a lecture on this issue.  The speaker noted that every day that an Injured Worker missed as a result of their injury impacted on the probability that the worker would return to their usual and customary job.

Thus, Risk Managers acknowledge that an Injured Worker returning to work can have a profound impact on both their workers’ compensation case and the Injured Worker’s employment.

Thus, there may be some instances where Insurance Companies and Employers may encourage early return to the workplace.  This can be done via offers of alternative or modified work.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

 

OCCUPATIONAL PNEUMONITIS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

There are a variety of lung diseases that may have occupational components.   One of these lung diseases is Pneumonitis.  If a Worker succumbs to Pneumonitis, and there is an occupational component as to its cause, they would be able to file and pursue a workers’ compensation claim to obtain medical treatment and monetary benefits for their lung condition.

This article will discuss Pneumonitis, how it can be work-related, and a discussion of various caselaw that addressed issues relating to the disease.

What Pneumonitis? Is It the Same as Pneumonia?

Pneumonitis is a medical condition which involves the inflammation of lung tissue.

The medical disease Pneumonia is essentially a subset of Pneumonitis.  It is an inflammation of the lungs caused by an infection.

What Are the Symptoms of Pneumonitis?

Symptoms of Pneumonitis can include difficulty breathing and a dry, nonproductive, cough. If the condition progresses to Chronic Pneumonitis, symptoms can also include fatigue, loss of appetite and unintentional weight loss. Mayo Clinic.

Are There Degrees of Pneumonitis?

Yes. There are varying degrees of Pneumonitis.  The degrees are Acute, Subacute and Chronic.

Pneumonitis is very serious.  If it goes unnoticed or untreated can cause irreversible lung damage.

What Tests and Treatments are there for Pneumonitis?

Pneumonitis is a complex medical condition. Therefore, a thorough evaluation by a specialist is recommended.  This specialist will conduct the physical examination and order testing.

The testing with respect to Pneumonitis can include blood tests, bronchoalveolar lavage (BAL), chest x-rays, computed tomography (CT), inhalation challenge tests lung biopsies, lung function tests, and precipitin tests.  Mayo Clinic.

How Is Pneumonitis Diagnosed?

Diagnosis of the condition can be complicated. It can take a long time to diagnose. In writing this blog, this matter must be deferred to a specialist without further comment.

The diagnosis of HP in general remains often challenging as there is no gold standard test and the diagnosis is made from a combination of procedures. In addition, the diagnosis of OHP requires ascertaining the work relatedness of the disease with a high level of confidence. A multidisciplinary approach, including clinicians, radiologists, pathologists, and occupational physicians/hygienists, is strongly recommended to improve the diagnosis of OHP, as demonstrated for IPF  Quirce S, Vandenplas O, Campo P, Cruz MJ, de Blay F, Koschel D, Moscato G, Pala G, Raulf M, Sastre J, Siracusa A, Tarlo SM, Walusiak-Skorupa J, Cormier Y. Occupational hypersensitivity pneumonitis: an EAACI position paper. Allergy. 2016 Jun;71(6):765-79. doi: 10.1111/all.12866. Epub 2016 Mar 11. PMID: 26913451.

What is Occupational Hypersensitivity Pneumonitis (OHP)?

“Based on the key features of the disease that were outlined by previous authors 411 and the EAACI nomenclature for allergic diseases 12, the following consensus definition is proposed: ‘OHP is an immunologic lung disease with variable clinical presentation and outcome resulting from lymphocytic and frequently granulomatous inflammation of the peripheral airways, alveoli, and surrounding interstitial tissue which develops as the result of a non‐IgE‐mediated allergic reaction to a variety of organic or low molecular weight agents that are present in the work environment’. Quirce S, Vandenplas O, Campo P, Cruz MJ, de Blay F, Koschel D, Moscato G, Pala G, Raulf M, Sastre J, Siracusa A, Tarlo SM, Walusiak-Skorupa J, Cormier Y. Occupational hypersensitivity pneumonitis: an EAACI position paper. Allergy. 2016 Jun;71(6):765-79. doi: 10.1111/all.12866. Epub 2016 Mar 11. PMID: 26913451.

What Is the Treatment for the Condition?

Treatment for some medical conditions is not just medical care.

In the case of Pneumonitis, one of the forms of treatment is avoidance of harmful exposure.   This can include the removal of causative substances, the replacement of products that have the causative substances, changes in work that will avoid exposures to the causative substances, and avoidance in general of known sources of the causative substances.

Treatments can include corticosteroids or other immunosuppressants. Treatment can include oxygen therapy, bronchodilators, opioids, and lung transplants.  Mayo Clinic.

In viewing the range and scope of treatments, it is fair to say that Pneumonitis should be viewed as a serious medical condition.

What Are the Causes of Pneumonitis? What Are Occupational Causes of Pneumonitis?

Common causes of pneumonitis include airborne irritants at your job or from your hobbies. In addition, some types of cancer treatments and dozens of drugs can cause pneumonitis.

With respect to work-related exposure, “A large number of occupational agents/antigens have been described as potential causative agents of HP in a wide variety of occupations. These offending agents can be classified into six broad categories that include bacteria, fungi, animal (glyco) proteins, plant (glyco) proteins, low molecular weight chemicals, and metals (Table 2). Using a quantitative structure–activity relationship (QSAR) model, it was found that chemicals causing OHP tend to have a higher predicted asthma hazard, are more lipophilic, and are more likely to be protein cross‐linkers than those causing occupational asthma .” Quirce S, Vandenplas O, Campo P, Cruz MJ, de Blay F, Koschel D, Moscato G, Pala G, Raulf M, Sastre J, Siracusa A, Tarlo SM, Walusiak-Skorupa J, Cormier Y. Occupational hypersensitivity pneumonitis: an EAACI position paper. Allergy. 2016 Jun;71(6):765-79. doi: 10.1111/all.12866. Epub 2016 Mar 11. PMID: 26913451.

What Types of Occupations That Are At Risk of Pneumonitis?

The following are occupations that may be at risk for the disease: aircraft industry, animal feeding, bagasse workers [slaughterhouse], bird breeders, ceramic workers, cheese workers, chemical and polyurethane industry, compost workers, cork workers, cosmetic industry, dental technicians,  farmers, florists, food processors, hard metal workers, humidifiers, laboratory workers, maple bark strippers, malt workers, mushroom workers, painters, paprika slicers, pearl industry, peat moss processors, pharmaceutical industry, plastic industry, plastic workers, potato riddlers, seaweed workers, smelters, stucco workers, textile workers, tobacco growers, wine makers, wood workers, and yacht manufacturing. Quirce S, Vandenplas O, Campo P, Cruz MJ, de Blay F, Koschel D, Moscato G, Pala G, Raulf M, Sastre J, Siracusa A, Tarlo SM, Walusiak-Skorupa J, Cormier Y. Occupational hypersensitivity pneumonitis: an EAACI position paper. Allergy. 2016 Jun;71(6):765-79. doi: 10.1111/all.12866. Epub 2016 Mar 11. PMID: 26913451.

Is There An Alternative Theory of Industrial Causation for Pneumonitis?

Yes.  Radiation treatment has been considered as a source of this disease.

Treatment for an industrial injury can give rise to a work injury claim.   Thus, if there is a work-related medical condition that involves radiation treatment, they may possibly be able to pursue a claim.   This may be the case with cancers such as lung or breast.

Is There Any Caselaw Concerning Pneumonitis?

Yes.  There have been a variety of cases with respect to the disease.

The pneumonia presumption for safety and law enforcement officers was found to not apply in the case of pneumonitis.  As noted above, pneumonia is a subset of the disease.

Pneumonitis was found work-related for a meat cutter.  The WCAB panel determined that the applicant developed compensable hypersensitivity pneumonitis while working as a meat cutter. See Costco Wholesale Corp vs. WCAB (2010) 75 C.C.C. 1187 (writ denied.)

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

 

EXERTIONAL HEAT SYNDROME: HEATED WORK ENVIRONMENTS, WORK INJURIES AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Heat Exertion can produce serious injuries in the workplace. The medical condition is commonly known as Exertional Heat Illness (ESI.) Heat Illnesses are multi-causal. Human’s body temperatures can be elevated by a number of factors. First, there is the heat and humidity in the environment. Second, there is the clothing and equipment being used by the worker. Third, there is the nature, extent and the duration of the activities.

This article is focused towards the Heat Exertion as opposed to the Heat Exposure. Note: Heat Exertional Illness is a huge concern for military. Thus, this matter has been studied within that context. Heat Exertion is a concern for all military personnel. Even Military Working Dogs have been studied. Predicting military working dog core temperature during exertional heat strain: Validation of a Canine Thermal Model Catherine O’Brien William J.Tharion Anthony J.Karis Heather M.Sullivan https://doi.org/10.1016/j.jtherbio.2020.102603Get rights and content

In the civilian setting, there are also various occupations that involve serious issues that can bring rise to heat exertional illness.

This article will discuss Heat Exertion Illness, risk factors involved with HEI, the nature and extent of injuries arising from heat exertion, and how it can be addressed within a workers’ compensation setting.

What Is Exertional Heat Illness (EHI)?

Exertional Heat illnesses (EHI) is essentially a variety of medical conditions that may occur during physical exertion that is performed in hot and humid environments. This can be the case when there is performance of strenuous physical activities for extended durations in hot environments.

In the civilian workforce, HEI may impact occupations such as Agriculture, Construction Workers, Police Officers, and Refinery Workers.

For instance, with respect to Wildland Fire Fighters, a study noted the nature and extent of the clothing and equipment that they carry. The study noted that “WLFFs wear standard fire equipment: Nomex long-sleeve shirt and pants, mid-calf leather logger boots, a 100% cotton short-sleeve undershirt, leather gloves, hard hat, and a 12 to 20 kg pack containing food, water, safety gear, and work tools.” High Work Output Combined With High Ambient Temperatures Caused Heat Exhaustion in a Wildland Firefighter Despite High Fluid Intake John S.Cuddy MS Brent C. Ruby PhD https://doi.org/10.1016/j.wem.2011.01.008

Why is EHI a Serious Concern?

Due to the fact that EHI can cause a variety of medical conditions, there is also a wide range of medical problems that EHI can cause.

Mild forms of EHI can include heat cramps. Severe forms of EHI can include heat stroke. Severe EHI can lead to multiorgan damage and death. Alele FO, Malau-Aduli BS, Malau-Aduli AEO, J Crowe M. Epidemiology of Exertional Heat Illness in the Military: A Systematic Review of Observational Studies. Int J Environ Res Public Health. 2020 Sep 25;17(19):E7037. doi: 10.3390/ijerph17197037. PMID: 32993024.

Does Body Temperature Play a Role?

Yes. Body Core Temperature plays a role in the severity of the injury. Temperatures less than 40 degrees Celsius (104 degrees Farenheit) percent are associated with milder symptoms and temperatures greater than 40 degrees Celsius brought on more serious symptoms which provided central nervous system symptoms such as dizziness, confusion, and loss of consciousness. Alele FO, Malau-Aduli BS, Malau-Aduli AEO, J Crowe M. Epidemiology of Exertional Heat Illness in the Military: A Systematic Review of Observational Studies. Int J Environ Res Public Health. 2020 Sep 25;17(19):E7037. doi: 10.3390/ijerph17197037. PMID: 32993024.

What are the Main Risk Factors in EHI?

There are a variety of risk factors that can impact EHI. The main risk factors in the study were gender, physical fitness, obesity, previous history of heat illness, motivation, hot environmental conditions, and service unit. Alele FO, Malau-Aduli BS, Malau-Aduli AEO, J Crowe M. Epidemiology of Exertional Heat Illness in the Military: A Systematic Review of Observational Studies. Int J Environ Res Public Health. 2020 Sep 25;17(19):E7037. doi: 10.3390/ijerph17197037. PMID: 32993024.

“[T]these risk factors into three groups—host (individual physiologically limiting), environmental and organizational (training organization) factors. Supra.

Are There Risk Factors of Interest?

Yes.

Females were more likely to experience EHI than males.

High Body Mass Index (BMI) individuals are more likely to experience EHI.

Lower Physical Fitness individuals are more likely to experience EHI.

Over Motivated Individuals are more likely to experience EHI. One reason being is that they may not pace themselves.

A prior history of heat illness makes individuals more susceptible to heat stroke or severe heat illness.

Hot conditions such as summer seasons and in hot weather conditions make individuals at greater risk of EHI.

Some Units, task dependent and equipment dependent groups, can have increased risk of EHI versus other units. . Alele FO, Malau-Aduli BS, Malau-Aduli AEO, J Crowe M. Epidemiology of Exertional Heat Illness in the Military: A Systematic Review of Observational Studies. Int J Environ Res Public Health. 2020 Sep 25;17(19):E7037. doi: 10.3390/ijerph17197037. PMID: 32993024.

If a Worker is Suffering from a Heat-Related Illness, What Should They Do?

If the Injured Worker was exposed to excessive heat in the workforce, they can consider filing a workers’ compensation claim. This would allow them to claim medical care, monetary benefits in the form of temporary and permanent disability benefits. Also, vocational rehabilitation benefits may be indicated. If a fatality situation, a death claim for the dependents may be indicated.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

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