PROSTATE CANCER AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Prostate Cancer is a medical condition for which there may be an element of “industrial causation.” Since Prostate Cancer, in certain circumstances, may be industrially-related, an Injured Worker could make a workers’ compensation claim for their Prostate Cancer. If the Workers’ Compensation Claim was accepted, the Injured Worker would be entitled to receive the full range of benefits.  This includes disability payments, medical care, and death benefits.

This article will discuss Prostate Cancer, Prostate Cancer Treatment, Permanent Disability as a result of Prostate Cancer, Industrial Causation of Prostate Cancer, Labor Code Statutes relating to Prostate Cancer, and Caselaw relating to decisions involving Prostate Cancer.

What is Prostate Cancer? What are the Signs of Prostate Cancer? 

Prostate Cancer is a disease in the Prostate Gland. It occurs when cells in the prostate grows abnormally and uncontrollably. It is a slow growing cancer which may cause symptoms with respect to both urine flow and sexual function. Additionally, there may be more generalized symptoms such as pain in the low back or pelvis area, weakness or numbness in the legs or feet, dizziness, or fatigue. Sources: National Cancer Institute and American Cancer Society.

How is Prostate Cancer Diagnosed?

Per the American Cancer Society, there are many tests that are used to both diagnose and stage prostate cancer. Basically, an individual will go through a series of testing in order to assist in diagnosis. Urology is the field of medicine that address Prostate Cancer. Doctors who specialize in Urology are Urologists.

Tests include

  • Prostate-Specific Antigen (PSA) [Blood Test]
  • Digital Rectal Examination (DRE) [Physical Examination Test]
  • Prostate Biopsy [Surgical Procedure] Tissues are removed from the Prostate. A Pathologist makes a determination as to whether the tissue is negative for cancer, suspicious for cancer, or positive for cancer. Note: negative results does not mean that the individual should not be concerned about cancer. Further monitoring should be conducted.
  • Imaging Studies: X-Rays, Magnetic Resonance Imaging (MRI), Ultrasound (Transrectral ultrasound aka TRUS), Radiology, Bone Scan, Computed Tomography (CT), and Lymph Node Biopsy

What are the Non-Industrial Risk Factors of Prostate Cancer?

There are a number of risk factors for prostate cancer. These risk factors include family history of prostate cancer, inherited genetic mutations, conditions such as prostatitis, inflammation of the prostate, and benign prostatic hyperplasia or BPH, a noncancerous enlargement of the prostate gland, diet high in red meats and high-fat dairy and low in fruits and vegetables, obesity, Age: approximately 60 percent of cases are diagnosed in men older than 65, Race and ethnicity (note: African-American men and Caribbean men of African ancestry are more likely to be diagnosed with prostate cancer.)

Please note: Research has also shown that a healthy lifestyle, including a well-balanced diet and maintaining a healthy weight, may reduce prostate cancer risk.

What are the Industrial Risk Factors for Prostate Cancer? Are There Other Factors?

Prostate Cancer can be work-related in two fashions. First, there is a scientific basis for showing that there is a causative factor in certain occupations or occupational exposures with respect to the development of Prostate Cancer. Second, there is a legal basis for showing a causative factor. A legal basis is a statutory presumption. For certain law enforcement officers and safety officers, they are afforded a “Cancer Presumption.” If they fit within the elements of the “Cancer Presumption,” they can be legally found to have industrial cancer without having to prove it on a scientific basis. Their Departments, however, are afforded the opportunity to “rebut the presumption.”

How is Prostate Cancer Work-Related?

Prostate Cancer can be work-related in a variety of manners. Prostate Cancer can be work-related with respect to certain:

  • Worksite Exposures: Certain Pesticides, Chromium
  • Occupations: Administrative and Management Positions, Firefighting and Law Enforcement, Pilots, and Agriculture
  • Work Activities: Shift Work
  • Labor Code Sections: Labor Code Presumption for Cancer 3212.1

See Cancer Med. 2018 Apr; 7(4): 1468–1478, Published online 2018 Mar 1. doi: 10.1002/cam4.1358 Prostate cancer surveillance by occupation and industry: the Canadian Census Health and Environment Cohort (CanCHEC)

Jeavana Sritharan, Jill MacLeod,  Shelley Harris, Donald C. Cole, Anne Harris, Michael Tjepkema, Paul A. Peters, and Paul A. Demers; and J Cancer Prev. 2019 Jun; 24(2): 91–111.

Published online 2019 Jun 30. doi: 10.15430/JCP.2019.24.2.91, Occupational Risk Factors for Prostate Cancer: A Meta-analysisSrmena Krstev and Anders Knutsson

What is the Statutory Basis for Supporting Industrial Prostate Cancer?

Labor Code Section 3212.1 provides for a “General” Cancer Presumption. This Presumption applies to certain Safety and Law Enforcement Officers. This Presumption has been used to specifically make claims for “Prostate Cancer.” It provides as follows:

“(a) This section applies to all of the following:

(1) Active firefighting members, whether volunteers, partly paid, or fully paid, of all of the following fire departments:

(A) A fire department of a city, county, city and county, district, or other public or municipal corporation or political subdivision.

(B) A fire department of the University of California and the California State University.

(C) The Department of Forestry and Fire Protection.

(D) A county forestry or firefighting department or unit.

(2) Active firefighting members of a fire department that serves a United States Department of Defense installation and who are certified by the Department of Defense as meeting its standards for firefighters.

(3) Active firefighting members of a fire department that serves a National Aeronautics and Space Administration installation and who adhere to training standards established in accordance with Article 4 (commencing with Section 13155 ) of Chapter 1 of Part 2 of Division 12 of the Health and Safety Code.

(4) Peace officers, as defined in Section 830.1, subdivision (a) of Section 830.2 , and subdivisions (a) and (b) of Section 830.37, of the Penal Code , who are primarily engaged in active law enforcement activities.

(5)(A) Fire and rescue services coordinators who work for the Office of Emergency Services.

(B) For purposes of this paragraph, “fire and rescue services coordinators” means coordinators with any of the following job classifications:  coordinator, senior coordinator, or chief coordinator.

(b) The term “injury,” as used in this division, includes cancer, including leukemia, that develops or manifests itself during a period in which any member described in subdivision (a) is in the service of the department or unit, if the member demonstrates that he or she was exposed, while in the service of the department or unit, to a known carcinogen as defined by the International Agency for Research on Cancer, or as defined by the director.

(c) The compensation that is awarded for cancer shall include full hospital, surgical, medical treatment, disability indemnity, and death benefits, as provided by this division.

(d) The cancer so developing or manifesting itself in these cases shall be presumed to arise out of and in the course of the employment.  This presumption is disputable and may be controverted by evidence that the primary site of the cancer has been established and that the carcinogen to which the member has demonstrated exposure is not reasonably linked to the disabling cancer.  Unless so controverted, the appeals board is bound to find in accordance with the presumption.  This presumption shall be extended to a member following termination of service for a period of three calendar months for each full year of the requisite service, but not to exceed 120 months in any circumstance, commencing with the last date actually worked in the specified capacity.

(e) The amendments to this section enacted during the 1999 portion of the 1999-2000 Regular Session shall be applied to claims for benefits filed or pending on or after January 1, 1997, including, but not limited to, claims for benefits filed on or after that date that have previously been denied, or that are being appealed following denial.

(f) This section shall be known, and may be cited, as the William Dallas Jones Cancer Presumption Act of 2010.”

Is There Caselaw concerning Industrial Prostate Cancer?

Yes. There has been some significant litigation with respect to Prostate Cancer.

Most caselaw has related around the “Cancer Presumption” and the issues related to it. Issue of interest in presumption litigation can include the burden of proof, the potential rebuttal of the presumption and the statute of limitations. The following are a sample of cases. County of Fresno vs. WCAB (2019) 84 C.C.C. 996 (writ denied) (Issue: whether claim barred by Statute of Limitations); County of Orange vs. WCAB (2005) 70 C.C.C. 1499 (Prostate Cancer found industrial. Defendant failed to rebut presumption.) Faust vs. City of San Diego (2003) 68 C.C.C. 1822 (Panel Decision) (Issue: the procedure concerning both establishing presumption and rebutting the presumption. In summary, in a case where an applicant has invoked the presumption of section 3212.1, the applicant has the initial burden of showing (1) that he or she was employed in an included capacity; (2) that he or she has been exposed to a known carcinogen during the employment; and (3) that he or she has developed or manifested cancer. When the applicant has made this showing, the burden shifts to the defendant to rebut the presumption by evidence that: (1) the primary site of the cancer has been identified; and (2) that the carcinogen is not reasonably linked to the disabling cancer.)

What is Permanent Disability Impairment for Prostate Cancer?

Permanent Disability Impairment for Prostate Cancer is multi-factorial. Prostate Cancer directly impacts two Activities of Daily Living (ADLs), urination and sexual function. The AMA Guides for Permanent Impairment, 5th Edition, has a Table 7-8 which addresses the Criteria for Rating Permanent Impairment Due to Prostate and Seminal Vesicle Disease discusses Prostate Cancer. It provides that “[f]or Prostate and seminal vesicle ablation; occurs almost exclusively with extirpative surgery for prostate cancer; combine impairment estimates for prostate and seminal vesicle loss with impairment for sexual dysfunction or urinary incontinence if present (see the Combined Values Chart, p. 604.)”

In sum, Permanent Disability Impairment from Prostate Cancer can be complex due to the nature and extent of both the condition and the treatment that has been provided.

What If I Need Legal Advice?

If you would like a free consultation concerning any workers’ compensation case, 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 28 years.

Photo by Gus Moretta on Unsplash

KAISER PERMANENTE (KAISER) AND WORKERS’ COMPENSATION: INJURED WORKERS, MANAGED CARE, TREATMENT FOR INJURIES, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

In California Workers’ Compensation, an Injured Worker’s treatment for their industrial injuries is limited. Insurance Companies limit the treatment by the employment of Managed Provider Networks (MPNs) which dictate the providers that an Injured Worker can use. Kaiser Permanente is a Medical Provider in the State of California which provides both treatment for Injured Workers as well as providing non-industrial Managed Care in the form of Health Insurance.

Many Employees in California rely upon Kaiser Permanente to provide their general health coverage. Some of these Employees have been Kaiser members for decades. Some of these Employees, in the event of an industrial injury, prefer to treat with Kaiser. They are comfortable with the facilities, they know that their providers have all of their medical records, and they have some faith that they will be fairly and respectfully in treated by Kaiser with respect to their industrial injury.

This article will discuss Kaiser Permanente and its Occupational Medical Program called Kaiser On-The-Job. 

What is Kaiser Permanente (Kaiser)? 

Kaiser is a Managed Care Institution. Kaiser provides Health Care Plans for Employers, Individuals, and for Medicare Recipients. Also, Kaiser provides Occupational Care for Work Injuries. Kaiser Permanente is frequently listed as a Medical Care Provider for many Managed Provider Network Plans or MPNs

What Occupational Services Does Kaiser Provide?

Kaiser has a Department called Kaiser On-The-Job. This Department provides medical treatment for workers’ compensation injuries. In addition, the Department provides for Medical Evaluations, Screening and Monitoring, Drug and Alcohol Testing, and Immunizations.

  • The Medical Evaluations provided can include Pre-Placement and Post-Offer Examinations, Fitness for Duty and Return to Work Examinations, and Department of Transportation and Department of Motor Vehicle Examinations.
  • The Screening and Monitoring services provided include Respiratory Clearance, Asbestos Evaluations, Lead Surveillance, Hazardous Waste Worker Evaluations, Firefighter Examinations, and Hearing Conservation.
  • The Drug and Alcohol Testing provided can include Urine Specimen Collection and Breath Alcohol Testing.
  • The Immunization Services provided include immunization for Hepatitis A & B, Tetanus, Diphtheria, and Pertussis.

Per Kaiser, “On-the-Job” provides: specialized care for work-related injuries, skilled physicians who are board certified or board eligible in occupational medicine or a related specialty, urgent and after-hours care available 24 hours a day, every day at many locations, coordinated clinical services, including physical therapy, radiology, specialty care, and pharmacy, and onsite staff who works with you, your employees, and any medical or insurance providers.”

They note that “[m]any of [their] dedicated occupational health centers are located on Kaiser Permanente hospital campuses, so it’s easy for ..employees to take care of their health needs in one trip.”

Further, the Kaiser promotes “On The Job” as “Cost savings — Employees in [their] care get back to work faster and at a lower cost; Available to all …employees — All of your employees [at a company for which Kaiser is a provider], not just … Kaiser Permanente members can access [their] occupational health services; Support for [the employer] throughout the process — [they will] get timely reports on employee work status, and we’ll work closely with you to coordinate … employees’ appropriate return to work. One-stop convenience — Nearly all of [Kaiser “On The Job”] centers are located in or near clinical facilities, offering convenient access to specialists, pharmacy, X-ray, physical therapy, and more; Advanced health information technology — Caregivers have real-time access to the electronic medical records of Kaiser Permanente members, helping them make quick, well-informed decisions that improve outcomes; and Culturally responsive care — Members receive care that respects their diverse.”

Why Do Insurance Companies Employ Kaiser in Their Managed Provider Networks?

Insurance Companies utilize Kaiser for many reasons. First, Kaiser is a Managed Care Facility. As a result, Kaiser has been able to promote itself as a “cost-saving” provider. They refer to various studies as proof of that assertion.

Note: As an advocate for Injured Workers, the term “cost savings” concerns me. Cost savings can be achieved by various means which are to the detriment of an Injured Worker. This can include the denial of treatment, the premature return of the employee back to their usual and customary occupation, the issuance of medical reports which do not support an award of permanent disability, the failure of the doctors to refer the injured worker out to address all work-related conditions, and the failure to award the he need for future medical care.

Kaiser asserts that they achieve this goal by following “state-mandated fee schedules, relying on an outcomes-based strategy to manage claims costs. Elements of this approach include: Integrated care — [their] occupational health physicians, nurses, care coordinators, and therapists are connected to the same electronic health record system. Real-time access to medical records means they can make well-informed decisions faster for better outcomes and higher patient satisfaction. Convenient locations — Many Kaiser Permanente On-the-Job facilities are located at or near [their] medical offices and hospitals. This means employees — even those who aren’t Kaiser Permanente members — can get the care they need quickly, so they can return to health and to work as soon as appropriate. Coordinated case management — Kaiser Permanente On-the-Job keeps employers informed with regular work status reports, and works with them to help ensure employees return to work appropriately.”

In the study they cite that they have be able to reduce costs per claim, medical costs per claim, average pharmacy costs per claim, fewer claims involving litigation, lowering medical costs for low back injuries per claim and lower costs for shoulder and upper arm injuries per claim.

Note: As an advocate for Injured Workers, implied within these reduced costs are the denial of treatment, early return to work, the provision of less costly medications, the less advice by doctors to injured workers that they should get a lawyer, and possibly less sophisticated reporting and analysis of claims by treating doctors as to addressing all affected body parts. A more sophisticated analysis would allow for more permanent disability and medical care for the Injured Worker.

As a Representative of Injured Worker’s, How Do You Feel About Kaiser?

Kaiser can be both good and bad with respect to treatment for industrial injuries. Unlike other treatment arrangements, Kaiser employs a “gatekeeper” doctor to manage the treatment. This means that you are sent to an Occupational Medicine Doctor for your treatment. You are then reliant upon that doctor to refer you to various specialties such as an orthopedic surgeon or internal medicine doctor.

Kaiser does have nice facilities and has many diagnostic testing available at the facilities. Also, they have pharmacies at facilities as well. Therefore, there is a convenience factor for injured workers.

What If I Need Legal Advice?

If you would like a free consultation concerning any workers’ compensation case, 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.

Photo by Pop & Zebra on Unsplash

FRAGRANCES AND WORK-RELATED ASTHMA: WORK INJURIES CAUSED BY EXPOSURE TO PERFUME AND FRAGRANCES: WHAT YOU NEED TO KNOW

Workplaces contain many chemicals that can irritate a Worker’s Lungs.   These irritations can occur in two ways.   It can occur when a Worker with pre-existing conditions, such as asthma, is exposed to the chemicals.   Also, it can occur with Worker who has no pre-existing conditions.

Asthma is a significant illness within the United States Population. Per the Centers for Disease Control and Prevention, in 2018, 24,753,379 individuals suffered from the disease and 2,607,598 of them were from the State of California.   In addition, there are large amounts of the population that suffer from Childhood Asthma, 5,530,131, in the United States.   The large number of individuals with Asthma implies that there is a large number of the workforce has pre-existing Asthma.

This article will discuss Asthma, Fragrances, Perfumes, and Work-Related Asthma.

What Is Asthma? What Is Occupational Asthma or Work-Related Asthma?

Per the American Academy of Allergy, Asthma & Immunology, “Asthma is a chronic disease involving the airways in the lungs. These airways, or bronchial tubes, allow air to come in and out of the lungs. If you have asthma your airways are always inflamed. They become even more swollen and the muscles around the airways can tighten when something triggers your symptoms. This makes it difficult for air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and/or chest tightness.”

Occupational Asthma “is caused by inhaling fumes, gases, dust or other potentially harmful substances while on the job.”  Per the CDPH, “[a]sthma is work-related when it is caused or made worse by something at work. Symptoms can start right after an employee breathes in a substance, or hours after leaving work. Sometimes a person can suddenly develop work-related asthma from substances they have worked around for years.”

What are Fragrances?

The term “fragrances,” for the purposes of this article, refers to perfumes and products that contain “fragrances.” A “fragrance” is essentially a pleasant scent.  In essence, a perfume is a “fragrance” that is placed upon a person.   Besides perfumes, various commercial and household products are enhanced with “fragrances” so that they “smell” good.

Both perfumes and fragrances contain chemicals effect an individual’s respiratory system.  As a result of exposure to these perfumes or fragrancies, an individual may suffer from respiratory symptoms which can include wheezing, chest tightness, cough, shortness of breath, or difficulty breathing.

What About Air Fresheners?

There are problems with Air Fresheners.   Per CDHP, “Air fresheners and deodorizers come in many forms: plug-ins, sprays, liquids, and gels. These products mask bad odors rather than get rid of them. Air fresheners add chemicals to the air that can cause asthma and other health problems such as headaches and allergies.”

How Does an Industrial Onset of Asthma Arise?

Occupational or Work-Related Asthma can be from a single event of inhalation or inhalation of a substance over a prolonged period of time.

What Are Examples of Industrial Exposures?

Use of Air Fresheners: There was one report where the use of an air freshener triggered asthma symptoms required the Worker to go to the emergency room for a visit.  As a result, the Worker required treatment of oral steroids to control their asthma.

Scented Lotions: Scented lotion from one worker got on a co-worker’s jacket.  This exposure worsened the co-worker’s asthma symptoms and gave him hives.  He was required to go to the emergency room 6 times as a result of it.

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.

OUTDOOR WORKERS, INSECT-RELATED INJURIES, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Many Occupations which involve “Outdoor Work.”   “Outdoor Work” exposes workers to insects.  Particularly in the outdoors, there are insects that can either carry illnesses or can exact injuries.  The common method of transmission of these illnesses or injuries are “bites.”   The severity of an Insect Bite Injuries can range from mild to fatal.  A Insect Bite, in the workplace, can bring rise to a workers’ compensation claim and entitlement to both monetary benefits and medical care.

Human succumbing to diseases related to insect exposure has become more prevalent.   Irrespective of work-relatedness, insect-related disease cases have tripled from 2004 to 2016.  Further, there have been new germs [that are insect related] which have been either discovered or introduced since 2004.   CDC

The increase in these types of cases is explained by a vibrant economy and tourism in that “[c]ommerce moves mosquitoes, ticks, and fleas around the world; Infected travelers can introduce and spread germs across the world; and Mosquitoes and ticks move germs into new areas of the US, causing more people to be at risk.”  CDC

This article will discuss “Outdoor Work,” the types of insect exposures that occur in the workplace, and the types of injuries that can occur in the workplace. The article will discuss special laws that apply to certain insect bite injuries as well as caselaw of interest with respect to insect bites.

What Type of Occupations Involve “Outside Work?”

There is a large variety of occupations that involve “outdoor work.”  Occupations with “outdoor work” can include Agriculture, Construction, Firefighters, Forestry, Landscaping, Law Enforcement, Lifeguard. Mining, Prison, and Refining,

How Common Are Insect Bite Injuries?

Per the ACAAI, “[t]housands of people enter hospital emergency rooms or urgent care clinics every year suffering from insect stings. It has been estimated that potentially life-threatening allergic reactions occur in 0.4% – 0.8% of children and 3% of adults. At least 90 – 100 deaths per year result from insect sting anaphylaxis.”   Some of these individuals were working at the time they were stung.

What Are Common Insect Bites?

Per the ACAAI, “[t]he majority of insect stings in the United States come from wasps, yellow jackets, hornets and honeybees. The red or black imported fire ant now infests more than 260 million acres in the southern United States, where it has become a significant health hazard and may be the number one agent of insect stings.”

What Are the Consequences of Insect Bites and Insect Bite Allergies?

Per the ACAAI, “[t]he most serious reaction to an insect sting is an allergic one. This condition requires immediate medical attention. Symptoms of an allergic reaction may include one or more of the following: Hives, itching and swelling in areas other than the sting site, Abdominal cramping, vomiting, intense nausea or diarrhea, Tightness in the chest and difficulty in breathing, Hoarse voice or swelling of the tongue or throat, or difficulty swallowing.

An even more severe allergic reaction, or anaphylaxis can occur within minutes after the sting and may be life-threatening. A dose of epinephrine (adrenaline), typically administered in an auto-injector, and immediate medical attention are required. Symptoms may include: Dizziness or a sharp drop in blood pressure [or] Loss of consciousness or cardiac arrest.”   It should be noted that “People who have experienced an allergic reaction to an insect sting have a 60% chance of a similar or worse reaction if stung again.”.

The California Department of Public Health (CDPH) has reported on a tragic story of a date palm tree worker who died after he was attacked by multiple bees at an organic orchard in Southern California.

What Insects are Problematic?

Some of the problematic insects include bees, fleas, mosquitos, and ticks.

What Types of Diseases Can Rise from Insects?

Mosquito-borne diseases can include California Serogroup Viruses, Chikungunya Virus, Dengue Viruses, Eastern Equine Encephalitis Virus, Malaria Plasmodium, St. Louis Encephalitis Virus, West Nile Virus, Yellow Fever Virus, and Zika Virus.

Tickborne Diseases can include Anaplasmosis/Ehrlichiosis, Babesiosis, Lyme Disease, Powassan Virus, Spotted Fever Rickettsiosis, and Tularemia.

Flea-borne disease can include the Plague.

Can Bites Cause Other Injuries?

Yes. Sometimes the bite itself can cause injury.  For example, there are Africanized Honey Bees.  They have a venom that can impact various human organs. Further, they can cause anaphylactic shock due to multiple bee stings.

Other bites of concern include fire ant bites, hornet bites, scorpion bites, wasp bites.

If Someone is Allergic to Insect Bites and They are Bitten at Work and Sustain Illness, Is it Work-Related?

Yes.  Pre-existing conditions do not bar an Injured Worker from making a workers’ compensation claim.   An aggravation or acceleration of an underlying condition can be considered as a work injury.  Therefore, a Worker who is allergic to particular insect bites could be able to claim an injury if they were bitten while at work.

Are There Statutes Which Protect Injured Workers Who Sustain Work-Related Insect-Bites?

Yes.  There are two statutes which protect certain Police and Safety Personnel with respect to certain types of insect bites.

There is a statute that provides for a statutory presumption for Lyme Disease, Labor Code Section 3212.12, which applies to certain Police, Safety and Conservation Corps members. For an article on the Lyme Disease Presumption click here.

There is a statute that does not specifically address insect bites but does address some insect bite injuries.   There is a statute that provides for blood-borne illnesses.   This statute applies to insect-bites in that some of them involve a blood borne transmission of a disease or illness.   In those circumstances, the presumption would therefore apply to an insect bite.   Labor Code Section 3212.8 provides a blood borne disease presumption to certain Safety and Law Enforcement Officers.   For an article on the Blood Borne Disease Presumption, click here.

Is There Case Law Concerning Insect Bites?

Yes. There are various issues relating to insect bites in the workplace.

There are issues of whether the bite should be considered as a work-related event.

LYME DISEASE: In the matter of County of Mendocino vs. WCAB (1995) 60 C.C.C. 220, the “WCJ found that Applicant sustained a tick bite while employed by Defendant but could not conclude whether Applicant presently had Lyme Disease. However, the WCJ stated that the medical history was clear that the problems Applicant had were the result of the tick bite in question, and whether or not it was called Lyme Disease, the medical evidence clearly showed that, from this tick bite, Applicant suffered damage, including lost time from work and need for medical treatment, as well as possibly the need for future medical treatment.

WEST NILE VIRUS: In Leggette vs. CPS Security (2020) 85 C.C.C. 321(Board Panel Decision) the WCAB found that Applicant sustained an injury for West Nile Virus when Applicant bitten by mosquitos while working as a security guard at a construction site.

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.

DENTAL HYGIENISTS, MUSCULOSKELETAL DISORDERS, AND WORKERS’ COMPENSATION: MEDICAL PROFESSIONALS AT RISK OF INDUSTRIAL ORTHOPEDIC INJURIES: WHAT YOU NEED TO KNOW

Many occupations are susceptible to work injuries.  One of these occupations is that of a Dental Hygienist.  More specifically, Dental Hygienists are at risk for musculoskeletal disorders (MSDs.)  This has been recognized by the California Department of Public Health (CDPH.)

This article will discuss the occupation of Dental Hygienist, how Dental Hygienists are at risk for musculoskeletal disorders, and caselaw of interest.

What is a Dental Hygienist?

Per the American Dental Association(ADA), a Dental Hygienist is a licensed position which varies from state to state.  Note: The practice of dental hygiene in California is regulated by the Dental Hygiene Board of California.

The tasks of Dental Hygienists can include “patient screening procedures; such as assessment of oral health conditions, review of the health history, oral cancer screening, head and neck inspection, dental charting and taking blood pressure and pulse, taking and developing dental radiographs (x-rays), removing calculus and plaque (hard and soft deposits) from all surfaces of the teeth, applying preventive materials to the teeth (e.g., sealants and fluorides), teaching patients appropriate oral hygiene strategies to maintain oral health; (e.g., tooth brushing, flossing and nutritional counseling), counseling patients about good nutrition and its impact on oral health, making impressions of patients’ teeth for study casts (models of teeth used by dentists to evaluate patient treatment needs,)[and] performing documentation and office management activities.”

Dental Hygienists can work in a variety of locations.   This locations include Dental Offices.  This can include Dental Offices of General Practitioners as well a Specialty Practitioners’ Offices such as Periodontics and Pediatric Dentistry.

Dental Hygienists also may work at Public Health Agencies, Hospitals and Community Health Clinics. They can work for public school systems, dental schools and dental hygiene educational programs.  Dental hygiene services can be performed in hospitals, nursing homes, prisons and public health clinics.

Note: Activities of interest involve the activities in which the patient is in the dental chair and the Dental Hygienist is performing services upon them.

What Are Musculoskeletal Disorders (MSD)?

Per the Centers for Disease Control and Prevention (CDC), Musculoskeletal disorders (MSD) are injuries or disorders of the muscles, nerves, tendons, joints, cartilage, and spinal discs.

What Types of Musculoskeletal Injuries Do Dental Hygienists Sustain?

Dental Hygienists are susceptible to a multitude of musculoskeletal disorders.  Upper Extremity problems are common.  These upper extremity diseases or conditions include tendonitis, tennis elbow, and carpal tunnel syndrome.

Has There Been Any Caselaw Concerning Dental Hygienists with Cumulative Trauma Musculoskeletal Injuries?

Yes. In Barnes vs. WCAB (2013) 78 C.C.C. 1137 (writ denied), the case involved a Dental Hygienist who suffered a cumulative trauma musculoskeletal injury to her neck and back.  In the matter, there was a dispute as to whether there was also an aggravation of an underlying fibromyalgia and chronic fatigue syndrome.  In the case, there was a finding of industrial causation for those body parts.

Are Musculoskeletal Disorders for Dental Hygienists a Concern for the State of California?

Yes.  The State of California is concerned over the risk of injury for Dental Hygienists. The State recommends ergonomics programs in order to promoted a safe and efficient workplace.

What Are Ergonomics?

Per OSHA,  “ [w]orkers in many different industries and occupations can be exposed to risk factors at work, such as lifting heavy items, bending, reaching overhead, pushing and pulling heavy loads, working in awkward body postures and performing the same or similar tasks repetitively. Exposure to these known risk factors for MSDs increases a worker’s risk of injury.

Work-related MSDs can be prevented. Ergonomics — fitting a job to a person — helps lessen muscle fatigue, increases productivity and reduces the number and severity of work-related MSDs.”.

Are There Ergonomic Tools for Dental Hygienists?

Yes. The State of California offer videos designed for Dental Hygienists.  Here is the link. https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/OHB/Pages/ErgonomicsDentalHygiene.aspx

There are videos which include topics such posturing and position, use and choice of instruments and body strengthening.

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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