Occupational disease claims can strike without warning. They can be presented long after employment has ended, and may or may not be the result of employment. Medical and scientific proofs for causal relationship can be vague or misleading, and more and more normal health failures are being alleged and adjudged as work induced. When occupational disease litigation is necessary, the trend in these cases has been favoring the employee.
These are just a few of the problems accompanying Occupational Disease Cases.
Injury Factors:
On the job injury claims are usually associated with a definite date, time, and place; with medical recovery and return to work the expected outcome. The majority of these claims can be adequately measured for expected cost and should follow a consistent protocol of injury response: claim investigation, medical management, return to work, etc. Litigation is usually a small percentage of claims.
Experience and premium ratings are easily determined since most injury losses are measurable.
Occupational Disease Factors:
There are occupations where employees can be exposed diseases contracted on the job, where the outcome is not as clear cut. Medical, Police, and Fire Professionals can easily come in contact with many foreign elements on the job. Drug manufactures or users, forensic laboratories, and chemical manufacturers are more places where employees can be exposed to situations not common to the public at large. Jobs exposed to high noise levels, repetitive motion, vibrations, and airborne particles can also be expected to develop occupational diseases and disabilities.
Many diseases and disabilities in these industries are fairly well documented to have occurred due to the job. Black lung, brown lung, carpel tunnel syndrome, contaminated needle punctures, and asbestosis with its ensuing mesothelioma cancer are some examples.
However, hearing or eye sight loss, most cancers, allergies, heart disease, cardio vascular diseases, pulmonary conditions, blood diseases, and skin conditions are a few illnesses that can be the result of everyday life exposures. The normal aging processes accounts for the bulk of such conditions.
Additional factors:
- Improper use of everyday household items can trigger many illnesses, diseases and even death.
- People fail to read warning labels or wear proper protective clothing when doing everyday home activates.
- Crowds where people cough, sneeze, shake hands, or preform other physical activities can spread many diseases and health conditions quickly.
- Improper personal health and hygiene habits cause sickness.
- Smoking, substance abuse, alcoholism, poor personal life styles, diabetes, as well as obesity can all contribute or cause many illnesses and health disabilities.
- Physical or mental abuses in the home can lead to many psychotic conditions that can also be alleged to have occurred due to job conditions.
Occupational Disease Cost:
Many diseases and mental conditions require lengthy expensive medical care, and some conditions might not be treatable. Some can aggravate or initiate other health situations, or require lifetime medical treatment and personal care. While all conditions affect normal quality of life.
Factors affecting cost:
- Constantly increasing medical care costs and new treatment development costs can challenge even the best cost estimates.
- Lifetime benefit payments can be subject to annual inflation adjustments.
- Life expectancy exposures must be considered.
- Investigation, defense, special scientific consultation, and expert medical opinion, will add large cost to any challenged claim.
Controlling Occupational Disease:
OD claims demand thorough investigation of job exposures and hazards, and determining the relationship of the disease to the public at large is necessary. The employee’s health and life style need exploration for possible contribution to the disease, while strong medical evidence as to causal relationship also needs to be developed.
There is huge potential of diseases that might be claimed as job related, so the importance of investigation cannot be understated. Employers must seek professional investigators, medical personnel, engineers, and other professionals that have strong experience and qualifications.
Employer’s loss control departments also need to constantly be on lookout for job conditions, products, environments, or equipment which could produce occupational disease. In addition to a pre-employment screening system that includes physical examinations, experience, training and education to determine if the employee is fit to do a job where OD might occur.
Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: [email protected].
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