7 Steps to Manage Occupational/Environmental Exposure Claims

You want to make sure your injured workers get the benefits they need to recover and get back to work. At the same time, you don’t want to waste money on a claim unrelated to the workplace. That can be especially tricky when an occupational/environmental exposure is involved.


Injuries caused by toxic substances in the worker’s environment may not be immediately apparent to the employee; or the cause may not be easily identified. It’s important to take all necessary steps to determine if, and to what extent your workplace caused the employee’s illness.



What Are Occupational / Environmental Exposures?


Occupational/environmental exposures that pose a risk include chemical, physical and biological substances and can enter the body through breathing, skin exposure or ingestion.


Examples are:


  • Fumes, such as those from diesel vehicles.
  • Airborne materials such as coal dust.
  • Infectious materials, including those found in the blood or bodily fluids of infected patients.
  • Drugs used in cancer treatment and medical research.
  • Materials used in construction.


Workers especially at risk include those in health services, fabricated metal products, rubber and plastics products, textile mills, machinery, transportation equipment, and electrical or electronic equipment.





When an employee (or employees) report an illness they believe was caused by exposure to something in the workplace, there are several issues to consider.


  1. Safety and risk. First and foremost, you want to get the affected employee(s) out of harm’s way. That may require more or better ventilation or even temporarily moving the employee(s) to a separate area.


  1. Number of employees. If multiple employees report similar symptoms, chances are there is a problem that needs to be addressed immediately. For example, if a work area has undergone painting, cleaning or had carpeting installed and multiple employees report breathing problems you need to address the concern ASAP. If a single employee is having issues, there may be something unique about the area where that employee spends time, or substances he works around. He may be having an allergic reaction, or have a low sensitivity threshold. You need to investigate to try and determine the cause.


  1. A diagnosis from a medical provider can give you clues to the problem, if there is one. If the employee(s) has seen a physician and has a diagnosis, determine whether the type of exposure associated with it is present in your workplace. If it is, find out if, when and for how long the employee(s) was exposed to it. If personal protective clothing and/or equipment was required, find out whether the employee(s) used it.


  1. Investigate. As with any workers’ compensation claim, you need to look into the situation to uncover the facts. With occupational exposure claims you should be even more diligent.


– Interview the affected worker(s) and any witnesses. Ask, for example, whether there have been any recent spills of potentially toxic substances.

– Check out the work area for things such as leaks, ventilation issues, or cleaning or renovation work that may have involved toxic chemicals.

– Ask an expert. You may want to consider environmental testing from an outside party.

– Look at your documents regarding exposure; such as safety data sheets for substances used, purchase orders, or disposal logs. Also look at safety reports.

– Be transparent. You want your employees to know you take their symptoms and concerns seriously and are addressing them. Once you’ve investigated the situation and have some answers, let your employees know the results — and what you plan to do about it. Also share the findings with treating physicians to help them.


  1. A one-time event can alert you to a problem before others are affected. An ongoing situation may be evidence of something more serious, such as mold growth, which must be taken care of.


  1. Past claims. If a worker has reported the same or similar claims in the past, it could be an indication of a past exposure that has developed into something more serious for the worker, such as lead poisoning or lung or hematologic cancer.



Accept or deny


Your investigative efforts may yield no concrete information. At that point, you may want to either accept the claim(s) or pursue denial.


  • Accepting the claim. You may decide the expense and time needed to pursue denial is fruitless. If you accept the claim, you still need to address whatever the problem is. If accommodations can be made for the employee(s), consider them. Alternatively, you may need to consider whether the person is a good fit for the work environment, due to a preexisting condition.


  • Denying the claim. If you proceed with denying a claim in which causation is questionable even after your investigation, a medical expert should be called. The person should be board certified and have experience with the exposure condition. You should familiarize the expert with the work environment and the employee’s duty, and provide complete medical records.





Occupational/environmental exposures should be taken as seriously as any other workers’ compensation claim, even though the evidence may not be as clear cut. Ignoring them or failing to fully investigate can end up being extremely costly.




Michael Stack - AmaxxAuthor Michael Stack, CEO 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 & lead trainer of Amaxx Workers’ Comp Training Center. .


Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/


©2017 Amaxx LLC. All rights reserved under International Copyright Law.


Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.


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