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How Workers’ Compensation Claims for Occupational Diseases Work

Offered by Pasternack, Tilker, Ziegler, Walsh, Stanton & Romano LLP

What is an occupational disease?

As defined by the World Health Organization, an occupational disease is “any disease contracted primarily as a result of an exposure to risk factors arising from work activity.” In other words, this is a disease that is tied to the specific responsibilities and conditions of your job. Just catching a cold at the office is not an occupational disease; it has to be caused by work activities or specific environmental conditions in the workplace. Some common types of occupational diseases include:

  • Respiratory diseases caused by breathing in chemicals used in your workplace.
  • Dermatitis and other skin diseases caused by toxic exposure.
  • Repetitive strain injuries (RSI) caused by repetitive movements, ergonomically awkward positions and high work demands.
  • Hearing loss caused by high noise exposure in industries such as construction.
  • Cancer developed due to exposure to carcinogens common in your industry.
  • Infectious diseases, if you work in a setting, such as a hospital, where the risk of exposure to disease is high.
  • Mental health disorders, most notably post-traumatic stress disorder (PTSD) in high-pressure workplaces that expose workers to trauma.

As far as the workers’ compensation system is concerned, occupational diseases are compensable injuries that happen over a period of time, as opposed to work accidents (like a broken leg or traumatic brain injury) that happen at a single moment in time.

How an occupational disease affects the timing of workers’ compensation

A key moment in any workers’ compensation claim is the date of the injury. For instance, injured workers have a specific window of time (which varies from state to state) to notify their employer of an injury for that injury to be compensable, and that window begins on the date of the injury.

For injuries that happen at a specific moment, this is straightforward, but for occupational diseases, it’s harder to pin down a specific date when the injury occurred. Usually, for workers’ compensation purposes, the date of the injury is the date you were diagnosed with the disease or informed that the disease was work-related. As with all workers’ compensation claims, the best practice is to notify your employer right away – and do so in writing so there’s a record of the notification.

Proving an occupational disease is work-related can be complicated

Some occupational diseases, even if it’s tough to pin down exactly when they happened, are relatively simple to connect to your job. For instance, if you became sick after being exposed to a particular chemical that is found in your workplace but not typically encountered in everyday life, it’s easy to draw the connection between your job and your illness. Diseases like asbestosis and black lung disease (which comes from inhaling coal dust) fall in this category.

Other occupational diseases are not so clear-cut. Hearing loss, for instance, is often job-related, but it can also be caused by noise exposure outside the workplace, or as a natural result of aging. The same is true of repetitive strain injuries (RSI) such as carpal tunnel. In general, the injured worker must prove, by clear and convincing evidence, that something specific to the job caused the injury.

The same standard applies to infectious diseases. For example, during the COVID-19 pandemic, many workers who contracted the disease at work wondered whether their medical bills and lost wages were compensable. As a rule, whether such a claim is covered by workers’ compensation depends on whether the specific workplace exposed the worker to an increased risk of COVID-19 compared to any other public place. Someone who worked in a hospital or nursing home and contracted the disease, for instance, would most likely be covered by workers’ compensation because of the known risks of healthcare settings. Someone who worked in an office would most likely not be covered, although this varies from state to state.

Many states have laws that presume certain diseases are work-related among workers in a certain profession. For instance, some states’ laws include a presumption that heart disease is work-related if the person who develops it worked as a police officer or firefighter because of the elevated stress of those jobs.

The laws regarding occupational diseases vary widely from state to state

The basic principle that you can get workers’ comp for an injury that happens over time is true in every state, but the details vary widely. For instance, the laws presuming that certain injuries are work-related vary from state to state. States also have substantially different laws regarding work-related mental illnesses, such as post-traumatic stress disorder (PTSD), as well as situations where an occupational disease aggravates a pre-existing condition.

In short, if your work injury happened over a period of time, it’s in your interest to talk to a workers’ compensation attorney in your state right away. An experienced attorney will know what your rights are and what evidence needs to be obtained to protect those rights. Don’t leave yourself at the mercy of the workers’ comp insurance company. Know your rights and get legal help.

Pasternack Tilker Ziegler Walsh Stanton & Romano LLP is a workers’ compensation law firm in New York City.

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