Many people do not realize that there are two kinds of workers’ compensation claims in Washington State: An industrial injury claim and occupational disease claim. Often, arguments are made to decide if an industrial injury claim should be allowed as an occupational disease. A lot of L&I and workers’ compensation claims are plagued by lack of understanding and misinformation about occupational disease claims.
Industrial injury claim versus occupational disease claim?
If we go to trial regarding allowance of an occupational disease, the jury is instructed as to the meaning of occupational disease. The pattern jury instruction for occupational disease states:
“An occupational disease is a disease or infection that arises naturally and proximately out of the worker’s employment.”
“A disease arises naturally out of employment if the disease comes about as a matter of course as a natural consequence of the distinctive conditions of the worker’s employment. It is not necessary that the conditions be peculiar to, or unique to, the particular employment.”
“A disease does not arise naturally out of employment if it is caused by conditions of everyday life or all employments in general. A disease arises proximately out of employment if the conditions of the worker’s employment proximately caused or aggravated the worker’s disease including the aggravation of a pre-existing non-work-related disease.”
No wonder there is so much confusion regarding occupational diseases! Put more simply, an occupational disease is a condition or disease that is caused or aggravated, at least in part, by distinctive conditions of a worker’s employment. For example, say that you work in sheet metal. Moreover, say that spend significant portions of each day repetitively and forcefully snipping sheets of metal with snips. Gradually and eventually you develop numbness and tingling in your hands. In this case, you may have developed an occupational disease condition.
Most frequently, when occupational disease claims are rejected, it’s because the doctor lacked enough accurate information to provide a compelling opinion for claim allowance. Therefore, when I speak with individuals that believe they have an occupational disease claim, I often suggest that they see a doctor to better understand whether their symptoms correlate with a medical diagnosis. However, in addition to informing the doctor of the symptoms, it is important to provide a clear history of the onset and development of symptoms. It is also critical to concisely and accurately convey key details about the physical demands of the job. This help the doctor to formulate an opinion based upon a correlation between work activities, symptoms and the resulting diagnosis. Consequently, the likelihood of the occupational disease claim being allowed increases significantly.
Additional resources: The Department of Labor and Industries (L&I) website.