January 26, 2009

The Politics of Work-Related Illness

Ed Abney is 53 year old tool-and-die worker with Parkinson's disease. For over 20 years, he was literally up to his elbows in drums of the powerful solvent, trichloroethylene (TCE). He worked for the now defunct Dresser Industries in Kentucky. As we read in Felicity Barringer's excellent article in the New York Times, Abney's illness was probably caused by work, but in the world of workers comp, "probable" does not meet the standard for compensability. Even with compelling research by the University of Kentucky suggesting that exposure to TCE increases the risk for Parkinson's, Abner is unable to access workers comp benefits.

The Kentucky study focused on Ed and his co-workers at Dresser. Researchers sent surveys to 134 former employees; 65 responded. The research found 27 workers with Parkinson's symptoms or with impaired motor skills. That's 42 percent of respondants and 20 percent of the total surveyed. Statistically significant, to be sure. Nonetheless, the medical researchers were unwilling and unable to certify that the onset of Parkinson's was caused by workplace hazards.

As Dr. Don Gash, one of the researchers, put it: "Was it the [TCE]? It could have been. But it could have been other things, too," including a genetic predisposition to the disease. Unfortunately for Abney and thousands of workers like him, the world of workers comp operates on a rather simplistic model of cause and effect: if you can prove that the injury or illness is work related, it is compensable. In cases of occupational disease, there is almost always grounds for doubt. You simply cannot prove definitively that chemical exposure caused the illness - even though there is compelling anecdotal evidence that it did.

Fighting Fire with Politics
Which leads us back to the world of firefighters. As we discussed in a June 2008 posting , 40 states have created a presumption of compensability for heart disease and cancers occurring in firefighters. Like Ed Abney, firefighters are exposed to cancer causing substances in the performance of their work. But unlike Abney, firefighters are much more likely to receive disability benefits based upon this exposure. There is little if any burden of proof on the firefighter to demonstrate that the illness is work-related.

Where firefighters get the benefit of the doubt, ordinary workers just get the doubt. Ed Abney and thousands of other industrial workers suffering from debilitating and often fatal occupational illnesses face virtually insurmountable obstacles in collecting workers comp. As Dwight Lovan, Kentucky's commissioner of workers comp, puts it: "We are dependent upon the scientific and medical communities for the element of causality." Well, yes and no. Ultimately, compensability is a political issue: state legislatures have blown open the causality issue for firefighters. They could do the same for ordinary workers, but in all likelihood, they will not. Everyone supports public safety, but when it comes to the ordinary Joes and Josephines, Eds and Ednas, who do their jobs and come home reeking of toxic solvents, sympathy quickly evaporates under the guise of keeping employer costs to a minimum. In their struggles to treat their illnesses and support their families, these plain folks from Main Street are pretty much on their own.

| 1 Comment

1 Comment

I can only speak for the state of Massachusetts. We have extremely powerful unions for police and fire personnel. So powerful, in fact, that they are exempt from the worker's compensation system. If a police officer or fire fighter is injured on the job, that person becomes the responsibility of the community in which he/she lives.

The ordinary Joes and Josephines will never get such a cushy deal. Every worker should be covered by their state's Worker's Compensation entity; make it a level playing field and I suspect there might be at least a slight movement towards fairness.

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This page contains a single entry by Jon Coppelman published on January 26, 2009 11:24 AM.

Health Wonk Review is posted was the previous entry in this blog.

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