Compensable Occupational Diseases: What Counts And What Doesn’t In Workers’ Compensation

This case Russo v. Schaffer, DMD, decided August 8, 2014involves a dental hygienist who worked for different dentists between 1991 and 2007 and made six separate claims for workers’ compensation benefits for multiple health problems including right carpal tunnel syndrome and depression. The claims were consolidated into one case. In a workers’ compensation case, the petitioner (person who brings the claim) must prove legal and medical compensation by a preponderance of the possibilities. Medical causation means proof that the disability was actually caused by a work-related event. Legal causation means that the injury is work-connected or affects the job. “Reasonable probability” refers to something that is in all likelihood the truth.

In this particular case it was found that the depression the petitioner experienced was related not to her job or any work-related stress but rather to the chronic pain she experiences from fibromyalgia and other ailments. There was only one doctor who claimed it was work-related but their report was general and they did not have substantial personal experience with the petitioner nor knowledge of her medical history. Therefore the depression was ruled not work-related. The carpal tunnel syndrome was found to be work-related as all the examining physicians agreed on that fact, but the petitioner’s many other physical ailments were found to be unrelated. This is because the other ailments were not “compensable occupational diseases.” A compensable occupational disease is one which are due in a “material degree” to causes and conditions characteristic of employment. So for example if a steel mill worker contracted a particular lung ailment that was common among workers exposed to the chemical processes used to make steel this would likely be a compensable occupational disease that is claimable for workers’ compensation benefits.

One flawed argument that the petitioner in this case attempted to make was that because her former bosses had paid for certain treatments related to her other ailments, this meant that those ailments were work-related. This is not the case. Treatment for other claimed injuries is insufficient to show that employment caused them to a material degree. The petitioner also attempted to apportion some of her disability to prior employment but lacked a fix and definitely measurable time period and medical testimony with which to prove that employment was related. What is most important to learn from this case is that injuries must be caused by the employment, related to the employment, and expert reports must be from physicians who are reasonably acquainted with the petitioner in so much that they can make more than a net or general medical assessment. This is what prevents Workers’ Compensation from being used as a “catch all” for all of the ailments an employee suffers from when only some of them may be related to the job.