Wednesday, October 1, 2014

Ebola and Work Comp

What if the ebola virus is industrially acquired? Working abroad, or health worker infected...

The general media yesterday ran headlines about an adult who recently traveled from West Africa to Texas and tested positive for Ebola, the first case to be diagnosed in the U.S.

According to the reports, the man developed symptoms of the viral disease about four days after landing in Texas and was admitted into isolation on Sunday at Texas Health Presbyterian Hospital in Dallas.

The Centers for Disease Control and Prevention in Atlanta confirmed that the patient had tested positive for Ebola and said "a handful" of people may have been exposed. They also reiterated that the disease could be contained with standard public health efforts and said the patient can be treated safely at the Dallas hospital.

Also in the Wall Street Journal yesterday was a story about the spreading of disease and germs in the work place.

Regardless of your sanitation habits at work, it's pretty hard to avoid the germs of your co-workers, even the ones you don't know personally.

Just one door contaminated with a virus spreads the germ to about half the surfaces and hands of about half the employees in the office within four hours, according to a study at the University of Arizona, in Tucson. 
Bowzer may be infectious...

The research was presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy in Washington D.C. earlier this month.

According to the article, researchers calculated that employees had a 30% chance of infection just being in the work place.

Albeit most of the time an infectious disease in the work place doesn't have any real consequence - flu bug or common cold, these diseases don't arise to industrial significance at least for workers' compensation.

But what if that infectious disease is ebola? The report of the Texas man transporting the disease to the U.S. demonstrates the portability of disease, and the transmission of it can occur quite easily, as demonstrated by the Arizona researchers, in the work place without detection until it could be too late.

California Governor Jerry Brown yesterday vetoed a couple of presumption bills put on his desk, one of which would have granted a presumption to certain health care workers that contract methicillin-resistant Staphylococcus aureus infections.

The bill, AB 2616, was sponsored by Nancy Skinner, D-Berkeley, and is the third attempt to create the presumption, but the first time it got to the governor's desk. It also would have been the first time any industrial disease presumption would have extended into the private work place.

In general I'm opposed to presumptions. I think they do more harm than good, create more animosity between employee and business, generate more litigation and medical discovery than not, and in general are bad policy.

We have seen over time now public safety employee presumptions grow outside of intentions - on Monday I blogged on a Los Angeles Times report about first responders taking advantage of salary continuation benefits for reportedly minor issues - and presumptions follow the same discourse.

The argument for the presumptions is that proving industrial causation of disease is inordinately difficult for the employee, and I get that.

But the reason for the public safety presumptions was to encourage people to seek careers in that sector and not be afraid that some disease was going to ruin their lives serving the public.

There isn't any evidence that the possibility of contracting MSRP inhibits potential health worker employment opportunities.

There apparently is evidence of health workers being harassed and otherwise intimidated in their quest to get benefits to cover treatment and disability associated with MSRP, and Brown has directed officials to look into this - perhaps that is what is needed for the nurses to get their presumption.

Here's what it really all comes down to - workers' compensation, like pretty much everything in life, has limitations and borders. Some of those limits are easily defined, and clearly denoted. Some are fuzzy and create more controversy and discourse than others.

At some point lines are drawn; not necessarily to discriminate against any particular sector or occupation, but simply because a line has to be drawn so that people affected or functioning within a system know what to do.

With communicable disease, where infection can as easily occur in the work place as not, there is nearly always going to be disagreement on causation and employer liability.

In the end the question is what does society want workers' compensation to be?

Does society want work comp to be more of a universal health and disability program that covers anyone for anything as long as they have a job? And society is willing to pay for it?

Or does society want a more circumspect system that covers only the obviously employment related injuries and illnesses, and put the burden of covering the fuzzy cases onto the general health system?

This is an age-old debate, one that will likely carry on for many, many years, particularly as the country wrestles with the ongoing implementation and coverage of the Affordable Care Act and its many permutations.


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  2. OK I take my nomination for Gov. Brown back now. Peace

  3. This issue will go on for many years. ...I think the headache it caused should be compensable.
    The lines will always be blurry and mixed likely with personal information.