If you suffer a job related medical condition, whether it is an "occupational disease" or an "injury" can make a significant difference in whether you can prove your claim. In this article, we define each term, and explain what you need to prove one kind of claim, versus the other.
An "injury" is a medical condition that occurs over a discrete period of time. You fall and break your ankle. You have a sudden onset of back pain with lifting a heavy object. These things happened suddenly, and so they are considered an "injury." A discrete period of time, however, does not have to be a second, or two. It could be a week, or two, depending on how you hurt yourself. There is one case where a worker developed low back pain after unloading trucks over a two week period, and that is discrete enough to be considered an injury.
An "occupational disease" claim on the other hand, is some medical condition that results from a long time exposure to some condition at your work. It could be excessive noise that causes hearing loss, repeated gripping and grasping that causes carpal tunnel, or arthritis form the repeated stress on your knee from getting in and out of a delivery van a hundred times a day. There is no magic time period for your work activity or environment to cause an occupational disease, but it does not happen suddenly.
So, why is this so important?
It's all about proving your claim.
In an injury claim, you only need to prove that the injury event at work is a significant factor in causing the resulting medical condition. One way of looking at this is to talk percentages. "Significant" or "substantial" may mean 30% of the cause, or a third of the cause. It is a pretty straightforward standard. The question is whether the incident at work is a factor, not the main factor, in causing the medical problems.
An occupational disease claim, on the other hand, is more difficult to prove. The relationship between the exposure to some condition or substance at work has to be the major cause of your occupational disease. In other words, it has to be more than 50% of the cause of your condition. This is more than 50% when compared to all other causes combined. So, if you took out a scale of justice, and you piled all the work related cause on one side of the scale, it has to weigh more than all other causes, piled on the other side of the scale, combined. That can be a tough standard to meet.
So, how do you prove an occupational disease claim?
Basically, you need a medical opinion, and you need a medical opinion that is well informed. So, when a doctor says work is the major cause of your carpal tunnel, or your hearing loss, or your reactive asthma, he or she has to consider all other causes of these conditions, and have a very good idea of the work environment or activities that caused the condition. They may have to review medical journal articles to rebut defense doctor opinions.
One thing to keep in mind is that in many cases, it is not clear whether a medical condition should be evaluated as an occupational disease claim, or an injury claim. Oregon Administrative Law Judges with the Workers' Compensation Board will evaluate whether a case involves an injury, or an occupational disease in many cases.
If you have questions about a Workers' Compensation claim, give us a call at 503 325 8600. We help people with these issue every day.
