Biomedical subjects
Publications and source records attributed to S I Richman.
Workers with pre-existing asthma that has become "aggravated" by stimuli in the workplace can be "disabled" in a legal sense. Should workers compensation be extended to provide disability benefits when the aggravating stimuli are ubiquitous, when the employment relationship was brief, when separation from the offending stimuli ends symptoms, or when hyperreactivity can be medically managed?
In the United States, the two legal remedies available to victims of occupational lung disease are claims for benefits under workers' compensation laws and suits for damages under the laws of products liability. In both types of legal proceedings, the role of the physician as medicolegal consultant and expert witness is (1) to describe and diagnose all significant pathology, (2) to prove or disprove a causal relationship between the significant pathology and impairment or death, (3) to identify and explain the etiology of the significant pathology, and (4) to evaluate impairment and disability. The physician's opinions, which must take into account legal as well as medical criteria, are given by way of written report and oral testimony. The purpose of this article is to advise and instruct the physician how to perform the functions of medicolegal consultant and expert witness in a case of occupational lung disease.
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The two principal legal remedies available to victims of asbestos-related disease are (1) claims for benefits under workers' compensation laws and (2) suits for damages under the laws of products liability. The medicolegal issues and the part of the consulting pathologist as medicolegal consultant and expert witness in each of these legal proceedings are essentially the same.
Under the current system of disability determination and workers' compensation for occupational lung disease, disabled workers or their survivors can reasonably count on being compensated. However, by rejecting established scientific truth in order to pay workers' compensation in circumstances where disability or death had not been due to occupation, the system has operated unfairly and has undermined public confidence and respect. To gain more scientific integrity and fairness, the system should be changed to provide for adjudication by scientifically informed disability boards. The adversary system sould be retained, however, as needed protection against bias, quackery, and mendacity.
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This chapter analyzes and explains the meanings, under the federal Black Lung program, of the terms impairment, disability, and pneumoconiosis. To accomplish this objective, this chapter reviews the regulations and administrative and judicial decisions made under the Black Lung Act, and for comparison, it refers to definitions given to, or applications made of, those terms in other jurisdictions and programs.