Document NNy3QBmbv2vZQzGGBQVXrL0oQ

FILE NAME: Saranac 7th Symposium (SSY) DATE: 1952 DOC#: SSY004 DOCUMENT DESCRIPTION: Text of Presentation by Richard Wagner - Definition of Pneumoconiosis-Some Legal Aspects t RtULIVtU hH.H&S DATE: JU13jJ929 M.E.M DZFH7ITI0N OP PHEOMOCOHIOSIS - SOKE LEGAL ASPECTS ^ Paper Read ly . Richard C. Vagner, Manager, Casualty Department, . Association of Casualty and Surety Companies, at Seventh Saranac Symposium, on September 22, 1952, at The Saranac Laboratory, Saranac Lake, Rev fork. ^ c>OiO The question of definition of medical terms vould seem, as a matter of first impression, to be a problem exclusively for the medical profession. Ceri tainly it can be conceded that it is primarily a medical problem. Obviously that was the view of the sponsors of this meeting, for here I am the only attorney in a group of five mninent physicians. However, somewhat closer study reveals, as is often the ease in the field of occupational diseases, that medical definitions have important, often vital, bearing on legal rights both of employers and employees. Ibis is especially true where such definitions, and any defects they may contain, are incorporated into any statute. They are also of importance where they form pert of the testimony or influence the judgment of a medical witness. Let me illustrate. Ve are here interested in the definition of the term jaeumoconiosis* and those of the other diseases or conditions that fall within the broad scope of that general term. In Hew Hampshire for example, the Workmen's Compensation Lav provides compensition for certain listed diseases, inducing silicosis and other pulmonary dust diseases.* Whether a particular condition can be classed as a pulmonary dust disease will determine whether or not that particular individual will receive compensation therefor. The ultimate determin ation in such a case is very likely to rest on the medical testimony which is pre sented. Does beryllium poisoning, for example, fell within this category? Whet about an allergic reaction toilet us say^ flour dust? A medical expert confronted with the necessity of expressing an opinion on the point might be inclined, if ay experience is any criterion, to a liberal interpretation in order to enable the claimant to receive compensation. What .\ . RECEIVtD KH.H&5 hatf-JUL 3 11979 L>CU *" M.LM would his testimony be, however, where Instead of resulting in the granting of compensation, classifying a particular condition as a pulmonary dust disease would result in reducing or possibly barring the payment of compensation. As no doubt any of you know, many states have special provisions with respect to silicosis and some of the other dust diseases. There are provisions for graduated scales of benefits, the so-called escalator clauses, whereby compensation for disability occurring shortly after the affective date of the law is limited. Special re quirements as to exposure or time limitations are also provided. The particular facts of a specific case might veil not fit those particular requirements. let consistency is necessazy. A different answer to the same question can hardly be Justified because of the difference in the effect such an answer would have. At the same time, it might be veil if in fomruleting the definitions on which opinions have to be based, the legal effect of the use of particular language asy well be given some consideration. Their effectiveness as useful tools in the solution of practical problems would thereby be enhanced. 1 have indicated that the problem of definitions is of significance under a schedule type law. It is of importance also, particularly with respect to dust diseases, under a lav providing broad occupational disease coverage either with or without definition. As I have mentioned, a number of states have found it necessary because of the special nature of the dust diseases, to include provisions specifically dealing with such diseases which differ from those relating to occupational diseases generally. A general descriptive term is necessary to describe the diseases to which these special provisions should be applicable. At the same time, such a term should not be so broad as to be applicable to conditions to which those special pro visions should not apply. The term would have to be general for if specific diseases, say silicosis or asbestosis, only are mentioned, avoidance of these special provisions may be attempted ty alleging disability from one of the other dust diseases. RECEIVED F.H.H&S - 3- 5012 The legislative history of such provisions in Michigan is interesting in this connection. Vhen provisions for compensation for occupational diseases vere first enacted in 1937, the schedule of such diseases included three different references to dust diseases. One was stone workers or grinders phthisis caused ty quarrying, cutting, crushing, grinding or polishing of stone, or grinding or of etel. The other was silicosis caused ty mining. The third referred to pneumoconiosis caused ty quarrying, cutting, crushing, grinding or polishing of metal. It is apparent that the Legislature in this instance was having some diffi culty with definitions. In 1943 the schedule was repealed and a hroad definition substituted. In that state the special dust disease provisions both before anc after the 1943 amendment referred to "silicosis'or other dust disease." Tram the use of the word silicosis the inference seems plain that the disease must be pulmonary, let I believe the special inclusion of that word would have been desirable. Some doubt as to the scope of these provisions, however, must have existed for in 1945 vhen provisions for periodic physical examinations were added these referred to "silicosis, pneumoconiosis or other dust disease." These, I may add, have since been repealed when because of indefiniteness they vere held unconstitutional ty the court. This legislative history is of interest as indicating the difficulty ex perienced in the use of terms in just one state. It might be noted further that vhil. the schedule v>s in fore, in Michigan there vac considerable question vhether ailicosia vae compensable in any industry except mining end whether the term pneumoconiosis was broad enough to include silicosis, Sutter vs. Kalaaaxoc Stove and Furnace Company, 1911, 297 Mich. 226 , 297 K.V. 175; Gerl.slts vs. Uiey Foundry and Machine Company, 1917, 319 Mich. 229 , 29 H.V. 2d 856; Mercant. vs. Michigan Steel easting Company, 1918 , 320 Mich. 512, 31 H.V. d 712. Vhile we ere discussing terms, I would like to express e word of caution. DATE:. JUI 3, MW - 1- M.E.M If . sedition ha. a m . * " * ' - 4" * -- ^ ^ th*`- ^ u * . . ,, to be ,, d * . 1 It M i d be * * diff.rmt M a . - * " " . v.. hmn maid to eene vithin the "r*rtrt"* tr^ U*nCy' U * t lt w 4 ganerl .cope of the vert jmeumconloal.. that t e n or " * " ^ without adequate definition in a U u , an, eonaiUos vhieh rtjht ^ within it. .cop. 1. darned U be nsidered to be dltabling. of these sre not considered to ne * * if 1 " "1,UlKt' * " The Fifth Edition of Sould Helieel Dictionary (19a) define. pMononobonioel. . * p m l tern applied to chronic Indention or fibroot ln flu n * o- ot the lunge due to the M U M of du.t. V.rlou. nmee ere | M * It eeeortlng to the bind of duet earning the i n f l a t i o n : mthncoele, tnat dne to the M U M of el-du.t, .id.ro.ie, thet due to M U M or i t a l i c duet; chelico.i., t u t due to the M U M of m e r e ! du.t.- A U y m n might veil feel that 1 1 th... condition, ere or M U be c < - Z^ U e -- . let u. loob, M .. M at the 1919 Ultion - M - * of the M " * " " * is defined as: Chronic liflmnatioh of the long, n e e d * the inhaetion o. boob - a l of th. recognized for*, ere due to mineral duet., (deitber irrltaticr, * th. bronehlel tree nor .cut. infection, r e n t i n g f r inhaler, o organic du.t. .re da.eed .. F-- oM o m ..) Tbe pr.donin.ht r e a d e r . ' j , i. type vith the etiologic dust. SilicoE^s an is fibrosis, vhieh varies in type asbestosis are the ~in r of pnennenoconiosis hnovn to cause dise . Other forms, bno a. henign ^mnohooonio.e., ih vhioh th, reaction . United to the stromal tissues, are anthracosis, due to carbon **- siderosis, due to iron dust, ealclccsls, due to marble dust, ana terlto^-, due to barium dust. JLlso see beryllosis." ' - 5- KtutivtD F.H.H&S DATE;_jyU [ 4 _lto_ I you vill agree that there it considerable difference in the effect these two definitions vould have on laymen. That sy point is not academic, it evidenced ty a law recently adopted llabaaa. This lav enacted in 1951 (Act Ho. 180, Lavs of 1951, effective June 29, 1951) provides compensation only for occupational pneumonoeoniosis." This is defined as: *L disease of the lungs caused ty inhalation of minute particles of dust over a period of time and which said dust is due to causes and conditions arising out of and in the course of the employment without regard to whether or not said causes or conditions are inherent in the employment or can be eliminated or reduced ty due care on the part of the employer. The term 'occupational pneumonoeoniosis' shall include, but without limitation, such diseases as silicosis, siderosis, anthracosis, anthra-silicosis, anthraco-silicosis, anthraco-tuberculosis, tuberculo-silicosis, silico-tuberculosis, aluminosis, and other diseases of the lungs resulting from causes enumerated in this section." Please note the inclusion of siderosis, anthracosis and aluminosis. I would dis like to attempt to define with any degree of certainty the scope of this lav. let at least some of you may be called upon to give an opinion whether or not a specific condition is or is not -occupational pneumonoeoniosis" within the meaning of this definition. Some of the other statutory references to dust diseases may be of interest. In Hew fork the reference is to -silicosis or ether dust diseases." A rather interesting situation arose under this provision. In 1942 an employee claimec and was awarded compensation under Article 4-A, since repealed, relating to dust diseases. The claim was for disability alleged to have been suffered from exposure to dust from vacuum cleaners, Sturesky vs. Straussman, 1941, 263 A.D. 771, 30 K.I.S 886. After a period in military service he reopened his case. He now contended RECEIVED F.H.H&S r_0 : Q DATE:J U L 3 1 1979 - 7- M.E.M - - *" ' * " " " ,, lt provided for oocup.tio-1 ai.aa.es 4*r te0*i 4*tisiU" - 7 rr _ % further specifically oteted tbst -disability fre. elllcoel., asbe.tns.s . * * di... - a * -- * - * ti toUc e ;e 1>mg, caused * . the l o t i o n of tot.- Thus her. t o d with refereo to dust diseases e specific reference to fibrosis which you will have note - ing in sons of the other statutory references. Iter. ere. of course, a number of states that neb. specific nen-icu, a . - vith or without definition, of silicosis and asbestos!.. These definitions cr, fairly similar in wording although they do differ in enact lgu.ge from . t o state. Son, include a specific reference to nodulaticn with respect to siliccs s. Others refer to the -characteristic fibroUc condition of the lungs cause- * - halation- of silicon diosid. dust or asbestos dust, as the case nay be. 1 b ~ - not heard of any particular difficulty arising fro. these thought night be given, however, to whether or not the reference to nooulatic- should or should not be Bade. l have endeavored to , + point +j-v some to some of of the the aore Bor important ^ legal probler- that arise through the use of terns without definitions or where the d e f i n e s used are not ocnpletely satisfactory. In illustration, specific reference U ~ provisions of the U v s of the various states and axp.ri.nc, thereunder has be - d . . Vhil, these are legal problems, lasers of necessity must profession for their solntlon. 1 believe it would be of mutual bene it 1 , formulating such tents and their definitions the nedioal profession bept -one ,h -estions in Bind. I. there a general descriptive tent t o t veulc cove n* th.s, and, at th.e tsne tine, exclude non-cast . s i l i c o s i s and other similar 4 p ^ o c o n i o s i s 1? Tr.e:, + vbat iE and vhat should be covered under w..e .e. p conditions. Vba .. _ helpful if such anr-c. end ether question, vill require an answer. It wou.. ver, based on informed opinion reeched after mature - -