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FILE NAME Insurance Industry INS DATE 1950 DOC INS054 DOCUMENT DESCRIPTION American Bar Association Conference Presentation - Dust Disease Essentials of Compensability of Defense SECTION OF INSURANCE LAW PROCEEDINGS SEPTEMBER 18-20 1950 WASHINGTON C. OFFICERS AND COMCOMMMIT BIRGT.6 2 1950-1951 . ROSTER AMERICAN BAR ASSOCIATION 1140 North Dearborn Street |, Chicago 10 Illinois 180 INSURING AGREEMENTS AGREEMENAGRTEMESNTS OF BUHGLARY BUHGLARY POLICIES POLICIES tuations of loss caused by the pur- chase of a fraudulent security This policy contains conditions and delinitions like or sumlar to those already desembed My concluding thought is that I have asked more questions than I have given awavers But although i may regret that am not in the happy position of being able to give all the answers am at least performing my function of provoking the learned comments of you who are in atten- dance at this discussion ROUND TABLE VI DUST DISEASE ESSENTIALS OF COMPENSA- ELEMENTS OF DEFENSE BY INSURACE SUCI 1 THOMAS C. ANGERSTEIN CHICAGO ILLINOIS Be We had the privilege and pleasure 1911 aft as well as certain other state of discussing at the American Bar Association meeting in Boston in 1936 utory | provisions were uncoristitu tional grounds other than those the defense of suits at law for dam- ages in occupational disease cases-- which might well have been called dust disease cases in that the occupa previously presented to the supreme court and also that there was to common law right of action in Illi nois for damages for injudes to the nonal diseases generally alleged were pirnumoconiosis silicosis tuber- health disabilities or death from all leged occupational diseases culosis and disenses of the lungs and respiratory system due to the mhala- We became associated in the dem fense of certam cases that had been Tum of dusts --usually silica dust There had been in Hlinois the Oeru pational Diseases Act of 1911 which had been enacted at the same session of the legislature as was its first cous pensation act which provided an ac- for set trial and withdrew pleadings that had been filed and then pre . sented constitutional questions and such cases became known as test pendig caseansd proceedings in all other pending cases in both state and fed- hon at law for damages but it was eral courts were stayed by the courts - not until 1933 that there were two decisions of the Supreme Court which affirmed judgments on jury verdicts until test cases could finally be those held determined It was that the statutory provisions upon which such for damages and which also held that uncon- statutory provisions were not stitutional on the grounds presented There had then followed a sudden and rapidly increasing epidemic of law- cases were based were unconstitu- tional that there was no comui^-on law right of action for alleged occupational diseases in Illinois and that the federal courts would follow the suits for dinages Some cases had been rule declared by the Supreme Court tued with large jury verdicts result- of Illinois As a result of those de i- ing and many such cases were ap- sions all proaching trial A situation was rape | dismissed idly developing that might well have other pending suits were then * been destructive of industry and employment throughout the state 18 See Boshuizen v Thompson & Taylor Co 360 Hl 160 Parks v Those depression years Owens Glass Co. 360 III We had arrived at the conclusion 130 Sylvester v Buda Co 281 HP that the statutory provisions of the App 139 McCreery v Owens- Ford Glass Co. 363 1 321 and First National Bank of Ottawa Admr v Wedron Silica Co. 351 Ill McGuire v Williams Co , 87 - F. 2d 112 Gestautz v American . 560 Madison v Wedion Silica Co Manganese Steel Co. 87 F 24 1005 352 . 60 Gestautz vo American Manganese 181 head ! il 1 Uh, CIBRARY i CIBRARY CIBRARY |i | CIBRARY CIBRARY CIBRARY | MEN ti MEN . - INC INC 1) 182 DUST DISEASE CASES THOMAS C ANGERSTEIN 183 Incidentally practically all plam- rills returned to employmenemptloyment employment as soon as jobs wete avzulable In some ofler states at that time ent states for providing providing compensaticoompensnation for injures of disabilities or death Jeam occupational diseases may vary greatly but the fundamental and ser cases where compensation 1 comed for disablement or death alged to be due to dust diseases or termed dust cases These ade sometimes generally desenbed as pneumoconiosis and more particularly INSURACE by occupational problems difficulties l then was litigation for damages for entibe facts as to dust disease eases other alleged occupational diseases as stheosas and tosis but pin- alleged dust diseases and the geword the essentials of compensability and but us which all of the essentials of etpally silteosis cases suhijeet and particularly the then re- elements of defense are and should compensability are not present then it becomes necessary to consider vari- In considering dust disease cases there are certain underlying facts facts and cent inets decisions above referred be of common and general importance of great general infer and appleation As we shall later see ous elements of defense and there circumstances which actual practice To wear very est and maportance and they were however the present relative impor- then obviously are elements of de- and experience have proved to be then extensively extensively reviewed and dis tance of such cases also varies greatly fense that are proper and upon which fundamentally essential not only in in different states and in some states reliance should be placed consideration of our subject but also cussed cussed In some other states at that tone depending upon conditions later con- The beneficent purposes of com- to a proper solution of the problema compensation had been provided for sidered it is gratifying to know that pensation for disabilities or death from occupational diseases are not of dust disease cases Inasmuch as occupational diseases occupational disease either ameadment of compensation acts or by sep- they no longer are serious problems The providing of compensation for achieved or realized neither are the interests of employees generally best acts are essentially the application of the principles and purposes rights arate nets or because of compensation Disabilities or death resulting from served nor is the public welfare bene- remedies and procedure of compensa- acts which provided compensation for diseases arising out of filed by imposing upon the consum- tion acts which had beenin operation Dyjuries or personal injuries or death and in the course of the employment ing public which ultimately pays all in most states for many years prior irrespective of whether such injuries whether by amendment of previously were accidentally sustamed existing compensation acts to make compensation costs the burden of to the enactment of occupational dis- In Hmous largely because of the them applicable to injunes or death expense attendant upon compensation pase legislation it might seem that htigation fetted to and the dec- without limitation to accidental in- for disabilities or death not proxi- there should be no particular Uiffi- sions that there was then no statutory junes or death or by enactment of mately caused by occupational dis- culties or in operating un- 01 common law night of achon for occupational diseases diseases acts as separate eases but which are due to ordinary der such acts or in their administra damages for alleged occupational dis- aels or by construction of provisions diseases of life There have been tion by commissions or courts but anny injustices to employees gen- in actual practice and operation thiev else representatives of employees in compensation aels providing com- and of ermployers agreed upon at oc- pensation for injuries or death has eally by erroneous views and errone- i have involved many not generally compen cupational diseases bill which was on- been essentially the extension to dis- ous decisions in dust disease cases experienced under ,, , sition acts nase acted and which became effective abilities or death resulting from occu- and particularly in cases of alleged or TIBRAY October 1936 pational diseases arising out of and in actual silicosis The general welfare Probably the outstanding reason for At the present time the states gen- The course of the employment of the 1 not benefited by the unwarranted the principal difficulties or problems dust OF erally lawe provided compensation rights remedies and procedure that distortion or extension of statutory under occupational diseases acts- TIBRAY for or disabilities or death had been applicable under compensa- provisions under the guise or cloak and particularly as to called injuries of called liberal construction either contrasted witli com- Hisease.cases due to occupational diseases and dust tion acts to accidental injuries or by industrial boards or commissions acts has been that there MN pensation disease cases have become problems death arising out of and in the course under compensation The matter of suits al Law for damages belween em- ployee and employer f^...ralleged occupational diseases just as cases of accidented inpnies or death has be- come one largely of historical inter- EN execpt execpt that under certain federal at the Beberad government has maxan~-lthe old common law S- tem of actions for damages which has universally condemned by all of the states as being economically morally and legally unsound and detTimental to the pubhe interest The statutory provisions of differ- Steel Co. 302 | 811 8 Led Andri v Dupont CellophaneCo 28 121 of the employment The fundamental and beneficent neaples and punsatisfactory poses of compensation for accidental mjuries or death should be equally applicable to disabilities resulting from occupational diseases When all of the essential elements of compensability under whatever act involved are present there is no qu^stion but that all reasonable and neeUsSalty medical services should be promptly provided and that compenSation should be paid in full accordaner with the provisions of the act in order that there may be a full and immediate compliance with the beueficent purposes and provisions of the particular act or by courts If existing acts are unpunsatisfactory or insufficient orderly procedure requires the remedy should be by legislative enactment There fore the defense of claims not fairly within the scope or purview of the law under which they are brought is of public interest and actually esen- essen- ual to the proper administration of the Occupational Diseases Act In the voluntary observance of statutory provisions by employers and employees or their representatives and in the administration of such provisions by the commissions or courts the cases that generally and particuaily at least for certain periods of time have presented the greatest difficulties have been what are generally was a general common knowledge as to accidental injuries or death by em- ployers and employees and their representatives as well as by the inedical and legal professions and also hy those having tration not did | having to do with the adminis- compensation acts that exist as to occupational dis- cases generally and as to called - dust disease cases in particular when such occupational disease casos first came under compensation It may here be stated for later explanation that the solution of the problems of occupational diseases and especially the called dust disease cases is directly dependent upon an accurate knowledge regarding them Tho experience in various states nad ' I THOMAS C ANGERSTEIN 181 DUST DISEASE DISEASE CASES i fibrosis if Individual view sts the conttel of exposures the diag- duer ^ fibrosis that is chistacletistie chistacletistie such as ITE ronsin and later In abbties any of sileosis and the evaluating only asbestos dust and is not a of Hinois and in other states that have points quite naturally are largely m nosis if were essentially siliross None of the inorganie dusts approached the problem fairly and of the fluenced by a number of factors including the provisions of the net of of disability any new subjects which were but little except cadmium beryllium etc. which have a toxic effect canses intelligently conclusive proof one's own state upon the period of understood not only by employers may foregoing statement There was as to accidental injuries ime such act has been in operation and employees and their representaand by the general puble but any material fibrosis impaument of respiratory function disab~...ement or or death comition Laws background upon the knowledge and experience tives disease Orger dusts oreuna ional precedents and compensation with occupational diseases and of by state departments of labor publie health and factory inspection and by such as iron coal carbonujudru ev substiuhon not produwe ails were essentially 1 substitusuhbstoitunhon the authoritative literature regarding the medical and legal professions and ment gypsum ete do gypsum of new nights remedies and procedure them by employers and employees the Industrial Commission There sibrosis any material lung fibrosis instead of the old common law sys- and their representatives the know by The hardness or sharp- tem of suits for dantages | An act edge and experience of the medical had however developed saubonita- or pathology of called abrasiveness of dust definite decur- and legal professions and upon the Dive scientific and medical literature ness dental nav was knowledge and administration of the regarding dust exposures dust dis- particles that may into the lungs renre at definite time and place eases and particularly silicosis The do not cause any material fibrosis or and there generally was definite oh- tribunal of the particular state Industrial Commission of disease or pathology or any increased Eli- Jective oe nee Disabilities and charged with administering the law present nois under the chairmanship of Mr susceptibility to pulmonary tubej death forse rains disperses were lield For illustration and without any re- i to be compensable because because they came flection upon the accomplishments in B Jay Knight who is an able and Josis the definition of accident other state with most of which experienced lawyer has made an ex- Experumculation over many year within any tensive study of the authoritative ht- and under heavy exposures persodin such as anthrax acute arserural poi- We are not particularly familiar in eature and dust disease cases are n examinations and also post mortem INSURACE soning typhoid meningitis ete Gen- the State of Wisconsin and the State longer a particular problenu There examinations have clearly established erally however occupational diseases of Illinois with which we are familiar essentials of may be medical testimony for illus that such dusts as carborundum sili artifi such as lead poisoning silicosis ete dust disease cases the tration that increased linear or pori- con carbide alumunun oxide develop er long periods of tune and compensability and elements of de- bronchial markings or hilum shadows eal abrasives extensively used in ins were not accidental injinies and were fense are no longer serious problems are diagnostic of silicosis and dustry iron and metal particles and ed of compensable under compensation and dust disease cases are definitely ete sach testanomy coupled with subjec- even diamond dust have ppt pro aels Occupational diseases were on the wane although for a number to one unfamiliar suced any significant lung tissue re ee SOCIET strangers fo common Law and they of years they were very serious prob- tive complants with authoritative records might be actrum or caused any increased sus were without common Law background leins considered as sufficient basis for an ceptability to tuberculosas Likewi~ o LIBRAY SOCIETI or precedents precedents Generally in any par- As perhaps best illustrating the mis- award of permanent total disability calcium carbonate marble gypsum ticular state at the time occupational understandings of employers and en- however the Illinois Industrial Com- cement or tin oxide and all dusts A va diseases arts hecaine ellective or dust ployees the difficulties and problems mission as presently constituted re- other than free silien and asbestos F .. disease eises became serious problems confronting the medical and legal pros proof in secordance with es- have either been absorbtive or inert there was hitle actual knowledge re- fessions and an industrial commis quires tablished medical and scientific facts and have not produced material fibro Mm garding them by the medical and ston when occupational dust disense because the commission has made a sis impairment of respiratory fune legal professions or by commissions cases first became compensable and careful study of the subject matter tion occupational disease or disable and counts having to do with the ad- of the constructive procedure that When speaking of dust disease ment and it cannot be said that ministration of such arts may be followed to secure satisfac cases essentials of compensability pulmonary tuberculosis is inculept In discussing the subject generally tury understanding administration elements of defense consideration is thereto and witheat reference to the act m and solution of the silicosis dust dis- any party ular state without reference ense problem we have often referred given only to the diseases of silicosis The terus siderosis and anthorosi and asbestoses The only dusts that etc. are frequently seen but siderosi to the period of time such art may to The Employability of the Sil- material fibrosis of the merely means iron particles in the Terve her an operation and withouf colar presented June 3 1938 by may cause tefooemee to the general knowledge Wrabetz chairman of the In- langs and material impairment of res lungs which are ined and is a be spiratory function occupational dis- nign pneumoconiosis and anthravosa and experiences of employers and em dustrial Commission of Wisconsin al eases and disablemnt disablement are silira dust merch means coal or carbon particles ployees and of the medical and legal the twenty annual mireting of and asbestos asbestos dist What is termed the which are also inert and professions professions and the administrative body in any particular state there mecessarily must be considered generally and principally the authouta- tive established medical and setentific facts relative to dusts thete effect any the diagnosis of dust devises devises and the evaluating of dis Industrial Physicians and Sungeons in Chicago S In Illinois beginning October 1 1936 when its present Occupational Diseases Act became effective dust disease cases and particulaly silien- 27 July 1938 INDUSTRIAL MEDICINE free silica dust Si0 which is silion in its amcombined form as distiv- guished from silicates is the only dust that can produce siheosis on any material lung fibrosas with the exception of asbestos dust which is a mag- nesium silicate and which may prus is merely a pigmentation of the lungs There may be silica dust in associa- tion with iron particles or silica dust in connection with coal dust as in the anthracite fields but then the correct terminology is sidera sphen- " sis CHE authinco sileoses buth of THOMAS ANGERSTEIN ANGERSTEIN 187 180 DUST BLASLASE BLASLASE CASES which we demonstrable on ray and mien in such industries and by gen- Where cord mining is done in the anthracite regions where thee 1 where exposures have been controllist controllist within safety standards which cause fibrosis perupational discase and perhaps disability but as eral and periodic examinations of men over many years in practically siben bearing rock and non Dindig is done where there a material ex- Reports of mvestigations of various industries by the United States P^"blic the sahex dust and not the non or the no dust that produces the fibro- all of the called dusty trades In many instances X ray appearances posures to silica dust fibrosis may des velop but the proper terms applica Health Service and by the United States Department of Labor and Bu- as and disease have been checked with post mortem ble in such cases are anthraco reau of Mines the reports of the len fundamentally essential that lindings where death occurred from and silicosis cause the fibro National Silicosis Conference reports there be a correct and general under- variants causes There has often been sis due to the sibea dust and not of investigations of industries and m- standing of the effects if any of vanotos das upon the lungs and of may great difficulty and much confusion in the consideration and deteriuma- to iron or coal particles or dusts vestigations and experimental work The problem of dust disease cases by the Saranac Laboratories and by manifestations manifestations or interprefations and tion of dust disease cases because of and particularly that of sibeosis in 60 Dr. LeRoy U Gardner and his asso- that there be correct definition manch classification as determined by the lack of uniformity or common understanding of terms in some of the far as essentials of compensability ard concerned is determined by admin ciates investigations and reportosf the varjous state commissiohs and latest authoritative scientific and maher hierature and reports and on islative bodies and the elements of state departments the work and pub- medic | anvestigations reports and the descriptions of ray appearances defense before administrative bodies licationosf Dr. A. Lanza Dr. Wil- hferaine which are recognized as au- and the testimony of medical wit- any particular state has been de liam S. McGann Dr. Eugene G. fioratave by those who bave de- nesses who regardless of high qualifi- pendent very largely upon the general Pendergas Dr. Henry K. Paukoast INSURACE authoritative solid cany years to the problem In evaluating may findings and interprefidions related to disabilities if any die legand must be given to the accults of actand experience in the Kenetki and periodic exanimationS eations as physicians and surgeons live not unde any special study of of had any special experience with dus diseases cases The term preranoromiosis has of- ten becar user as n ening n ening an occupa- knowledge of the authoritative hteratime and the experience of the medi cal and legal professions and of the administrative bodies The problems of dust disease case and particularly those of silicosis in~fl Dr. O. A. Sander Dr. L. E. Hamlin Dr. Norbert Enzer and other men of high qualification and extensive ex- perjence have been of tremendous importance in providing | information ovet Bally THIS of large numbers of tional disease or as descriptive of cluding knowledge of the hazard and A bibliography of lit- authoritative 600093 1 industries where where there are ray appeases appeases appeases and even as being control of exposures the definition erature and reports to which we are woe show other dust exposures as well synonymous with fibrosis or sihrosis and diagnosis of silicosis the question greatly indebted for our expressed ge to nacidental findings of chest ray of men 331 such such mibestues - Phpunoconiosis literally and as re- cently defined by Dr 0 Sander of disablement if my where silicosia exists with and without infection and opinions is attached It should be stated that the general e t tiken for other purposes and not whose definition has been accepted the employability of silicoties are subject of occupational diseases is a SOCIET merely to the subjective complamis and quoted generally m recent btera- subjects primarily for qualified und continually expanding one because of aN CIBRAY of He cona aratively few mien who tore merely means dust added to experienced medical men patholoj the continuing industrial progresa have rela) sts and dietdisease cases rN pending and whose naoby is given and at heatings did whose medical testi- mony is that of physicians who have the lungs Pucumaconiosis does not imply or signify any material fibrosis of the lungs or any arment el respiratory function or any disease or gists roentgenologists and industria hygienists who have devoted many years and even a lifetime to those particular fields and who have studied and the development of new indus- tries processes Continued studies and investigations and the carrying carrying on of such important work as is being aw te t!- exammed for the purpose of such pathological process of any disease or and corelated the work and actual done bythe Industrial Hygiene Foun- testing any after such eres were pending and who assortate subjective complaints then made with ray ap- disability is not synonymous with fibrosis or silicosis with anthracosilicosis or sileosis or asbestosis experience of others and who havd contibuted to and have knowledge of the authoritative scientific medij dation in discovering and evaluating industrial hazards is of the greatest| importance because the knowledge of pearances but who have never had For illustration anthracosis a benign cal literature and reports Actual hazarda and the control of exposures any actoid actoid experience in the goveral and periodic examinations examinations and rays pneumoconiosis is merely a term used by pathologists to designate a state practical experience in the general and periodic examinations of men in in is fundamentally essential to the solu- tion of occupational diseases and in of the men in industry or who me of pigmentation without any material dustries having silica and other dust the proper application of compensa- nat familiar with authoritative medi- fibrosis caused by coal or carbon at exposures over a number of years tion | and sucntifie biterature on those subject The effect at various dusts upon the lungs and the X may appearances if any and the proper interpretation interpretation other mert particles or even by coal smoke etc as found in the lungs of cily dwellers | Siderosis a benign pneumoconiosis is merely term applied to the depasity of iron proficies proficies and knowledge of similar examinations and findings of others in similar industries have been and are of very great general importance in evaluating disablement if any m establish- We shall now more specifically consider the essentials of compensability in such dust disease cases under the following headings 1 ther have been authoritatively de- termed by many years of expen- in the lungs which are mert and harmless It is found anong ar- ing that silicotics are employable and in providing accurate and valuable 1 EXPOSURE to the HAZARDS OF THE DISEASE mentation with silea and other dusts welders or grinders of iron castings information with reference to silicosis and by anya digations of various indusities including examinations of etc where artificial abrasive grinding wheels are used its prognosis and also as to the inci- dence of tuberculosis among workers There must be exposure to the hazard of incurring the occupational dis- en ~ 188 DISEASE CASES THOMAS C. ANGERSTEIN ' 1 189 . tase in the emploxieut of the omplayer sought to be charged with compensation Some acts as the Ill unis art specifically defines what shall constitute an exposure but snelt exposure does not of itself mmpose a habahity Silica is one of the most common where there is offut eyndener eyndener to sus Lam the award 2 THE INCUBHING OF THE ALLEGED DISEASE The occupational disease must have been incurred or there must have definitions of silicosis include characteristic ray appearances of dis- crete nodulations or shadows not ex- reeding 6 mtu in diameter tending 10 uniformity in size density and bilateral distribution and without such ray appearances a clinical diagnosis of silicosis may not be made ray examinations and many cm- ployers having only a simple silicosis after twenty on more years of em- ployment at skilled trade and at | a high nitte of wage have quit such employment on the advice of physi cians had had no pat iculaj ex- perience with or knowledge of sili and the most abundant constituint the mimetals and rocks that make up the crust of the earth and may be in the form of fice silica or may be combined as sihcale Ord~- been a material progression of an ex- isting disease in the employment of the employer sought to be changed with compensation The diagnosis of silicosis and the It is entirely clear from the late and most authoritative reports that a clinical diagnosis of silicosis can be made only where there is such characteristic jay appearances that a diagnosis cosis . There has been much confusion resulting from early reports and Interature and from previous lack of common understanding of and uniformity nary and is most common form of free silica and quartz and other silicabearing rock are further illustrations There is no particular dilliculty an determining in which occupation there Imay be exposure to silica dust Silica particles must be of a size of from t to 10 unerous in order to cause im- pument of lung function Ainieron Ainieron INSURACE as 1,250101,25010 of an mich Safety standindustries sunds bolow which is assumed that an employee may work a lifetime without menting silicosis have been stated as 5,000,000 particles of such changed silien dust per cubre foot of an at te The working level The formati necording to the technique described described by SUCIET USPHS USPHS in Reprint No. 1520 from Puble Health Reports Much 18 1932 was to multiply the percentage percentage my of free schica by the total particle dust | count and if the result was under the million the condition may be con- sidered permissible the mastiming of dust exposines within such units is of greatest am employ- portance to cmployers and employ- ers hequrse under such bonts the probabilities are that sibeasts will misundertandig never develop develop and any existing existing ease diagnosible simpl ness probably will never determination of the weight to be given medical testimony as to ray appearances have presented many problems in most states for at least a considerable period of time after occupational diseases became compensa- ble and dust diseases cases were pre- sented The medical and legal professions and the administrative body were then generally without actual knowledge of and expenence with The diagnosis of silicosis There has been much confusion resulting from Some of the earlier literature and re- poils and because of the lack of common understanding of or uniformity of descriptions of ray appearances Increased linear or peri bronchial markings and hilar shadows have often been diagnosed as silicosis There have been descriptious of antepomaly or pienodular stages or appearances of silicosis Such ray appearances are not diagnostic of or pathognomonie of silicosis and may be caused by many other conditions and are generally within the classilication of Healthy Chest and Annexa Even though they may have been caused by silien dust they are nal diagnoshe of silicosis and cer- of called primary or pre- nodular silicosis cannot be made from an ray and that such increased markings previously referred to cannot establish a diagnosis of silicosis ) EVALUATING THE DISABILITY RESULTING IF ANY There must be a disablement as in result of silicosis incurred or a material increase of existing silicosis to disablement in the employment of the employer sought to be with compensation In order for a case of sitrensis to compensable there must also be lau compensable disablement on death resulting therefrom Some acts such as that of Illinois and of Indiana specifically define disablement in substance as an event of becoming d~- abled from carning full wages at work in which the employee was ejgaged or equal wages in other soitable employment There has geneally been durig the early years of the operation of any act a great deal of misunderstanding as to the effrofrmom the standpoint of presesil or future disablement of of description of ray appearances There have been descriptions of anteprimary and of nodular stages of silicosis and also of called first second and third , degree silicosis which were never satisfactory from the standpoint of evaluating any dis- ablement It is well to state and to understandi that the earlier investigations of many , and of the called dusty tiados were mole when the silicosis- hazard was but httle understood by employers and employees and even by state departments and the medical profession and silica exposures had not been controlled within safety standards that man^employees cy aumined had worked for years subject to tremendous exposures of salen dust and the health conditions and the m- cidence and development of siheosis were such as had resulted from such exposures There had been a view that anyone with any degree or stage of silicosis was doomed that siheosis was progressive even after termi- antion of exposure and that at Jehst 75 per cent of those basing silicrisis later died of tuberculosis ' There have now been for a mum- To kineral However m tainly they do not constitute a basis silicosis which is properly termed a ber of years in some states at leash cont an as an element of de for any disability The authoritative simple silicosis that is not complies many industries that haves controlled fete pleal W val that the actual actual exposite exposite uch tecognized tecognized safety safety Sex Habron Walker Refractoric Refractoric cated by infection and as to the employability of those having simple silica exposures well within safety lumits and there have been periodie limits ce test the exposure dul not b vy Turks 39 N.E 2d 791 silieosis that has resulted in many examinations over a number of years even exced that to which the puble Ind ) Harbison Refractories injustices to employees and in many of men generally in such industries many large city is exposed does not ws matter matter of law constitute a des Tease where h car dre DeViewing an and for citopelisation citopelisation particularly Co. v Hermian 51 NE 20 398 Ind Inland Steel Co. v Votoms 77 NE 24 126 Ind National Malteable & Steel Castings Co. v IndusDual Comm 377 I 069 unjust awards Many employees have been rejected from employment or refused employment after employment and the findings and results and con-clusions have differed greatly from the earlierinvestigations It has now been definitely estubs iad 190 DESTDEST DISEASE DISEASE CASES THOMAS C. ANGERSTEIN 1 191 ashed by periodis Hustions Hustions of men penerally mandusaues mandusaues muck by other investigations that simple sal- dence to assist the shatve body to proper determimation of the Festes The vidence to be pre- A MINERAL Srapy OF SILICOSIS by R Emmons and Ray Wilcox genology and Radium Therapy Vol LVIII No 3 Sept. 1947 I costs diagnosable by characteristie as indigs without infection does sented in any profimilar case in any particular state mast obviously be covering experimental work at the Unis ersity of Wisconsin BENJON PNEUMOCONIOsis by Eugene P. Pendergrass MD and not geneally produce any physical governed by conditions within that CHEMICAL AND PATHOLOGIC STUDY OF Simon $ Leopold D. in J. of conditions vable upon physical State such as the period of time the PNEUMOCONIOsis by Drs Henry Ain Med Assn Vol 127 No 12 exammation and seldom produces act has been in operation the general Sweany Juluis D. Porsche and Jesse OCCUPATIONAL MEDICINE AND INDUS- any material disablement In mvestgation made in the United States knowledge and experience of the mil imistrative body the knowledge of Douglas REPORT ON SECOND SYMPOSIUM SYMPOSIUM ON Trial Hygiene by Dr Rutherford T. Johnstone 1948 : seldora has silicosis without pulino mary infection been found to produce any serious disability A classituation classituation of simple siliconi as being not materially disabling and the muthoritative literature on the subject the character of testimony that has been heard in previous cases und the character of testimony that may be available Silicosis Saranar Lake June 3 1935 STUDY ON THE INDUSTRIAL DOST PhonLEM DUST INHALATION INHALATION AND ITS RE- LATION TO INDUSTRIAL INDUSTRIAL TUBERCULOSIS, by Pendergrass BENION Peumocniosi P Due eumoconiosis To Tin OXIDE Eugene P. and Arthur W. Pryde J. of Industrial Toxicology Vol 30 No 2 March 1948 , of silicosas complicated by infection Squicosis phe: commonly called pulmonary Lathereu- losis which may be and generally is disabling has been recommended The dust disease of asbestosis raft- ust be ratesidered within the muts knowledge We f the article and reference is inade We conclude in again relating relating in substance that knowledge of the hazard of silicosis or of other dis- ruses and of the control of exposures within established safety standards knowledge as to the proper diagnosis Publication by the U. S Pub Health Service THE HEALTH OF WORKERS IN INDOSTRIAL TRADES EXPOSURE TO SIL- ICA DUST Pub Health Bull No. 187 by U. Puble Health Service INDUSTRY TUBERCULOSIA COMPENSATION DIAGNOSIS And Prog- NOSIS by Dr. LeRoy U. Gardner PATHOLOGICAL ANATOMY by Dr. L^s Roy odne Saranac Lake Symposan Report INSURACE to the fabliography for information ie jelmave to asbestosis The disesse is caused only by the Juhalation of asbestos dust and there are dhenacteristic ray appearances esseum to diagnosis It may be here dated that as of the presisit time the of sahrosis and of evaluating the effect of siteosis and of the employability of siluenties -have insanably been of great importance in the solution of the saleosis saleosis problem With the contial of exposures willon safely limits new cases of silicasts have not devel- devel- The EmployABILITY EmployABILITY OF THE Silicotie by Voyia Wrabetz Chairman of the Wisconsin Industrial Commission July 1938 Industrial Medicine NATIONAL SILICOSIS CONFERENCE RE- PORT ON MEDICAL CONTROL Buli No 21 Part US US Dept. of Labor THE ETIOLOGY OF Silicosts by Don- ald C Cummmgs Suranne Lake Symposium Report RESPIRATORY IRRITANTS DUSTS FUMES AND GASES by Dr. LeRoy U Gardner Tuberculosis in Industry HEALTH OF ARC WELDERS IN STEEL NATIONAL SRICOSIS CONFERENCE RE- uxurlaide evidence or information at oped and my of those having Ship Construction Report by U SUCIEl EIBRARY least tends to establish that palno- silcosts there has not been priajes- PORT Bull No. 21 Part 3 A Prac- Pub Health Service 1944 firal Discussion of the Silicosis Lary tuberculosis is not an incident of sion to disablement and there bas FOURTH SARANAC LABORATORY Simpo- Simpo- ad asbe tests and also that while the heen no greater incidence of pulmo Problem A Sauder MD sium on Silicosis TubercULOSIS IN A roy. ae hazard of incuring silicosis is nary tuberculosis than among the p 47 INDUSTRY and BIBLIOGRAPHY censed by the fineness of the silica general pubhe After there has been INDUSTRY Tonenemosis SilicosisClinical Picture INDENE OK Pn 7 dast the reverse seems to be the sit Compensation Prepared by Com- sar understanding of the proper dias- mittee on Tuberculosis in Industry . Sosis IN THEORY THEORY Av itation with reference to asbestos fust noses of silicosis and there has been -of the National Tuberculosis TRY by O. A Sander MD Fouth in that the timer the particles of as- an chunation of erroneous diagnoses Assn and American Trudeau So- Saranac Laboratory Symposium on bestos dust the less harnial they appear to he and with the recognition of the fact ciety LeRoy 1. Gardner MD Silicosis 1941 that those having only a simple sili- Falifor published by the National THE PATHOLOGY AND ROENTGENO- j hot TF 7 Hey costs after years of ,, posuje are em- Tuberculosis Assn 1945 GRAPHIC MANIFESTATIONs of Pneu- ~ MTALENTS ~ MTALENTS GL DEFENSE DEFENSE ployable there are no longer unjust THE RESPIRATORY HAZARDs or se MOCONIOSIS by Dr. LeRoy U Gard The clemost clemost of defense if any m Joty profica User HLEV well be de termamed all 1 consideration of rejections from employment and the timg of claims and the awarding of compensation except where the essen- TRIC ARC WELDING by 0 A San- der M.D. in Industry Tuberculo, Silicosts Compensation ner of Am Med Assn Vol 114 No. 7 REVIEW OF LITERATURE ON EFFECTS OF whether or not the essentials essentials of com- pensadality are present Where thals of compensability are in fact present cease be a serious prob- REVIEW OF SILICOSIS FOR THE INDUSTRIAL HYGIENIST AND MEDICAL PRAC BREATHING DUSTS WITH SPECIAL REFERENCE TO Silicosis US Dept at all of the esseblists of compelisIU lem TITIONER by Dr. 1. E. Haml~-n of Intenor Bureau of Mmes Bull bility are tat present then the ele ments of deferese are cheadly indicated BIBLIOCHAPITS BIBLIOCHAPITS Medical Ducsfor Amenean Brake Shoe Company in Industry Tuber No 400 REVIEW OF LITERATURE ON DUSTS S Whether such essentials aue present ETIOLOGY OF PNEUMOCONtosts PNEUMOCONtosts by Dr culosis Silicosis- Compensation Dept of the Interior Bureau of au stabs of furt The defense should present the best available evi- LeRoy U d Gardner of Am Mest Assi Nov. 19 1938 BENIGN PNEUMOCONIOSIS DUE TO METAL FUMES AND DUST by Th 0 A Sander in Am J of Roent Mines Bull 478 1950 " SOFT COAL MINERS HEALTH AND Wqick- ING ENVIRONMENT Pub Health oe i 192 DUST DISEASE DISEASE CASES Ball No 270by US Pub Health IN ASBESTOSIS Service 1911 Sardosts A BENIGN PNEUMOCON JO PNEUMOCON sis Due To Toe ALATION --- A Study or ^ spustusis In The As- BENTOS TEXTILE Industry Repot by ,. 8 Pub HealthService Bull No. BEST Pater by E Handia N ROUND TABL~ VI MD Medical Director and B Weber Chief Industrial Hygienist American Brake Sline Co. Part II . AN EXPERIMENTAL STUDY THE PULMONARY REACTION FOLLOWING FOLLOWING THE INHALATION OF DUST GENER Also By FoUNDICY Cleaning Room 241 SILICOSIS AND ASBESTOSIS by A Lanza M DCUPATIONAL MEDICINE and Innus- TRIAL HYGIENE by Di Rutherford T Johnstone 19M8 ANNUAL REPORT TRUDEAU SANFTORIUM SANFTORIUM TRUDEAU FOUNDATION-- 1948 THE EVALUATION AND ADJUSTMENT ADJUSTMENT OF PERSONAL ; i INJURY CLAIMS A COMMENTARY COMMENTARY Y CHARLES N SERGEANT NEW YORK CITY CIFERATIONS by Arthur J Vor- TUBERCULOSIS IN INDUSTRY Respina- wald M Philqi ( Pratt MD Thomas M. Duikon Anthony B 1 claim and Delahant and Doland A. Bailey Satanae Laboratory of the Trudeau INSURACE or Foundation Saranac Lake NY TORY IHRITANTS DUSTS FUMES AND Gases by LeRoy U Gardner M NATIONAL Silicosis CoNFERENCE RE port on Medical Control Bull 21 Part . The underlying principles of , relation of the local defense counsel evaluation if not consciously realized to the policyholder to the insur- are applied subconsciously by most ance company The importance of attorneys and claim men The basic factors require no elaboration They such influences will vary with a par ,, ticular claim and an excessive stress are ) liability 2 the nature and upon one or more or the failure to extent of the injuries 3 special damages 4 the ability to prove recognize their operative affection will lead to error and mistake disprove liability Actually however the ultimate The method of adjustment cannot be separated from the evaluation of CIBRAY evaluation is determined by numer , a claim for the former frequently de- ie ous other factors objective and sub- termines the latter There are many CIBRARY jective The basic factors are substan- approaches to the disposition of a tially influenced by the collateral . claim Each chim department execu ones unrelated to the merits of the 1 SOCIEly Pn claim and except for fixing the maxi- - tive usually has his own distinctive system and style which may vary mum evaluation play a minor role i with the claimant the attorney and CIBRAY in the final adjustment Perhaps we Ur exis- ae are reluctant to recognize the the claim itself depending upon his , tence of such collateral considera- astuteness or capacity to realize the . =" tions and the legitimacy of some effectiveness of one method over the ~ =a must be seriously challenged other However the more well| The incidental and subordinate ele- known if not the most successful ad- ments affecting the evaluation of a claim are 1 the method of adjust- ment 2 the character reputation social and financial position of the justers have , uniform approach which has become a habit and does not yield to the necessities of chunging circumstances The constancy claimant policyholder and the wit- may prove advantageous to the com- nesses and the nature and character : pany when the results are viewed istica of the community in which the collectively but not if each cla^>mus parties reside and those of the place of trial 3 the experience knowledge ability and the emotional make- up of the claim adjuster 4 the status of the claim whether in litigation or not 5 the aptitude knowledge reputation social and financial position of the respective legal representatives 6 the capability and attitude of the judicial tribunal 7 the examined individually Some of the characteristic up- proaches may be typified as follows 1 The application of the principles of comparative negl- gence This involves a deier- mination of the maximum evaluation apportioned in ac cordance with the extent of Inga habibty er 4 193