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Q & A:
How did we
get here?
Our American system
of workers' compensation came to us early in the last century from
Germany, via Great Britain.1 While other countries
have made changes, we have continued the original no-fault system – and
that is the core of the problem. Under workers' compensation, the
employer is protected from tort liability. Thus the worker cannot sue
his/her employer for injury or death. The quid pro quo is supposed to be
swift and certain compensation and medical care in exchange for having
given up the right to sue. What has happened over the years is that the
freedom from lawsuit prevails, while worker medical treatment and wage
compensation have been delayed and denied away. There is no monetary
disincentive for employers and insurers failing to pay for the disease
that cripples, or the corporate negligence that injures or kills. It's
in the corporation's best monetary interest not to pay. The longer the
money stays in the insurer's pocket and investment portfolio, the more
desperate the worker's situation
becomes.
Aren't there laws or
regulations that hold corporations accountable when they cause the
destruction of health or life of their
employees?
The Occupational
Safety and Health Administration (OSHA) has the responsibility for
setting safety and health standards, monitoring and ensuring the safety
and health of the workplaces. OSHA is woefully underfunded and
understaffed.
OSHA fines for citations (violations) have been so
minimal that it's generally cheaper for the corporation to pay the fines
than it is to provide a safe workplace.
In over thirty years of
existence, federal OSHA has referred only a small number of cases to US
Department of Justice (DOJ) for criminal prosecution, and only a minute
number of those were pursued by DOJ. In those few cases when OSHA does
deem a citation "willful," (a prerequisite for referral to DOJ for
prosecution) the crime is considered a misdemeanor punishable by a small
monetary penalty, or by imprisonment for not more than six months, or
both.
For a more detailed exploration of what usually happens in
a workplace disaster, see Chapters 2 and 4. In some cases, (see Chapter
5) there aren't even any OSHA regulations in place to protect workers
from injury and death. (See also Chapter 12, Recommendation
6).
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What
about medical treatment under workers' compensation? Aren't employers
obligated to provide that?
The
abuses in medical treatment under workers' compensation are legion and
varied. Themes that run throughout the experience of injured workers are
the delays; the denial of treatment; the inadequate, inappropriate, and
cursory medical treatment; inhumane treatment; and the shunting of costs
that should be paid by workers' compensation to others, primarily
injured workers and their families.
Workers' compensation
insurers and their powerful lobbyists, supported by employers, regularly
persuade state legislators to shrink even the meager legislated health
and wage compensation and to further limit worker attorney fees,
claiming its too costly for employers. The injured and the families of
the deceased have weak voices, if they are heard at all in state
legislatures. And legislators, who are generally ignorant of the
workers' compensation system, and concerned for the pockets of business,
acquiesce to the demands of the insurers. (See Chapter 8)
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If
employers and insurers aren't paying for worker injuries, toxic
exposures and deaths, then who is paying?
Employers and their insurers pay only a small portion of
the costs of occupational injuries, illnesses and deaths. In the
Introduction, I cite rigorous research that shows that the lion's share
of the costs of occupational injuries, illnesses, and deaths are paid by
the victims and their families; with a sizable portion paid by
taxpayers.2
Is there an environmental impact to the
toxic exposures that occur in the workplace?
One cannot witness the repeated toxic chemical exposure of
workers without also seeing its fallout on communities. There are
long-term consequences to this devastation for individual workers, for
their families, for communities, for society, and ultimately, for our
planet. Why is it that the connection between the tens of millions of
workers exposed to toxic metals, neurotoxic solvents, other toxic
compounds and carcinogens is not identified as the monumental
environmental disaster that it is? Like the canary in the coal mine,
worker toxic exposures are the harbinger to environmental
devastation.
While the United States has only set permissible
exposure limits on about 300 of the hundreds of thousands of chemicals
in use in workplaces throughout our country,3 the EU
regulates 30,000 chemicals utilized in their workplaces, and many that
we allow here have been banned for years in the EU.4
Even the small number of chemicals, upon which exposure limits have been
set in the US, are grossly out of date based on more recent scientific
data.
Increasingly as a nation, we have been all too willing to
push corporate costs onto workers and taxpayers; and all too willing to
cut protections for workers, communities, and the environment. Chapter
11 gives many examples of how our failure to regulate occupational
toxins that kill workers is devastating communities and the environment,
now and into the future. (See also Chapter 1 Addendum and Chapter 10).
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This is
such a complex subject. Where did you start your
research?
When I first started my
research, I asked a simple question: What happens to injured workers one
year, five years, ten years out from their injury? I thought that
governmental departments with responsibility for compiling information
on occupational injuries and illnesses would have that information. I
was shocked that there was no one place that had the answers; not the
government, not the NGOs. They didn't seem to be looking at that. And
the long-term impact from worker toxic exposures wasn't even on the
radar screen. The number of worker fatalities is grossly under-reported.
Worker deaths from toxic exposures, other work illnesses are
conservatively estimated by NIOSH and other researchers to be at least
ten times the number of fatalities from work injuries. Yet, these deaths
don't appear in the BLS fatality data. The United States has no
comprehensive occupational health data collection system.
Other
questions followed in order to comprehend the magnitude and complexity
of the impact of this system on our society. Fortunately, there are
environmental and occupational medicine specialists, epidemiologists,
other scientists and academic scholars whose rigorous research of
specific aspects of the medical and economic sequelae of the workers'
compensation system have been reported in books and scientific journals,
and whom I cite throughout Depraved Indifference: the Workers'
Compensation System. I also relied on other governmental data, OSHA
investigation reports, autopsy reports, local sheriff and police
department reports of workplace fatalities, court cases, hearings, and
settlement agreements, as well as personal interviews across industries
and occupations, all across the
country.
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What do you hope
readers will take away from Depraved Indifference: the Workers'
Compensation System?
There has been very little general public awareness of
this system that maims and kills with impunity. The time is long overdue
to re-evaluate a structure that evolved over one hundred years ago; and
which clearly doesn't meet the needs of seriously injured, ill, or toxic
chemical-exposed workers, or the families of workers who died from their
work – a system that has fostered devastating and lasting damage to
families, to communities, to our environment.
Each year in our
country, an estimated 60,000 deaths occur which are attributable to
occupational disease and occupational toxic exposure. These are
conservative cancer and other disease death estimates.5 Occupational disease deaths get subsumed into the
International Classification of Diseases (ICD) classification labeling
the cancers and other diseases that are the final cause of death. No
attention is paid to the toxic exposures that lead to the body systems
breakdown resulting in death.
If occupational disease death
proportion statistics were isolated, they would be more than total
breast cancer deaths; over twice the number of prostate cancer deaths;
more than deaths from colon and rectal cancer; or heart failure; about
three times the number of deaths from leukemia; and four times the
deaths from HIV.6 Yet each of these diseases gets
far more government, public, and media attention than occupational
diseases and resultant deaths. (see Introduction, and Chapter 12,
Recommendation 4).
The final chapter lays out thirteen
recommendations and strategies for action to bring justice and fairness,
corporate accountability, and disclosure to this system. It is my hope
that a better understanding and awareness of the issues will inspire a
willingness to work for change, to right this terrible, continuing
American tragedy.
1 White, Lawrence.
Human Debris: The Injured Worker in America. Seaview/Putnam,
New York, 1983.
2 Leigh, J. Paul; Markowitz, Steven; Fahs, Marianne;
Landrigan, Philip. Costs of Occupational Injuries and Illnesses.
University of Michigan Press, 2000.
3 Cullen, Lisa. A Job To
Die For. Common Courage Press, Monroe, ME, 2002.
4 Regulation EC
1907/2006 of the European Parliament and of the Council of 18 December
2006 concerning the Registration, Evaluation, Authorization and
Restriction of Chemicals (REACH), http://eur-lex.europa.eu
5 op. cit.
Leigh, et al, 2000, and Steenland, Kyle; Burnett, Carol; Lalich, Nina;
et al.Dying for Work: The Magnitude of US Mortality From Selected
Causes of Death Associated With Occupation, American Journal of
Industrial Medicine, Vol 43, pp 461-482, 2003.
6 US Department of
Health and Human Services, National Center for Health Statistics,
Centers for Disease Control and Prevention, National Vital Statistics
System, National Vital Statistics Reports, Vol 53, Number 5. Deaths:
Final Data for 2002, Table 10 and Worktable I, pp. 1585, 1634, 1662,
1703, 2220-2224, at
cdc.gov/hchs/data/dvs/mortfinal2002_workipt2.pdf.
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