• DOI:10.2190/NS4.1.e
• Corpus ID: 50341562

Letters to the Editor

@article{Pfister1993LettersTT,
  title={Letters to the Editor},
  author={Robert E. Pfister},
  journal={NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy},
  year={1993},
  volume={4},
  pages={31 - 36}
}

• R. Pfister
• Published 1 May 1994
• Medicine
• NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy

CONCERN ABOUT APPORTIONMENT To the Editor: A RLENE RITZEN ANDLINDA Rosenstock wrote a very interesting and useful article on apportioning causes (and benefits) for occupational disease in workers' compensation. ["The Misuse of Epidemiology and Apportionment in Compensation for Occupational Disease," Spring 1993] The authors raise several concerns about apportionment, and I would like to raise another. Workers' compensation statutes replaced common-law liability as a way of compensating injured workers. Workers' compensation pays these workers less than the liability system, but eliminates the necessity of showing fault. Workers' compensation pays benefits to even the most careless of injured workers. In return for this guaranteed benefit, covered workers give up their right to sue negligent employers and collect substantially higher benefits than paid by workers' compensation. Apportionment in workers' compensation is fault in disguise. As such, it is not acceptable in principle. Takethe case discussed in Ritzen and Rosenstock's article: lung cancer in an asbestos-exposed worker who smokes cigarettes. Why might we apportion workers' compensation benefits?Hasbestos-exposed workers did not smoke cigarettes, fewer of them would develop lung cancer. The workers' smoking is blamed for some of the excess cancers. Rephrased, the worker is partially at fault. How does workers' compensation handle injuries with multiple causes? Suppose that I stayed up all last night, came to work exhausted this morning, ran my fork lift truck into the wall, and injured myself.Suppose further that the fork lift truck was working well, the warehouse in which I worked was well-lit, and the aisles were wide, clear, and well-marked. I would still be eligiblefor workers' compensation benefits. That's the bargain, at least for injuries. Now let's apply the logic of apportionment of occupational disease to this fork-lift accident. What is the risk attributable to workplace conditions? I would venture to say that it is small compared with the risk attributable to lack of sleep. So, applying apportionment to this accident would leave me either uncompensated or with greatly diminished benefits. Now suppose that I had the flu last week, ate very little, and was in bed for five days. Monday, when I return to work, my leg and back muscles are weak. I lift a box and strain my back. How do I apportion workers' compensation payment for this? Need I go on? Apportionment and fault are close cousins, if not siblings. If we apply apportionment to occupational diseases, logic requires us to apply it to occupational injuries. But applying it to occupational injuries clearly reintroduces fault into a no-fault system. It turns workers' compensation into a litigious, uncertain program with low benefits. This is not in the spirit of the tradeoff established early in this century. Leslie 1. Boden &ston,MA