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Occupational illness. The issue of causality.
Journal of Occupational Medicine. : Official Publication of the Industrial Medical Association
|August 1, 1984
Summary
Workers' compensation and Social Security Disability Insurance were intended to cover work incapacity but now focus on injury and disease. Understanding their evolution helps physicians guide patients and distinguish clinical from legal issues.
Area of Science:
- Occupational Health
- Social Insurance Law
- Public Health Policy
Background:
- Workers' compensation and Social Security Disability Insurance (SSDI) programs in the U.S. were established to address work incapacity.
- These programs were modeled after European systems.
- The initial intent was to insure against wage loss from workplace injury and poverty from work incapacity.
Purpose of the Study:
- To analyze the historical evolution of U.S. workers' compensation and SSDI programs.
- To understand how program objectives have been distorted over time.
- To inform physicians about the distinction between clinical work incapacity and legal culpability.
Main Methods:
- Historical analysis of legislative intent and program implementation.
- Review of program outcomes and financial award criteria.
- Examination of the divergence between intended purpose and current practice.
Main Results:
- Programmatic goals have been significantly altered by factors like employer culpability and disease quantification.
- Both workers' compensation and SSDI now often base awards on damage and disease, not solely on work incapacity.
- A shift from insuring work incapacity to compensating for injury and disease has occurred.
Conclusions:
- Understanding the historical trajectory of these programs is crucial for physicians.
- Physicians can provide better patient guidance by differentiating clinical pathogenesis from legal fault.
- Informing the sociopolitical discourse requires a clear distinction between legal culpability and clinical work capacity issues.