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When Is Asthma a Compensable Occupational Disease in New York State Workers’ Compensation Claims?

In the state of New York work-related injuries are compensable, giving rise to an entitlement to medical and indemnity benefits from the self-insured employer or insurance carrier, if the work injury was causally related to the claimant’s employment. According to Workers’ Compensation Law (WCL) § 21, injuries that occur at a claimant’s job are presumed to be compensable work-related injuries for the purposes of awarding indemnity benefits unless substantial evidence to the contrary is submitted.

Therefore, if an employee suffers an injury or develops an occupational disease during work hours, on the premises of his or her place of employment, or as a result of becoming exposed to irritants or pollutants as a consequence of employment, the claimant will be entitled to indemnity benefits for any causally related lost time from their employment as long as they are able to produce medical reports evidencing a disability resulting from the injury.With regard to occupational diseases, such as respiratory conditions alleged to have been contracted as a result of exposure to pollutants at work, in order to prove a nexus between the occupational disease and his or her employment the claimant must “. . . demonstrate by competent medical evidence that her condition resulted from unusual environmental conditions or events assignable to something extraordinary at her workplace.” Matter of Adams v. Univerva Health Care/Excellus, 26 AD3d 587, 588 (2006); Matter of Wilson v. Yonkers Raceway/Empire City, 126 AD3d 1260, 1260 (2015).

The recent case, Waddy, Eileen v. Barnard College, et.al., 135 AD3d 1257 (2016), focused on the situation where a claimant alleged that she developed asthma as a result of exposure to atmospheric irritants at her workplace where she worked in a mail room. Id.

The matter was brought before a law judge at a New York State workers’ compensation hearing where the Board disallowed the claim upon finding that the claimant had failed to establish that her asthma was causally related to her employment.  The claimant appealed from that decision.

On appeal, the New York State Appellate Division affirmed the decision of the Board to disallow the claim. In its opinion, the Court noted that its opinion was based upon the medical evidence and testimony that was submitted to the record which failed to demonstrate a definitive causal relationship between the claimant’s asthma and her employment conditions. One of the claimant’s treating physicians testified that he could not determine whether or not the claimant’s asthma resulted from exposure to environmental irritants at her work place or from other allergens present outside of the workplace. The Court also relied on a report that was issued by an independent medical examiner, a pulmonologist, who opined that the claimant’s asthma was not caused by conditions at her work place and cited to a 2012 indoor air quality test of the workplace which revealed that there were no adverse environmental conditions at the site.

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For more than 20 years we have represented insurance carriers, self-insured employers, third party claim administrators, and employers before New Jersey’s Division of Workers’ Compensation. Our founding partner, Gregory Lois, is co-author of the LexisNexis “Practice Guide to Workers’ Compensation in New Jersey” (2017, ISBN:9781632838735) and served as Law Clerk to Hon. Joan Mott, Administrative Supervisor of Workers Compensation.

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