CALIFORNIA WORKERS’ COMPENSATION APPEALS BOARD RULES FOR WORKER IN CANCER CLAIM: WHAT EMPLOYERS AND INSURERS CAN LEARN FROM THE DECISION

According to a report from Human Resources Director Magazine, a California Workers’ Compensation Appeals Board (WCAB) has upheld a lower court’s ruling, finding that a claimant’s cancer is reasonably likely to be work-related. It is a noteworthy decision on an important and often misunderstood workers’ compensation claims matter: The extent to which workers’ compensation benefits are available for long-term medical needs. In this blog post, our California workers’ compensation defense lawyer provides an overview of the decision and explains the key lesson for employers and insurers.

Highway Patrol Officer Developed Cancer, Diesel Exhaust, and Fire Considered Probable Cause

A workers’ compensation administrative law judge recently determined that an employee of the California Highway Patrol suffered from industrial injuries, including colon damage, ovarian cancer, a hernia, and peripheral neuropathy. The employee spent nearly 30 years working for the California Highway Patrol (CHP). During that time, she was exposed to diesel exhaust fumes. Additionally, the record also showed that she was exposed to other hazardous chemicals as her job involved responding to fires.

She was treated for ovarian cancer, and thankfully, the cancer went into remission. However, her doctors recommended continued treatment. Even though the cancer was gone, the doctor stated that continued, frequent visits to specialists were needed because clear-cell ovarian cancer has a high risk of recurrence. She sought workers’ compensation benefits for the continued treatment. The CHP challenged the claim. A workers’ compensation judge and the WCAB ruled in favor of the employee.

Workers’ Compensation Benefits are Available for Insidious, Progressive Diseases (Cancer with High Risk of Recurrence Can Qualify)

In California, workers’ compensation insurance covers reasonable and necessary medical care. With acute injuries, the extent of medical treatment that is needed is often not an issue. Though, disputes can seriously arise. However, with chronic disease, the extent of ongoing medical needs can be especially complicated. California’s workers’ compensation laws hold that workers are entitled to continued benefits for medical care if they have an insidious and progressive disease.

The key lesson for employers and insurance companies that can be gleaned from this workers’ compensation case is that cancer that is in remission (or even totally gone) can still qualify as an insidious and progressive disease. As the administrative judge and the WCAB determined, cancer that has at least a 50% chance of recurrence is considered to be an ongoing medical condition that requires continued care. Trips to specialists—including cancer screening—can be covered.

We are Solutions-Driven California Workers’ Compensation Defense Law Firm

At Yrulegui & Roberts, our California workers’ compensation defense advocates go the extra mile to provide reliable, cost-effective legal services to clients. We are the law firm that employers and insurers can trust in a complex case. Contact us today to set up your confidential, no-obligation case review. Our firm is well situated to provide workers’ compensation defense representation all across Central California.