Dr. Yasunosuke Suzuki, A Pioneer of Mesothelioma Medical Research

I am saddened to report the passing of Dr. Yasunosuke Suzuki. Dr. Suzuki partnered with the late Irving J. Selikoff MD at the Environmental Sciences Laboratory (ESL) of The Mt. Sinai School of Medicine and conducted some of the most famous and pioneering scientific research linking asbestos exposure with mesothelioma. Dr. Suzuki passed away on August 8, 2011, at 82.

I met Dr. Suzuki in the early years of my career when I litigated some of the initial claims involving asbestos exposures at The Union Asbestos and Rubber Company's (UNARCO) plant in Paterson, NJ. Dr. Selikoff, and my late father, a lawyer, both of Paterson, were involved in the "original 17" asbestos worker claims in 1954 before the New Jersey Division of Workers' Compensation. 

Following the successful disposition of those claims, Dr. Selikoff expanded his research at the ESL in New York City. Dr. Suzuki became the lead pathologist of that pioneering medical-investigative team. Dr. Suzuki played a critical role in the Paterson Asbestos Control Group that followed up, through autopsy, the cohort of 933 former workers of the UNARCO facility and their families. His analysis of the pathology of the asbestos-related tumors produced, along with Dr. Selikoff and his knowledgeable team, some of the sentinel epidemiological studies linking asbestos-related exposure of workers and their families and bystanders to asbestos exposures. 

The following obituary was published by the Collegium Ramazzini

Death of Professor Yasunosuke Suzuki August 8, 2011

It is with great sadness that the Collegium Ramazzini informs its Fellows of the death of one of its most illustrious and beloved colleagues, Professor Yasunosuke Suzuki. Professor Suzuki was an influential member of the Collegium and was honored with the Ramazzini Award in 1993 for his contribution to the scientific knowledge on the pathology of mesotheliomas among asbestos-exposed workers. Upon his retirement from the Mount Sinai School of Medicine in 2006, the Collegium Ramazzini again honored Professor Suzuki with the Irving J. Selikoff Award to recognize his many years of work as a pathologist who meticulously studied the diseases caused by asbestos and who also ventured forth courageously from his laboratory, as a true follower of Ramazzini and Selikoff, to press the urgent need in nations around the world for the banning of all production and use of all forms of asbestos. In fact, Dr Suzuki played a critical role in the decision by the Government of Japan to ban all use of asbestos in Japan. 

Collegium Ramazzini President Philip Landrigan remembers the occasion of the Selikoff award noting "(It) was a bittersweet occasion. Dr. Suzuki served as a member of the faculty of the Department of Community and Preventive Medicine at Mount Sinai for 40 years. While there are many of us still at Mount Sinai who worked with Dr. Selikoff as junior faculty, students and trainees, Dr. Suzuki is the last member of the "Selikoff generation" the group of age peers who worked most closely with Dr. Selikoff for so many years in Dr. Selikoff's pioneering studies of other asbestos and other occupational hazards."

Professor Suzuki received his M.D. degree from the Keio University School of Medicine in Tokyo in 1953. He completed one year internship in Tokyo at the Setagaya National Hospital, and was licensed in 1954 by the Japanese Government. 

In 1954 he joined the Department of Pathology in the Keio University School of Medicine starting as an "Assistant of Pathology". Dr. Suzuki's early work on the kidney he proved the presence of the mesangium, the third structural element of renal glomerulus. Working with new technology - the electron microscope, he was able to further define the structure of the mesangium.

In 1959, he was awarded the Doctorate of Medical Sciences in the field of Pathology. In 1960 he was sent abroad as an International Post Doctoral Research Fellow at the U.S. National Institutes of Health (NIH) training at New York University School of Medicine under Professor Johannes Rhodin. In 1961 he trained at the Mount Sinai Hospital Renal Pathology Division under Dr. Churg. He returned to Keio University 1962 as a faculty member. In 1966, Dr. Suzuki was invited to re-join Mount Sinai as a Research Associate. In addition to renal pathology with Dr. Churg, he started to investigate pathology of asbestos related diseases with Dr. Dr. Irving J. Selikoff. 

The research on asbestos-related diseases included seminal work on pulmonary asbestosis, the development and formation of asbestos bodies and electron microscopy of human malignant mesothelioma. In 1973, Dr. Suzuki again returned to Japan to serve as Chairman and Professor of Anatomy at Fujita-Gakuen University School of Medicine.

He returned to Mount Sinai in 1975 as Research Professor of Community Medicine and Research Associate Professor of Pathology. For the next 31 years, from 1975 to 2006, he devoted his time solely to the investigating the pathology of asbestos-related diseases. One of his most significant contributions was providing support to Selikoff's ground-breaking epidemiological study on asbestos insulation workers. Slide by slide, he reviewed the pathologic autopsy and biopsy samples taken from approximately 5,000 cases of insulation workers and confirmed the diagnosis of asbestos-related diseases. 

He was promoted to Professor of Pathology in 1989 and in 1991 to Professor of Community and Preventive Medicine. 

Dr. Suzuki published 171 peer review scientific papers. Dr. Suzuki estimated that over the course of his career in research, he had examined and written up approximately 538,000 individual slides.

Suzuki received several honors in addition to those conferred by the Collegium Ramazzini. Other awards include the honorary title of Guest Professor at Tokai University School of Medicine (1993-1996) and Honorary Visiting Professor of Pathology at Keio University School of Medicine (1999-2000). 

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The author, Jon L. Gelman, practices law in Wayne, NJ. He is the author of NJ Workers’ Compensation Law (Thomson-Reuters) and co-author of the national treatise Modern Workers’ Compensation Law (Thomson-Reuters). For over five decades, the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com have represented injured workers and their families who have suffered occupational accidents and illnesses.

© 2011 Jon L Gelman. All rights reserved.

Recommended Citation: Gelman, Jon L., Dr. Yasunosuke Suzuki, A Pioneer of Mesothelioma Medical Research,  www.gelmans.com (2011), https://workers-compensation.blogspot.com/2011/11/dr-yasunosuke-suzuki-pioneer-of.html

Allianz Firemans Fund Increases Asbestos Reserves by $301 Million

Fireman's Fund Insurance Company a Division of Allianz has announced that it will increase its asbestos and environmental risks reserve by $301 Million. The company stated, "The move follows the completion of its regular independent external asbestos exposure review."


Asbestos has been a known carcinogen for decades. It is a natural occurring mineral that that has been used for its non-flammable properties. Medical conditions occur such as asbestosis, mesothelioma and other cancers, decades after the initial exposure.


Initially sold by companies in the 1920s, without warning of its known dangers, asbestos use continues not to be banned in the US. Disease from asbestos exposure is predicted to continue at very high rates.

 The largest transfer of economic wealth in the United States from Industry to the private sector, other than in the Attorney General’s thirty-eight State tobacco litigation, emanated from asbestos litigation which had its geneses in workers’ compensation.   The late Irving Selikoff, MD’s pioneering efforts in providing expert testimony, based upon his sentinel studies of asbestos workers in Paterson, NJ, created the trigger mechanism for a massive wave of claims for occupational health care. The workers' compensation program never did adequately nor efficiently or expeditiously provide medical care.

The workers’ compensation system did not provide an adequate remedy because of a constellation of reasons, and subsequently, the wave spread to civil litigation out of desperation for adequate benefits. Asbestos litigation has been named, "The Longest Running Tort” in American history.   Asbestos litigation expanded into  bankruptcy claims that continue unabated and the epidemic of disease continues. The remaining cases in the Federal court system were transferred to Federal Multi District Litigation (MDL 875) and the majority are finally concluding after twenty years of Panel consolidation.


Large verdicts continue to be reported in asbestos claims. A Los Angles jury recently awarded $208.8 Million in what has been recognized as the largest asbestos verdict ($200 Million punitive damages) in the State of California.  The case involved a household contact exposure to asbestos fiber. The wife of the asbestos worker was exposed to asbestos fiber on the clothes of her husband that he brought home and that she cleaned.


Click here to read more about asbestos related disease and claims for benefits. For over 3 decades the Law Offices of Jon L. Gelman1.973.696.7900 jon@gelmans.com  have been representing injured workers and their families who have suffered asbestos related illnesses.

$208.8 Million Awarded in California Asbestos Case

A Los Angles jury awarded $208.8 Million in what has been recognized as the largest asbestos verdict ($200 Million punitive damages) in the State of California.  The case involved a household contact exposure to asbestos fiber. The wife of the asbestos worker was exposed to asbestos fiber on the clothes of her husband that he brought home and that she cleaned.

Liability was apportioned 70% against CertainTeed Corp and 30% against the Los Angles Department of Water and Power.

Asbestos is a known carcinogen and knowledge of the relationship of human exposure to asbestos fiber and mesothelioma, a rare malignancy, has been known since the 1920's. Cases for household contact exposure to asbestos fiber are common.

In Paterson NJ the Union Asbestos and Rubber Company Plant (UNARCO) was the subject of a sentinel study by the late Irving J. Selikoff, MD, who found that of the 933 workers who were employed during the war years, over 300 had died by 1976 of asbestos related disease, and that household contact illness and disease was very prevalent.

Click here to read more about asbestos related disease and claims for benefits. For over 3 decades the Law Offices of Jon L. Gelman 1.973.696.7900 jon@gelmans.com  have been representing injured workers and their families who have suffered asbestos related illnesses.

The Health Reform Act Charts a New Course for Occupational Health Care

The occupational healthcare program embodied in the recently enacted legislation has the potential for being the most extensive, effective and innovated system ever enacted for delivering medical care to injured workers. The “Libby Care” provisions, and its envisioned prodigies, will embrace more exposed workers, diseases and geographical locations, than any other program of the past. Potential pilot programs  will now be available to injured workers and their families who have become victims of the failed workers’ compensation occupational disease medical care system.

The legislation initially establishes a program for the identification, monitoring and treatment of those who were exposed to asbestos in Libby Montana where W.R. Grace formerly operated an asbestos (vermiculite) mine producing, among other things, attic insulation. The plant belched thousands of pounds of asbestos fiber into the air of the geographical area daily. Libby Montana has been declared a Federal Superfund Site and the asbestos disease that remains as its legacy has been declared a National Public Health Emergency.

The newly enacted national health care law will have profound effect upon the treatment of occupational disease.  Placed deep within the text of the bill (H.R. 3590), on page 836 (Section 1881A Medical Coverage for Individuals Exposed to Environmental Health Hazards), is the new occupational medical care model, “Libby Care.”  The Manager’s Amendment, embracing the concept of universal occupational health care, inserted in the final moments of the debate, will make all the difference in world to the future of medical care and the handling of work-related illnesses.

What We Learned From History

Historically it is well known that occupational diseases are problematic issues confronting workers’ compensation.They are problematic for all stakeholders in the system. For employers, it is difficult to defend a claim that may occur over a lengthy working period, ie. 280 days per year. Defending occupational disease claims has always been an elusive and a costly goal for employers and insurance carriers. Employees also are confronted with obstacles in obtaining timely medical benefits. Occupational disease claims are universally contested matter and medical care is therefore delayed until the claim is successfully litigated and potentially appealed. This process results in delay and denial of medical care and sometimes death.

In the 1950’s the insurance industry put tag-along verbiage in the statute to modify the 1911 workers’ compensation act to encompass occupational disease claims. This was not a philanthropic gesture, but one rather intended to shield Industry from rapidly spreading silicosis liability in civil actions emerging in the 1950s.

Over time, the failure of the workers’ compensation system to provide adequate medical care to injured workers suffering from occupational illness has given rise to the emergence of several attempted collateral benefit systems by the Federal government. The Black Lung Act-The Federal Coal Mine and Safety Act of 1969 established the Federal Black Lung Trust Fund, which obtained its revenue from the assessment of a percentage tonnage fee imposed on the entire Industry. In October 2000, the Federal government established The Energy Employees Occupational Compensation Program Act that provided a Federal bailout of liability for the monopolistic beryllium industry. The hastily enacted Smallpox Emergency Personnel Protection Act of 2003 (SEPA) shielded pharmaceutical manufacturers from liability.  Following the horrific events of September 11, 2001, the Federal government quickly established The Victims Compensation Fund to compensate the victims and their families through an administrative system.

The largest transfer of economic wealth in the United States from Industry to the private sector, other than in the Attorney General’s thirty-eight State tobacco litigation, emanated from asbestos litigation which had its geneses in workers’ compensation.   The late Irving Selikoff, MD’s pioneering efforts in providing expert testimony, based upon his sentinel studies of asbestos workers in Paterson, NJ, created the trigger mechanism for a massive wave of claims for occupational health care. The program never did adequately nor efficiently or expeditiously provide medical care.

The workers’ compensation system did not provide an adequate remedy because of a constellation of reasons, and subsequently, the wave spread to civil litigation out of desperation for adequate benefits. Asbestos litigation has been named, "The Longest Running Tort” in American history. While the Fairness in Asbestos Resolution Act of 2003, failed to be release from committee, the insurance industry tried to stifle the litigation but the effort failed.  Asbestos litigation expanded into  bankruptcy claims that continue unabated and the epidemic of disease continues. The remaining cases in the Federal court system were transferred to Federal Multi District Litigation (MDL 875) and the majority are finally concluding after twenty years of Panel consolidation. Medical benefits were not a direct component of that system. Unfortunately, asbestos is still not banned in the United States and the legacy of disease continues at historic rates.

The Costs

In a study prepared in 2000 by Dr. Steven Markowitz for a book entitled “Cost of Occupational Injuries  and Illnesses”, it was revealed that the direct medical costs attributed to occupation illness by taxpayers, amount to $51.8 Billion dollars per year for the hospital physicians and pharmaceutical expenses. Overall workers’ compensation is covering 27% percent of the cost. This amounts to 3% of the National Gross National Product. The cost is passed on to: employers, insurance carriers, consumers, injured workers and the taxpayer. Medicare, a target of the cost shifting mechanism employer by Industry, continues its “pay and chase” policy in an effort to seek reimbursement under the Medicare Secondary Payer Act. All the stakeholders and the compensation systems have become increasingly bogged down as cost-shifting continues by Industry. The workers' compensation claims process has become stagnant. 

Reportable Data A Questionable Affair

The quantification of occupational illness data has been very problematic as it is based on sources of questionable reliability. The US Bureau of Labor Statistics (BLS) based its collection on employer driven safety reporting, ieNCCI), keeps its data and procedures under wraps.

Both the NY Times and Nebraska Appleseed have reported that there exists underreporting of occupational disease conditions in epic proportions. They report that the elements of fear and intimidation directed to injured workers compound the defense attitude of employers and the insurance industry resulting in a massive underreporting of occupationally related medical conditions.

Increased Hurtles for Compensability

There have been attempts over the years to integrate more claims statutorily into the workers’ compensation system to shield employers from civil action and resultant large liability verdicts. This resulted in a flood of occupational exposure claims into the workers’ compensation arena. An effort in the mid-1980’s, following the asbestos litigation explosion, was by Industry to contain costs and restrict the payment of occupational disease claims even further in the workers’ compensation.

The initial effort was to create higher threshold standards and requirements in the area of mental stress claims. That was quickly followed by efforts to limit orthopedic and neurological carpal tunnel claims.  Restrictive language interpreting what is peculiar to employment further limited all occupational disease claims.

Furthermore, scientific evidence proof requirements became increasingly difficult to surmount. Daubert type arguments emerged by the defense in the nations’ workers’ compensation forums where simplicity of a remedial and efficient benefit delivery program had existed in the past. Where a biological marker was not present, as was in asbestos exposure claims, the establishment of causal relationship was universally challenged.

Pre-existing and co-existing factors soon became other hurtles for injured workers and their families.  Medical histories of orthopedic difficulties such as back conditions soon complicated repetitive motion trauma litigation. Co-existing and pre-existing smoking habits, family genetics and obesity were yet another obstacle to recovery.

Societal Habits Changed

Life and the way we look at work have changed dramatically with the onset of technology. Off-premises work is becoming more and more common with the advent of Internet access and economic globalization. Defining the barriers between work and pleasure has grown to be exceedingly difficult.

People are working harder and longer. More chronic conditions are prevalent in older workers. Disease increases with age and results in more total disability claims.

Occupational Medical Costs

The compensability of occupational claims is much more difficult to sustain in court. In recent studies over 99.9% of occupational deaths and 93.8% of the medical costs of occupational disease were held to be non-compensable. Over 50% of the lifetime medical costs are incurred during the last year of one’s life.

The Legacy of The Libby Montana Gold Rush

In 1881 gold miners discovered vermiculite, a form of asbestos in Libby, Montana. In 1920 The Zonolite Company was established and began to commercially mine vermiculite. W.R. Grace bought the mining operations in 1963. In 1990 the mine was closed and production ended.

For decades W.R. Grace belched over 5,000 pounds of asbestos into the air in and around Libby on a daily basis. The residents who worked at the plant and their families and household contacts were exposed to asbestos fiber.  Mineworkers brought home the asbestos on their clothing. The unknowing inhabitants and their families  used the asbestos to fill their gardens, their driveways, the high school track, the little league field and in their attics for insulation.

The US Environmental Protection Agency (EPA) visited Libby in 1999 and investigated the incidence of disease and the contamination of the site. The EPA declared Libby a Superfund site in October 2002 and a physical clean-up began of the geographical area. The question of who would pay for the medical care of Libby remained an unknown.

A Manager’s Amendment

Senator Max Baucus (D-MT), Chair of the Senate Finance Committee, utilizing a mechanism known as “A Manager’s Amendment,” at the last moment, modified the Senate’s version of the Health Care Reform Bill. The Patient Protection and Affordable Care Act passed the Senate, ultimate cleared the House and was signed into law by President Obama on March 23, 2010. Section 10323, Medicare Coverage for Individuals Exposed to Environmental Health Hazards, 2009 Cong US HR 3590, 111^th Congress, 1^st Session (December 31, 2009).

Senator Bacus said,  “This provision is important because it will provide vital medical services to American who—through no fault of their own—have suffered horrible effects from their exposure to deadly poisons. It will provide vital medical services we owe these Americans under our commitment in the Superfund Act.”  The amendment initially provides for screening and medical care to residents of the Libby Montana asbestos contaminated site that was owned and operated by W.R. Grace. It essentially provides for universal health care.

“Libby Care” Is The New Occupational Medical Care Model Legislation

The Libby site qualified for the medical program because the hazardous asbestos contaminated site in Libby was deemed to be “a public health emergency” on June 17, 2009 as defined by the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA). While there are 1700 designated Superfund sites, Libby is the first site in the history of the program that has been designated as “a public health emergency.” The program may be expanded in adopted to other communities at the discretion of the Secretary of of the Department of Health and Human Services (HHS). 

The plan authorizes a grant for initial medical screening purposes. The screening would determine if a medical condition is present that is attributable to the environmental exposure. It allows those individuals with a diagnosed medical condition due to the environmental exposure at the site to get Medicare services. The Secretary of the Department of HHS may establish additional pilot programs to provide additional medical care appropriate for the residents of contaminated communities so designated. The delivery of Medicare medical benefits will be directed to those “who have suffered horrible effects from their exposure to deadly poisons.”

The purpose of the legislation is  “…. to furnish such comprehensive, coordinated and cost-effective care to individuals…..” p2224 l3-1. It mandates the furnishing of “Flexible Benefits and Services,” for items, benefits or services NOT covered or authorized by the Act. It further authorizes the institution of “Innovative Reimbursement Methodologies,” for reimbursement subject to offsets for individuals “eligible to receive public or private plan benefits or legal agreement.” p2226 ll8-11. The Secretary of HHS will maintain “waiver authority.”

Charting A New Course

After a century of struggle, the United States now embarks upon a new course for occupational medical care. The law charts a new path for the delivery of  occupational disease medical benefits on a timely basis. It will permit researchers an avenue for the collection of epidemiological data so that the workplace can be made safer. All will benefit. The innovative legislation provides for a long awaited and much needed initiative to provide an efficient, responsive and coordinated treatment plan and preventive health program that hopefully will expand and will vastly improve occupational health care.

To read more about health care and workers' compensation click here.

Positive Pathological Findings in the Lungs of World Trade Center Patients

The forensic pathological skills of the Mt. Sinai Medical Center (MSMC) in New York have yet again revealed the mysteries of an occupational exposure. MSMC was the medical laboratory of Irving J. Selikoff and sentinel studies on asbestos related disease attributing exposure to asbestosis, lung cancer and mesothelioms.

MSMC took the early initiative in medically investigating the World Trade Center (WTC) first responders. Following up on the 2001 event MSMC had conducted pathologic evaluations of WTC dust present in lung tissue of a sampling of the lose exposed to WTC dust. It is estimated that between 60,000 to 70,000 responders have been exposed.

"We found that three of the seven responders had severe or moderate restrictive disease clinically. Histopathology showed interstitial lung disease consistent with small airways disease, bronchiolocentric parenchymal disease, and nonnecrotizing granulomatous condition. Tissue mineralogic analyses showed variable amounts of sheets of aluminum and magnesium silicates, chrysotile asbestos, calcium phosphate, and calcium sulfate. Small shards of glass containing mostly silica and magnesium were also found. Carbon nanotubes (CNT) of various sizes and lengths were noted. CNT were also identified in four of seven WTC dust samples."

Click here to read more about the WTC exposures and workers' compensation.

Secretary at Former Asbestos Plant Awarded $17.87 Million

A former secretary at an Illinois asbestos plant, Union Asbestos and Rubber Company (UNARCO) was awarded $17.87 Million as a result of contracting an asbestos related disease, mesothelioma. The woman was employed from 1967 to 1969 at UNARCO as a secretary.

The lawsuit alleged that Pneumo Abex LLC and Honeywell International Inc. and their corporate predecessors knew of the dangers of asbestos and failed to warn their employees and customers of the hazards.

UNARCO also operated an asbestos plant in Paterson NJ from 1942 through November, 1954. It produced asbestos pipe covering and textile material for US Navy ships and and others. The Paterson NJ group of workers, and their families, became the cohort group for sentinel studies conducted by the late Irving J. Selikoff, MD (1915-1992), who linked asbestos exposure to various disease including: asbestosis, lung cancer and mesothelioma. Those studies ultimately lead to a world renown conference in 1964 sponsored by The New York Academy of Sciences.

Asbestos is still mined in Canada. The use of asbestos in the United States has yet to be banned in the United States.

Disease caused by asbestos has resulted in an epidemic of disease and resulting massive amounts of workers' compensation occupational exposure claims and civil actions. Asbestos litigation has been deemed "The Longest Running Tort in American History."

Click here to read more about asbestos and workers compensation.

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Congress, Health Care & Unintended Consequences

This past week some very dramatic things happened in the workers’ compensation world. The US Senate moved forward on initiating a floor debate on health care. At the same time, a group of workers’ compensation scholars met in Washington DC to discuss the future of workers’ compensation and the interplay with social security disability.

 Highlights of the NASI (National Academy of Social Insurance) conference convened in Washington were findings presented by eminent leaders in the field. Professor John Burton, Rutgers University, pointed out that newly created barriers to workers’ compensation were pushing more injured workers to the Social Security disability system for benefits. This reflects a phenomenon that occurred in the late 1970’s when a study commissioned by the US Department of Labor and conducted by Mt. Sinai Hospitals’ Environmental Sciences Laboratory, revealed that the inadequate benefit delivery system of workers’ compensation for asbestos related illness, was forcing injured workers and their families into the civil justice arena for adequate compensation.

The problems have not changed in decades; they have only gotten worse, maturing into a system that is in critical condition and on life support. In 1980 Irving J. Selikoff, M.D. reported, “There has been widespread acknowledgement of significant problems with disability compensation for workers in the United States. One major area of concern has been the shortcomings with regard to occupational disease. Whatever the suitability of current workers’ compensation systems in the 50 states for injuries and work accidents, there has been little disagreement about the inadequacies of such systems for workers who become disabled by illness or, if they die, for their surviving dependents.”

Complex questions continue to exist between the scientific and legal communities as to the path to be taken. Barriers placed into the path of recovery, including pre-existing and co-existing conditions, which result in limited or delayed recovery and major shifting of the economic responsibility upon the public/private benefit systems need to be removed. The unspoken social consequences continue as a silent epidemic as families and survivors struggle in silence.

Looking backward over the noble experiment in California which turned sour, Tom Rankin, former President of the California Labor Federation, AFL-CIO, expressed his regret of the reform. The former Labor leader theorized that the results were “unintended consequences.” Indeed he is looking forward to solutions springing forth in a “public option” embedded into the national health care legislation.

Some participants at the NASI conference alleged a major shortcoming of the California workers’ compensation legislative reform effort. Doug Kim, a lobbyist for the claimant’s attorneys, disclosed that the injured workers’ advocates were not invited to partake in the discussion that lead up to crafting the initial drafts of the 2004 California reform legislation SB 899.

History reveals, that when the theoretical reforms were practically applied, the injured workers suffered serious setbacks. If these were in fact “unintended consequences,” then one must consider the active involvement of all stakeholders when looking forward to solutions. The courts in California have consistently upheld challenges to the inequitable results, pointing to the legislative intent to reduce costs. Absent from the discussions of the presenters were practical systemic applications to improve the present system. The “blood and guts” of the traumatic, delay and denial, struggles of navigating in a crippled workers’ compensation system, in California and elsewhere, is verification that change is mandated.

As North Carolina attorney, Valerie A. Johnson, so eloquently remarked, “workers’ compensation is supposed to be a simple system.” The process has now been obstructed by encroaching elements of fault, contributory negligence, apportionment of pre-existing conditions and difficulties of the element of time, manifested by latent diseases unknown to the fathers of the system a century ago. The advance of medical science has brought forth new and innovated modalities that have contributed to soaring medical costs. The convergence of these issues has generated higher administrative costs.

Pecuniary Industry motives have worked adversely to improving safety in the workplace. The need for workers’ compensation would be minimized by adopting a safer occupational environment. Under reporting of workplace accidents continue as the Government Accountability Office announced. Nebraska Appleseed reveals that workers feel intimidated and are apprehensive to report injuries and unsafe work conditions. This is scenario is compounded by the fact that undocumented workers, who have even less job security, work in jobs with higher risk. The Bush Administration did not make efforts to allow OSHA to heighten enforcement efforts. All of these ingredients combine to create a recipe that just doesn’t work.

The US Senate advanced the health care legislation to a floor debate in an unusual late Saturday night session. This action may indeed provide an opportunity for the stakeholders in workers’ compensation to all join in the debate and look for solutions to the delivery of appropriate medical care in an efficient and timely fashion. To avoid “unintended consequences” yet again, injured workers and their advocates will need to be active participants and engage in the debate now.

.......

To read more about workers’ compensation and universal health care solutions click here.

APHA Calls for US Asbestos Ban

The American Public Heath Association (APA) has called for a ban by Congress on the manufacture, sale, export, or import of asbestos containing products including products in which asbestos is a contaminant. Asbestos claims 10,000 American lives each year.

“As early as 1898, the British government factory inspectors recognized adverse health effects associated with exposure to asbestos fibers. By the 1930’s the scientific evidence was well established of the association between asbestos exposure and nonmalignant respiratory disease, and with the publication of Dr. Irving Selikoff’s study of insulation workers in 1964, the evidence of carcinogenicity was incontrovertible as well.”

“Despite the concerns of asbestos exporting countries and business interests of the mining industry, the scientific consensus today is that all types of asbestos fibers, including chrysotile, cause asbestosis, lung and other cancers, specifically mesothelioma. The magnitude of the public health problem presented by asbestos and its ubiquitous use during the last 50 years is revealed by death certificate data analyzed by the National Institute for Occupational Safety and Health (NIOSH). NIOSH identified 2,485 deaths in the U.S. in 1999 in which malignant mesothelioma was listed as an underlying or contributing cause of death; and that during 1968--2005, asbestosis was identified as the underlying cause of death for 9,024 decedents, 13% of these were aged 25-64 years. These data undoubtedly underestimate the situation as asbestos-related disease can take 10 to 50 years to present. The estimated portion of lung cancer deaths attributed to asbestos exposure is 2-3 percent.”

During the 1950’s and 1960’s Dr Selikoff would testify in the NJ Division of Workers’ Compensation as a medical expert for injured workers. I had the privilege of knowing him and observing his efforts to assist injured workers and spread his scientific discoveries on the harmful effects of asbestos products.

It is shocking that in 2009 the US permits the use, manufacturing and distribution of asbestos containing products. It is certainly well passed the time to ban asbestos in the US.

To read more about asbestos and workers’ compensation click here.

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The Asbestos Debate is Over

Almost 45 years following the historic 1964 NY Academy of Medicine conference in New York experts continue to memorialize the history of asbestos related disease. Now enters, defense expert John E. Craighead, who has written his viewpoint on the subject.

Asbestos is one of the modern world’s most historic occupational medical disasters. Not only is it well documented, it continues not to be banned in the US , in fact, the incidence of asbestos related disease reported has turned upward, according to recently released NIOSH data (1979-2003.

In a recent review of the Craighead volume, the New England Journal of Medicine, has called it, “….highly personalized with strong individual viewpoints. It is less authoritative as a source for risk assessment and litigation issues.”

Yet others have including: Victor L. Roggli (Pathology of Asbestos-Associated Diseases), Barry I. Castleman (Asbestos: Medical and Legal Aspects, Fifth Edition) and Paul Brodeur (Outrageous Misconduct) have followed in the historic footsteps of the late, Irving J. Selikoff, MD and have guided us to seek a remedy and cure for wrongdoings of the past.

The asbestos debate is over. It is no longer time to profit from the debate and sell controversy. It is no longer time to allow this product to be sold anywhere in the world for profit. It is time to direct attention to provide medical treatment to those who suffer from asbestos related illness and draw our attention to find a cure for this disease.

Diagnosing and Curing the Ailing NJ Workers' Compensation System

On the eve the NJ Senate's investigation into New Jersey's workers' compensation system, the question lingers on how to evaluate its health. New Jersey has always had a very large and very dedicated workforce A recent newspaper series by Star-Ledger reporters Dunstan McNichol and John P. Martin revealed that the system is serious flawed and that it is in need of a “complete overhaul.”

The State has a history of being a heavily industrialized state with a huge legacy of pollution from asbestos to petrochemical. Dr. Irving J. Selikoff, of Paterson, NJ, began his landmark studies on asbestos workers in New Jersey. In 1911, almost a century ago, NJ adopted an administrative system known as workers' compensation and it was the intent of the Legislature to provide a speedy and cost effective system of delivering statutorily defined benefits to injured workers while passing the costs onto the consumers of products and services.

This will be the first major evaluation of the workers’ compensation system in 30 years. The last one resulted in a fraud report from the NJ State Commission of Investigation and subsequent statutory change.

Much has changed from the past. In 1911 modern medicine was unknown and so were the diseases that it now treats. The program’s benefits were meager and the conditions eligible for compensation were few and far between. More Americans have died from occupational disease in the United States of America in the past 40 years than in all wars dating back to 1776. Hearings on S.79 before the Subcomm. of Labor and Human Resources of the Senate Comm. on Labor and Human Resources, 100th Cong. 1st Session, S.Hrg. 100-56, pt. 1, at page 1 (1987). Collateral benefit programs did not exist: major medical insurance, long term disability, social security and pension programs.

We are experiencing a struggling economy today. Former Labor Secretary Robert Reich stated, “Fifty years ago, when over a third of the American workforce was unionized and most big industries were oligopolies, it was fairly easy for unionized workers to get higher wages and benefits without putting any individual company at a competitive disadvantage. The higher wages and benefits were merely passed on to consumers in the form of higher prices or came out of profits that would otherwise go to investors. Today, though, most companies are in fierce competition because new technologies combined with globalization have destroyed the old oligopolies and allowed many new entrants.”

Today the workers’ compensation process is confronted with the complexity of the causal relationship of new diseases to synergistic occupational exposures to complex substances as well as traumatic events. Multiple bureaucratic benefits programs that are not formally connected burden the system with claims and liens. Revenue is limited by fewer manufacturing facilities and it is more costly to provide medical treatment and pharmaceutical protocols that result in miraculous recoveries as well as serious and fatal unfortunate results. Benefits must be paid out longer since the average person has a greater life expectancy, ie 1911 – 50 yrs of age and 2007 – 78 years of age.

As in medicine, one must look at both subjective complaints and objective findings to guide its evaluation of the workers’ compensation system. One can hear the cry’s of injured workers “Waiting in Pain,” and of the injured workers and the families of those who did not survive the compensation system. Stories of frustration and outrage are reported in the press. Testimony to the NJ Senate will come from the stakeholders who have economic interests in the system and those who are organized representatives of those who are unable to speak any longer. Those voices must be heard and evaluated. It is important to heed to words and wisdom of all and evaluate them in the context of self-motivation.

The compensation system has been portrayed as, “a dead elephant in the room,” and one that fails to carry out the legislative intent of 1911. Professor Emeritus, John F. Burton, Jr., of Rutgers University of the School of Management and Labor Relations, describes the NJ system as, "It's kind of a sleepy system…” that is “…not particularly worker-friendly."

Unlike The Constitution, the workers' compensation act deals not in the theoretical and vague general concepts of Democracy. The compensation act is a document, which within its four comers, speaks with certainty, specifics and details.

The program has failed because under the present system the Legislative intent cannot be carried out. One cannot drive a 1911 model car on the NJ Turnpike today. Workers' Compensation should be viewed in that context, and not as a cash cow for any interest parties.

The Act can no longer provide medical treatment in an efficient and effective manner consistent with the legislative intent to provide social remedial benefits through a liberal and summary social insurance program. Medical coverage has become acute in NJ and in other jurisdictions. Almost a majority of workers will soon be uninsured for major medical coverage. NJ should take the initiative, as other states have, to provide for universal health care. NJ should combine workers' compensation medical coverage with a universal employer based medical care program and have a single payer system. A single payer system will be cost effective, efficient and provide more appropriate delivery of medical care.

The workers' compensation system began in 1911 with the noble mission as a social remedial system providing an efficient and certain system of benefits to injured workers. Today, the system struggles to protect employees as the rapidly evolving landscape is demanding increased attention to reconsideration of an IHC system in light of the consequences of the program's costs and the consequences of being uninsured for healthcare benefits. The participants in the current program, including employees and employers , will require a more balanced and certain medical delivery system. The lack of healthcare coverage takes an enormous toll on the uninsured, which results in avoidable deaths each year, poorly managed chronic conditions, undetected or under treated cancer and untried life-saving medical procedures. An Integrated Health Care plan is a potential national shift to reduce costs so that a healthcare safety net can be maintained for workers and their families.

“Full-time healthcare would save money. Instead of paying for two insurance plans – one to cover healthcare for injuries and illnesses on the job and another for injuries and illness off the job – businesses would buy one plan. As Roger Thompson, former director of Travelers Insurance Workers’ Compensation Strategic Business Unit put it, the present system is ‘like having two trains going down separate tracks and it doesn’t make a lot of sense to have all the administrative costs to maintain these separate systems.’” R. McGarrah, “Full-time Healthcare for America’s Working Families [Draft],” AFL-CIO (August 22, 2003).

In the short run, adopting such concepts, proposed by Senator Stephen M. Sweeney and Assemblyman Neil M. Cohen, would be fine initial steps:

• prohibiting the future raiding of revenue on designated workers' compensation funds (CSR-60) should be enacted;
• swifter scheduling and use of continuous trials;
• greater permanent, temporary rate and dependency [A-2499], benefits;
• rate increases [A-2498] should be enacted;
• a review of judicial appointments as recommenced in the 1974 by the State Commission of Investigation report;
• an enhanced in-service judicial training curriculum;
• exclusive jurisdiction of the Division of Workers compensation over medical fee disputes [A-2501];
• a less burdensome Uninsured Employer Fund system to shift the responsibility to the State to locate and serve responsible parties and in the alternative to carryout the mandate of the Legislature to make payment to uninsured workers and asbestos victims expeditiously and even more swiftly in exigent cases;
• an independent oversight commission [A-2503] should continuously evaluate the status and progress of this system that handles trust funds and benefits valued at over $1.8 Billion dollars per year; and
• Data Match with the Centers for Medicare and Medicaid Services to comply quickly with the Medicare Secondary Payer Act which was enacted decades ago.

By evaluating the health of the compensation system thorough an intensive analysis of both the objective findings and subjective complaints, the NJ Senate will have the opportunity to enact modern, creative and innovative solutions that will be able meet the present needs of the workers, the employers and taxpayers of State. The NJ Legislature has the opportunity to craft an up-to-date system that will cure the ailing and antiquated workers’ compensation system and embrace today’s needs and tomorrow’s future and bring the State into a new century.