By the point that Dennys Rene Rivas Williams had fallen so in poor health that he wanted new lungs, physicians at Olive View-UCLA Medical Middle expressed little doubt about what was accountable for his illness.
Docs had identified the 36-year-old with silicosis: an incurable illness brought on by inhaling tiny bits of lung-scarring silica. It was an affliction that had debilitated dozens of staff in Los Angeles County like him, who had toiled chopping counter tops sure for kitchens and bogs.
Well being officers had sounded the alarm {that a} new epidemic of the sickness was killing younger laborers amid the rising recognition of engineered stone, which is often a lot larger in silica than pure slabs. In recent times, greater than a dozen California staff who minimize counter tops have misplaced their lives to the illness.
Rivas Williams’ medical information state that his silicosis was attributable to “engineered stone fabrication/chopping,” with a physician advising him to give up his job to forestall additional injury.
But Rivas Williams had been turned down when he utilized for staff’ compensation, which is meant to cowl medical care and different advantages for laborers injured on the job. Attorneys representing the younger father have been galled, asking the place else he would have inhaled a lot silica.
Rivas Williams mentioned that the Pacoima store the place he labored was blanketed in mud, and that he and different staff have been provided solely flimsy masks, reasonably than protecting respirators. In January, he obtained a double lung transplant — a lifesaving surgical procedure however one that always means solely an extra six years of survival.
Silicosis has been referred to as an occupational sickness for hundreds of years, afflicting miners, stonecutters and others uncovered to silica mud.
The overwhelming majority of instances are tied to work, mentioned Dr. Jane Fazio, a pulmonary crucial care doctor and UCLA researcher. Amongst countertop cutters, if “somebody has this job and so they have silicosis, it ought to clearly be presumed to be work-related.”
But as California sees surging numbers of younger staff affected by the illness, many haven’t efficiently tapped staff’ compensation. Help can embrace medical care, incapacity funds and demise advantages for households.
Fazio and different researchers analyzing dozens of instances of California countertop staff struggling silicosis discovered that solely 13% had staff’ compensation advantages when identified and handled. Practically half stored working within the business even after getting the prognosis.
Staff’ compensation is meant to make sure that if staff are harmed on the job, “they don’t need to swap their livelihood for his or her well being” and “can get entry to medical care and time away from work and incapacity and other forms of sources they could have to make themselves complete once more,” mentioned Kevin Riley, director of the UCLA Labor Occupational Security & Well being Program.
California employers are required to supply staff’ compensation advantages for his or her staff, usually by shopping for insurance coverage protection. A state fund can deal with such claims if a enterprise flouts the necessities, however advocates say many staff — particularly immigrants — concern retaliation for even pursuing the advantages.
And staff’ compensation attorneys say lodging a declare isn’t any assure that laborers will get assist shortly, even for a illness roundly acknowledged as stemming from work. Lawyer Gary Rodich mentioned this summer time that his agency was representing greater than a dozen staff with silicosis who have been denied staff’ compensation advantages after they utilized — together with Rivas Williams.
Earlier than he obtained his prognosis, Rivas Williams had filed a declare that talked about injury to his lungs together with “repetitive work” accidents to his knees, shoulders and different components of his physique, aided by a distinct legal professional. The denial letter from Amtrust North America mentioned there wasn’t sufficient proof that “your alleged damage resulted out of your employment at Primus Marble,” the store the place he was working.
Shortly after he was identified with silicosis, Rivas Williams submitted an amended utility with the assistance of Rodich. In medical experiences obtained for his case, docs have drawn a direct line to his work chopping counter tops. One wrote that his silicosis was “100% work associated.”
Amtrust mentioned in Could that his case “entails a number of complicated points our claims workforce is working diligently to resolve.” It didn’t reply to questions from The Occasions about what these points have been.
Rivas Williams’ state incapacity funds ran out final yr. In January, his attorneys accused the insurance coverage firm of “unreasonable and/or frivolous delay” in a court docket submitting, saying it had left him on the verge of homelessness. At that time, almost a yr and a half had handed since his preliminary declare.
That very same month, based on his attorneys, Amtrust agreed to pay short-term advantages as the 2 sides continued negotiating. Amtrust mentioned in a Could electronic mail that “we’re assured a decision shall be reached quickly.”
Rivas Williams has to take an array of tablets morning and evening to forestall his physique from rejecting the brand new lungs. The medicines disarm his immune system, leaving him weak to different threats. His docs warn him to keep away from cigarette and marijuana smoke, so he shuts the home windows of his South Los Angeles residence.
Rivas Williams, 36, exhibits the scar from a double lung transplant.
(Al Seib / For The Occasions)
“I’m shut up virtually on a regular basis,” Rivas Williams mentioned in Spanish in an April interview. “I’m afraid to exit as a result of I’ve no defenses.”
He is aware of three males who’ve already died of the illness. When he went to say goodbye to one in every of them, “that mentally ruined me. I spiraled. I noticed his youngsters cry. And I felt like I used to be seeing my very own youngsters cry.”
The 36-year-old mentioned his objective was to help his youngsters, whom he delivered to the U.S. from Guatemala. Rivas Williams mentioned he burned by means of financial savings and piled up money owed after falling in poor health.
“Not every thing on this life is cash,” Rivas Williams mentioned. “However think about if I’m not right here.
“Their lives are going to alter.”
In June — almost two years after Rivas Williams first filed for staff’ compensation — the 2 sides reached a settlement. Rodich mentioned his consumer declined to publicly disclose the quantity.
Primus Marble, the place Rivas Williams as soon as labored, didn’t reply to messages searching for remark.
As of early July, the California Division of Public Well being had recognized 156 instances of silicosis associated to engineered stone lately — greater than 90 of them amongst residents of Los Angeles County. Practically half of these instances have been recognized final yr alone, amid rising consciousness of the silicosis epidemic.
Public well being officers consider many extra instances have gone undetected as immigrant staff go with out care or are misdiagnosed with different lung illnesses. Outbreaks of the lethal illness have erupted worldwide as engineered stone has soared in recognition.
In Australia, the place an alarming surge in instances led authorities officers to ban engineered stone, silicosis has been categorized amongst “deemed ailments” for staff’ compensation — these assumed to be brought on by work until there’s robust proof on the contrary.
If an Australian employee has silicosis, “I diagnose someone. I fill out” the paperwork, mentioned Dr. Ryan Hoy, lead doctor for the occupational respiratory illness clinic at Alfred Hospital in Melbourne. “It goes to the regulator and so they settle for the declare. They will’t deny it.”
That doesn’t exist for countertop cutters right here. California has granted “presumptive eligibility” for staff’ compensation for some illnesses — equivalent to COVID-19 sickness suffered by well being staff and first responders earlier within the pandemic — however not for silicosis claims from stonecutters.
Within the U.S., staff’ compensation differs from state to state, however the issues that silicosis victims in California have encountered usually are not distinctive. In one examine of silicosis sufferers in Wisconsin, researchers discovered many had run into issues getting staff’ compensation “and are pissed off by having to show the work-relatedness of silicosis — a situation which seldom is acquired exterior of labor.”
Virtually all have been initially rejected as a result of medical information lacked details about their work histories, which isn’t routinely gathered by many clinicians, the examine famous.
Rivas Williams says he doesn’t exit a lot as a result of he takes medicines that suppress his immune system after his double lung transplant.
(Al Seib / For The Occasions)
Too typically, “docs both don’t have the time, don’t take the time, or don’t know how one can take an entire occupational historical past,” mentioned Dr. Cecile Rose, an occupational pulmonologist at Nationwide Jewish Well being in Denver.
Silicosis could present up years after somebody is uncovered, requiring docs to additionally probe into previous employment.
Many sufferers by no means pursue the method. One evaluation of silicosis sufferers in Michigan, the place the illness has sickened folks whose work entails metallic casting or abrasive blasting, discovered solely 35% had utilized for staff’ compensation — and the proportion had tumbled over time. Different research involving a spread of industries have put the numbers even decrease.
“Even for clear-cut accidents, solely about 50% of people apply for compensation,” mentioned Dr. Kenneth Rosenman, chief of the division of occupational and environmental medication at Michigan State College.
Rivas Williams together with his spouse, Monica Abigail Santos. He worries about his household. “Not every thing on this life is cash,” Rivas Williams mentioned. “However think about if I’m not right here.”
(Al Seib / For The Occasions)
Specialists mentioned the California system tends to be smoother for staff lodging claims involving one-time accidents than for these dealing with ailments that developed over time. Rand senior economist Michael Dworsky estimated roughly 1 in 8 claims for staff’ compensation are initially denied in California, however mentioned rejection charges have tended be larger for diseases tied to office publicity, equivalent to most cancers or coronary heart illness.
If injured staff fail to get staff’ comp, “it places the burden on different sources. It places the burden in your medical insurance,” mentioned legal professional Cheryl Wallach, a board member with the advocacy group Worksafe.
Like many California staff stricken with silicosis, Rivas Williams mentioned he was insured by means of Medi-Cal, California’s Medicaid program. State officers didn’t promptly present figures for the way a lot Medi-Cal pays for such care, however physicians estimated the prices of a double lung transplant exceed $1 million.
As extra staff develop in poor health, “it’s an enormous pressure on taxpayers, when it actually must be staff’ comp” shouldering these prices, mentioned Dr. Sheiphali Gandhi, an assistant professor of medication at UC San Francisco who has studied silicosis.
