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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”



On Thursday, 24 Jan 2002 at 17:17:21, Alex Baskous, M.D., wrote:

Is it true, as I have heard, that if medical personnel refuse the
required Hep B series (with no proof of immunity and no medical
contraindication) and then contract Hep B, that workmans comp is
justified in declining their claim?

If true, with somewhat similar logic, is a worker who is documented to
be at risk and choses to work anyway also declined for exacerbations of
the documented contraindicating condition?


Since work comp laws vary state-to-state, this question has no one
answer.  In the states from which I handle claims, I would not feel
completely comfortable denying either of these claims.  The employer
would be responsible for, at least, the exacerbation of the pre-existing
condition.  Some states provide for a reduction of benefits if the
employee fails to follow a safety regulation.   

In the case of the Hep B infection, I would rely on the treating
physician to tell me if he/she could say with a reasonable degree of
medical certainty that the employee contracted Hep B at work.  If the
employee was working with a patient who was documented as having Hep B
and there was a possible source or cause for the transmission, then I
would bet that it would be compensible. 

In the case of the employee who is "...documented to be at risk and
chooses to work anyway...," I feel that the exacerbation would be
compensible.  The employer would not be responsible for the entire
condition, just that portion caused by the work injury.  Of course, this
can be a muddy mess to try to separate what is pre-existing and what is
caused by the work injury.  If an employer has a baseline exam
(pre-employment back screen for example), then it may be easier to



Amy L. Petersen, AIC
Claims Examiner III
Sedgwick Claims Management Services, Inc.
PO Box 540040
Omaha NE 68154
(800)486-2152, ext. 337
(402)496-6511 fax

In Ontario (Canada)WCB is "no fault" insurance, and
as such if the individual declined Hep. B. vaccination and subsequently became infected on the job, then (s)he would still be entitled to WCB benefits.  The only recourse for the employer would be the ability to prove that the condition was pre-existing...and the easiest way for this would be to establish the baseline serology at the pre-placement health review/exam.  The only other "defence" would be to make vaccination mandatory,
in a manner similar to hard hats and safety boots on a construction site, but most employers I know have been reluctant to do this...However, where there is a strong push, and an organizational climate conducive to prevention, in my exprience the vast majority of employees at risk opt for vaccination. (I am the occ doc to numerous "at risk" healthcare
  facilities in Toronto).

Dr. Gabor Lantos  P.Eng, MBA, MD
Occupational Health Management Services inc.
8 King St. E. #1500
Toronto, Ontario  M5C 1B5     

Tel: (416) 410-5018       Fax: (416) 214-5146