Developing a List of Compensable Occupational Diseases: Principles and Issues

Abstract

Background: A number of countries have a list of occupational disorders for use in workers' compensation processes and decisions. These lists have two potential uses - to formally recognise that a disorder may be related to work (and so be potentially compensable), or to formally identify disorders that are likely to be related to work and so can be considered to have arisen from work if sufficient relevant exposure can be confirmed. However, many of these lists have shortcomings. Objectives: The aim of this paper is to provide an overview of the concepts and approaches that should be taken into ac- count when developing a list of occupational disorders that can be accepted for fast tracking of the compensation claim. Results and Conclusions: A list of occupational disorders to be used as a schedule for compensation purposes is best based on a combination of specific disorder-exposure combinations, unless the number of potential exposures linked to a particular disorder, or the number of disorders linked to a particular exposure, make it impractical to list them all. For in- clusion in a schedule it is desirable that there is strong evidence of causal link between the occupational exposure and the disorder; there are clear and repeatable criteria for diagnosing the disorder; and the disorder comprises a considerable pro- portion of the cases of that disorder in the overall population or an identifiable subset of the population.