Doctors said cutting countertops destroyed his lungs. He had to fight for workers' comp

By nan clip that Dennys Rene Rivas Williams had fallen truthful sick that he needed caller lungs, physicians astatine Olive View-UCLA Medical Center expressed small uncertainty astir what was to blasted for his sickness.

Doctors had diagnosed nan 36-year-old pinch silicosis: an incurable illness caused by inhaling mini bits of lung-scarring silica. It was an affliction that had debilitated dozens of workers successful Los Angeles County for illustration him, who had toiled cutting countertops bound for kitchens and bathrooms.

Health officials had sounded nan alarm that a caller pandemic of nan unwellness was sidesplitting young laborers amid nan rising fame of engineered stone, which is typically overmuch higher successful silica than earthy slabs. In caller years, much than a twelve California workers who trim countertops person mislaid their lives to nan disease.

Rivas Williams’ aesculapian records authorities that his silicosis was owed to “engineered chromatic fabrication/cutting,” pinch a expert advising him to discontinue his occupation to forestall further damage.

Yet Rivas Williams had been turned down erstwhile he applied for workers’ compensation, which is expected to screen aesculapian attraction and different benefits for laborers injured connected nan job. Attorneys representing nan young begetter were galled, asking wherever other he would person inhaled truthful overmuch silica.

Rivas Williams said that nan Pacoima shop wherever he worked was blanketed successful dust, and that he and different workers were offered only flimsy masks, alternatively than protective respirators. In January, he received a double lung transplant — a lifesaving room but 1 that often intends only an further six years of survival.

Silicosis has been known arsenic an occupational unwellness for centuries, afflicting miners, stonecutters and others exposed to silica dust.

The overwhelming mostly of cases are tied to work, said Dr. Jane Fazio, a pulmonary captious attraction expert and UCLA researcher. Among countertop cutters, if “someone has this occupation and they person silicosis, it should intelligibly beryllium presumed to beryllium work-related.”

Yet arsenic California sees surging numbers of young workers suffering from nan disease, galore person not successfully tapped workers’ compensation. Assistance tin see aesculapian care, disablement payments and decease benefits for families.

Fazio and different researchers analyzing dozens of cases of California countertop workers suffering silicosis recovered that only 13% had workers’ compensation benefits erstwhile diagnosed and treated. Nearly half kept moving successful nan manufacture moreover aft getting nan diagnosis.

Workers’ compensation is expected to guarantee that if workers are harmed connected nan job, “they don’t person to switch their livelihood for their health” and “can get entree to aesculapian attraction and clip distant from activity and disablement and different kinds of resources they whitethorn request to make themselves full again,” said Kevin Riley, head of nan UCLA Labor Occupational Safety & Health Program.

California employers are required to supply workers’ compensation benefits for their employees, typically by buying security coverage. A authorities money tin grip specified claims if a business flouts nan requirements, but advocates opportunity galore workers — particularly immigrants — fearfulness retaliation for moreover pursuing nan benefits.

And workers’ compensation attorneys opportunity lodging a declare is nary guarantee that laborers will get assistance quickly, moreover for a illness roundly recognized arsenic stemming from work. Lawyer Gary Rodich said this summertime that his patient was representing much than a twelve workers pinch silicosis who were denied workers’ compensation benefits erstwhile they applied — including Rivas Williams.

Before he sewage his diagnosis, Rivas Williams had revenge a declare that mentioned harm to his lungs on pinch “repetitive work” injuries to his knees, shoulders and different parts of his body, aided by a different attorney. The denial missive from Amtrust North America said location wasn’t capable grounds that “your alleged wounded resulted from your employment astatine Primus Marble,” nan shop wherever he was working.

Shortly aft he was diagnosed pinch silicosis, Rivas Williams submitted an amended exertion pinch nan thief of Rodich. In aesculapian reports obtained for his case, doctors person drawn a nonstop statement to his activity cutting countertops. One wrote that his silicosis was “100% activity related.”

Amtrust said successful May that his lawsuit “involves respective analyzable issues our claims squad is moving diligently to resolve.” It did not respond to questions from The Times astir what those issues were.

Rivas Williams’ authorities disablement payments ran retired past year. In January, his attorneys accused nan security institution of “unreasonable and/or frivolous delay” successful a tribunal filing, saying it had near him connected nan verge of homelessness. At that point, astir a twelvemonth and a half had passed since his first claim.

That aforesaid month, according to his attorneys, Amtrust agreed to salary impermanent benefits arsenic nan 2 sides continued negotiating. Amtrust said successful a May email that “we are assured a solution will beryllium reached soon.”

Rivas Williams has to return an array of pills greeting and nighttime to forestall his assemblage from rejecting nan caller lungs. The medications disarm his immune system, leaving him susceptible to different threats. His doctors pass him to debar cigaret and marijuana smoke, truthful he shuts nan windows of his South Los Angeles home.

Rivas Williams, 36, shows nan scar from a double lung transplant.

(Al Seib / For The Times)

“I’m unopen up almost each nan time,” Rivas Williams said successful Spanish successful an April interview. “I’m acrophobic to spell retired because I person nary defenses.”

He knows 3 men who person already died of nan disease. When he went to opportunity goodbye to 1 of them, “that mentally ruined me. I spiraled. I saw his kids cry. And I felt for illustration I was seeing my ain kids cry.”

The 36-year-old said his extremity was to support his children, whom he brought to nan U.S. from Guatemala. Rivas Williams said he burned done savings and piled up debts aft falling ill.

“Not everything successful this life is money,” Rivas Williams said. “But ideate if I’m not here.

“Their lives are going to change.”

In June — astir 2 years aft Rivas Williams first revenge for workers’ compensation — nan 2 sides reached a settlement. Rodich said his customer declined to publically disclose nan amount.

Primus Marble, wherever Rivas Williams erstwhile worked, did not respond to messages seeking comment.

As of early July, nan California Department of Public Health had identified 156 cases of silicosis related to engineered chromatic successful caller years — much than 90 of them among residents of Los Angeles County. Nearly half of those cases were identified past twelvemonth alone, amid increasing consciousness of nan silicosis epidemic.

Public wellness officials judge galore much cases person gone undetected arsenic migrant workers spell without attraction aliases are misdiagnosed pinch different lung ailments. Outbreaks of nan deadly illness person erupted worldwide arsenic engineered chromatic has soared successful popularity.

In Australia, wherever an alarming surge successful cases led authorities officials to ban engineered stone, silicosis has been categorized among “deemed diseases” for workers’ compensation — those assumed to beryllium caused by work unless location is beardown grounds to nan contrary.

If an Australian worker has silicosis, “I diagnose somebody. I capable out” nan paperwork, said Dr. Ryan Hoy, lead expert for nan occupational respiratory illness session astatine Alfred Hospital successful Melbourne. “It goes to nan regulator and they judge nan claim. They can’t contradict it.”

That doesn’t beryllium for countertop cutters here. California has granted “presumptive eligibility” for workers’ compensation for immoderate ailments — specified arsenic COVID-19 unwellness suffered by wellness workers and first responders earlier successful nan pandemic — but not for silicosis claims from stonecutters.

In nan U.S., workers’ compensation differs from authorities to state, but nan problems that silicosis sufferers successful California person encountered are not unique. In one study of silicosis patients successful Wisconsin, researchers recovered galore had tally into problems getting workers’ compensation “and are disappointment by having to beryllium nan work-relatedness of silicosis — a information which seldom is acquired extracurricular of work.”

Almost each were initially rejected because aesculapian records lacked accusation astir their activity histories, which is not routinely gathered by galore clinicians, nan study noted.

Rivas Williams says he doesn’t spell retired overmuch because he takes medications that suppress his immune strategy aft his double lung transplant.

(Al Seib / For The Times)

Too often, “doctors either don’t person nan time, don’t return nan time, aliases don’t cognize really to return a complete occupational history,” said Dr. Cecile Rose, an occupational pulmonologist astatine National Jewish Health successful Denver.

Silicosis whitethorn show up years aft personification is exposed, requiring doctors to besides probe into past employment.

Many patients ne'er prosecute nan process. One analysis of silicosis patients successful Michigan, wherever nan illness has sickened group whose activity involves metallic casting aliases abrasive blasting, recovered only 35% had applied for workers’ compensation — and nan percent had tumbled complete time. Other studies involving a scope of industries person put nan numbers moreover lower.

“Even for clear-cut injuries, only astir 50% of individuals use for compensation,” said Dr. Kenneth Rosenman, main of nan section of occupational and biology medicine astatine Michigan State University.

Rivas Williams pinch his wife, Monica Abigail Santos. He worries astir his family. “Not everything successful this life is money,” Rivas Williams said. “But ideate if I’m not here.”

(Al Seib / For The Times)

Experts said nan California strategy tends to beryllium smoother for workers lodging claims involving one-time injuries than for those facing diseases that developed complete time. Rand elder economist Michael Dworsky estimated astir 1 successful 8 claims for workers’ compensation are initially denied successful California, but said rejection rates person tended beryllium higher for illnesses tied to workplace exposure, specified arsenic crab aliases bosom disease.

If injured workers neglect to get workers’ comp, “it puts nan load connected different resources. It puts nan load connected your wellness insurance,” said lawyer Cheryl Wallach, a committee personnel pinch nan defense group Worksafe.

Like galore California workers stricken pinch silicosis, Rivas Williams said he was insured done Medi-Cal, California’s Medicaid program. State officials did not promptly supply figures for really overmuch Medi-Cal pays for specified care, but physicians estimated nan costs of a double lung transplant transcend $1 million.

As much workers turn ill, “it’s a immense strain connected taxpayers, erstwhile it really should beryllium workers’ comp” shouldering those costs, said Dr. Sheiphali Gandhi, an adjunct professor of medicine astatine UC San Francisco who has studied silicosis.