Valley Fever Covered By Heart-Lung Law

In 1997, Edward Gorre began working as a firefighter paramedic for the City of Tacoma, Washington. Prior to being hired, Gorre passed a demanding test of physical strength and stamina and a physical examination that included blood testing and x-rays. In 2007 he became a fire medic lieutenant.

Over the course of his career as a firefighter and paramedic, Gorre responded to thousands of residential, commercial, industrial, and wild fires. His duties also included fire suppression, search and rescue, and “overhaul,” which involves looking for seeds of fire to make sure the fire does not start up again. He was exposed to smoke, diesel, chemicals, and mold when responding to fire calls, hazardous material spills, daily building inspections, car incidents, and medic calls. Such exposures frequently placed him in close contact with patients with fever, HlNl flu virus, and other respiratory diseases. Gorre did not wear respiratory protection when he fought wildfires, inspected manufacturing plants, dug trenches, or responded to medical calls. Similarly, Gorre did not wear a self-contained breathing apparatus during overhauls; instead, his face was completely exposed.

In 2007, Gorre’s physician initially diagnosed him with hypersensitivity pneumonitis, a respiratory disease, and treated him with steroids. A dermatologist who evaluated a nodular skin lesion on Gorre’s forehead concluded that Gorre had coccidioidomycosis, also known as “Valley Fever.” Eventually, all physicians who examined Gorre except the first settled on a Valley Fever diagnosis. When the City denied Gorre’s workers’ compensation claim for his Valley Fever, a legal dispute began that wound up in the Washington Court of Appeals.

The Court found that Gorre’s conditions should have been covered by the City. The Court’s decision turned on Washington’s rebuttable evidentiary presumption that certain diseases contracted by firefighters are “occupational diseases.” The types of conditions covered by the presumption include “respiratory disease” and “infectious diseases.” The presumption of occupational disease may be rebutted by a preponderance of the evidence which may include evidence of the use of tobacco products, physical fitness and weight, lifestyle, hereditary factors, and exposure from other employment or nonemployment activities.

The Court acknowledged that Washington law did not define “respiratory disease,” and so turned to a standard dictionary definition that “respiratory disease” meant “a discomfort or condition of an organism or part that impairs normal physiological functioning relating, affecting, or used in the physical act of breathing.” The Court found that the medical testimony established that Valley Fever impairs a person’s respiratory system. A Valley Fever expert opined that Valley Fever is transmitted through inhalation exposure to arthroconidia in the soil that impacts in the lungs, usually causing pneumonic disease. Another doctor testified that (1) symptoms of Valley Fever are generally pulmonary symptoms such as coughs, fever, and sputum; (2) the cause of Valley Fever is through the production of arthrospores in the air that when breathed into the lungs, causes disease in humans; and (3) more severe Valley Fever leads to other pulmonary symptoms, such as abscesses in the lungs, chronic pneumonias, and meningitis.

“It was undisputed that Gorre had Valley Fever. The record shows that Valley Fever is an airborne disease that humans contract through inhalation, that the organism causing Valley Fever impacts in the lungs, and that Valley Fever patients suffer respiratory symptoms and pulmonary symptoms. Accordingly, we hold that Valley Fever meets the dictionary definition of ‘respiratory disease.’”

The Court also concluded that Valley Fever was an “infectious disease” covered by the statute. The City argued that since the statute listed four specific infectious diseases – Human immunodeficiency virus/acquired immunodeficiency syndrome, all strains of hepatitis, meningococcal meningitis, or mycobacterium tuberculosis – the Legislature must have intended to exclude all other infectious diseases. The Court disagreed, holding that “nothing in the plain statutory language suggests that the Legislature intended this list of four diseases to be exclusive or even illustrative; rather, it appears that the Legislature included this statutory list so that firefighters could benefit from the statutory presumption of a benefit-qualifying occupational disease if they contracted one of four specified serious infectious diseases perhaps not otherwise readily recognized as occupational diseases: HIV, hepatitis, meningitis, and tuberculosis. Thus, this list of four specific diseases illustrates the legislature’s intent to expand the scope of qualifying ‘infectious diseases,’ not to limit them.”

Gorre v. City of Tacoma, 324 P3.d 716 (Wash. App. 2014).