California Stoneworkers With Silicosis Struggle to Get Workers’ Comp

Occupational doctors are simultaneously pressing California regulators to restrict engineered stone, the countertop material many physicians believe is driving the surge in silicosis cases, a claim disputed by manufacturers of the popular product in a multibillion-dollar industry.

The companies oppose the move to limit engineered stone, also known as quartz or artificial stone, arguing that it’s not their product that’s causing the problem, but fabrication shops that fail to follow proper safety measures.

Taxpayers are bearing the cost of lifesaving medical treatment for many sick stoneworkers, including lung transplants estimated at more than $1 million each. Medi-Cal, the state’s public health insurance program, was the main payer — not workers’ compensation — even though the disease is occupational, according to a study published last year.

“Ultimately, workers’ comp should be paying for these patients’ medical care, especially if they do not have some other form of insurance, because that is the goal of workers’ comp,” said Dr. Sheiphali Gandhi, a pulmonologist at UCSF, who co-authored the report. “Silicosis, there’s no other cause other than work exposure.”

The California Department of Insurance, which oversees insurer behavior and the workers’ compensation market, did not respond to multiple requests for comment. In 2024, Insurance Commissioner Ricardo Lara requested a detailed analysis on silicosis claims to “ensure that affected workers receive the benefits they are entitled to.” But it’s unclear what the outcome was.

Lara called for an evaluation shortly after a Los Angeles Times story detailed the struggles of a lung transplant patient to get workers’ compensation from AmTrust North America, the same insurer that continues to deny Resendiz Cortes’ claim.

Mounting scientific evidence shows people get sick from inhaling toxic crystalline silica particles generated when cutting or polishing artificial stone, even when safety precautions are followed. The silica dust released by engineered stone is much more dangerous than that of granite and other natural stones, doctors say.

The Occupational Safety and Health Standards Board plans to vote Thursday on whether to advance a medical association’s petition to ban the fabrication and installation of artificial stone with more than 1% crystalline silica. In an analysis disclosed last week, the board’s staff concluded a prohibition may be the quickest and most cost-effective way to stem the industry’s silicosis epidemic.

“Why are we keeping a toxic product in our state that is costing taxpayers millions of dollars?” said Gandhi, who cares for dozens of silicosis patients. “It’s not benefiting the California population other than just the way people’s countertops look.”

Silicosis is an ancient illness afflicting stonemasons, sandblasters and miners that has resurfaced in the U.S. as artificial stone became the top countertop material. The global market for engineered stone, valued at $26.5 billion in 2025, is estimated to reach $45 billion by 2033.

Consumers prefer it to natural stones because it’s often cheaper, stain-resistant and available in beautiful designs and colors. But many ignore the risks the material brings to the workers who make and install their kitchen and bathroom countertops.

Australia became the first country to ban artificial stone in 2024, and some manufacturers have developed alternatives with lower crystalline silica.

In California, the only state actively tracking silicosis linked to the material, 31 stoneworkers have died, and nearly 60 have undergone lung transplants since 2019. At least 560 people have been diagnosed with the disease, a figure that’s expected to balloon. Most of these cases, 75%, were confirmed over the last three years.

Nearly all of those sick statewide are low-income Latino immigrants who didn’t know about the dangers of inhaling engineered stone dust until they or coworkers got sick.

Resendiz Cortes worked in countertop fabrication shops for a decade, first in the San Fernando Valley, which has become the U.S. silicosis epicenter, and then in Bakersfield. The father of three girls said a back injury, which he attributes to lifting heavy stone slabs on the job, also prevents him from returning to work.

He received state disability benefits for the maximum period of one year. His family now relies on help from relatives to survive. Resendiz Cortes worries about their economic uncertainty as well as the worsening shortness of breath that keeps him from biking or swimming with his children as he used to. He mourns that his entire life was transformed.

“I don’t see anything positive. Just negative things, and that doesn’t help much,” said Resendiz Cortes, who doesn’t leave his house most days. “What I want is for someone to take responsibility. In this case, the insurance companies.”

In California, all employers with more than one employee are required to have workers’ compensation insurance. Workers who suffer an injury or illness on the job should be technically eligible to receive compensation to cover medical care and long-term disability, but the system often does not function well for ill laborers.

AmTrust North America denied all liability in Resendiz Cortes’ case in an August 2024 letter viewed by KQED, citing “no substantial medical, legal or factual evidence to support the cumulative trauma claim.” The Cleveland, Ohio-based company did not respond to requests for comment.

A top executive for a second insurer, Omaha National, said the company could not comment on the specifics of Resendiz Cortes’ case but is investigating.

“We remain committed to handling every claim fairly and in accordance with policy terms and established processes,” said Chris LaMantia, Omaha National’s chief sales and marketing officer, in a statement.

Resendiz Cortes said his last place of employment, Custom Stone Interiors, dry-cut artificial stone slabs, and also used wet methods to tamp the dust down. Although he wore a filter respirator when polishing and cutting countertops, he said, he still found white dust over his face and nostrils at the end of the day. He would blow the dust out of his nose.

Custom Stone Interiors declined to comment.

“We saw your email but are not interested in a comment,” a company representative said when reached by phone before hanging up.

Statewide, at least 80 other sick stonecutters remain without workers’ comp payment after fighting for a year or longer for the benefits, according to Barry Rodich, whose L.A. law firm represents them and Resendiz Cortes. Insurers have an economic incentive to deny or delay the expensive claims, he said.

“They will always try to say, ‘Well, there’s a latency period, and it’s not my client that’s responsible. It’s somebody before us,’” said Rodich, whose firm specializes in silicosis cases. “These delays by the insurance company just make my clients worse.”

Laborers can challenge insurance denials at the state Division of Workers’ Compensation and the Workers’ Compensation Appeals Board, but obtaining a resolution can take months or years. About 460 cases were awaiting a judge’s decision at the appeals board last month, a smaller backlog than in recent years, according to the Department of Industrial Relations, which oversees the agencies.

“Penalties related to unreasonable delays or refusals are addressed through the adjudication process on a case-by-case basis and depend on the facts and circumstances of each individual matter,” the spokesperson said in a statement.

Most of the hundreds of California stonecutters with silicosis don’t seek workers’ compensation benefits because they are self-employed or past workplaces lack the insurance. Others decline to apply for benefits that will likely increase costs for their former employers, according to Rodich.

“There’s a lot of loyalty,” he said. “Some of these individuals feel like they have an allegiance to these employers. And the reason why is because they helped get them a job, they may have helped them in other ways… And so when they find out that their insurance premiums could potentially be affected in the following year, they don’t want to do anything.” 

Rodich’s firm has settled a handful of silicosis cases for amounts ranging between $1.5 million and $3 million each, usually when the workers’ disease is so advanced that a lung transplant is required, he said.

The high price tag likely elicits extra scrutiny from insurers, which aim to weed out any fraudulent claims. Insurers’ investigations aim to determine whether their client employer indeed hired the injured worker and is liable for illness.

But in the countertop fabrication industry, workers often have multiple employers over their careers, and job records might be missing, said Yvonne Lang, who has represented insurers on silicosis claims and helped settle one case recently.

“When there’s multiple employers, the employers are going to point the fingers at each other,” said Lang, a former president of the California Workers’ Compensation Defense Attorneys Association. “And if the employers are pointing the fingers at each other, the [insurance] carriers are going to point the fingers at each other.”

Insurance companies are more likely to deny claims for illnesses developed over time, when compared to physical injuries linked to a single accident, such as a ladder fall, according to experts. To fight the insurer’s denial, workers must often enlist an attorney willing to help on time-consuming and costly cases, which is another barrier.

Sick workers’ struggle to get compensation benefits has led the federal government to intervene and create separate programs to support some of them, such as for Virginia coal miners with black lung disease, and nuclear plant workers with cancer from radiation, said Glenn Shor, a retired public policy and research analyst with the California Department of Industrial Relations, Cal/OSHA, and Division of Workers’ Compensation.

For insurers, “denial is often the first step because they think some of those cases will go away,” said Shor. “If they’re denied, some people will contact a lawyer, but some people just say, I shouldn’t have worked at that place or I should have worn a mask more.”