Actions Arising from Work Accidents and Occupational Disease
A work accident or occupational disease may give rise to different responsibilities for the employee, the employer, the subcontracting employer, the employer’s representative, third parties, the Social Security Institution and the insurance company. Whether the event is regarded as a work accident, fault, the causal link, occupational health and safety measures, loss of earning capacity, permanent incapacity for work, the support relationship and the income awarded by the SGK are assessed together.
Our work in this area:
- Notifying the SGK and the relevant authorities of a work accident
- Determination of a work accident
- Determination of an occupational disease
- Review of fault and occupational health and safety
- Losses from temporary and permanent incapacity for work
- Claims for treatment, care and loss of economic future
- Actions for material and moral compensation
- Compensation for loss of support in the event of death
- Moral compensation claims of beneficiaries
- Assessment of SGK income and recoverable payments
- The SGK’s recourse actions against the employer
- Liability of the subcontracting employer, the principal employer and third parties
- Employer liability and personal accident insurance
- Assessing the criminal investigation and the civil action together
- Preserving the scene, minutes, camera, training, risk analysis and health records
headings are covered. Material and moral compensation arising from work accidents and occupational disease, and the related determination and recourse actions, are assessed outside the general scope of mediation as a condition precedent to litigation that applies to employee or employer receivables. The nature of the specific claim should nonetheless be determined separately before filing an action.
Related detailed page: Social Security Law and SGK Cases
Service Determination and Social Security Disputes
Failure to file an insurance notification although work was actually performed, reporting incomplete working days or reporting earnings subject to premiums below the actual wage affects the employee’s social security rights. In these disputes, the scope of the workplace, the fact of work and the SGK records matter as much as the employer’s records.
In this context:
- Determination of uninsured work
- Determination of incompletely reported working days
- Determination of earnings subject to premiums
- Hiring and termination notifications
- Disputes arising from records of more than one employer or workplace
- Allegations of sham insured status and actual work
- SGK inspection reports and institutional acts
- Social security disputes that require an administrative application
- Annulment of an institutional act and labor court proceedings
- Disputes concerning the work accident or occupational disease insurance branches
- Service records that affect retirement and the awarding of pensions
- Work performed in countries with which there is a social security agreement
are assessed. Because service determination actions have features such as public order, a special preclusive period, actual work and the principle of ex officio investigation, the legal structure of the claim, which is distinct from an employee receivables action, should be taken into account.
Related detailed page: Social Security Law and SGK Cases
A Work Accident and a Service Determination Are Not the Same Action
Determination of a work accident or occupational disease, benefits from the Institution, compensation from the employer and recourse are different claims. That an event is a work accident does not by itself prove every item of compensation and its amount; fault, loss, causation and social security payments are assessed together.
Exception to mediation as a condition precedent to litigation
Under Art. 3, paragraph 3 of Law No. 7036, material and moral compensation arising from work accidents and occupational disease and the related determination, objection and recourse actions are outside the scope of general mediation as a condition precedent to litigation. This exception does not mean that all of a person’s wage receivables are also outside the scope.
SGK application and service records
In social security disputes, whether a prior application to the Institution is required is determined according to the claim. The exception provided in Art. 4 of Law No. 7036 for claims to determine periods of compulsory insurance is taken into account. In service determination, distinctions based on case law, such as the special preclusive period and cases where the Institution knew of the work, are examined separately; this is not to be confused with the five-year statute of limitations for wage receivables.
Preserve the first records
The incident report, medical records, notifications, shift and training documents, occupational safety records and witness information should be kept. In an ongoing medical emergency, medical help should be obtained first. Health data should be shared securely, and unnecessary documents should not be uploaded to the general contact form.
Preparing for the Consultation
Prepare the employment period, contract, termination or application documents and the related records. Mention missing documents and any approaching deadline at the first consultation.