Radiation Injury, Occupational Disease and Material and Non-Material Damages Claims Arising from Denial of Şua Leave

Denying a person working with ionising radiation the health leave commonly known as şua leave may amount to a breach of the employer's working-order and radiation-protection obligations. However, that breach does not by itself make a cancer, cataract or other health problem that later appears in the worker an occupational disease, nor does it cause compensation to arise automatically.

The questions that must be answered separately in a compensation file are these: Was the worker entitled to şua leave in the relevant period? Was the leave granted fully and correctly? What was the worker's actual exposure to ionising radiation? What is the medical diagnosis and when did it begin? Can an appropriate causal link be established between the illness and the work? Which protective measure did the employer breach? How large are the physical, economic and non-material losses? Which judicial route and time limit apply?

This article addresses these questions by distinguishing between private-sector employees and civil servants, and by covering the period-based legislation, the distinction between occupational accidents and occupational diseases, the Institution health boards, disease-specific medical causation, dose reconstruction, the map of parties and liability, the means of proof under the Code of Civil Procedure (HMK), verified case law, and the procedural changes of 2026.

1. What is şua leave and what is it not?

Şua leave is a special health leave linked to the actual work of suitably qualified personnel in a controlled area in health services provided using ionising radiation and radionuclides. It is not the same right as annual leave and cannot replace the general annual leave, which serves a rest purpose.

The current basic regulation is the Regulation on Health Services Provided Using Ionising Radiation and Radionuclides, published in the Official Gazette No. 32162 of 13 April 2023. Under the Regulation, health leave is determined as between one day and thirty days according to the time actually worked in the controlled area. One day is taken for the first 50 hours; one more day is taken for each subsequent 50-hour band, and the upper limit of 30 days is reached in the 1,451–1,500 hour range. Accordingly, an unconditional and fixed 30-day leave for every radiation worker does not reflect the current regulation.

Leave cannot be split; it is used in the year to which it belongs, cannot be carried over to the following year, and cannot be turned into a means of making the employee work in exchange for a financial payment. Periods listed in the Regulation, such as birth, death, marriage and annual leave, falling within the relevant year are not added to the calculation of actual work in the controlled area. When calculating leave, the legislation in force for the relevant period must also be determined separately; past periods cannot be calculated automatically using today's rule.

The immediate removal from work/health leave measure applied when the dose limit is exceeded must be kept separate from the planned health leave to which the employee is entitled according to annual actual hours. The 35-hour weekly working time limit, personal dose monitoring, risk assessment and health surveillance are obligations independent of şua leave. Fulfilling one does not remedy a shortfall in another.

1/A. Which legislation applies according to the dispute period?

Because radiation-related physical harm may appear years later, applying today's leave rule directly to past years is an error. First, each working year must be identified on a separate line; then the leave, working time, dose monitoring and health surveillance provisions in force in that year must be applied.

In the decision of the 12th Chamber of the Council of State, E.2023/3019, K.2025/2741, the majority found no violation of higher norms in the provisions of the 2023 Regulation on the table of actual work in the controlled area and leave. The dissenting opinion argued in particular that the one-month leave under Article 103 of Law No. 657 could not be narrowed by a regulation. Since the decision text states that the appeal route is open, the finality/appeal status must be checked separately before publication and before each concrete application.

This period table determines only the şua leave claim. The years in which the illness arose from exposure, the employers' fault and contribution, and the limitation period for compensation are assessed separately. In the twenty-year working life of the same person, four different periods of law may apply to the leave calculation, while medical causation may be examined over cumulative exposure.

2. Who may be entitled?

Entitlement is not established solely by reference to a diploma, post or department. Working in radiology, nuclear medicine, radiation oncology, interventional procedures, an operating theatre or any other unit is important; however, the decisive examination is actual work in the controlled area and exposure conditions.

In its decision of February 20, 2024, E.2023/16380, K.2024/2775, the 9th Civil Chamber of the Court of Cassation stated that, in addition to dosimeter records, the work and operations performed by the employee, the number of daily patients/procedures, the devices, the duration and rate of exposure must be investigated, and that reports must be obtained from expert medical and technical experts in the field and, where necessary, an on-site inspection carried out at the workplace.

For this reason, none of the following persons can automatically be considered entitled or non-entitled solely because of their title:

• Radiology technician/technologist and radiologist,
• Nuclear medicine and radiation oncology staff,
• Operating theatre staff using fluoroscopy or C-arm fluoroscopy,
• Interventional cardiology or interventional radiology team,
• Dental imaging unit staff,
• Other health personnel working with a radiation source or device.

In every case, the definition of the controlled area, the workplace, the nature of the device, the employee's distance from the source, shielding, the patient/procedure volume and the actual hours for the relevant year must be examined together.

3. Why does non-granting of leave matter?

Incomplete or no granting of şua leave may have consequences in three different fields of law:

1. Work and leave right: The leave to which the employee is entitled must actually be granted, and the working order must be lawfully organised. The consequences for past leave/receivables are assessed according to whether the employment relationship continues and the legislation of the period.
2. Occupational health and safety: Recording leave is one of the obligations to reduce exposure time, supervise the work schedule and complete protective organisation. However, it does not replace substitution, shielding, distance, time, personal protective equipment, training, dosimetry and health surveillance.
3. Evidence for compensation: Denial of leave is a fact that may show the employer's breach of regulations and organisational fault. However, it does not prove by itself that the illness arose from radiation.

Health leave is not a medical treatment. It cannot be concluded with certainty that the leave "repairs" DNA damage that has already occurred on a particular day or prevents the disease. Its legal function is to ensure that the employee stays away from the exposure environment in the period prescribed by the legislation and that the protective working order is applied.

3/A. Is a sudden event an occupational accident or repeated exposure an occupational disease?

Every health injury linked to radiation does not fall into the same social security category. The legal classification must be made according to the way in which the process that caused the injury occurred, not according to the name of the illness.

The fact that an event has been reported as an occupational accident does not eliminate the claim of exposure spread over years; nor does the determination of an occupational disease make examination of a concrete acute event unnecessary. Incorrect classification may lead to loss of rights in terms of reporting period, SSI examination, the competent court and the evidence plan. For this reason, the question "occupational accident or occupational disease?" must be answered by the chronology of the event and the exposure, not by the title of the petition. The reporting obligation and period must also be checked separately according to the insured status and the time and manner in which the event became known.

4. The scientific distinction between radiation injury and occupational disease

The health effects of ionising radiation are not uniform. The World Health Organization states that high doses may cause acute or delayed tissue/organ effects and that the effect depends on the dose and dose rate. The IARC has classified X-rays and gamma rays as carcinogenic to humans. This information strongly supports the need for protection in the workplace; however, it does not by itself prove that a particular person's illness arose from exposure at a specific employer.

The ICRP's radiation protection approach aims to prevent tissue reactions and reasonably reduce stochastic risks. The NDK's public information states the occupational effective dose limit as an average of 20 mSv per year over five years, and as not exceeding 50 mSv in any single year. These limits are protection standards; remaining below the limit does not definitively exclude an individual illness, and exceeding the limit does not by itself definitively establish the cause of a particular illness.

4/A. Medical causation matrix by type of illness

"Radiation disease" is not a single diagnosis. As the type of illness changes, the relevant organ dose, the expected time relationship and the common causes that must be excluded also change. The matrix below is the minimum framework of an expert examination; it does not create an automatic presumption of occupational disease for any diagnosis.

In a specific person, there is usually no specific biomarker alone showing that chronic low-dose exposure caused a particular illness. Demonstrating an increase in risk in an epidemiological group is not by itself a decision on causation in an individual event; however, together with dose, illness subtype, time relationship and alternative causes, it may form a scientific basis. Numerical "causation probability" tools used in foreign countries are also not a rule of law binding a Turkish court. The result must rest on an assessment by the relevant clinical branch and the specialists in occupational and work-related illnesses, together with radiation physics data.

4/B. How should dose reconstruction be carried out?

Dose reconstruction is not choosing the single highest figure in the file. It is an examination that combines measured periods and periods with missing data, the employee's actual duties and the target organ within the same model, and clearly shows uncertainty.

1. Collect direct measurements: Raw period results of TLD, OSL or electronic personal dosimeters; records of NDK and of the authorised dosimetry service; extremity and eye dosimeters, if any, must be obtained.
2. Test the validity of the badge data: It must be investigated to whom and when the badge was delivered, whether it was returned, whether it was actually worn during work, and whether it was used under or over the lead apron at collar level. Constant zero, missing or unusually high values must be checked by comparing them with the workflow.
3. Establish a duty-exposure matrix: For each device and procedure, the employee's position, distance from the source, shielding and lead apron, procedure/fluoroscopy time, and shift matched with patient/procedure numbers must be matched historically.
4. Interpret device and procedure data correctly: PACS, RIS, HBYS and device logs; where available, Radiation Dose Structured Report, kerma-area product (KAP/DAP), CTDIvol and DLP data may support the workload and the model of scattered radiation. These are essentially patient/device outputs; none of them can be treated as the employee's personal dose without conversion and a geometric model.
5. Add area and technical safety: Area measurements, shielding project, quality control, calibration, maintenance, leak tests and unusual event records must be read together with the duty matrix.
6. Calculate the target organ separately: Effective dose may not replace the lens, thyroid, breast, lung, active bone marrow, skin or extremity dose needed for a particular illness. As ICRP 139 explains for interventional procedures, the use of two dosimeters, one under the apron at the trunk and one above the apron at collar level, may provide the best available information for estimating effective dose; the collar dosimeter also provides data for lens dose. Depending on the duty, a ring/extremity dosimeter may be required.
7. Report internal exposure and uncertainty separately: When working with open radionuclides, external dosimetry alone is not sufficient. An appropriate internal dose assessment according to the radionuclide, route of intake and biokinetics is required. Missing years must not be filled with a single precise value; the assumptions used, low/high scenarios and the confidence interval must be clearly stated.

The final report must distinguish between the measured dose, the modelled dose and the period for which no data exists. "0 mSv", "no record" and "below measurement" are not the same fact. Instead of a single decimal result that creates false precision, a range justified by data quality and sensitivity analysis is more verifiable.

5. Conditions for occupational disease and employer liability

Assessing an illness as an occupational disease for SSI purposes and the employer's private law compensation liability are related but not identical matters. The file usually examines the following elements:

• A valid and documented medical diagnosis,
• An occupational connection between the work performed by the employee and the illness,
• The nature, intensity, duration and timing of exposure,
• The expected latency/development period of the illness,
• The employer's breach of its obligations to take precautions, supervise and provide training,
• An appropriate causal link between the employer's breach and the damage,
• Temporary or permanent incapacity for work, cost of treatment, loss of earnings or non-material damage,
• Previous workplaces, medical history and alternative causes,
• Where there is more than one employer, the contribution of each to the exposure and the damage.

As emphasised in the decision of the 10th Civil Chamber of the Court of Cassation, E.2020/7011, K.2021/4792, the existence of the illness alone is not sufficient; an appropriate causal link must be established between the illness and the work carried out. The decisions E.2024/5160, K.2024/6367 and E.2024/6591, K.2025/5113 require that medical history, all working periods, workplace conditions, similar cases, measures taken and the contribution of each employer be determined through a multidisciplinary examination.

5/A. Who may be liable and on what legal basis?

In a radiation file, the word "employer" is not a single liability label covering all actors. For each defendant, the legal relationship, breach, causation and damage must be established separately.

It cannot be said that the rule of liability for an undertaking posing a significantly dangerous risk under Article 71 of the TBK automatically applies to every health institution working with radiation. The nature of the undertaking, the realisation of the special danger, the damage and causation must be discussed separately in each concrete case. This provision can be raised as an alternative or supplementary legal basis only if its conditions are explained; it does not render the examination of the employer's fault and duty of supervision unnecessary in advance.

6. The employer's main obligations

When Law No. 6331 on Occupational Health and Safety, Article 4 et seq., Article 417 of Law No. 6098 on the Turkish Code of Obligations, Law No. 3153 and the relevant radiation protection regulations are considered together, the employer's obligations are not limited to keeping a leave chart. Depending on the nature of the concrete workplace, the employer may be required to:

• Carry out and update the risk assessment,
• Reduce the hazard at source and apply the principles of time, distance and shielding,
• Correctly classify controlled/supervised areas and restrict access,
• Have devices maintained, calibrated and quality-controlled,
• Have personal dosimetry duly provided, monitor the results and investigate abnormalities,
• Keep area dose measurements and event records,
• Provide appropriate personal protective equipment and supervise its use,
• Provide training and information specific to the duty,
• Ensure pre-employment and periodic health surveillance,
• Plan the weekly working time and health leave correctly,
• Take immediate protective action in case of dose excess or unusual exposure,
• Retain health data and dose records in accordance with the legislation

may be required. The employer's failure to produce or retain records may matter in the evaluation of evidence; however, the absence of a record does not by itself prove the illness or causation.

Avoiding work in serious and imminent danger

An employee facing a serious and imminent danger under Article 13 of Law No. 6331 may apply to the occupational health and safety board or, where there is no board, to the employer, requesting that the situation be determined and the necessary measures taken. If a decision is made in favour of the request, a right to refrain from work arises until the measures are taken, and during this period wages and rights arising from the laws and the employment contract are protected. If the danger is serious, imminent and unavoidable, the employee may leave the dangerous area and go to a safe place without having to comply with the prescribed procedure.

If the necessary measures are not taken despite the request, the consequences for terminating the employment contract are assessed according to the employee's status and the law applicable to them. Not every dose record, every missing leave or every abstract risk creates this right by itself; the current, serious and imminent character of the danger and the documentation of the applications made are required. If there is an urgent health risk, the workplace physician, emergency health services and the authorised radiation protection unit must be contacted without waiting for legal correspondence.

7. What evidence should be collected?

The most important feature of a radiation file is that the medical and technical timelines are established together. A file consisting only of a diagnostic report or only of dosimeter output does not form a sufficient case.

Consistently "zero" or very low dosimeter results may be an important piece of data in favour of the employer. Nevertheless, if the badge was never delivered, was used by someone else, was carried in the wrong location, was placed incorrectly under or over the lead apron, reading periods are missing, there is a laboratory or device calibration problem, or there is a clear inconsistency with the workflow, the raw record and the system as a whole must be examined. Likewise, the mere absence of a dosimeter record does not automatically confirm the employee's claim.

For lost electronic data, evidence preservation, obtaining the records from the court and, if the conditions are met, evidence preservation under Article 400 et seq. of the HMK may be considered. For this purpose, the risk that the evidence will be lost or that its later production will be substantially impaired must be made concrete.

7/A. Burden of proof, specification, production of documents and evidence preservation

Under Article 190 of the HMK, each party proves the facts on which its right is based, unless the law provides a special rule. This general rule cannot be reduced in a radiation file to an automatic formula of "the employer must prove" or "the employee must produce all records". The employee specifies the actual duty, the damage and the occupational connection on which the claim is based. The employer, if it relies on leave it claims to have granted, training, protection or supervision it says it provided, or records that should be kept in its own system, presents them. Ease of proof and the party in whose control the evidence lies are important for the court's evaluation of evidence; however, the statutory burden of proof cannot be reversed without reasons.

Under Article 194 of the HMK, instead of an indeterminate request such as "all radiation records", each fact and the evidence linked to it must be specified. For example, a request in the form of "the shift, device log and dosimeter delivery-reading records of the operating theatre using C-arm fluoroscopy for January–June 2021" makes both the enforcement of a production order and the expert review possible.

For the court to order production of a document in the possession of a party under Articles 219–220 of the HMK, the relevance of the document to the dispute and a sufficient description must be shown. Failure to comply without an acceptable reason with a properly issued production order by the court may have consequences for proof of the fact relating to the conditions in Article 220 of the HMK. This consequence does not automatically amount to a presumption of "winning the case"; first, the existence of the document that may be produced, its relevance, the scope of the order and the reason for non-production are examined. For documents held by third persons, the provisions of the HMK on the production of documents by third persons apply.

Where specialist technical or medical knowledge is required, an expert is appointed under Article 266 of the HMK. The parties must show the incomplete, unclear or contradictory points in the report with specific questions under Article 281 of the HMK; under Article 282 of the HMK the court must freely evaluate the report together with other evidence. The expert must not make a legal characterisation; the expert must explain the scientific-technical reasoning of the dose calculation, the medical correspondence, the breach and the contribution analysis.

Where there is a risk of deletion, overwriting, replacement of the device or loss of witness memory, evidence preservation under Article 400 et seq. of the HMK may be considered before or during the action. The risk must be made concrete by the record system, the retention period and the date range. Article 50 of the TBK gives the court the power to determine the amount, where full proof of the amount of damage is not possible, by taking into account the ordinary course of events and the measures taken by the injured party; however, this provision does not make up for the total absence of proof of the breach and the appropriate causal link.

8. The SSI occupational disease process

Under Law No. 5510, an occupational disease is a temporary or permanent illness, physical or mental disability suffered by the insured person because of repeated exposure arising from the nature of the work performed, or due to the conditions of carrying out the work.

In practice, the process generally proceeds as follows:

1. The diagnosis and documents are prepared at health service providers authorised by SSI.
2. For insured persons under 4/a, the employer fulfils its notification obligation within three working days from the date on which it learns of the occupational disease. If the employer does not notify, the employee or beneficiaries may apply to the Institution.
3. The health report, work/exposure documents and other records are evaluated by the Institution Health Board.
4. Objections and judicial routes under the social security legislation are used against the decision, depending on the concrete status.
5. If the conditions are met, the temporary incapacity allowance applies; if it is determined that the capacity to earn in the profession has decreased by at least 10%, permanent incapacity income becomes relevant.

Permanent incapacity income should not be described as a "fixed and unconditional lifetime payment"; there may be control examinations, changes in the rate and cases of legal termination or modification.

The determination of occupational disease by SSI is a strong and often central element in a compensation action against the employer. However, the Institution's decision and the employer's fault and liability for compensation are not the same decision. If the occupational disease status is disputed, the court may stay the proceedings until the Institution process is completed or until the separate determination dispute is resolved. The path to follow must be determined according to the insured status and the current Institution decision.

Occupational disease list, obligation period and illness outside the list

The fact that an illness appears in the Occupational Diseases List under the Regulation on Procedures for Determining the Loss of Working Capacity and Loss of Earning Capacity does not by itself complete occupational causation for that person; the illness, occupation/work, exposure period and obligation period conditions in the list must be concretised. "Obligation period" means the longest period between the date on which the insured person actually left the work that caused the illness and the date on which the illness appeared; "exposure period" means the minimum time required for the start of contact with the harmful agent and for the appearance of disease symptoms. None of these is the same concept as the limitation period for the action.

Within the framework of the conditions in Article 14 of Law No. 5510, the assertion that an illness not on the list arose from work, or that the period provided in the list has been exceeded, does not remove the claim from legal and medical examination solely for that reason. The Institution's competent health boards and, where necessary, the Social Insurance Supreme Health Board evaluate the illness-occupation link on the basis of medical and technical documents. The list, obligation period, clinical diagnosis, nature of the work and actual exposure must be reported under separate headings.

Institutional decision flow and contradictions between reports

1. Suspicion and health documents: The health board report of the authorised health service provider and the medical documents on which it is based are completed. The employer's failure to notify does not prevent the insured person or beneficiaries from applying to the Institution.
2. Work and exposure examination: SSI collects the workplace, duty, insurance, occupational history and exposure documents and conducts the necessary examination and inspection process. A diagnostic report does not substitute for evidence of the working condition.
3. Institution Health Board: For occupational disease and loss of earning capacity, the file is evaluated by the Institution Health Board. If there is missing work/dose data, it must be questioned on which assumption the decision is based.
4. Social Insurance Supreme Health Board: An objection to the Institution Health Board decision may be brought before the Social Insurance Supreme Health Board through the provincial/central unit of SSI, using the objection petition published by the Institution. The Board's decision is the final administrative stage for the Institution; it does not remove judicial review for the parties of the dispute.
5. Litigation and independent medical examination: During the action, depending on the nature of the dispute, the court may obtain reports from the Forensic Medicine Institution or the relevant specialist boards of university hospitals. These reports are not an automatic "higher board" replacing the administrative objection to SSI; they are evidence for the court.
6. Resolving contradictions: Where there is a contradiction between the Institution, the Supreme Health Board, Forensic Medicine and university reports as to illness, rate, onset or causation, the subject of the contradiction must be clearly determined and a competent and more comprehensive board report that can be controlled must be obtained.

The decision of the General Assembly of the Court of Cassation dated September 25, 2024, E.2023/10-287, K.2024/474 relates to a special procedural situation: in a file where the Institution health boards refrained from deciding, and where the occupational diseases hospital and the 1st and 3rd Specialist Boards of the Forensic Medicine Institution had consistent reports, it was accepted that the court could proceed to the merits. This decision cannot be generalised to mean that the SSI process may be skipped in every case; it must be read within the limits of the exceptional event in which the institutional process has actually stalled and consistent, competent reports exist.

9. The path for private-sector employees and civil servants is different

For a person working under an employment contract, a pecuniary and non-pecuniary compensation dispute arising from the employer's breach of its occupational health and safety obligations is, as a rule, heard in the labour court. The defendants must be correctly identified, as must the insured status and the relationship between subcontractor and principal employer. In social security disputes, such as annulment/determination of an SSI decision, the Institution's status as a party is assessed separately.

For a civil servant, the damage may arise from an administrative act or administrative action. Under Articles 12 and 13 of the Administrative Procedure Law (İYUK), a distinction is made between the application, the full judicial review and the action period. For damage arising from an administrative action, an application to the administration concerned may be made within one year from the date on which the action became known and in any event within five years from the date of the action; the action period may become relevant after rejection or after the lawful response period has passed. Since "knowledge" and the start date may be disputed in hidden or gradually emerging illnesses, an application must be made without delay as soon as the diagnosis and the occupational connection are learned. For damage arising from an administrative act, the options in Article 12 of the İYUK are also examined separately.

The fact that the hospital or institution is publicly owned does not by itself show that the employee is a civil servant. Public personnel employed with worker status and civil servants or contract public employees may follow different routes.

10. What may be claimed under pecuniary compensation?

Depending on the concrete event and the evidence, the following heads may arise in calculating pecuniary damage:

• Actual loss of earnings during the period of temporary incapacity for work,
• Damage linked to permanent loss of working capacity/capacity to earn in the profession,
• Documented and necessary treatment, medicine, transport, care and auxiliary expenses,
• Damage arising from the shaking of economic future,
• In the event of death, funeral expenses and loss of support.

The calculation cannot be made using a fixed online formula or an amount from a comparable file. Age, actual wage, active/passive period, distribution of the rate of incapacity for work, fault and inevitability, the past/future period, SSI payments and the current actuarial method are considered together.

The recoverable part of the income bound by SSI, and payments covering the same damage, may be assessed in the calculation in order to prevent double recovery. The decision of the 10th Civil Chamber of the Court of Cassation dated March 19, 2024, E.2023/14034, K.2024/2880, emphasises the need to investigate the first advance capital value subject to recourse by the Institution in the context of an occupational accident. In an occupational disease file too, the nature of the payment and its recoverable part must be determined concretely.

11. Compensation and increased claims after 31 July 2026

Law No. 7589 has introduced important changes concerning bodily injury calculations and the procedure for actions:

• Under the provision added to Article 55 of the TBK, interest runs from the date of the judgment on compensation for the unknown period, and from the date of the harmful event on compensation for the known period.
• Payments made before the start of the proceedings are set off in proportion to the compensation amount on the date of payment.
• These amendments to Article 55 of the TBK apply, under the transitional provision, to harmful events occurring after the entry into force of the Law; earlier events are subject to the old provisions.
• Article 107 of the HMK was repealed as of 31 July 2026. In uncertain-claim actions opened before its repeal, the old provision continues to apply.
• Under Article 109/4 of the HMK, in a partial action the claim may be increased once until the end of the investigation; for the increased part, limitation is deemed interrupted on the date of the action, and the prohibition on extending or changing the claim does not apply to the increase.

These provisions must be applied in each file by checking the date of the event, the date of the action, the nature of the claim and the transitional provisions. The recommendation in older articles that an "uncertain-claim action must always be filed" is no longer current.

12. Non-pecuniary damages

Where bodily integrity is impaired under Article 56 of the TBK, a suitable non-pecuniary damages award may be made if the characteristics of the event justify it. In the case of death or serious bodily harm, the right of relatives to non-pecuniary damages may also arise depending on their conditions.

Non-pecuniary damages are not a mathematical tariff, and their purpose is neither enrichment nor punishment. The seriousness and permanence of the illness, the treatment process, age, the nature of the fault, the effect of the event on working life and everyday life, the social and economic situation of the parties, the purchasing power of money and equity are considered together. An amount awarded in another file is not a guarantee for this file.

13. Is mediation mandatory?

Under Article 3/3 of Law No. 7036 on Labour Courts, the rule of mandatory mediation does not apply to material and non-material damages arising from an occupational accident or occupational disease, or to determination, objection and recourse actions relating to them.

However, if a claim for şua leave pay, wages, overtime, severance pay or any other ordinary labour receivable is also to be made in the preparation of the same file, it must separately be examined whether those claims fall within the scope of mandatory mediation. Treating all claims under the "occupational disease" label as subject to a single procedure may cause loss of rights. Voluntary mediation is a separate option that the parties may consider to the extent it is legally possible.

14. Limitation periods and time bars

There is no single "two-year/ten-year" formula applicable to all events in an occupational disease file.

The decisions of the Court of Cassation in claims for compensation arising from breach of the employer's duty of supervision generally rely on the ten-year limitation period under Article 146 of the TBK. However, depending on the concrete case, the provisions on tort, the learning period and the upper periods under Article 72 of the TBK, a longer criminal limitation period where the act also constitutes a crime, the development of the damage over time, and the time when the damage capable of supporting an action was learned may be discussed. The decision of the 21st Civil Chamber of the Court of Cassation, E.2018/4197, K.2019/5879, shows the importance of the analysis of learning of the damage capable of supporting an action in the case of progressively developing bodily damage; however, every new check-up does not restart the period.

For claims relating to şua leave or to labour receivables converted into wages, separate rules such as the five-year limitation period and the date on which the employment contract ends may arise. For civil servants, the administrative application and action periods in Articles 12 and 13 of the İYUK apply. Reporting to SSI and objections to Institution decisions are also subject to their own specific periods.

When the diagnosis, occupational connection or employer breach becomes known, it should not be awaited on the assumption that the "period has not yet started"; all possible periods must be placed on a timeline on the same day.

15. How should the fault and causation report be structured?

A general report from a single field of expertise is not sufficient in most files. Depending on the concrete need, the board may include an occupational health and safety specialist, a radiation physics/medical physics specialist, an occupational and work-related illness specialist, a physician from the relevant clinical branch and an actuarial expert. Where a previous workplace has contributed, the work and level of precautions at each workplace must be examined in separate periods.

It is not sufficient to put only the question "is the defendant at fault?" to the expert. The following verifiable questions are more practical:

• Which statutory provision was breached, on what date, and by which concrete act?
• What is the actual controlled-area time and duty matrix of the employee?
• Are the personal dose and organ dose data reliable; what is the margin of uncertainty?
• Is the type of illness and the latency period consistent with the exposure identified?
• What are the alternative or common causes?
• If leave had been granted, how far would the exposure period have changed; with what degree of scientific certainty can it be said that this change would have affected the illness?
• What is the contribution of each employer's and each employee's conduct to the damage?
• If unavoidability exists, what scientific and technical reasoning does it rest on?

The report must not merely give a result percentage; it must explain the records used, the scientific sources, the assumptions and the uncertainties. Where SSI, Forensic Medicine or expert reports contradict one another, no decision should be made without resolving the contradiction.

15/A. Concrete facts, principles and limits of application of verified decisions

The following decisions have been verified through full texts or decision summaries that are accessible. None of them establishes an automatic causation rule to the effect that "if şua leave was not granted, the cancer is the employer's responsibility". When using a precedent, not only the concluding sentence but the concrete facts of the decision and the reason for reversal must be taken as the basis.

The citation details and links are given as accessible on the update date of this article. Before the decisions are used in a petition, the integrity of the text, the decision date, the route of appeal and the similarity of the concrete facts must be rechecked against the UYAP/precedent database or an approved copy of the decision.

16. Possible defences of the employer and counter-examination

"The doses were below the limit." This data is important; however, the integrity of the records and the correct measurement conditions must be examined. The limit is a protection standard; it is not by itself a definitive ruling on individual causation.

"The employee did not use the dosimeter." The employer may show that it provided the device, gave usage training and supervised its use. The employee's conduct contrary to instructions may affect the distribution of fault; however, it does not automatically remove the employer's supervisory and organisational obligation.

"The illness is genetic or personal." The relevant medical factor must be evaluated concretely and scientifically. An abstract possibility does not break causation; likewise, personal predisposition does not automatically exclude occupational contribution.

"The leave records bear the employee's signature." Leave dates, attendance, device logs, HBYS/PACS procedures and shifts must be compared. If the records are consistent, they are strong evidence; if they conflict, a detailed examination is required.

"Previous employers are responsible." The whole exposure history is examined. Establishing liability without separating each employer's period and contribution may constitute an incomplete examination.

17. Application scenarios

Scenario A: No leave, incomplete dose and workflow records. The employee claims to have worked in a controlled area for years; there is no leave record and some dosimetry periods are missing. These facts may show the employer's record or organisational deficiency. Nevertheless, causation cannot be established without investigating the diagnosis of the illness, the latency period, the procedure volume, area measurements, witnesses and alternative causes.

Scenario B: Leave missing, doses regular and low. An error in the leave calculation may constitute a separate violation of the right to work. As regards the compensation for illness, however, low and reliable dose data is an important counter-evidence in favour of the employer in the appropriate causation assessment; the medical board weighs all the data together.

Scenario C: Dose excess and unusual event. Where the alarm, event minutes, biological dosimetry and the timing of acute symptoms are consistent with one another, the link between the event and the damage may be established more strongly. Nevertheless, the organ dose and the medical suitability of the diagnosis must be determined.

Scenario D: Multiple hospitals/employers. If, within fifteen years of work, there were different workplaces, a conclusion cannot be reached solely from the records of the last employer. Earlier exposures and the protective measures of each employer are assessed in separate periods.

Scenario E: A period overlapping with maternity or paternity leave. Maternity, birth or annual leave periods are not added to the actual controlled-area working hours. Different types of leave cannot be substituted for one another; the şua leave calculation for the relevant year is made separately according to actual working records. The specific occupational health and safety measures for protecting pregnant employees from radiation risk also apply independently.

18. Step-by-step application and preparation of an action

1. Determine the status: Distinguish between worker, public worker, civil servant, contract personnel, subcontractor employee or self-employed person.
2. Establish a timeline: Place the workplaces, units, devices, leave, dose records, first symptoms, diagnosis, treatment and SSI procedures in chronological order.
3. Preserve the records: Request in writing that the personnel/leave/dose/procedure/device records be kept and that copies be provided. Do not share health data by open email or in publicly accessible folders.
4. Complete the medical file: Collect the records of the authorised health service provider, pathology and the relevant specialties; do not discard earlier illnesses and treatments.
5. Check the SSI process: Determine the status of the notification, the Institution Health Board decision, the objection and the income documents.
6. Determine the judicial route and the period: Distinguish between the labour court, a social security dispute or administrative jurisdiction.
7. Assess the risk of loss of evidence: For HBYS/PACS logs, cameras, devices or digital shift records that may be deleted, consider evidence preservation where necessary.
8. Build the expertise plan: Keep separate the calculations of medical causation, radiation physics, occupational safety fault and actuarial matters.
9. Separate the claims: Do not assume a single procedure for occupational disease compensation, the SSI determination, the şua leave/labour receivable and administrative full-jurisdiction claims.
10. Apply the transitional provisions: Determine the regime of HMK Article 107, HMK Article 109/4 and TBK Article 55 by the date of the event and of the action.

19. Sample request text for records

Subject: Request for preservation/copies of records concerning work with radiation, health leave and dose records

I request that, in relation to the duties I performed during the period …/…/… to …/…/…, the actual working hours in the controlled area, shift and on-call rosters, health/şua leave records, raw personal dosimeter results and delivery-return information, area measurements, maintenance-calibration/quality control documents for the devices I operated, risk assessments, radiation protection training records, personal protective equipment delivery records, and procedure/HBYS-PACS logs that can be linked to my identity be kept for their applicable retention periods, and that access or copies be provided in accordance with the legislation in respect of my personal data.

This sample must be adapted to the status of the concrete case and to the data security procedure of the institution. Third-party patient data must not be requested; if necessary, it should be obtained through the court, under masking and restricted-access measures.

20. Health data and confidentiality

Diagnosis, genetic information, pathology and health board records are special category personal data. The right to collect evidence does not authorise the disclosure of health data unrelated to the file. Documents must be kept to what is necessary, access authorisation must be restricted, they must be transmitted through a secure channel, and the data of third persons must be masked where possible.

When patient/procedure data is requested from the court, the areas sufficient to prove the employee and the workload must be identified; irrelevant elements such as patient identity must be anonymised or opened only to the expert/court. No health document, open identity or dosimeter number may be shared in internet publications.

21. Frequent mistakes

• Assuming that every radiation worker automatically has 30 days of leave,
• Confusing şua leave, the 35-hour weekly limit, annual leave and dose-excess leave,
• Presenting the denial of leave as the definitive cause of the illness,
• Establishing entitlement solely on the basis of a title or payroll,
• Reading dosimeter records independently of the workflow and calibration,
• Keeping out previous workplaces and alternative medical factors,
• Regarding an SSI determination and the employer's fault as the same decision,
• Assuming the labour court route applies to a civil servant,
• Assuming that all claims are subject to the same mediation regime,
• Believing that HMK Article 107 is still in force after 31 July 2026,
• Sharing health data through insecure channels,
• Reducing limitation to a single date and a single period.

22. Frequently asked questions

Does denial of şua leave alone prove an occupational disease?

No. A breach of leave may show the employer's violation of regulations; the illness, exposure, appropriate causation, damage and liability must be proven separately.

Does every radiation worker have 30 days of şua leave?

No. Under the 2023 Regulation, leave is determined between 1 and 30 days according to the actual working hours in the controlled area. For past years, the regulation in force on that date is the basis.

Can şua leave be deducted from annual leave?

No. Health leave and annual leave are separate rights. As a rule, one cannot be used in place of the other.

Can leave be converted into money?

While the employment relationship continues, the essential matter is that the leave is used in accordance with its purpose. The outcome and calculation of a receivable after the employment contract ends are assessed separately according to the legislation of the period and Court of Cassation practice. Making payment in place of leave in order to keep the employee working with radiation is not consistent with the protective purpose.

If the dosimeter shows "zero", can a lawsuit not be brought?

This record is an important counter-evidence; however, the delivery, use, position, reading periods and reliability of the device/laboratory of the badge may be investigated. A zero record does not automatically end the action, and the absence of a record does not automatically win the action.

Is compensation certain if the dose limit was exceeded?

No. An excess may be a serious protection breach and strong evidence; nevertheless, medical causation and damage relating to the specific illness must be proven.

Does exposure below the limit entirely exclude the possibility of illness?

No. The limits are radiation protection standards. Individual causation is assessed by experts together with cumulative dose, type of illness, latency period and other factors.

What happens if the employer does not make a notification?

The employee or beneficiaries may apply to SSI. The administrative and financial consequences of the employer's breach of its notification obligation may also arise separately.

Does an SSI occupational disease decision automatically give rise to compensation?

No. The Institution's decision is very important for the occupational connection; the employer's fault, appropriate causation, damage and calculation are separately examined in the litigation.

Is mediation required before a compensation action?

Pecuniary and non-pecuniary compensation arising from occupational disease and the determination, objection and recourse actions relating to it are outside mandatory mediation. Ordinary labour receivables claimed together require separate checking.

Does everyone working in a public hospital go to administrative jurisdiction?

No. It must be determined whether the employee is a civil servant/contract public employee or a worker subject to an employment contract.

Who is responsible where there are several employers?

The exposure, measures taken and contribution to the illness at each workplace are examined. Responsibility is determined by the legal relationships of the concrete case and the scientific contribution analysis.

Which illnesses are automatically radiation occupational diseases?

No individual diagnosis can be imposed automatically on a specific employer solely because of its name. For cancer, cataract or any other illness, duty, dose, latency period, medical characteristics and alternative causes are examined together.

How long does a case take and how much compensation is awarded?

Duration and amount cannot be guaranteed in advance, due to the number of parties, the SSI process, expert boards, medical records and legal remedies. A sound assessment requires complete records and a concrete calculation.

Conclusion

Denial of şua leave is a serious problem of legislation and work organisation in terms of protecting a person working with radiation. Nevertheless, in the law of compensation, the outcome does not arise from a single leave form; it arises from the joint assessment of entitlement, actual exposure, medical diagnosis, appropriate causation, the employer's precautions and measurable damage.

A proper file combines the leave records with dosimetry, the workflow with device and area data, the workplace history with the medical history, and the SSI process with the correct judicial route on one timeline. In this way, the risk to the employee's health is neither minimised nor a scientifically unestablished causation accepted in advance.

This general information text, prepared within the institutional knowledge accumulated in legal practice since 1999 by Att. Umut Güneş, has its working centre in Antalya for the law firm. This statement does not constitute a commitment as to outcome, period or compensation in any specific matter.

Legal and medical information note: This article is for general information only; it is not a legal opinion, a medical diagnosis or a guarantee of outcome for a concrete case. The legislation may change according to the date of the event and of the action. In a personal file, health, radiation physics, occupational safety, social security and procedural law must be assessed together.