You are entitled to compensation for occupational disease

What to do if you suspect an occupational disease

The first step is to see your GP, who may refer you to an occupational doctor. He or she will assess whether it may be an occupational disease and, if necessary, refer you to a specialist centre that is authorised to recognise such diseases.

It is important to collect all evidence of working conditions – job description, length of exposure, contact with chemicals, vibration or repetitive movements (e.g. when working with a computer or on an assembly line where carpal tunnel occurs). Similarly, keep medical reports and sick leave certificates.

If the doctor recognises the illness, he or she will issue a decision to that effect, which will be sent to the employer and the insurance company. At this point, the process of settling the occupational disease compensation begins. The employee has the right to have the whole process legally checked, as even a minor error can affect the amount of compensation.

What occupational disease compensation you are entitled to

Once an occupational disease has been recognised, the employee is entitled to several forms of compensation under the Labour Code:

1. Compensation for loss of earnings – both during and after incapacity for work. This compensation is paid in the form of an occupational disease annuity, which makes up the difference between the original earnings and the current earnings.
2. Compensation for pain and suffering – determined in accordance with the methodology for compensation for non-pecuniary damage to health.
3. Reimbursement of reasonable medical expenses, including rehabilitation, medicines or aids.
4. Material damages, e.g. if the illness requires home adaptations or special equipment.
5. Lump sum compensation on termination of employment – a lump sum of 12 times the average monthly earnings

Compensation is paid by the insurance company with which the employer has compulsory liability insurance (Kooperativa or Generalli). If the illness causes death, the survivors are entitled to a lump-sum compensation and reimbursement of funeral costs.

How the amount of compensation for occupational disease is calculated

The amount of compensation for occupational disease is determined individually, according to the specific health consequences and the employee’s earnings. The aim is to compensate for the actual loss caused by the illness. If, for example, an employee loses the ability to carry out his or her job completely, he or she may be entitled not only to an occupational disease pension but also to a lump sum occupational disease compensation to compensate for the permanent limitations on his or her working and personal life.

The loss of earnings is determined as the difference between the original average earnings and the current earnings (or sickness benefits). This amount is then indexed annually to the current increase in average earnings. The employee thus receives compensation that reflects not only his or her health status but also economic changes.

The claim also usually includes pain and suffering and difficulty in socialising, i.e. compensation for suffering, restrictions on leisure activities, social relations or the inability to continue with the current lifestyle. Whether the illness requires long-term treatment, rehabilitation or a permanent change of employment is taken into account.

The employee should insist that the doctor make a full assessment, including all the physical and psychological effects of the illness. Even minor omissions can lead to a reduction in the amount of compensation awarded.

Compensation for loss of earnings due to occupational disease

One of the most important forms of compensation is the so-called compensation for loss of earnings after incapacity for work due to occupational disease. This is paid over a long period of time, often for decades, to supplement the income of an employee who has lost part of his earnings as a result of the illness.

An annuity is payable when an employee works after an occupational disease, but at a lower rate of pay, or is taken out of work altogether. The amount of the annuity is calculated as the difference between his/her original average earnings and his/her current earnings (including sickness or disability pension).

The annuity is periodically increased (indexed) by government regulation following increases in wage levels and the cost of living. The insurance company pays it either monthly or quarterly. The employee also has the right to request a recalculation of the amount of the annuity if his/her health deteriorates or if the insurance company has incorrectly assessed the amount of loss of earnings.

The pension may also be awarded retrospectively, for example if the occupational disease was recognised years later. In this case, the employee will receive a refund of all amounts owed, including the indexation for the previous period. This is particularly important for people who have worked for a long time in demanding occupations such as labourers, health workers or workers in the chemical industry.

Occupational disease and dismissal

An employer may not give notice to an employee simply because he has been diagnosed with an occupational disease. However, if the employee has lost the ability to perform his/her previous work, the employment relationship may be terminated for organisational reasons with the right to severance pay and compensation for loss of earnings after the end of the incapacity for work (annuity).

The Labour Code obliges the employer to offer the employee other suitable work corresponding to his/her health condition. If this is not possible, the employment relationship may be terminated with a severance payment of at least 12 times the average monthly earnings.

If the illness manifests itself after the termination of the employment relationship, the employee is still entitled to retroactive compensation for occupational disease. In such cases, it is crucial to have medical reports that prove a causal link between the performance of work and the onset of the illness.

Occupational disease risks and preventive claims

Workers may also be recognised as being at risk of occupational disease if it is clear that their health is deteriorating as a result of their working conditions, even if they do not yet meet all the characteristics of the disease.

In this case, the employer (in cooperation with the doctor) may reassign the employee to another job. If this means lower earnings, the employee is entitled to occupational disease compensation – called wage differential compensation. This situation is often underestimated, but it is the employee’s legal right to protect his or her health and income.

The issue of occupational disease risk is also a common discussion among employees – many believe that they are not entitled to compensation until the disease is officially recognised. However, this is not true, as even being at risk constitutes grounds for an award of financial compensation.

What to do if your claim for compensation is rejected

It happens that a medical facility or insurance company does not recognize an occupational disease. In this case, it is possible to appeal and request a review. The appeals process takes place at the regional office and, in extreme cases, an administrative lawsuit can be filed.

Employees should not rely solely on the employer’s in-house doctors in these situations. Independent expert opinion and legal representation are often helpful. With the help of an expert, an employee can sometimes eventually prove that the illness was actually work-related.

Summary

An occupational disease is a disease arising in connection with the performance of work, which must be listed and recognised by a specialised occupational health centre; the employee is then entitled to compensation, regardless of the length of employment, even retrospectively. Compensation includes compensation for loss of earnings (including long-term annuities), pain and suffering, reimbursement of medical expenses, material damage or a lump sum for permanent loss of capacity to work. It is paid by the employer’s insurance company (e.g. Kooperativa or Generali) and the amounts are regularly indexed to the increase in average wages. The employer may not give notice just because of occupational disease, but if the employee is not fit for work, he or she is entitled to severance pay and an annuity; compensation may also be claimed if the employee is threatened with occupational disease. If the claim is refused, there is a right of appeal or recourse to the courts, and medical reports and often legal advice are crucial.