Accidents regularly occur at work, on the way there or during the lunch break – but when is it actually an occupational accident?? In the social security code everything is clearly regulated, but again and again ambiguities arise – courts then have to clarify whether it is an occupational accident or not.
Industrial accident- What to do and who pays?
An accident is a sudden event in which a person or thing is unexpectedly harmed. Accidents regularly occur at work, on the way there or during the lunch break. In 2016 alone, 877 accidents occurred in the.071 Work accidents.
When is it an accident at work and how should you proceed afterwards?
What is an accident at work?
Statutory accident insurance defines an occupational accident as: Accident suffered by the insured person as a result of an insured activity.
Consequently, it is not only employed persons who can suffer an occupational accident. Pupils, kindergarten children and people who provide first aid after a traffic accident also receive insurance benefits in the event of an accident. An injury in physical education is insured in the same way as a wound at a craftsman’s shop. Accidents that occur on the way to kindergarten, school or work are also covered by the statutory accident insurance. The relevant employers’ liability insurance association acts as the responsible body in this regard. Which cooperative or. You can find out which accident insurance fund is responsible for you by asking your employer’s personnel department.
After the accident at work: What to do?
The correct procedure is essential in the case of occupational accidents, because a mistake can lead to the denial of insurance benefits.
Investigating the accident
After first aid services and notification of the responsible persons, a detailed accident investigation must be carried out. The following groups of persons must be involved:
- accident victims
- Employer
- Responsible managers
- assigned safety specialists and the safety officer
- evtl. witnesses present
- the works council (this must ensure that all evidence concerning the course of the accident is recorded and secured and that all witnesses are questioned and their names recorded)
Further medical treatment
After the accident has been examined, a doctor must be consulted. The degree of injury as well as necessary treatment measures are clarified. The appointment also serves to document and secure evidence. The responsible doctor documents how the accident at work occurred. If legal proceedings are instituted, the injured employee has evidence through the medical determination, evidence. For this reason, it is essential to consult a transit doctor instead of the family doctor. Documentation from a family doctor may not be considered sufficient under certain circumstances. A transit doctor specializes in accident surgery and has received separate approval from the state associations of the German Social Accident Insurance (DGUBV).
The notification by the employer
If the employee submits a sick note of more than 3 days due to an accident at work, the employer must report to the Employer’s Liability Insurance Association (BG). Even if the consequences are considered minor, this process is very important. If psychological or physical consequences only become apparent later and notification was previously waived, the accident insurance may possibly deny benefits. Tip: Make absolutely sure that your employer reports the accident! In the event of serious injury or even death, notification must be made immediately or. be carried out by telephone.
Who pays in the event of an accident at work?
After an accident at work, the employer pays sick pay for 6 weeks in the form of continued salary payment. The prerequisite is existing employment in the company (min. 4 weeks) as well as the presentation of a certificate of incapacity for work.
What comes after continued payment of wages? – Injury compensation
After the first 6 weeks, the employer is no longer obliged to continue paying wages. This is paid by the relevant employers’ liability insurance association. This financial benefit is called an injury benefit and is paid by health insurance companies.
The following should be noted:
- Injury benefit is 80% of gross wages, less unemployment and pension insurance contributions.
- The aim is to rehabilitate the employee and return him to his previous working life. If this is not possible due to health restrictions, this may mean retraining.
- In addition to injury benefits, you may be reimbursed for separate rehabilitation expenses such as crutches, special shoes, a wheelchair, a modified car, and appropriate home or workplace modifications.
- Injury benefit is generally tax-free. It must still be declared in the tax return, as it is used in the calculation of the tax rate.
As soon as the accident victim is able to return to work that is subject to social insurance contributions, he or she is no longer entitled to injury benefits.
Injury pension
If the 26. If there is a reduction in earning capacity of at least 20 percent beyond the first week after the work accident, the employers’ liability insurance association pays an injury pension. However, the following always applies: reintegration before pension.
compensation for pain and suffering after an accident at work?
Only in rare cases is the employer obliged to pay compensation for pain and suffering. Certain liability privileges apply to compensation for pain and suffering. Evidence of intent is difficult to prove. Generally, supervisors are presumed not to have intended to cause a claim, even if safety deficiencies prevail. However, if you have evidence of intentionality, it is advisable to consult with an employment law attorney.
Dismissal after an accident at work?
The employer may generally terminate the employee only if it complies with the legal deadlines and has a specific reason. This also applies after an accident at work.Furthermore:
- In the first 6 months of a new job, employees are more easily dismissed, regardless of whether or not there is a contractually defined probationary period.
- Termination must not be contrary to good faith or morals. That means it may e.g. not be made out of personal dislike of the employee’s private life. A termination is also invalid if it is expressed in a form that is personally hurtful.
- Formal errors favor an objection. In such cases it is always advisable to consult a lawyer for labor law.
Occupational accident for freelancers and self-employed persons- Who pays?
Even as a freelancer or self-employed person, you can also insure yourself against the consequences of an accident at work with the employers’ liability insurance association. However, you are not legally obligated to do so and can negotiate the amount yourself.
Occupational accident or occupational disease?
Occupational diseases are much more difficult to prove than occupational accidents. Occupational diseases are medical conditions that have developed over the years as a result of the respective working conditions. Factors such as chemicals, physical impact (pressure), vibration, heavy carrying, and working in noise or dust are all considered. All recognized occupational diseases are listed in the Occupational Diseases Ordinance (BKV).
What counts as an occupational accident?
Accident on the way to and from work (commuting accident): A commuting accident may occur on the way to work or from work to home. It is only an occupational accident if it is the direct route, without detours (e.g.B. supermarket), concerns. However, if the employee is forced to take a detour due to a construction site or a detour, this commuting accident is insured.
Accident during continuing education or training: An accident that occurs during professional training or education is covered as an occupational accident.
Accident while making private phone calls/smoking breaks: Private telephone calls count as "own business", as do smoking breaks (and the way to them). They do not fall under the insurance coverage of the statutory accident insurance, since they are personal matters of the employee, which have no factual connection to the professional activity.
Accident during breaks and basic needs: Accidents on the toilet are not considered as occupational accidents. Only the way to the toilet or to the canteen is covered by the statutory accident insurance, but not the stay in these rooms.
Accident at home office: Here are accidents covered by the statutory accident insurance that happen at the desk. If it is the way to the toilet or the way to the kitchen, the insurance coverage does not apply.
When is there no insurance cover?
No insurance cover is provided if injuries or damage to health occur accidentally during the insured activity without external influence. In addition, the statutory accident insurance does not replace material assets.
- Property damage, due to rendering first aid (z.B. torn clothing)
- tools damaged as a result of the accident at work (e.g., a car).B. glasses)
A private accident insurance protects comprehensively
More than 70 % of accidents happen during leisure time – exactly where the statutory accident insurance does not apply. In addition, it makes sense to take out private accident insurance. This covers you around the clock and in all situations in life. DFV UnfallSchutz is the most powerful and flexible insurance on the German market You are comprehensively protected, can increase your insurance coverage at any time, decrease it again and at the same time insure friends and family depending on the situation. With DFV AccidentCover, you’re ready for any adventure.
With DFV-KombiSchutz, you can protect yourself against the biggest risks of everyday life. So what’s the point of individual insurance policies when you can bundle everything into one combination policy??
- Accident insurance
- household& Glass insurance
- Bicycle theft insurance
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