Occupational disease is defined according to Article 14 of the Social Insurance and General Health Insurance Law No. 5510. According to that definition; ”Temporary or permanent illness, physical or mental disability, which the insured suffers due to a recurring reason cause of the nature of the work or the performance of the work.” The insured has an occupational disease due to his job;
- Examining the health board report and its supporting medical documents duly prepared by the health service providers authorized by the institution (occupational diseases hospitals, training and research hospitals, state university hospitals affiliated to the ministry of health),
- When deemed necessary by the Institution, inspection reports and other necessary documents revealing the working conditions in the workplace and related medical results are determined by the Institution’s Health Board.
If the occupational disease occurred after leaving the job and was caused by the insured job; In order for the insured to benefit from the rights provided by this Law, it is obligatory that no longer than the period specified in the regulation issued by the Institution for this disease has elapsed between his actual resignation from his former job and the emergence of the disease. Persons in this situation can apply to the Institution together with the physician’s report of their illness and other medical documents. This period has been determined as a minimum of 2 days and a maximum of 25 years, according to the types of diseases, in the Regulation on Determination of the Rate of Loss of Working Power and Profitability.
In cases where any occupational disease is determined by clinical and laboratory findings and the factor causing the occupational disease is determined at the end of the examination in the workplace; Even if the liability period in the list of occupational diseases has been exceeded, the said disease can be considered an occupational disease with the approval of the Social Insurance High Health Board upon the application of the Institution or the relevant person.
Occupational diseases; were collected from 5 main groups as occupational diseases caused by chemical substances, occupational skin diseases, pneumoconiosis and other occupational respiratory system diseases, occupational infectious diseases and occupational diseases due to physical factors.
- By the employer who learns that the insured has an occupational disease or is informed about the occupational disease in terms of the insurance holders covered by the article 4/1-a (those who are employed by one or more employers with a service contract) and article 5 of the law numbered 5510,
- For those who work independently on their own behalf and on their own account, regardless of the employment contract with the village and neighborhood headmen of the article 4/1-b of the Law No. 5510; Those who are taxpayers of real or simple method due to commercial income or self-employment income; Those who are exempt from income tax and registered in the registry of tradesmen and craftsmen; shareholders who are members of the board of directors of joint stock companies, limited partners of limited partnership companies whose capital is divided into shares, and all partners of other companies and equipment subsidiaries; In terms of the insured within the scope of agricultural activities) by himself,
It is obligatory to notify the relevant institution with the occupational disease declaration within 3 working days starting from the day when this situation is learned. Temporary incapacity allowances, if paid with the expenses incurred by the Institution for this situation, shall be revoked to the employer who does not fulfill this obligation or to the employer who deliberately reports incomplete or incorrectly the matters notified in writing, or to the insurance holder under item (b) of the first paragraph of Article 4.
The employer is also obliged to immediately pay the amount of health care required by the health status of the insured person who has an occupational disease. Medical expenses made by the employer and based on documents are covered by the Institution in accordance with the provisions of Article 65 of Law No. 5510.
Occupational disease insurance provides some rights, only monetary, to the insured. These rights are;
- Giving a daily temporary incapacity allowance for each day of absence during the temporary incapacity for work; No minimum insurance period or number of premium payment days is required to make this payment. The incapacity allowance to be paid is half of the daily income of the insured in inpatient treatments and two-thirds in outpatient treatments.
- Attachment of permanent incapacity income; It is given to insured people whose earning power in the profession has decreased by at least 10%. The insured does not have to leave the job for this benefit. The amount of income is calculated according to the rate of loss of earning power in the profession of the insured. It is the rate of 70% of the monthly income of the insured who cannot work permanently. If the person is in need of continuous care, the income rate is 100%.
- Contribution of income to the beneficiaries of the insured person (Spouse,child, mother and father etc.) who died as a result of occupational disease.
- Giving marriage allowance to daughters with income; If the daughters of the insured get married while receiving a survivor’s pension and their pension is cut off for this reason, upon request, the two-year amount of the pension or income they receive is paid in advance as a marriage allowance, for once.
- Giving funeral allowance for the insured person who died as a result of occupational disease.
As can be seen, the financial losses of the insured are covered by the Institution. Apart from these, the employer is also obliged to compensate for the losses of the insured or his relatives that are not covered by the Institution. In this context, the insured has the right to demand material and moral compensation from the employer and responsible persons. If the insured dies as a result of an occupational disease, those who are deprived of support can file a lawsuit against the employer for deprivation of support and moral compensation.
If the occupational disease has occurred as a result of the employer’s intention or an act against the health protection legislation of the insured, the employer becomes liable to the Institution within the scope of the principle of inevitability. In this case, the employer shall make the employer pay the sum of the payments made or to be made in the future and the first cash capital value at the start of the income, limited to the amounts that the insured or beneficiaries may request from the employer.
If the insured is not notified to the Institution with the insured employment entry declaration within the period of the insured’s employment, the income and allowances of the related persons as a result of occupational diseases occurring before the date when the declaration was given later or the Institution determined that the insured was employed, shall be paid by the Institution. In accordance with this provision, even if there is no intention of the employer in the occurrence of an occupational disease or an act contrary to the legislation to protect the health of the insured, the expenses incurred will be charged to the employer!
Bodily harm that may lead to material compensation may occur in the form of injury to an organ as a result of an occupational disease, decreased vision or hearing, and deterioration of mental status as a result of occupational disease. The insured, who has an occupational disease, may claim treatment expenses, loss of earnings, losses arising from the deterioration of working power and loss losses arising from the deterioration of the economic future. The purpose of the compensation is to ensure that the situation in which the insured would be in the absence of an occupational disease is to occur. Additional damages that are not covered by SGK (Social Security Institution. SSI in short) are eliminated in this way. The fault of the insured is the reason for the reduction in compensation. Age at work and probable life expectancy are the most important factors in determining the damage.
In the event that the insured dies as a result of an occupational disease, the relatives who lost their support may claim compensation for deprivation of support. The purpose of the compensation for deprivation of support is to cover the amount of support that would have been received if the relative who was deprived of support had not died as a result of an occupational disease. The amount of assistance that the deceased insured can provide to those who are deprived of their support in order to separate from the income they can earn by working during their probable life period, is paid to these people in cash and in advance. In compensation for deprivation of support, the support is the person who actually and regularly helps the survivors in a way that makes a living, and who has a strong probability of providing this assistance in the future even if death did not occur.
Within the scope of the article of the Code of Obligations on non-pecuniary damage, the physical or mental pain, suffering and grief of the insured person suffering from an occupational disease are tried to be relieved. There is no need to have a loss in the earning power of the insured. If the conditions are met, the relatives of the insured can also claim non-pecuniary damages. In determining the compensation, the way the event occurred, the common fault rates, the pain felt, the economic and social conditions of the parties and equity are taken into consideration. Non-pecuniary compensation is not paid by SSI, so the employer must be applied for this compensation. In addition, if the occurrence or increase of the damage is caused by the action of the insured, the liability of the employer is limited.
In addition to all these, the employer will be liable within the scope of the Turkish Penal Code if the worker dies or is injured due to not being protected against the dangers in the workplace and these actions are caused by the employer’s intent or negligence.
It is very important that you get help from a lawyer in this legal process so that you can get all your material and moral rights. You can always contact us to get information and help from our expert team.
