What are occupational diseases?
Occupational diseases are work-related illnesses that employees suffer as a result of their occupational activity. The statutory accident insurance institution is responsible for occupational diseases as well as for work accidents.
According to the Social Code, diseases are to be designated as occupational diseases if they are “caused, according to the findings of medical science, by special effects to which certain groups of people are exposed to a considerably greater degree than the rest of the population as a result of their insured activity” (§ 9 para. 1 of the Seventh Book of the Social Code – SGB VII).
Occupational disease can be triggered by a wide variety of health effects. Some occupational groups are more frequently affected by occupational diseases than others. Such occupational groups are mainly those who
- come into contact with certain chemicals,
- come into contact with infectious agents and parasites,
- are exposed to physical impacts such as pressure or vibration,
- who are physically stressed by carrying heavy loads or
- who perform work in noisy or dusty conditions.
What are the occupational diseases?
Recognising an illness as an occupational disease is difficult because the connection between illness and work is not always clear. Many environmental influences in private life promote the same complaints as those caused by work. On the other hand, there are diseases such as certain types of cancer that have a long incubation period. In some cases, decades can pass before the disease even breaks out.
The most common occupational diseases are:
- Skin diseases
- Skin cancer due to UV radiation
- Lumbar spine, lifting and carrying
- Lung/throat cancer
- Noise-induced hearing loss
- Infectious diseases
All recognised occupational diseases can be found in the Annex 1 to the BKV.
What to do in case of occupational disease?
If an employee suffers from the typical symptoms of an occupational disease, their first step should be to visit a family doctor or specialist, or even better, an occupational physician. He or she will examine the signs of illness and determine their cause. If the suspicion is confirmed, the doctor will report the occupational disease to the authorities.
A founded medical suspicion exists if the symptoms of the illness could be related to the personal working conditions of the person concerned. Doctors use pre-prepared forms for the report, which include questions on the first onset of the symptoms and on dangerous influences on the sick person at the workplace.
But it is not only the doctor who has a duty to report, the person concerned, the employer or the health insurance fund can also report a possible occupational disease. The notification must be made immediately. Only in exceptional cases may sick persons prohibit the reporting of the notification.
On receipt of the report, the competent accident insurance institution contacts the sick person and clarifies the relevant facts with her. Together, the course of the illness is discussed with particular regard to the conditions at the workplace. The accident insurance institution also checks whether the illness is occupational. Under certain circumstances, a specialist medical opinion will be commissioned.
If the illness is recognised as occupational, the primary objective is to cure it, and if this is not possible, to alleviate it and prevent it from getting worse by providing appropriate medical care.
Benefits in the event of an occupational disease
Benefits in the event of occupational disease are laid down in the Seventh Book of the Social Code (SBG VII) “Statutory Accident Insurance” and in the Occupational Diseases Ordinance (BKV). The accident insurance institutions pay an accident pension in cases of reduced earning capacity due to a work accident or an occupational disease. They become liable to pay benefits in the context of an insured event even before the onset of the occupational disease.
Section 3(1) BK states that if there is a risk for the insured person that an occupational disease will develop, revive or certainly worsen, the insurers must counteract it by all appropriate means. If the danger cannot be eliminated, the accident insurance fund must work to ensure that the insured person stops the activity that is hazardous to health.
If the concrete danger exists, the accident insurance fund must take action within the scope of the entire scope of benefits under accident law – outside of pension benefits. In the event of work-related illnesses, employees are entitled to various benefits from the accident insurance. These include:
- Specialist treatment, outpatient or inpatient,
- Medicinal products and medicines,
- Physiotherapy, occupational therapy and speech therapy,
- Aids of an orthopaedic nature and provision of mobility aids, body replacements (prostheses),
- Work testing,
- Disabled sports,
- Stress testing,
all without co-payment following the latest medical advances and science.
In addition to the direct range of medical benefits, they are also entitled to comprehensive entitlements from the area of participation in professional life:
- CIM (company integration management), financial support from the employer to maintain the job, assistance measures for the job,
- Disability-friendly equipment of the workplace,
- Personal counselling and financial assistance in job search, occupational guidance measures, work testing, preparation for a new occupation,
- Education, retraining and further training measures,
- New construction of a house suitable for the disabled, or conversion, or installation of a lift,
- Household help or motor vehicle help, caregiver, care allowance or help with home care.
Also, travel expenses or childcare costs are included as reimbursable costs just like the personal budget. If the insured person can no longer work due to the occupational disease, she is entitled to wage replacement benefits or an accident pension. Other benefits are transitional benefits, survivors’ pensions, long-term care benefits or transitional benefits. All cash benefits can be claimed as an advance or settlement payment.
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