An accident at work always occurs in causal connection with professional activity.
In § 8 Abs. 1 SGB VII, an accident is defined as an event, which affects the human body from outside, unfree of charge and can lead to health damage or death.
A work accident is an accident that an employee suffers at his workplace that is subject to compulsory insurance. This means that accidents occurring during leisure activities, sporting activities and private participation in road traffic are excluded.
If an employee is injured directly while performing his work (e.g. at work equipment) an insured event of the statutory accident insurance will occur. It is irrelevant whether the employee himself causes the accident or not.
An accident at work always presupposes an essential connection with the insured activity. Suppose the employee has caused the accident himself through a self-created danger (e.g. drunkenness). In that case, it may no longer be possible to assume a causal connection in the occupational context. In such a case, the accident is not recognized by the insurance company as an accident at work.
If an accident is recognized as a work accident, the injured party is entitled to benefits from the statutory accident insurance. This can be rehabilitation measures, injury benefit, retraining or survivor's pension.
For this reason, every accident that is connected with an insured activity should be reported immediately to the responsible professional association or statutory accident insurance. Only then are consequential damages insured.
Typical work accidents are caused by:
Concrete examples of industrial accidents:
Occupational illnesses can, under special circumstances, also fall under the statutory accident insurance. Chronic diseases to which an employee falls ill in his working life can be recognized as occupational accidents. However, the occupational disease must be proven beyond doubt by scientific studies.
The correct procedure must be followed in the event of an accident at work; otherwise, it may lead to a refusal to provide compensation.
The employer must report an accident at work that leads to an inability to work for more than three days to the relevant trade association or accident insurance fund.
For this purpose, an accident report must be submitted. The attending physician writes a report intended for this purpose, which he/she forwards directly to the accident insurance institution. A detailed accident investigation precedes both.
After the accident investigation, the accident victim must visit a doctor. This doctor is especially qualified to treat accident victims. During the examination, the degree of injury and necessary treatment measures are clarified. The appointment also serves to secure and document evidence.
The documentation of the accident at work by a general practitioner may, under certain circumstances, not be considered sufficient. However, further treatment can be carried out by a general practitioner or specialist.