ENGLISH

Industrial Accident Compensation Insurance

Definition of Occupational Accidents

Standards for Recognition of Occupational Accidents by Accidents on Duty

Definition of Occupational Accidents

Definition of occupational accidents

- The term "occupational accident" means any injury, disease, disability or death of a worker which is caused by an occupational reason (Subparagraph 1 of Article 5 of the Industrial Accident Compensation Insurance Act).

Standards for Recognition of Occupational Accidents by Accidents on Duty

An accident shall be caused by an accident on duty.

- If a worker suffers any injury, disease or disability or dies due to an accident on duty falling under any of the following causes, it shall be deemed an occupational accident (Main sentence of Article 37 (1) of the Industrial Accident Compensation Insurance Act):

· Any accident that occurs while they perform a duty under their employment contract or other acts incidental thereto;

· Any accident that occurs while they use a facility, etc. provided by their business owner, due to any defect in or any careless management of such facility, etc.;

· Any accident that occurs while they participate in an event sponsored by or under the direction of their business owner or prepares for such event;

· Any accident that occurs at recess due to an act deemed to be under the control and management of their business owner;

· Any other accident that occurs in connection with their duties.

There shall be a proximate causal relationship between the duties of a worker and the accident.

- In spite of the standards for recognition of occupational accidents stated above, an accident (injury, disability or death) with no proximate causal relationship with the duties of a worker shall not be deemed an occupational accident (Proviso to Article 37 (1) of the Industrial Accident Compensation Insurance Act).

- Definition of a proximate causal relationship

· A “proximate causal relationship" shall be recognized if a certain occupational accident is deemed to be caused by a certain accident on duty based on general experiences and knowledge.

- Burden of proof of a causal relationship

· The burden of proof of a causal relationship is on a person who intends to receive insurance benefits (a worker or their survivors) (Supreme Court's Decision dated November 10, 2005, Case No. 2005Du 8009).

- Criteria for determining a causal relationship

· A proximate causal relationship between the duties of a worker and the accident shall be determined based on their health and physical conditions, instead of the health and physical conditions of the average person (Supreme Court's Decision dated January 31, 2008, Case No. 2006Du 8204, Supreme Court's Decision dated November 10, 2005, Case No. 2005Du 8009).

- A degree of proof of a causal relationship

· A causal relationship shall not have to be clearly proven, medically or scientifically. A causal relationship may be recognized where the accident is deemed to have a proximate causal relationship with the duties of a worker in consideration of all matters such as their health conditions at the time of joining the company as an employee, how the disease has occurred, details of the disease, treatment progress, etc. (Supreme Court's Decision dated April 12, 2007, Case No. 2006Du 4912).

- Determination of an occupational accident by an accident on duty

· In case of "an occupational accident by an accident on duty" whose occurrence can be specified by time or space, it shall be judged whether the accident has occurred while a worker performed their duties or activities accompanied by such duties. Unless the accident has occurred due to any reason other than their duties, the causality between the duties and the accident shall be recognized and such accident shall be deemed an occupational accident.

· In case of "an occupational accident by disease" whose occurrence cannot be specified by time or space, only the causality between the duties and the accident shall be judged regardless whether it has occurred while a worker performed their duties. If the causality is recognized, the accident shall be deemed an occupational accident.

An accident shall not be caused by the intentional action of a worker, self-harm or other criminal act.

- Any accident resulting from their intentional action, self-harm or other criminal act, or caused by such act (injury, disability or death) shall not be deemed an occupational accident (Main sentence of Article 37 (2) of the Industrial Accident Compensation Insurance Act).

- However, when the injury, disability or death is caused by any act committed in the state of a marked decline in their normal cognitive function, etc. and falls under any of the following cases, it shall be deemed an occupational accident (Proviso to Article 37 (2) of the Industrial Accident Compensation Insurance Act and Article 36 of the Enforcement Decree of the Industrial Accident Compensation Insurance Act):

· Where a person who received or is receiving medical treatment for mental illness arising from a work-related ground does self-harm in a state of mental disorder;

· Where a person who is receiving medical care due to an occupational accident does self-harm in a state of mental disorder caused by the occupational accident;

· Other cases where the fact that self-harm is done in a state of mental disorder due to a work-related ground is recognized based on proximate causation.