ENGLISH

Industrial Accident Compensation Insurance

Definition of Occupational Accidents

Standards for Recognition of Occupational Accidents by Diseases

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 Diseases

A disease, disability or death shall be caused by an occupational reason.

- If a worker suffers from any disease falling under any of the following cases or any disability arising from such disease, or dies due to such disease, it shall be deemed an occupational accident (Subparagraph 2 of Article 37 (1) of the Industrial Accident Compensation Insurance Act).

· Any disease caused by handling or being exposed to any physical agent, chemical substance, dust, pathogen, work imposing a burden on the worker's body, or any other agent causing trouble to their health while performing their duties;

· Any disease caused by an occupational injury;

· Diseases attributable to mental stress at workplace caused by workplace harassment, verbal abuse by customers, and other causes;

· Any other disease caused in connection with their duties.

There shall be a proximate causal relationship between the duties and a disease, disability or death caused by an occupational reason.

- In spite of the standards for recognition of occupational accidents stated above, a disease, 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 disease 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, and treatment progress, etc. (Supreme Court's Decision dated April 12, 2007, Case No. 2006Du 4912)

A disease, disability or death shall not be caused by the intentional action of a worker, self-harm or other criminal act.

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

- However, when the injury, disease, 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.