Work accident is defined as follows in Article 13 of the Social Insurance and General Health Insurance Law No. 5510:
Work accident;
a) While the insured is at work,
b) If the insured works independently on his own behalf and account due to the work carried out by the employer,
c) When the insured working for an employer is sent to another place other than the workplace as an official, without performing his/her main job,
d) (Amendment: 17/4/2008 – 5754/8 art.) During the times allocated for breastfeeding female insurance holders within the scope of subparagraph (a) of the first paragraph of Article 4 of this Law to give milk to her child in accordance with the labor legislation,
e) During the insured’s travel to and from the place of work with a vehicle provided by the employer,
It is an event that occurs and inflicts bodily or mental disability on the insured immediately or afterwards.”
In terms of the implementation of the Social Security Law, five elements must occur in order for an event to be qualified as a work accident.
Insured of the accident victim,
Accident by the insured by place and time (in workplaces or places considered workplaces)
If the insured works independently due to the work carried out by the employer,
Immediate or subsequent bodily (physical or mental) disability of the casualty,
There is a causal link in the accident.
Examples of work accidents accepted by Supreme Court decisions are as follows; In cases where the insured person is physically injured as a result of falling while running in the courtyard, or injured as a result of a fight in the cafeteria, or being shot by a gun at the resting place, or “suicide in the workplace” or drowning in places such as a pool within the boundaries of the workplace, cases of death are considered work accidents.
The death of an insured worker by having a heart attack while working at the workplace should be considered a work accident since it carries the elements listed under the Social Insurance and General Health Insurance Law No. 5510.
The Supreme Court decision on the subject is as follows;
C. Supreme Court of Appeals General Assembly 2004/21-529 E., 2004/527 K.
At the end of the trial due to the “detection” lawsuit between the parties; (Ankara Sixth Labor Court) upon the request of the plaintiff and the defendant SSK deputies to examine the decision dated 19.11.2003 and numbered 2001/515-2003/1112 regarding the rejection of the case, the 21st Civil Chamber of the Court of Cassation dated 12.4.2004 and 2004/501-3531. push the notification numbered; {…1- According to the articles in the file, the evidence collected, and the compelling reasons on which the judgment is based, all appeals of the defendant Institution must be rejected.
2- The lawsuit is about the determination that the damaging insurance event should be considered as a work accident, and there is no dispute between the parties that the event occurred at the workplace. The dispute is gathered at the point of whether the death of the plaintiff as a result of a heart attack can be counted as a work accident.
In this aspect, the case is the law! Its basis is Article 11-A of Law No. 506. According to the aforementioned article, an occupational accident is an event that causes the insured to malfunction, either physically or mentally, immediately or later. In other words, according to Articles 11-A-a and b of the above-mentioned Law, it is clear that there is a legal obligation to consider an occupational accident if the damaging insurance event occurs at the employer’s disposal due to the work being carried out by the employer and the insured is at the workplace. The subject matter of the case occurred while the plaintiff was working as an electrician and was at the workplace. The plaintiff died as a result of a heart attack while he was on duty to fix the electrical fault in the local of the workplace. In this case, while it is clear that there is a legal obligation to consider the incident as a work accident, the court; The decision to dismiss the case on the grounds of the report received from Hacettepe University Faculty of Medicine is contrary to the procedure and the law and is the reason for reversal.
In that case, the plaintiff’s appeal exclusions aiming at these aspects should be accepted and the verdict should be overturned…) and the file was rejected on the grounds that, at the end of the retrial, the court resisted in the previous decision.
Appellant: Plaintiff’s attorney and defendant’s SSK attorney.
After being examined by the General Assembly of Law, it was understood that the decision to resist was appealed in due time, and the papers in the file were read, the necessity was discussed:
- As the defendant’s SSK attorney’s appeal against the first decision was evaluated by the Special Chamber and the appeal was rejected, there is no legal benefit in appealing the decision to resist. The appeal must therefore be rejected.
- As for the appeal of the plaintiff’s attorney;
The case is related to the request for the determination that the damaging insurance event should be accepted as a work accident.
Insured worker Yusuf died of a heart attack on 2.10.2000 while he was trying to fix the electrical faults of the worker’s club at the workplace; Since this event is not accepted as a work accident by the Institution, the right owner of the deceased is sued by the plaintiff.
It has been.
Defendant SSK and employer’s attorneys defended the dismissal of the case.
By the court; Based on the report appointed by the expert committee consisting of doctors, the incident was not accepted as a work accident; the case was dismissed. Upon the appeal of the plaintiff and the defendant’s SSK attorneys, the Special Chamber decided to reject the SSK attorney’s appeal requests, and to overturn the judgment, stating that the plaintiff’s attorney’s appeal requests should be accepted and the incident should be counted as a work accident.
Miskin’s decision to resist the court’s previous decision was appealed by the plaintiff and defendant SSK attorneys.
There is no dispute that the deceased was an insured worker and that the damaging insurance event occurred at the workplace and during the performance of the work given by the employer.
The dispute, which came before the Legal General Council through resistance, gathers on the point of whether it is possible to accept death as a result of a heart attack during working at the workplace as a work accident.
In order to resolve the conflict, first of all, it would be beneficial to determine the legal bases to be applied and the principles to be applied in determining which incident is a work accident.
It should be stated immediately that “work accident” is not defined in the law; however, in which “states and situations” an accident will be considered an occupational accident is specified by being limited to “place and time” conditions.
The legal regulation on the subject is included in Article 11 of the Social Insurance Law No. 506, titled “Description of Work Accident and Occupational Disease”, and exactly as in paragraph (A) of this article;
“A) Work accident is an event that occurs in one of the following situations and causes the insured to malfunction, either physically or mentally, immediately or later.
a) While the insured is at the workplace,
b) Due to the work carried out by the employer,
c) When the insured is sent to another place by the employer on duty, without performing his/her main job,
d) During the times allocated to the child of the insured lactating woman to give milk,
e) During the transportation of the insured to and from the place where the work is carried out in a vehicle provided by the employer…..”
is called.
According to the provision of this article, work accident; It is an event that occurs in any of the situations and situations specified in the article and causes the insured to malfunction immediately or later, physically or spiritually.
As it is clearly accepted both in practice and in teaching and as can be understood from the text of the article, the cases listed in this article are not exemplary but restrictive. An insurance event that does not fall under one of these conditions cannot be considered as a work accident. There is no condition for these situations to occur together, it is necessary and sufficient for any of them to have taken place.
In other words, an occupational accident is an event of a legal nature, and this event must occur with the occurrence of any of the conditions specified in the above-mentioned law.
By the way, the elements of work accident should also be briefly mentioned. These can be listed as follows; this insured must suffer an accident and the accident must occur in one of the situations and situations listed in paragraph (A) of Article 11 of Law No. 506 explained in detail above; must take place in the form of an event that immediately or subsequently incapacitates the insured physically or spiritually; There must be an appropriate causal link between this event and the loss suffered by the insured.
It should be noted right away that the fact that the law defines work accident as an event that damages the insured necessitates to consider causality (causality; link) as an element of work accident. However, what is sought here is the “appropriate causality (causality) link”, which should be understood as the fact that the fact of occurrence and the result coincide with each other in any of the cases and situations sought by the law, and the existence of any other restrictive condition should not be sought even though it is not in the law.
In short; the aforementioned legal regulation should be evaluated within the principles of social security law; If there is compliance with any condition in the article, a narrow interpretation should not be made in the evaluation of whether the source of the damaging insurance event is the worker or other factors in its occurrence.
In the concrete case; the deceased insurance worker was assigned with another worker to review and repair the installation of the worker’s club within the scope of the workplace; While he was doing the job given here, he fainted while the other worker was leaving to buy materials and died on the way while being taken to the hospital by ambulance. No notification of work accident was made by the employer, and the cause of death of the insured was shown as myocardial infarction in the statistical form filled in by the hospital. The Defendant Institution also rejected the claims of the right holders for work accident.
However, the fact that an incident has not been accepted as an occupational accident for the institution or the employer, whether it occurs due to external factors or suddenly, will not necessitate that the incident be considered an occupational accident in the face of the explicit provision of the law. For; a in law
As it is clearly stated, it is necessary and sufficient for the damaging insurance event to take place in any of the cases and situations listed in the law.
To put it more clearly; The death of the insured person due to a heart attack while working at the workplace is a suitable event for the situation “occurring while the insured is at the workplace” as indicated in subparagraph (a) of paragraph (A) of Article 11 of the Social Security Law no. 506, as well as in subparagraph (b) of the same article. It is also suitable for the case of “occurring due to the work carried out by the employer”; should be considered an occupational accident. Since no other condition or restriction is included in the article, it is not possible to impose a restriction that is not in the law through interpretation.
According to the compelling reasons explained above and in the reversal decision, the Court decided to abide by the Special Chamber reversal decision adopted by the General Assembly of Law and to count the incident as a work accident, but with contrary opinions, it is legal and procedural to resist the previous decision and reject the case based on the report that does not count the incident as an occupational accident. . For this reason, the decision to tremble must be broken.
Conclusion: 1. The appeal petition of the defendant SSK attorney is listed above (1). There is no reason to be rejected for the reasons explained in the paragraph, and there is no reason to be charged because it is exempt from the fee,
The appeals of the plaintiff’s attorney are listed above (2). Acceptance of the decision for the reasons explained in the paragraph, due to the reasons indicated in the decision of the Special Chamber to reverse the decision (TO OVERFLOW) in accordance with Article 429 of the HUMK. It was unanimously decided on 13.10.2004 that the appeal fee be refunded upon request.
