Accident insurance: psychogenic factors and disability pension reduction

ATA/254/1996Cour de justice / Chambre administrative7 mai 1996Modified

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Résumé

A manual worker became totally unable to earn after an accident that left him with a frozen shoulder. The case turned on whether later psychical problems were causally linked to the accident. The court held that they were not in natural causal relation with the insured event. Because those psychical disorders nevertheless accounted for about half of the incapacity of gain, the disability pension was reduced by 50%.

Regest

Art. 6 LAA; natural causal link in accident insurance and apportionment of incapacity of gain. Accident insurance compensates only the loss of earnings that is in natural causal relation with the insured event. If an insured person's incapacity of gain is partly due to psychical disorders that are not causally related to the accident, that non-causal portion is excluded from the insured loss and may justify a proportional reduction of the pension; the compensable share is determined according to the degree to which the accident remains causative (consid. not stated).

Texte intégral

Descripteurs

ASSURANCE SOCIALE; LESION DE L'EPAULE; ACCIDENT; AA; AFFECTION PSYCHIQUE; CAUSALITE NATURELLE; ASSU

Normes

LAA.6

Résumé

Incapacité de gain de 100 % d'un travail manuel qui, à la suite d'un accident se retrouve avec une "épaule gelée". Réduction de la rente de 50 % dès lors que le trouble psychiques qui ne sont pas en relation de causalité naturelle avec l'accident, contribuent pour 50 % à l'incapacité de gain.

Mots-clés

social insuranceaccident insuranceshoulder injuryfrozen shoulderpsychical disordernatural causationdisability pensionearnings incapacitybenefits reduction