Engineering

Frequently Asked Questions and Answers on Occupational Accidents in 64 questions

Written by Thalib Tantary

1. What is income?

In case of work accident or occupational disease, the insured person or the insured in case of death is called permanent income.

2. What Are The Periods Not Taken Into Account in Short-Term Insurance Branches?

In terms of short-term insurance branches;

  • The period of service in the military insured taken under arms for any reason,
  • The time in detention by a conviction,
  • occupational accidents, occupational diseases, sickness and maternity insurance from temporary disability compensation, as long as the insured’s work see,
  • The Insured to participate in the strike or the period in which the employer is locked out,

It does not take into account the working periods specified in Article 18 (Transition for incapacity allowance), nor is it taken into account in the calculation of a year before the incapacity starts or when the disease is understood or the date of birth.

3. Is The Employer A Sanction If The Work Accident Occurs With The Intent of The Employer?

Occupational accident and occupational disease, the employer’s intentions or the protection of the health of the insured and has occurred as a result of a movement contrary to the security legislation, the insured or the right holders of the Institution by the Authority or the future payments made to the employer, the employer is paid.

4. Is The Employer A Sanction In Case The Work Accident Is Not Reported Within The Time Period?

(4 / a) In the event that the insured under the scope of work accidents in the event of an accident, notified to the employer within the legal period, until the date of the notification to the Authority to be paid to the insured, the necessary work will be done to collect the temporary incapacity benefit from the employer. (4 / b) for the period of time until the insured is notified of the work accident, the incapacity benefit shall be withdrawn in the non-paid-up ones.

5- What Is The Mode of Application If The Work Accident Occurs Due To The Reasons Arising From The Insured Person?

Temporary incapacity allowance or permanent incapacity benefit if the insured suffers from work accidents or occupational diseases, sickness, prolonged treatment period or increased incapacity for work due to the following reasons;

  • If the insured fails to comply with the measures and recommendations provided by the physician due to work accident, occupational disease, disease and maternity, prolonged treatment period or increased incapacity to work, it shall be reduced to one quarter by the Authority on the basis of prolonged treatment period or increased incapacity ratio. .
  • The Company shall be exempted by the Authority by one third according to the degree of defect of the insured who suffered from a work accident due to severe defect or who is ill or ill.
  • The insured shall be paid in half for the insured who has suffered a work-related accident due to a deliberate act, who is ill or ill, or who does not accept the proposed treatment despite the written notice of the Authority.
  • Temporary incapacity allowance shall not be paid to the insured employee without receiving a certificate from the physician he / she is being treated for, the treatment has been terminated and workable;

6. Who Can Benefit From Occupational Accident Insurance?

  • working with a service contract (4 / w)
  • Their name and account self-employed with village headmen (4 / B)
  • Criminal working in the Prison and Prison convicts and detainees,  a candidate apprentices, apprentices and trainees,
  • Duty with -Harp handicapped by Wheelchairs are
  • India Business Association trainees
  • who moved to run the Social security agreement countries without their workplaces abroad by employers.
  • who undertake work of Indian workers Into students
  • Agriculture and forestry work discontinuously employees insured by contractual services

7. What are the conditions for the adopted 7- work accident gained through the agricultural workers?

In order for the agricultural worker to benefit from the benefits provided by the occupational accident insurance branches, his insurance must be registered at least three months before the date of the work accident and his insurance must not be over.

In order to benefit from the benefits provided by the occupational accident insurance, employees who have been discontinued with service contracts in agricultural or forest works must have been registered at least ten days before the date of the work accident and their insurance must not be over.

8- Can A Heart Attack Occur In The Workplace Without An External Factor?

In order to evaluate whether an incident is an occupational accident,

it is necessary for the person who has an occupational accident, to be insured , to encounter an event, to be
physically or spiritually disabled due to the incident

In addition, a relationship between the cause of the event and the outcome of the incident that occurred during the determination of whether an incident is an occupational accident should be established and evaluated accordingly.

The insured must be counted as an occupational accident, if the result of a heart attack (death or malfunction) occurs outside the workplace at the workplace and at the time of the employer’s order, while the employer is at the disposal of the employer.

9. When The Insured Working In A Construction Workplace Is In The Dormitory, The Fire That Is Burned In The Fire In The Dormitory Overturned In The Dormitory Is Deemed As Work Accident?

Due to the fact that the incident occurred in the bed house of the workplace, the incident must be considered as an occupational accident.

10- When The Insured Working In A Factory Workplace Is Paid Leave, The Break of His Leg As A Result of His Friends Falling off The Stairs In The Workplace Where He Comes To Visit Is Considered As An Accident At Work?

Since the legal relationship with the workplace, ie the service contract is continuing during the period of the leave of the insured is not lost, therefore, the work must be counted as an accident.

11. If The Insured Working In The Workplace of The Auto Mechanic Is Assigned By The Employer To Repair A Vehicle That Has Failed On The Road, Is It An Accident At Work When The Vehicle Crashed In The Course Of Repairing The Broken Vehicle On The Road?

Since the accident occurred during the execution of the work, the incident must be considered as an occupational accident.

12. Does the insured work as a driver at the workplace is considered as an occupational accident at the time of taking his personal belongings to his summer house upon the instructions of the employer and the employer?

Since the insured has been transferred to another place by the employer, the incident must be counted as an occupational accident since it occurred during the time it took without doing the actual work.

13. Is it considered to be an accident at the time of the assault by an assault on the way while the housewife is going home to breastfeed her child?

Since the nursing woman insurance takes place in the time allocated for giving milk to her child in accordance with the labor legislation, the incident is considered as an accident at work.

14. Is a work-related accident caused by a motorcycle driver who is leaving the house to go to the workplace and waiting for the municipality to take the public transport vehicle?

As the incident that occurred during the arrival of the insured to the place where the insured was made by the employer, and the event that defined the insured immediately or later physically or spiritually is defined as a work accident, it should not be counted as an occupational accident because it is based on the principle of commuting with a vehicle provided to the employer.

15. Is the injury to the insured by a motorcycle driver waiting at the stop for leaving the house to go to the workplace and taking the public transportation vehicle?

Accidents occurring during the arrival of the place of work of the insured with a vehicle provided to the employer are considered as work accidents. There is no occupational accident due to the fact that no vehicle is allocated by the employer.

16. If the insured in the strike was beaten by other workers who did not participate in the strike while he was in the workplace to get the wages he deserved before the strike is considered a work accident?

If the insured has not lost its insurance quality, the incident is work accident.

17. When the insured working in the auto repair shop was out of the workplace for lunch, repairing a malfunctioning vehicle seen on the road, could the breakage of the leg break as a result of the shift of the jack?

Due to the fact that the insured employee, who works for an employer, is sent to another location outside the office as an official, accidents occurring during the time without doing the actual work are considered as work accidents. However, since there is no assignment by the employer, the incident should not be considered as a business excavation.

18. Is it possible to consider the death of a fire in the hotel where the insured person goes to get the goods with another person from the province where the workplace is located, and it can be considered as an occupational accident?

Accidents occurred outside the workplace due to the work of the insured employee are considered as work accidents.

19. (4 / b) insured himself working in the repair shop while the shopkeeper, jacket slip as a result of injury by staying under the vehicle foot injury is considered as an accident?

As the accident is caused by the work being carried out, the incident must be considered as an occupational accident.

20. Is the accident at the workplace considered to be an insured person in accordance with paragraph 4 (b) of Article 4 of the Law No. 5510 to be considered as work accidents?

(4 / b) incidents occurring in the workplace of the insured must be considered as an occupational accident.

21. In what way is the investigation conducted in order to make a decision about whether an accident at work is reported to the Authority or not?

Investigation can be carried out by the authorized officers of the institution with inspection and control or by the Ministry Labor Inspectors.

22- What are the rights provided by occupational accident and occupational disease insurance?

  • It is Temporary incapacity allowance done
  • Continuous incapacity income
  • Connecting the income holders to the beneficiaries of the deceased
  • Marriage allowance for the girls who have connected to the income.

23. Where and how many days should the work accidents occur outside the employer’s control?

It is required to inform the Social Security Provincial Directorates / Social Security Centers and within 3 working days from the date of learning of the accident.

24. How long does the insured have to be insured?

The only condition for the insured undergoing work accident is that it has been registered.

25. Is there an administrative fine for those who make a work accident notification?

In order to make a decision about whether the incident reported to the institution is considered as an occupational accident, an investigation can be carried out by the authorized officers of the Agency with the supervision and control or by the Ministry’s labor inspectors. If the matters notified in writing by the end of this investigation do not comply with the facts and it is understood that the incident was not a work accident, the payments made by the Authority for this event are made in accordance with the provisions of Article 96 of the Law no. 5510 from those who have made false notice since the date of payment.

26. I could not report work accident on-line due to system failure, can I give notice?

Work accident notification will be made by hast Work accident and occupational disease notification form ”in Annex-7 of Regulation. The Declaration can be notified to the Authority by e-Insurance or sent to the related unit directly or by post.

27. In case of an accident, the employees are paid a report?

The right to insurance is a legal right and compulsory at the same time. Insurance is not optional. Any verbal and written agreement that the employer and the employer will undertake on insurance shall be invalid. If a work accident or occupational disease is insured and the occupational accident / occupational disease is not notified to the Institution by the employer himself, he may apply to his wife, children or parents in writing by written notice. Article 23 of the Law, “Work accident, occupational disease, which occurred before the date when the insured was notified to the Authority with the insured employment declaration within the period in which the insured was started, or that the declaration was issued or insured was determined by the Authority. the income and allowances of the concerned persons as a result of illness and maternity status shall be paid by the Authority. Accordingly, in case of an accident, the worker who is working as an uninsured worker must be notified to the supervisor and action shall be taken according to the auditor’s report. In the event of an accident at the time of the first day of work and the employee who has an accident at work and not reported to the Authority, it is necessary to make the insurance registration process on the day of the accident and pay the incapacity allowance for the days when he / she is rested.

28. What is the responsibility of the employer who does not report the work accident?

In case the work accident is not notified to the Authority by the employer within the specified period, the temporary incapacity benefit to be paid to the insured for the period until the date of notification shall be collected from the employer by the Authority. The employer is obliged to provide immediate health care to the general health insured who has suffered an occupational accident or who has a health condition. For this purpose, the costs of health care expenses and the expenses to be made according to the provisions of Article 65 shall be borne by the Authority. Due to the negligence or delay in the fulfillment of obligations, the employer, who causes the duration of treatment of the general health insurance person to be extended or to be It is therefore obliged to pay any health care expenses incurred by the institution. In addition, an administrative fine is imposed under Article 105 of this law in accordance with the Labor Law.

29. What is the responsibility of the employer who reports the work accident of the worker he works without insurance?

The right to insurance is a legal right and compulsory at the same time. Insurance is not optional. Any verbal and written agreement that the employer and the employer will undertake on insurance shall be invalid. In this respect, it can make any right, such as a worker working as an insured employee, because it does not make sense in terms of law in terms of workers.

30. What is an institution health board? What are their duties?

By examining the medical reports of the health service providers authorized by the institution and by examining the documents which form the basis of this diagnosis;

  • Operating loss of income and earning power loss rates in the profession
  •  premature aging state, to do their duty, loss of earning power in profession
  • invalidity degrees to determine, from an authorized physician and / or the board of the dentist.

31. Can the temporary incapacity allowance be paid for the days when the insured who has an occupational accident on his / her day of work is left to rest?

If the accident is accepted by the Agency, it is possible for the insured to receive temporary incapacity benefit from our Institution for the days when the insured remains.

32. Is the number of premium days required in work accident reports?

If the insured does not work due to occupational accident and occupational disease, temporary incapacity allowance is paid for each day starting from the first day without the requirement of the number of premium payment days.

However, in order to benefit from the benefits provided by the insurance branches of the occupational accident and occupational diseases, the insured employees who are employed discontinuously in agricultural or forestry works; have been registered at least 10 days prior to the date of the work accident, all kinds of debts related to premiums and premiums must be paid and their insurances should not be over. The insured in this context will not be awarded temporary incapacity allowance if there is an accident in the next 10 days (including the tenth day) from the date of registration.

33. 4 (b) (self-employed and self-employed) work accident, occupational disease report is paid?

4 / b is covered in the short-term insurance premium – the company partners can not benefit from maternity – work accident, occupational disease and maternity in the form of a report fee is paid. In case of illness, these people are not paid a report fee.

34. How many days are paid by the SSI if a report is received due to work accident?

Provided that a resting report has been obtained from the physicians or health boards authorized by the institution; insured due to work accident or occupational disease is paid to the insured every day.

35. How is the report fee calculated if the person who receives permanent incapacity benefit and continues to receive the disease report?

The difference between the insured persons with permanent disability income and the ones receiving rest reports due to the same disability or occupational disease, the one-day temporary incapacity benefit to be calculated from the date of written request, and the thirty-one of the monthly continuous disability income is given as temporary incapacity allowance for each day.

If the insured is subject to an occupational accident or to a new occupational disease, the income is calculated on the basis of the total disability of the occupation and the income obtained during the last occupational accident or occupational disease which causes permanent incapacity for work. However, if the insured’s income is less than his / her first income calculated according to his / her daily earnings during the last work accident or occupational disease, the permanent incapacity of the insured is paid on the first income.

36. How is the full incapacity income calculated?

In case of continuous disability, the insured shall be subject to 70% of the calculated monthly income. However, if the insured person is in need of constant care of another person, the income bonding rate shall be applied as 100%.

37. How is the permanent partial disability income calculated?

Continuous partial disability income to be attributed to the insured is as much as 70% of the 30% of the daily earnings to be calculated corresponds to the rate of loss of earning power in the profession. If it is understood that the insured is in need of the care of someone else in the permanent partial disability income, the income bonding ratio will also be 100% of the monthly earnings.

38. (4 / b) liyim permanent disability income will be connected, but I have premium debt. Do I get permanent disability income while my debt remains?

As in the conditions of entitlement to temporary incapacity benefit, Law has also stipulated a further requirement in addition to the other conditions: in order to be eligible for permanent incapacity income, due to its insurance, all kinds of premiums related to premiums and premiums including general health insurance have been paid. it is mandatory.

39.If the person receiving permanent incapacity income dies, can the income holders be paid income?

If the survivor has died due to occupational accident or occupational disease, or if he / she has fulfilled the necessary conditions for the attachment of the deceased insured death pension, the survivors shall be charged with both death income and death. However, all of the higher ones are paid half of the low.

40. When receiving permanent incapacity income, is it given to the right holders of the deceased person?

Funeral allowance is paid to the right holders of the insured, who have died during the period of work accident or occupational disease or permanent disability income, duty disability or old age pension.

41. If the girl who receives orphan’s salary due to permanent disability income gets married, will the dowry allowance be granted?

Death income is attributed to the right holders of the insured who died while they are receiving an occupational accident or occupational disease or permanent incapacity benefit. Marriage allowance is the payment of two years of income and pension in advance on the date of marriage, if requested, to girls who are married while receiving death income or pension, and therefore are peculiar to their daughters. Daughter who is receiving death income due to permanent disability income is entitled to receive dowry allowance.

42. What is the application in case of prolonged treatment period due to the employee’s own fault after work accident?

Temporary incapacity allowance or permanent incapacity benefit if the insured suffers from work accidents or occupational diseases, sickness, prolonged treatment period or increased incapacity for work due to the following reasons;

  • If the insured fails to comply with the measures and recommendations provided by the physician due to work accident, occupational disease, disease and maternity, prolonged treatment period or increased incapacity to work, it shall be reduced to one quarter by the Authority on the basis of prolonged treatment period or increasing incapacity rate. .
  • The Company shall be exempted by the Authority by one third according to the degree of defect of the insured who suffered from a work accident due to severe defect or who is ill or ill.
  • The insured shall be paid in half for the insured who has suffered a work-related accident due to a deliberate act, who is ill or ill, or who does not accept the proposed treatment despite the written notice of the Authority.
  • Temporary incapacity allowance shall not be paid to the insured employee without receiving a certificate from the physician he / she is being treated for, the treatment has been terminated and workable;

43. (4 / b) What are the requirements for the insured under the scope of work accident or occupational disease to receive incapacity benefit?

In order for the insured or occupational disease insured to receive incapacity benefit, they should receive a resting report due to this treatment during the inpatient or inpatient treatment and they should not have any debts related to premiums and premiums.

44. How much is the incapacity benefit paid?

Work accident, occupational disease or maternity in the case of work as a disability allowance to be paid to the insured, is calculated from the daily earnings declared by the insured. In the outpatient treatment, 2/3 of the daily earnings and in the inpatient treatments is paid as ½.

45. (4 / b) where the insured under the lawyers and notaries to suffer from work accidents and occupational disease, or in case of maternity, to receive incapacity benefit, where to apply?

As lawyers and notaries are considered insured under 4 (b), they are required to apply to Social Security Provincial / Social Security Central Directorates with the necessary documents in order to receive incapacity benefit.

46. (4 / b) insured in the workplace under the legal notice of work accident notification is paid in case of incapacity benefit?

In case (4 / b) insurers are notified of an accident at work, the incapacity benefit is paid from the date of notification.

47. (4 / b) If the insured in the scope of the debtors are given inability to work?

(4 / b) insured, the insured (4 / b) insured have no indemnity benefit.

48. (4 / b) to the right holders who have a defect in the work accident of the insured within the scope of (4 / b)?

Rights to the beneficiaries who have defects in the occurrence of the work accident shall not be recourse to the income to be attributed by the Authority and the allowances to be given.

49. (4 / b) for the reasons arising from the insured himself due to prolongation of the treatment period, what if the increase in the inconvenience?

  • If the insured person does not comply with the cause or the advice of the physician, the duration of the treatment period increases and the incapacity to work will increase.
  • If the insured is subjected to a work accident due to the heavy defect or to the occupational disease, the disability benefit shall be deducted by the Authority until one third of the disability benefit shall be paid by the Authority.
  • An insured person who has suffered a work accident due to November movement, who is sick, who is sick or who does not accept treatment despite the written notification of the Institution is paid half of the incapacity benefit.
  • The insured is not paid the incapacity benefit to the insured employee without receiving a certificate from the physician who is being treated and that his / her treatment is over and the paid ones are taken back.

50. (4 / b) insured if the workplace accident occurred due to the fault of a third person, what is the operation?

Half of the first advance capital value made to the insured or right holders on the date of the income to be paid and the future payments will be recourse to the third party seen as defective.

51. What kind of action is taken if the work accident is reported late?

In the event that the work accident is not reported to the Agency within the periods specified in the Law, the temporary incapacity allowance to be paid to the insured by the Authority is collected from the employer until the notification is made to the Authority as of the date of the event.

(4 / b) temporary incapacity benefit is not paid to the insured.

52. If a couple of cases of work accident, occupational disease, disease and maternity in the insured are combined, which is the temporary incapacity benefit?

The highest amount of temporary incapacity benefit is paid to the insured.

53. Who is responsible for the investigation of the work accident claim reported to the Authority?

In order to make a decision about whether the event reported to the Authority is considered as an occupational accident, an investigation is carried out by the authorized officers of the Authority with inspection and control or by the Ministry Labor Inspectors. If necessary information is included in the reports and minutes of the Ministry Labor Inspectors, or if there is a judicial decision, it is not requested to review again.

54. The incidents that occurred in the time allocated for giving the milk to the child of the female insurance holder are considered as work accidents; the accident caused by the female insurance holders (4 / b) in their own name and in the name of independent workers is not considered as an accident at work.

According to the last paragraph of Article 74 of the Labor Law no. There is no need for such an arrangement in terms of the insured, and the female insured under 4-b does not have to be present in the workplace to provide milk to the child.

55. What are the health benefits to the insured who had work accidents?

Regardless of the number of days of premium payment, the insured patient who undergo an occupational accident continues treatment immediately after receiving the treatment, regardless of the specific period. In case of a relapse due to this work accident, re-health assistance is provided.

56. What are the obligations of the employer in the work accident?

It is obliged to inform the Authority about the accident incident within three working days after the accident.

57. What is the liability of the insured in the work accident?

It is obliged to inform the employer or the Authority within three working days following the accident and must also comply with the measures or recommendations of the treating physician. Otherwise, if the treatment is prolonged or disability, or if the degree of disability increases, a reduction of the temporary incapacity benefit and the deductible income shall be deducted.

58. Is the temporary incapacity allowance paid for the period of time that the insured person who is covered by the work accident is released?

Temporary incapacity allowance shall be paid to the insured person subject to an occupational accident regardless of the number of days of premium payment for each day he / she is released.

59. Is the work-insured insured sent to treatment abroad?

Where treatment is not possible in the country, it is sent for treatment abroad.

60. Which prostheses are given to the insured who has work accidents?

All kinds of prosthesis tools and equipments that are required to use with health board report are provided on the basis of the malfunction caused by work accident.

61. How many days of the number of days of premium payment are required for the benefits provided by the insured persons who work in this accident?

There is no requirement for any number of premium payment days to benefit from the benefits provided by the occupational accident insurance branch.

62. If the number of premiums paid by the work accident-insured person is not sufficient, will they benefit from health benefits?

As in the sickness insurance, there is no number of premium payment days in the work accident insurance branch, and it is necessary for the insured employer to take her / him to the nearest health institution immediately after the work accident.

63. Is the hospital bill paid to the employer who has undergone a work accident, and paid to the employer, to be paid to the employer?

The legal period of the work accident (within 3 working days after the accident) is paid to the Authority.

64. Can the objection rate determined by the work accident be challenged?

Re-evaluation of the rate of disability due to occupational accidents It is possible to appeal by applying with the petition since the Social Insurance is made by the High Health Council.

About the author

Thalib Tantary

My name is Thalib Mushtaq Tantary and i am the founder of this very site. I am a medical or civil engineering student and i love to help people get out of trouble they counter in their lives.
Since most often students find it difficult to understand their text books or even there many who can not afford such books, therefore we prepared ourselves to solve this problem faced by them.

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