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PubMedDate not supplied

[Unlisted osteoarticular pathologies. The National Insurance Institute for Occupational Diseases approach].

In the case of unlisted microtraumas, the patient must first be evaluated in terms of his or her risk exposure, followed by an exact determination of the relationship of causal dependency, and lastly an accurate diagnosis must be made. Since the disorder is not listed as an automatically compensated disease, the burden of proof lies with the insured. Regarding microtraumas, in particular, the causes must be studied with reference to: chronological criteria, qualitative and quantitative efficiency factors, topographic criteria, modal criteria, continuity of event seriation, evidence of unrelated pathogens. The principle of adequate causality appears to be the only one offering a sufficient guarantee of scientific exactness in determining the relationship of causal dependency. At present, Circ. 35/92 of INAIL regulations states that the work-relatedness of microtraumas may be admitted when the worker's personal history (anamnesis) points to the existence of an occupational risk whose nature, duration and intensity can reasonably be considered as to exert an equal or higher influence than that exerted by non-occupational aetiological factors. The statistical and epidemiological data must demonstrate a significantly higher incidence of the pathology among a given category of workers. Only cases featuring the aforementioned characteristics, are currently legally entitled to the relevant insurance services.

Causality↗
PubMed1997

[Day care as a component of comprehensive health care structure after introduction of nursing care insurance].

Detailed time protocols based on direct observation as well as socio-demographic and morbidity-related data were collected in Day-Care-Facilities for the Aged and the Handicapped (Tagespflege), in order to gain information regarding the users and the service activities of these institutions. Women aged 80 years and over constitute the main users; they use the facilities between 8 am and 4.30 pm in most cases. The analysis of employee activities showed that roughly one quarter of the time was spent on specific services of such facilities, e.g. group activities, individual activating therapy of patients. Should Day-Care-Facilities play an (increasingly) important role in the domestic social service provision for the aged and the handicapped, the financing of their costs (on the average DM 88 per day, not counting transportation cost) must be reconsidered.

Aged↗
PubMedDate not supplied

An overview of workers' compensation.

The authors compare and contrast the U.S. and Canadian systems; describe the roles of government, employers and employees, and insurance providers; examine the economics of workplace risk; assess different systems in six states and two provinces; and indicate challenges to be met.

Canada↗
PubMed1976

Demographic characteristics of disability applicants: relationship to allowances.

This article highlights some of the causes underlying differences in disability allowances by sex and race. Among the causes are differences in labor-force patterns, the educational background, and the age distributions of the insured and applicant populations. More than half of the differences between the black and white applicants in the proportion of claims allowed is explained by differences in their age distributions. The lower proportion of claims allowed for black applicants may reflect the greater tendency fo the black insured population to apply for disability insurance benefits.

Adult↗
PubMed1998

[Self-mutilation as insurance fraud].

The case of a self-amputation of the left-sided forefinger is presented. It was an isolated smooth amputation near the basic ankle of the finger without any accompanying injury of other fingers. The victim (a physician) claimed financial compensation from his accident-insurance; his contract included special disability taxes for finger injuries. However, the insurance company did not pay but was able to demonstrate--by means of a medico-legal reconstructive expertise--that the amputation was voluntary and self-inflicted. The argumentation concerning self-mutilation is presented (including the so-called execution-position of the finger and ergonometric aspects). Concerning the surgical care, intervention and diagnostic procedures a detailed documentation of the case history and the morphology of the injury pattern are recommended (especially in isolated finger-amputations of the non-working hand.

Aged↗