Industrial Accident Compensation Insurance Act: what are the standards for an occupational accident?

Hello. I see that you have asked about the standards for an occupational accident under the Industrial Accident Compensation Insurance Act.

The standards for an occupational accident can be broadly classified into three categories.

First, there is a case where an accident arises from an occupational incident.

Such an occupational incident includes not only an accident that occurs during work but also an accident that occurs while using facilities provided by the employer, or during a break under the employer's control and management.

Second, there is a case where there is a causal relationship between the work and the accident.

If there is no substantial causal relationship between the work and the accident arising from the occupational incident, it cannot be regarded as an occupational accident even where it falls under the above cases.

Finally, the accident must not be one caused by the worker's intentional or criminal act.

If an accident occurred as a result of conduct caused by the worker's intent or criminal act, it is not recognized as an occupational accident.

In addition, where an additional disease arises while receiving medical care after suffering an occupational accident, it is often an issue whether that disease can also be recognized as an occupational accident.

The Supreme Court held, "Where a worker suffers an occupational accident and a new disease arises during medical care, it must be shown that there is a causal relationship between the additional disease and the original injury or disease."

(Supreme Court, Judgment of November 12, 1991, 91Nu5624)

As you mentioned, if a worker suffers an occupational accident due to the employer's intent or negligence, the worker can claim damages against the employer and others.

However, the worker must prove the employer's intent or negligence directly, and if the worker has received damages, the worker cannot receive insurance benefits to the extent of the money and goods received as damages.

The Industrial Accident Compensation Insurance Act is insurance operated by the Korea Workers' Compensation and Welfare Service, and please note that where a worker can receive insurance benefits, the insured is exempted from accident compensation liability for the same cause.

If a legal measure is necessary, we recommend that you respond to the case with the help of an industrial accident attorney.