Current concepts in jurisdiction on occupational skin disease (OSD): New aspects regarding the omission obligation in job-related dermatological expertises - The medical perspective (part II) [Aktuelle rechtsprechung zur BK 5101: Neue aspekte zum unterlassungszwang in der berufsdermatologischen begutachtung - Aus medizinischer sicht (teil II)]

Abstract

Introduction: In Germany, the recognition of an occupational skin disease (OSD) No. 5101 requires certain prerequisites. The skin disease must be severe or repeatedly relapsing and it has to force the affected person to give up the hazardous occupation permanently. Recently, one of the statutory public accident insurances was sentenced to recognize an OSD No. 5101 in a nurse with a severe natural rubber latex (NRL)-allergy by the German Supreme Court in Social Matters (Bundessozialgericht) (as of Dec. 9th, 2003) although a necessity to quit the occupation did not exist (complete ban of NRL from the workplace) and the nurse, in fact, continued working. Methods: 59 anonymous expert opinions of the Statutory Accident Insurance for Health and Welfare services (Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege [BGW]) were analyzed retrospectively concerning different legal constellations in the light of the recent Supreme Court decision. Results: If one considers either the amount of remaining irritant skin damage or the effects of persisting, occupationally acquired allergies and assumes an avoidance of hazards-interval of 26 weeks the recent Supreme Court decision would result in 19% additional OSD-recognitions with an MdE of ≥ 10% and 3% additional OSD-recognitions with an MdE of ≥ 20%. Conclusion: The decision of the Supreme Court will create a substantial number of controversies in the accident insurance administration and in expert medical opinions. Preventive efforts of the statutory insurances may be hampered in the future by the practical consequences of the decision, because even if preventive measures are successful OSD No. 5101 recognition (and compensation claims) may result. © 2006 Dustri-Verlag Dr. Karl Feistle.