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Pre-existing osteoporosis did not break causal link to spinal fractures

ATA/178/1998Court of Justice / Administrative ChamberMar 31, 1998Granted

Open source

Extracted by Omnilex

Omnilex summary

An accident insurer dispute concerned whether vertebral fractures were attributable to an accident or to pre-existing osteoporosis. Medical expertise showed that the osteoporosis could not have caused the fracture of three vertebrae. The court therefore accepted natural causation for the accident consequences and admitted entitlement to a 100% disability pension. The case turns on the probative value of the expert evidence in excluding the pre-existing condition as the cause of the injuries.

Omnilex headnote

LAA art. 6; natural causation and pre-existing condition; evidentiary value of medical expertise. Where expert evidence establishes that a pre-existing osteoporosis could not have caused vertebral fractures, the accident remains the natural cause of the harm despite the underlying vulnerability. A pre-existing state does not interrupt causation merely because it made the insured more susceptible to injury; decisive is whether the accident is still a relevant cause of the disability (consid. unspecified). Entitlement to accident benefits, including a disability pension, follows if the accident-related sequelae are shown to be causally responsible for the incapacity to earn.

Full text

Descripteurs

ASSURANCE SOCIALE; ACCIDENT; AA; ETAT ANTERIEUR; CAUSALITE NATURELLE; ASSU

Normes

LAA.6

Résumé

Expertise permettant de déterminer qu'une ostéoporose préexistante à un accident n'a pu être la cause de la fracture de 3 vertèbres. Rente invalidité de 100 % admise pour les suites de l'accident.

Keywords

social insuranceaccidentnatural causationpre-existing conditionosteoporosisvertebral fracturedisability pensionmedical expertise

Extracted by Omnilex

Key legal questions extracted by Omnilex

Key legal question

Whether the spinal fractures were naturally causally linked to the accident despite pre-existing osteoporosis.

Extracted holding

Yes. The expert assessment ruled out that the pre-existing osteoporosis was the cause of the three vertebral fractures, so the accident remained the natural cause.

Extracted reasoning

The medical expertise showed that the claimant's pre-existing bone condition did not explain the fractures; the accident therefore retained causal significance for the injuries.

Key legal question

Whether a 100% disability pension was owed for the consequences of the accident.

Extracted holding

Yes. A full invalidity pension was admitted for the accident sequelae.

Extracted reasoning

Because the accident-related injuries remained causally relevant and resulted in total disability, the pension claim was upheld.

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