Invalidity rate confirmed at 60% despite AI’s 100% assessment

ATA/517/1998Court of Justice / Administrative ChamberSep 1, 1998Confirmed

Extracted by Omnilex

Omnilex summary

Following an accident, the insured person received a 100% disability assessment from AI and a 60% assessment from CNA. The court confirmed CNA’s rate, holding that its file was based on complete and detailed medical reports, while the AI assessment was too summary and failed to consider the insured’s objectively exigible residual capacity.

Omnilex headnote

LAA 6; assessment of disability rate in coordination between insurers and authorities; probative value of medical reports. Where several disability assessments diverge, the court gives decisive weight to the evaluation founded on complete, detailed, and methodologically coherent medical evidence. A summary assessment that omits consideration of the objectively exigible residual earning or working capacity does not prevail over a more substantiated file (consid. unspecified).

Full text

Descripteurs

ACCIDENT; AA; INVALIDITE(INFIRMITE); EVALUATION DE L'INVALIDITE; COLLABORATION ENTRE AUTORITES; ORGANISATION(PROCEDURE); COORDINATION(ASSURANCE); PROCEDURE; INDEMNITE POUR ATTEINTE A L'INTEGRITE; ASSURANCE SOCIALE; ASSU

Normes

LAA.6

Résumé

Taux d'invalidité fixé à 100 % par l'AI et à 60 % par la CNA. Confirmation du taux de la CNA, basé sur des rapports complets et détaillés alors que ceux de l'AI sont sommaires et ne tiennent pas compte de ce qui est objectivement exigible de l'assuré.

Keywords

accidentinvalidity assessmentsocial insurancemedical evidencecoordination between authoritiesresidual capacity

Extracted by Omnilex

Key legal questions extracted by Omnilex

Key legal question

Whether the CNA could rely on its assessment to fix the disability rate at 60% instead of 100%.

Extracted holding

Yes. The CNA assessment was upheld because it was based on complete and detailed medical reports, whereas the AI reports were summary in nature and did not account for objectively required residual capacity.

Extracted reasoning

The court accepted the CNA evaluation as more persuasive and methodologically sound, given the quality and completeness of the supporting medical evidence and the failure of the AI assessment to address what was objectively still exigible from the insured.

Invalidity rate confirmed at 60% despite AI’s 100% assessmentAI generated