Accident insurance: remittal for expert assessment of earning capacity

ATA/556/1997Court of Justice / Administrative ChamberSep 23, 1997Partially Granted

Extracted by Omnilex

Omnilex summary

The appellant challenged the assessment of disability benefits under accident insurance. The court found that the record did not yet permit a determination of earning capacity and therefore remitted the matter to the insurer for an expert assessment. At the same time, it upheld the 10% impairment award for the wrist injury.

Omnilex headnote

Art. 6 LAA; where the file does not permit a reliable assessment of earning capacity, the matter must be remitted for further expert clarification. An impairment compensation award may nevertheless be confirmed if the factual basis concerning the bodily injury is sufficient and the degree of impairment is established.

Full text

Descripteurs

ASSURANCE SOCIALE; ACCIDENT; AA; AFFECTION DE L'ARTICULATION; INDEMNITE POUR ATTEINTE A L'INTEGRITE; INCAPACITE DE GAIN; DECISION DE RENVOI; ASSU

Normes

LAA.6

Résumé

Dossier retourné à la caisse pour qu'elle effectue une expertise pour déterminer la capacité de gain de la recourante. IPAI de 10 % confirmé pour lésion au poignet.

Keywords

social insuranceaccident insurancewrist injuryimpairment compensationearning capacityremittalexpert assessment

Extracted by Omnilex

Key legal question

Whether the insurer had sufficiently established the appellant's earning capacity after the accident.

Extracted holding

No; the case had to be remitted so the insurer could obtain an expert assessment on earning capacity.

Extracted reasoning

The existing file was insufficient to determine the degree of incapacity of gain, so further medical/economic clarification was required.

Key legal question

Whether the impairment compensation for the wrist injury should be changed from 10%.

Extracted holding

No; the 10% impairment award was upheld.

Extracted reasoning

The wrist lesion justified the confirmed impairment degree.

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