Accident insurance: disc herniation not plausibly caused by accident

ATA/80/1998Court of Justice / Administrative ChamberFeb 10, 1998Dismissed

Extracted by Omnilex

Omnilex summary

The insured sought accident-insurance coverage for a lumbar disc herniation allegedly caused or aggravated by an accident. The court found no plausible causal link. It reiterated that a durable aggravation of a pre-existing spinal disorder is established only where imaging shows rapid loss of disc height after the trauma and the emergence or enlargement of marginal osteophytes. As those elements were absent, the claim failed.

Omnilex headnote

LAA 6; causal link and aggravation of a pre-existing spinal disorder by accident. A durable aggravation of a pre-existing vertebral condition is not established merely by post-traumatic pain or the later discovery of a disc herniation. It requires objective radiographic findings showing a rapid reduction in disc height after the trauma and the appearance or enlargement of marginal osteophytes. In the absence of such findings, the accident cannot be held to have caused or durably aggravated the spinal lesion (consid. not specified).

Full text

Descripteurs

ASSURANCE SOCIALE; ACCIDENT; AA; HERNIE DISCALE; LESION DE LA COLONNE VERTEBRALE; AGGRAVATION DE L'ATTEINTE A LA SANTE; ETAT ANTERIEUR; RECHUTE; CAUSALITE ADEQUATE; ASSU

Normes

LAA.6

Résumé

Il n'existe une aggravation durable due à l'accident, d'une maladie préexistante de la colonne vertébrale, que si les radiographies permettent de constater une diminution rapide de la hauteur d'un disque après le traumatisme et l'apparition ou l'agrandissement d'ostéophytes marginaux (arrêt non publié du TFA du 04.09.95 cité dans l'ATA P. du 03.02.98). En l'espèce, hernie discale sans lien vraisemblable avec l'accident.

Keywords

social insuranceaccident insurancedisc herniationpre-existing conditioncausationspinal injuryaggravation

Extracted by Omnilex

Key legal questions extracted by Omnilex

Key legal question

Whether the accident caused or durably aggravated the pre-existing spinal condition and disc herniation

Extracted holding

No durable accident-related aggravation was shown; the disc herniation was not plausibly causally linked to the accident.

Extracted reasoning

A lasting aggravation of a pre-existing spinal disease requires radiographic evidence of a rapid decrease in disc height after the trauma and the appearance or enlargement of marginal osteophytes. Those indicia were not established here.

Accident insurance: disc herniation not plausibly caused by accidentAI generated