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ATA/237/1997•Natural causation denied for back pain and psychological symptoms
ATA/237/1997Cour de justice / Chambre administrative15 avr. 1997Dismissed
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The court held that the appellant’s back pain was caused by a congenital anomaly and not by an accident-related fracture from the slip. Once the statu quo sine was reached, only psychological complaints remained, but the accident was not serious enough to be considered a legally relevant cause of those symptoms. The appeal therefore failed and no further accident-insurance coverage was owed for the claimed consequences.
Art. 6 al. 1 LAA; natural causation and psychological sequelae of an accident: where medical evidence shows that back complaints result from a congenital anomaly rather than from the alleged accident mechanism, natural causal connection is excluded. If, after reaching statu quo sine, only psychological symptoms persist, accident causation requires that the event be of sufficient objective gravity to explain the development of such disorders; absent such gravity, liability under accident insurance is denied.
Descripteurs
ASSURANCE SOCIALE; CAUSALITE NATURELLE; PREDISPOSITION; TENDANCE A LA REVENDICATION; STATU QUO SINE; FRACTURE; AFFECTION PSYCHIQUE; ASSU
Normes
LAA.6 al.1
Résumé
Il a été établi que les maux de dos dont souffre le recourant sont dus à une anomalie congénitale plutôt qu'à une fracture consécutive à la glissade dont il a été victime. A la date où a été recouvré la statu quo sine ne subsistaient que des troubles psychiques. Or, l'accident précité n'a pas été jugé suffisamment grave pour permettre l'apparition et le développement de tels troubles.
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Whether the back complaints were in natural causal relation with the accident
No. The back pain was attributable to a congenital anomaly rather than to an accident-induced fracture.
The medical evidence established a congenital predisposition as the real cause of the back complaints, excluding the asserted fracture mechanism.
Whether the remaining psychological symptoms were in natural causal relation with the accident
No. After recovery of the statu quo sine, only psychological symptoms remained, but the accident was not severe enough to cause or sustain them.
The accident was not of sufficient gravity to justify the onset or persistence of the psychical disorders under accident-insurance causation standards.
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