Accident insurance: remand for assessment of earning capacity

ATA/362/1995Cour de justice / Chambre administrative3 juil. 1995Remanded

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Résumé Omnilex

In an accident insurance dispute concerning a shoulder lesion and cervical syndrome, the Federal Insurance Tribunal found that the medical record contained conflicting expert opinions. It therefore remanded the matter to the cantonal court for a new assessment of the appellant's earning capacity on the basis of the existing file.

Regeste Omnilex

LAA art. 18; where the file contains diverging medical opinions on the insured person's work and earning capacity, a final judicial assessment is not possible without further evaluation. The court must ensure a sufficiently reliable medical basis before fixing the loss of earning capacity; if the evidence is inconsistent, the case is to be remitted for additional assessment (consid. not stated).

Texte intégral

Descripteurs

ASSURANCE SOCIALE; ACCIDENT; AA; LESION DE L'EPAULE; SYNDROME CERVICAL; EXPERTISE; RAPPORT MEDICAL; MOTIVATION

Normes

LAA.18

Résumé

Renvoi du TFA au TA pour la fixation de la capacité de gain du recourant, sur la base d'avis médicaux différents versés au dossier de la Cour de justice.

Mots-clés

social insuranceaccidentshoulder injurycervical syndromemedical evidenceexpert opinionearning capacityremand

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Questions juridiques clés extraites par Omnilex

Question juridique clé

Whether the insured's earning capacity had to be determined on the basis of the medical evidence in the file.

Solution extraite

The case had to be sent back for a new assessment of earning capacity because the medical opinions in the record were divergent.

Motifs extraits

The existing medical reports were not sufficiently concordant to permit a final determination; a fresh evaluation was therefore required.

Accident insurance: remand for assessment of earning capacityGénéré par IA