Accident insurance: remittal for expert assessment of earning capacity

ATA/556/1997Cour de justice / Chambre administrative23 sept. 1997Partially Granted

Extrait par Omnilex

Résumé Omnilex

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.

Regeste Omnilex

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.

Texte intégral

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.

Mots-clés

social insuranceaccident insurancewrist injuryimpairment compensationearning capacityremittalexpert assessment

Extrait par Omnilex

Question juridique clé

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

Solution extraite

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

Motifs extraits

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

Question juridique clé

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

Solution extraite

No; the 10% impairment award was upheld.

Motifs extraits

The wrist lesion justified the confirmed impairment degree.

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