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ATA/743/1997•Accident insurance: pension, daily allowance and IPAI after stabilization
ATA/743/1997Cour de justice / Chambre administrative2 déc. 1997Partially Granted
Extrait par Omnilex
The case concerns accident insurance benefits after a moderate accident causing a multifragmentary femur fracture and knee instability. The court held that once the insured person's condition had stabilized, the CNA had to pay an invalidity pension under Art. 18 LAA instead of continuing daily allowances. It also confirmed the 5% impairment-of-integrity compensation. Finally, it annulled the decision to resume the claimant's usual work at 100%, taking into account the claimant's current profound depression.
Art. 18 LAA; stabilization of the state of health and substitution of daily allowances by an invalidity pension; once the medical condition is stabilized, entitlement to daily allowances ceases and pension benefits are assessed from that point. An impairment-of-integrity compensation may be upheld if the medical findings support the percentage fixed. A reassessment of work capacity cannot be sustained where a relevant psychiatric disorder prevents a return to full habitual work capacity.
Descripteurs
ACCIDENT DE GRAVITE MOYENNE; INDEMNITE POUR ATTEINTE A L'INTEGRITE; INDEMNITE JOURNALIERE; FRACTURE; LESION DU GENOU; ATTEINTE A L'INTEGRITE; CAPACITE DE TRAVAIL PARTIELLE; DEPRESSION; ROUTE; INCAPACITE DE TRAVAIL; PROFESSION; MESURE DE READAPTATION(ASSURANCE SOCIALE); EVALUATION DE L'INVALIDITE; AFFECTION PSYCHIQUE; ASSURANCE SOCIALE; ASSU
Normes
LAA.22
Résumé
Accident de gravité moyenne ayant occasionné une fracture multifragmentaire du fémur et une instabilité du genou. La CNA est tenue de verser une rente, au sens de l'art. 18 LAA, à compter du jour où son état s'est stabilisé, en lieu et place des indemnités journalières. Confirmation du taux de l 'IPAI (5 %) et annulation de la décision de reprise à 100 % de l'activité habituelle, en raison de la profonde dépression dont souffre le recourant actuellement.
Extrait par Omnilex
Whether the accident insurer had to grant an invalidity pension from the date of medical stabilization instead of continuing daily allowances.
Yes. The insurer must pay a pension under Art. 18 LAA from the date the condition stabilized, replacing daily allowances.
The court accepted that once the insured's condition had stabilized, entitlement shifted from daily allowances to a pension.
Whether the 5% compensation for impairment of integrity should be upheld.
Yes. The 5% impairment-of-integrity award was confirmed.
The medical consequences justified maintaining the assessed impairment rate.
Whether the decision to resume the claimant's usual activity at 100% should be annulled because of the current severe depression.
Yes. The full-capacity work resumption decision was annulled in light of the claimant's profound depression.
The psychiatric condition prevented confirmation of a return to full habitual work capacity.
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