Ambulance in action (symbol photo)
Photo: Julian Stratenschulte / dpa
With an unusual decision, the Federal Social Court (BSG) in Kassel arouses hope that mental illnesses may soon be recognized as occupational diseases.
Because the BSG Accident Senate wants to clarify with an expert opinion whether paramedics are significantly more likely to suffer from post-traumatic stress disorder (PTSD) than the rest of the population
(Ref .: B 2 U 11/20 R)
If the reviewers answered yes to the question, recognition as an occupational disease would be possible.
The presiding judge of the BSG Accident Senate, Wolfgang Spellbrink, said the presumably one-time decision in the highest social court could "have a certain signal value beyond the case."
The starting point is the case of a former paramedic with the German Red Cross in the Esslingen district near Stuttgart.
He collapsed in 2016.
He was then diagnosed with PTSD, which he would like to have recognized as an occupational disease.
Use in Winnenden and in the event of several suicides
As a justification, he referred to numerous psychologically stressful events, including a deployment in the 2009 rampage in Winnenden and Wendlingen, in which 16 people died.
Among several suicides he faced on duty, there were two teenage best friends.
The first took its own life in a very bloody way in 2014, the second a year later in a very similar way.
The federal and railway accident insurance did not recognize an occupational disease.
There is no reliable evidence that repeated exposure to such events is likely to trigger PTSD.
The BSG now met this with "a certain mistrust".
The practice of statutory accident insurance, which has grown over decades, does not automatically have to comply with the requirements of the Social Security Code.
According to this, the federal government maintains the Occupational Diseases Ordinance, a list of recognized occupational diseases.
Which diseases are included in the ordinance is decided on the proposal of the »Medical Advisory Board for Occupational Diseases«, which is part of the Federal Ministry of Labor and Social Affairs.
Not a single mental illness in the list of occupational diseases
So far, stressed the BSG, not a single mental illness has been included in the ordinance.
On request, the Advisory Board stated that it did not want to discuss this in the foreseeable future.
The dispute was therefore about a so-called how-occupational disease.
According to the law, the employers' liability insurance association must recognize such a disease if the other requirements are met in the case of a disease not listed in the ordinance.
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These prerequisites include, first of all, that a certain occupational group is affected by the disease significantly more often than the rest of the population.
According to the current decision, the BSG now wants to clarify whether this is the case with paramedics and PTSD.
The paramedic procedure will be suspended until then.
According to the BSG, the Accident Senate has never commissioned an expert opinion, and the entire court has not commissioned an expert opinion at least in the past 30 years. The background to this is that the highest federal courts are not allowed to determine any new facts specifically relating to a case; this is reserved for the lower courts. The question about PTSD in paramedics concerns a "general fact", on which an expert opinion is possible, according to the BSG.
This also explains the "signal value" of the decision, of which Judge Spellbrink spoke: "The case law will critically accompany the activities of the legislator." impact.
A draft law was already discussed in the Bundestag last year, which could lead to an easier recognition of mental illnesses as occupational diseases.
mamk / JurAgentur