Occupational Disease and Its Legal Consequences in the Employment Relationship

In general terms, an occupational disease refers to health problems that arise over time due to factors to which an employee is exposed in the course of performing their duties, linked to the nature of the work or the working conditions. Performing a specific task repeatedly over a long period of time or working continuously in hazardous conditions, may cause wear and tear on bodily systems and lead to various health problems. For example, an employee who is exposed to chemical substances through inhalation may, over time, develop certain diseases caused by such substances. It should be noted that, for a disease to be classified as an occupational disease, it must be assessed not only from a medical standpoint but also from a legal perspective.

A. Occupational Disease and Conditions for Occupational Disease

As explained above, a disease that occurs due to the inherent nature and conditions of the work as a result of the actions performed by the employee during the course of their employment shall be considered occupational diseases where the necessary legal conditions are met. For an occupational disease to produce legal consequences, the following conditions must be met cumulatively.

• Status as an Employee: As a primary requirement, Law No. 5510 stipulates that in order to claim a right arising from an occupational disease, the employee must be insured. It should be noted, however that despite this statutory requirement, as established in the jurisprudence of the Supreme Court, it is possible to initiate legal proceedings to determine that a person was working without insurance coverage and contracted an occupational disease.
• Performance of the Work: As also noted above, an occupational disease must arise due to the performance of the work and there must be a clear causal link between the occupational disease and the employee's duties. In other words, it must be demonstrated that the disease to which the employee is exposed stems directly from the work performed or from the conditions under which the work is carried out. According to the jurisprudence of the Supreme Court, the occurrence of the disease as a result of certain factors present in the workplace is a prerequisite for the recognition of an occupational disease.
• Duration: Another essential condition of the concept of occupational disease is that the disease must arise as a result of a continuous working process over a certain period of time. In this context, sudden, one-time or incidental harms cannot be considered within the scope of occupational disease. This is because an occupational disease is a condition that develops gradually as a result of the employee's continuous exposure over time to certain risk factors, ultimately causing a loss of health in physical or psychological terms. If an occupational disease emerges after the termination of the employment contract, each disease is evaluated separately and within the framework of the concept of the liability period. The liability period is determined in the relevant legislation individually for each disease; however, in certain cases, even if the liability period has expired, a disease may still be recognized as an occupational disease with the approval of the High Health Council of the Social Security Institution.
• Disease: In the final paragraph of Article 14 of Law No. 5510, it is stipulated that the circumstances that shall be deemed as occupational diseases will be regulated by a regulation. Accordingly, in the annex of the Regulation on the Assessment of the Loss of Working Capacity and the Loss of Earning Capacity in the Profession ("Regulation"), the List of Occupational Diseases explicitly sets out the diseases, their symptoms, the principal occupations concerned and the liability periods. In cases of dispute as to whether a disease not specified in the Regulation should be considered an occupational disease, the matter is decided by the High Health Council of the Social Security Institution.

In summary, for a disease to be legally recognized as an occupational disease, a clinical diagnosis alone is not sufficient; certain conditions must be met cumulatively. It should be noted that whether a particular disease will be considered within the scope of an occupational disease must be assessed in light of the above-mentioned principal conditions, together with the relevant ancillary legislation.

B. Determination of Occupational Disease

An occupational disease must meet certain legal elements and it is equally essential that it be medically examined.

An insured employee who claims to have contracted an occupational disease may apply directly to the Social Security Institution or to healthcare service providers. If the employee applies to the occupational physician and the occupational physician makes a preliminary diagnosis of an occupational disease, the application may also be made through the referral of the workplace physician to the relevant healthcare service providers.

The aforementioned healthcare service providers prepare a medical board report following the necessary examinations. At this stage, the Health Council of the Social Security Institution reviews the relevant report and the supporting medical documents. Where deemed necessary by the Institution, inspection reports revealing the working conditions in the workplace and the resulting medical consequences, as well as other required documents, may also be examined. Accordingly, the council may reach one of two decisions at this stage. If the disease is determined to be an occupational disease, the employee becomes entitled to the benefits provided under the occupational accident and occupational disease insurance. However, if the disease is not determined to be an occupational disease, the individual will not be entitled to the benefits provided under the said insurance.

C. Rights Granted to Employees in Cases of Occupational Disease

In order to ensure the economic security of insured persons who have contracted an occupational disease and their dependents and to remedy their grievances, certain rights have been established under the social security legislation. Article 16(1) of Law No. 5510 explicitly sets out the rights granted to insured persons in cases of occupational accidents and occupational diseases. Accordingly, the rights granted to insured persons who have contracted an occupational disease, as well as to the beneficiaries affected by this situation, may be summarized as follows.

• Temporary Incapacity Allowance: Provided to prevent loss of income during the period in which the insured person is unable to work due to an occupational disease.
• Permanent Incapacity Income: Granted to an insured person who has suffered a permanent loss of earning capacity as a result of an occupational disease.
• Survivor's Income: A regular income provided to the eligible dependants of an insured person who has died due to an occupational disease.
• Marriage Allowance: A one-time payment made to the daughters of an insured person who is receiving income, upon their marriage.
• Funeral Benefit: A lump-sum payment made in respect of an insured person who has died as a result of an occupational disease.

D. Employer's Liability

It is the employer's obligation to take all necessary measures, taking into account whether the employee has the requisite training, experience and adequate equipment in terms of health and safety. Under both the Turkish Code of Obligations No. 6098 and the Law No. 6331, the employer is obliged to take all necessary precautions.

It should be noted that Article 21 of Law No. 5510 explicitly provides that "if an occupational accident or occupational disease occurs due to the employer's intent or as a result of an act contrary to the legislation on the protection of employees' health and occupational safety, the total amount of the payments made or to be made in the future to the insured or their beneficiaries by the Institution under this Law, together with the initial lump sum value of the income granted as of the date on which the income starts, shall be recovered by the Institution from the employer, limited to the amounts that the insured or their beneficiaries may claim from the employer. In determining the employer's liability, the principle of inevitability shall be taken into account". At this stage, it should be stated that the lump sum value refers to the amount calculated by taking into account the income to be paid in the future, the age, the probability of cessation, and the discount rate to be determined by the Social Security Institution.

Accordingly, in the event that an occupational disease occurs as a result of the employer's intent or an act contrary to occupational health and safety principles, the employer shall be held liable for the damages arising therefrom. As can be clearly seen, the relevant article states that "in determining the employer's liability, the principle of inevitability shall be taken into account". In general, the principle of inevitability refers to situations and consequences which cannot be prevented even when all the measures prescribed by law and technical conditions have been taken by the employer. In this context, if an occupational disease arises despite the employer having taken every precaution, a reduction in pecuniary damages may be applied based on inevitability. It should be emphasized that in order to speak of inevitability, the damage in question must not be attributable to the employer's fault, and the incident must have occurred despite all necessary measures having been taken by the employer.

In cases of occupational disease, in order for the insured person, or in the event of the insured's death, their beneficiaries to benefit from social insurance benefits, the occupational disease must be reported to the Social Security Institution, and the institution must recognize the incident as an occupational disease. In this regard, it is important to emphasize that Article 14 of Law No. 5510 states "if the employer learns that the insured person has contracted an occupational disease or is notified of this situation, the employer is obliged to report the matter to the Institution by means of an occupational accident and occupational disease notification form within three working days from the date on which the situation was learned. If the employer fails to fulfill this obligation or deliberately provides incomplete or incorrect information in writing, the expenses incurred by the Institution for this matter, as well as any temporary incapacity allowances paid, shall be recourseable to the employer". Accordingly, the employer is obliged to report the situation to the Social Security Institution by means of an occupational accident and occupational disease notification form within three working days from the date on which they learn that the employee has contracted an occupational disease. If the employer fails to make the notification within the specified period, the expenses incurred and, if paid, the temporary incapacity allowance may be recourseable to the employer by the Social Security Institution.

Without being limited to the above, if the employer, through a deliberate act or omission, knowingly and willingly causes the unlawful outcome of the insured employee contracting an occupational disease in the workplace, they shall be liable for the expenses incurred by the Social Security Institution on behalf of the insured.

E. Compensation Claims for Pecuniary and Non-Pecuniary Damages Arising from Occupational Disease

An employee who has contracted an occupational disease, or the relevant parties who have been deprived of support, may file a compensation lawsuit against the employer for the recovery of damages suffered, such as loss of earnings or medical expenses. In essence, a pecuniary compensation claim is based on circumstances such as the employee's inability to work, a reduction in earning capacity in the profession, or the complete loss thereof.

On the other hand, the right to claim non-pecuniary damages of the employee, or of the relevant parties who have been deprived of support in the event of the employee's death, is also reserved. Indeed, non-pecuniary compensation is a type of compensation that may be claimed by individuals whose personal rights have been infringed, with the aim of alleviating, to some extent, the distress, pain, and suffering they have experienced. Employees whose physical integrity or mental state has been harmed due to an occupational disease, as well as other relevant parties, may bring a non-pecuniary compensation claim against the employer.

F. Conclusion

An occupational disease is a serious phenomenon that develops over time as a result of occupational risks to which employees are exposed in the course of their working life, affecting the employee's physical or mental health. This is not merely a medical problem but also a multidimensional issue that concerns several branches of law, such as Labour Law and Social Security Law. The regulations contained in Law No. 5510 and Law No. 6331, together with the clear provisions regarding the definition, determination, and consequences of occupational disease, as well as the jurisprudence of the Supreme Court, shape the practice in relation to occupational diseases.

The employer's liability is assessed based on whether the necessary preventive measures have been adequately implemented, and the principle of inevitability can only be applied if the disease occurs despite all protective measures having been fully taken. If the employer fails to fulfill these obligations, they may be held liable both towards the Social Security Institution and towards the employee and any dependents deprived of support.

In conclusion, protecting employees exposed to occupational diseases is possible not only through the lawful fulfillment of the employer's obligations but also by ensuring that employees can effectively exercise their rights and that legal processes are properly carried out. Therefore, improving both preventive measures and effective inspection mechanisms is of critical importance for establishing a culture of occupational health and safety.