[Intervertebral disk-induced diseases (BK Nr. 2108, 2109, 2110). The so-called exacerbation and assessment of work...

Two problems are discussed from a multitude of problems arising with the assessment of the "new" occupational diseases classified under the heading "Vertebral Column" which are of essential importance in determining the amount of compensation payment under German statutory health insurance legislation. One problem concerns differentiation of damage from already existing damage or dividing the total disease into preliminary i.e. already existing damage on the one hand and worsening or exacerbation on the other. Pathogenesis of disk-related disease does not usually allow splitting the disease into an already existing damage that is not job-conditioned and an exacerbation caused by the insured exposure to job-conditioned risk: compensation must be based on the "all-or-nothing" principle. The second problem is to assess the reduction in ability to cope with gainful employment stress. Preventive considerations will decisively influence the number of working places that can be offered as alternatives if a person has been suffering from intravertebral disk disease. Not only those jobs that require heavy physical work are barred, but also those where the worker has to remain in the same position for a prolonged time. Such disease-specific preventive considerations result in a rejection of the usual assessment criteria for intervertebral disk diseases.