[Disability, the risk of disability and changes in work capacity-- unacceptable conditions for insurance in occupational injuries and diseases]

According to Croatian legislation disability, risk of disability and altered work capacity are prerequisites for recognition of job injuries, occupational diseases, and, consequently, of the worker's special rights. That is also valid for all areas of insurance. The legislation, if applied, would make it impossible for a great number of insured workers to realize their particular rights based on work related health damage, especially in the field of health insurance and reinsurance of health care costs. Health insurance boards, along with insurance companies, manage by evading the condition of disability, risk of disability and altered work capacity. This has been proved on a sample of 63 cases of job injuries and one occupational disease registered in the Occupational safety unit of the Clinical Hospital in Split from May 1994 to May 1995. In all cases the medical doctor of choice, the authorized health insurance board and the authorized insurance company enabled the insured (workers injured at work or having occupational disease, the employer) to make use of their specific insurance rights without waiting for the fulfillment of the prescribed condition of disability, risk of disability and altered work capacity. The authors consider such behaviour to be inadmissible in a state based on the rule of law. If the condition of disability, risk of disability and altered work capacity is unsuitable, as indeed it is, a solution should be sought for in changing the regulations. The simplest way of doing it is to invert the defining and taking over decrees in the Law on Pension and Disability Insurance and the Law on Health Insurance.