Workers who suffer a workplace accident or an occupational disease are entitled to certain benefits. The specific rights and benefits depend on the nature and severity of the injury or illness. When an insured worker experiences a work accident or occupational disease, the rights provided may include the following:
- Temporary incapacity benefits,
- Permanent disability income,
- Income provision to dependents in case of death,
- Marriage allowance for daughters who receive survivor benefits,
- Funeral allowance to cover burial expenses of the deceased insured worker.
What Is a Work Accident?
A work accident is an unplanned event that causes injury to employees and is not the result of intentional action. It may also include incidents that damage machines, tools, or equipment and temporarily halt production. According to Article 13 of the Social Insurance and General Health Insurance Law No. 5510, a work accident is defined as an event that immediately or subsequently causes physical or mental disability to the insured person.
When Is an Incident Considered a Work Accident?
- While the insured is at the workplace,
- During activities carried out by the employer or due to the employee’s duties; if the person works independently on their own account, when the accident occurs in connection with their work or business activities outside the workplace,
- When an employee working for an employer is sent elsewhere on assignment and is injured while away from their regular duties,
- During breaks reserved for nursing mothers to breastfeed their child,
- When insured workers travel to and from the workplace in a vehicle provided by the employer.
What Is an Occupational Disease?
Occupational diseases arise when continuous performance of specific tasks or exposure to certain workplace conditions causes health problems. These illnesses result from the conditions or nature of the work. An occupational disease is the deterioration of an employee’s health that occurs as a consequence of the tasks they perform as part of their duties. Article 14 of the Social Insurance and General Health Insurance Law defines an occupational disease as temporary or permanent illness, physical or mental disability caused by repeated exposure or the conditions under which the work is performed.
Who Is Covered by Work Accident and Occupational Disease Insurance?
- Employees working under an employment contract (4/a),
- Self-employed individuals and village or neighborhood headmen (4/b),
- Convicted persons and detainees working in penal institutions and detention centers,
- Apprentices, trainees, and interns,
- War-disabled and service-disabled persons,
- Participants in Turkish Employment Agency (İŞKUR) programs,
- Turkish workers sent abroad by employers to work in countries without social security agreements,
- Intern students,
- Workers employed temporarily under contract in agricultural and forestry jobs.
Conditions for an Incident to Be Classified as a Work Accident
- The person must be insured,
- There must be a specific event or incident,
- The event must cause physical or mental disability.
An incident that occurs while an employee is at the workplace, performing work, or otherwise available to the employer — including times spent outside the workplace while under the employer’s direction — and results from external causes (such as injury or death) is considered a work accident.
Benefits Provided by Work Accident and Occupational Disease Insurance
Employees covered for work accidents and occupational diseases may receive:
- Temporary incapacity benefits,
- Permanent disability income,
- Income provided to the deceased worker’s entitled dependents,
- Marriage allowance for daughters who receive survivor benefits,
- Funeral allowance for the deceased insured person.
Who Can Use These Benefits?
To be eligible for these benefits, the affected person must belong to one of the covered categories, such as:
- Workers insured under the 4A scheme,
- Self-employed insured under the 4B scheme,
- Village and neighborhood headmen,
- Convicted persons and detainees working in prisons or detention centers,
- Apprentices, trainees, and interns,
- War-disabled and service-disabled persons,
- Participants in employment agency training programs,
- Seasonal or temporary agricultural and forestry workers employed under contract.
Individuals in these groups are eligible to receive the benefits provided under insurance for work accidents and occupational diseases when they occur.
Temporary Incapacity Benefit
Temporary incapacity benefit is paid to insured workers who are unable to work for a period certified by a physician or medical board due to a work accident, occupational disease, or pregnancy. During this certified rest period, the benefit is paid by the social security institution rather than the employer.
How Much Is the Temporary Incapacity Benefit?
The amount of temporary incapacity benefit depends on the insured worker’s earnings and the form of treatment. The daily earnings of the insured determine the base amount. If treatment requires inpatient care, the benefit is generally half of the daily earnings. If the person is treated on an outpatient basis, the benefit is typically two-thirds of the daily earnings.
Payments for temporary incapacity should begin from the third day after the incapacity becomes apparent. During the rest period specified in the medical report, the institution pays the beneficiary the determined daily rate for each day of incapacity.
Conditions Required to Receive Temporary Incapacity Benefit
To qualify for temporary incapacity benefit, certain conditions must be met. The insured’s coverage must be active when the rest period begins under the medical report. Additionally, in the year prior to the incapacity report, the insured is generally required to have paid at least 90 days of short-term insurance contributions. If these conditions are satisfied, the insured may be eligible for benefits related to work accidents and occupational diseases.