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美国工业公司诉劳工赔偿局局长案:工伤赔偿案件分析中的“索赔”与“状况”

U.S. Industries v. Director: "claim" versus "condition" in the analysis of workers' compensation cases.

作者信息

Yospe J

出版信息

Am J Law Med. 1986;12(2):273-303.

PMID:2964779
Abstract

Under most workers' compensation statutes, an injury must "arise out of " and "in the course of" employment in order to qualify as a compensable disability. In U.S. Industries v. Director, the Supreme Court held that the Longshoremen's and Harbor Workers' Compensation Act must be strictly construed to avoid transforming the compensation system into a form of social insurance. In U.S. Industries, the Court denied a disability claim based on an arthritic condition which was manifested while the worker was at home in bed. This Note contends that the Supreme Court neglected to consider pertinent medical realities when analyzing the causation question. Thus, the decision undermines the overall rationale behind workers' compensation legislation. Nonetheless, the Note argues that the case does not relax the requirement of adequately scrutinizing the causative elements underlying any reasonable claim for disability benefits. An analysis adequately accommodating both medical and legal facts, instead of relying upon the vagaries of statutory interpretation, is necessary to improve the efficiency and fairness of workers' compensation disability determinations.

摘要

根据大多数工伤赔偿法规,工伤必须“因工作而起”且“在工作过程中”发生,才能被认定为可获赔偿的残疾。在美国工业公司诉局长一案中,最高法院裁定,《码头工人和港口工人赔偿法》必须严格解释,以免将赔偿制度转变为一种社会保险形式。在美国工业公司案中,法院驳回了一项基于关节炎状况的残疾索赔,该状况是工人在家卧床时出现的。本注释认为,最高法院在分析因果关系问题时忽视了相关的医学现实。因此,该裁决破坏了工伤赔偿立法背后的整体基本原理。尽管如此,本注释认为,该案并未放宽对任何合理残疾福利索赔背后的因果要素进行充分审查的要求。为提高工伤赔偿残疾认定的效率和公平性,有必要进行一种既能充分考虑医学事实又能兼顾法律事实的分析,而不是依赖于法定解释的变幻莫测。

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