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Scientific paper - Case study
Discrepancies in the evaluation of incapacity for work in a patient with epidermolysis bullosa acquisita between public pension fund and occupational medicine expert raise the issue of competencies
Arhiv za higijenu rada i toksikologiju, 69 (2018), 1; 77-79. https://doi.org/10.2478/aiht-2018-69-3072
Lalić, Hrvoje

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Lalić, H. (2018). Discrepancies in the evaluation of incapacity for work in a patient with epidermolysis bullosa acquisita between public pension fund and occupational medicine expert raise the issue of competencies. Arhiv za higijenu rada i toksikologiju, 69. (1), 77-79. doi: 10.2478/aiht-2018-69-3072

Lalić, Hrvoje. "Discrepancies in the evaluation of incapacity for work in a patient with epidermolysis bullosa acquisita between public pension fund and occupational medicine expert raise the issue of competencies." Arhiv za higijenu rada i toksikologiju, vol. 69, no. 1, 2018, pp. 77-79. https://doi.org/10.2478/aiht-2018-69-3072

Lalić, Hrvoje. "Discrepancies in the evaluation of incapacity for work in a patient with epidermolysis bullosa acquisita between public pension fund and occupational medicine expert raise the issue of competencies." Arhiv za higijenu rada i toksikologiju 69, no. 1 (2018): 77-79. https://doi.org/10.2478/aiht-2018-69-3072

Lalić, H. (2018) 'Discrepancies in the evaluation of incapacity for work in a patient with epidermolysis bullosa acquisita between public pension fund and occupational medicine expert raise the issue of competencies', Arhiv za higijenu rada i toksikologiju, 69(1), pp. 77-79. doi: 10.2478/aiht-2018-69-3072

Lalić H. Discrepancies in the evaluation of incapacity for work in a patient with epidermolysis bullosa acquisita between public pension fund and occupational medicine expert raise the issue of competencies. Arhiv za higijenu rada i toksikologiju [Internet]. 2018 March 20 [cited 2024 November 08];69(1):77-79. doi: 10.2478/aiht-2018-69-3072

H. Lalić, "Discrepancies in the evaluation of incapacity for work in a patient with epidermolysis bullosa acquisita between public pension fund and occupational medicine expert raise the issue of competencies", Arhiv za higijenu rada i toksikologiju, vol. 69, no. 1, pp. 77-79, March 2018. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:184:547286. [Accessed: 08 November 2024]

Metadata
Title (english)Discrepancies in the evaluation of incapacity for work in a patient with epidermolysis bullosa acquisita between public pension fund and occupational medicine expert raise the issue of competencies
Title (croatian)Evaluacija radne nesposobnosti pacijentice sa stečenom buloznom epidermolizom: neusklađenosti između Zavoda za mirovinsko osiguranje i eksperta medicine rada – otvaranje pitanja mjerodavnosti
AuthorHrvoje Lalić
Author's institutionUniversity of Rijeka
Faculty of Medicine
(Department of Family Medicine)
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Public Health and Health Care
Occupational and Sports Medicine
Abstract (english)
A 50-year-old female patient suffering from a severe form of epidermolysis bullosa acquisita (EBA) took legal action against the Croatian Pension Insurance Institute (CPII) in an attempt to overturn their assessment that she was no longer capable of working as a seamstress but still capable of doing administrative jobs. Her claim was that she was not capable of doing any job at all. She was first diagnosed EBA in 2000, and the disease progressed slowly with intermittent remissions. In 2012, skin erosions appeared on her feet, followed by the loss of all toenails and lesions and infiltrations on the tongue and oral mucosa. Her whole body was covered in oozing wounds, she was in pain, and parts of her skin would stick to fabric while changing clothes or bandages. The most recent findings showed oesophageal stricture. She can consume only liquid food and is on the waiting list for receiving a feeding tube. The occupational health expert witness confirmed that the patient was generally incapable of work and was fighting her life. The judge and CPII lawyers fully accepted this report and the earlier assessment was overturned. To avoid incompetent assessments of working (in)capacity in the future, CPII and similar institutions should engage occupational medicine specialists to work in their assessment teams.
Abstract (croatian)
Pacijentica u dobi od 50 godina, oboljela od teškog oblika vrlo rijetke bolesti epidermolysis bullosa acquisita, Upravnom je sudu podnijela tužbu protiv Hrvatskoga zavod za mirovinsko osiguranje (HZMO) tražeći da joj se umjesto profesionalne nesposobnosti za rad prizna opća radna nesposobnost. U praksi to znači da su u HMZO-u zaključili da je pacijentica nesposobna obavljati svoje dosadašnje poslove modne krojačice te donijeli rješenje da je sposobna obavljati druge poslove razine srednje stručne naobrazbe, kao što su administrativni poslovi. Još 2012. godine pacijentica je dobila kožne mjehure i erozije na stopalima uz gubitak svih nožnih noktiju te rane u usnoj šupljini: na jeziku i sluznici obraza. Rane na tijelu na mnogim su mjestima konfluirale, uz vlaženje i bolove, što se svakodnevnim preodijevanjem pogoršavalo jer bi se odizali i dijelovi slijepljene kože. Isto se događalo pri skidanju zavoja. Tijekom 2017. bolest se je proširila na jednjak i dovela do strikture, zbog čega više ne može uzimati krutu hranu. Smatrajući se potpuno nesposobnom za bilo koji posao, podnijela je tužbu Upravnomu sudu protiv HZMO-a, nakon čega je u spor uključen nezavisni sudski vještak medicine rada, koji je pacijenticu pozvao na pregled. Na temelju pregleda i uvidom u medicinsku dokumentaciju, među ostalim i u novi nalaz strikture jednjaka, zaključeno je sljedeće: pacijentica može uzimati samo tekuću hranu, znatno je smršavjela i bit će pozvana u Kliniku za internu medicinu radi ugradnje sonde za hranjenje. Sudski vještak medicine rada procijenio je da je u slučaju pacijentice koja se više ne bori za lakši posao nego za vlastiti život riječ o potpunoj općoj radnoj nesposobnosti. Sudac Upravnoga suda i odvjetnik Hrvatskoga zavoda za mirovinsko osiguranje prihvatili su bez primjedbi stručno objašnjenje sudskog vještaka medicine rada. Pacijentica je zadovoljna takvim ishodom te je dobila nužna financijska sredstva za daljnje liječenje i pomoć u kući. Da bi se izbjegle neusklađenosti u procjeni radne nesposobnosti pacijenata, javni zavodi za mirovinsko osiguranje i srodne institucije trebaju angažirati stručnjake medicine rada za rad u njihovim timovima. Tako će se prevenirati preopterećenost sudova tužbama neprimjereno procijenjenih pacijenata, uštedjet će se državna i privatna materijalna sredstva i, što je najvažnije, spriječiti daljnje neugodnosti i oštećenja zdravlja uistinu bolesnih osoba nesposobnih za posao.
Keywords (english)
Keywords (croatian)
Languageenglish
Publication typeScientific paper - Case study
Publication statusPublished
Peer reviewPeer review
Publication versionPublished version
Journal titleArhiv za higijenu rada i toksikologiju
Numberingvol. 69, no. 1, pp. 77-79
p-ISSN0004-1254
e-ISSN1848-6312
DOIhttps://doi.org/10.2478/aiht-2018-69-3072
URN:NBNurn:nbn:hr:184:547286
Publication2018-03-20
Document URLhttps://hrcak.srce.hr/196031
Type of resourceText
Access conditionsOpen access
Terms of useLicence Attribution 4.0 International (CC BY 4.0) icon
Created on2018-03-21 18:00:08