While the employee was out having a coffee during her 15-minute break, she fell down and hit her arm, producing a temporary disability leave that the Private Health Insurance considered as derived from an ordinary disease. The employee submitted a complaint before The National Social Security Institute, which declared the accident as a labour contingency.
The Private Health Insurance submitted a claim to the Court, which declared the accident as a non-labour incident. After that, the employee appealed and the High Court of Justice qualified the situation as derived from a labour accident, because they considered that it occurred as a consequence of work.
The Private Health Insurance submitted a cassation appeal for unification of doctrine to the Supreme Court. The matter discussed consisted of determining if the Temporary Disability must be considered as derived from a labour accident, as it was caused by a fall to the ground when the employee left the workplace to enjoy the 15-minute break.
The Supreme Court, like the High Court of Justice, reminded that Article 156.1 of the General Social Security Law understands as a Labour Accident, any bodily injury that an employee suffers as a consequence of work. In this case, it considers that the theory of “relevant casualness” is applicable. This is characterised by a negative circumstance (that the elements which produced the accident were not intrinsic to the work), and another positive one (that the event occurred due to the normal activities of working life).
Therefore, in this case, both circumstances occurred:
- the employee had the accident when she left her workplace to go for a coffee during the legally scheduled working time -15 minutes as her working time is longer than 6 hours – which is usually spent to “have a break”, as a normal and usual activity within the labour world; and
- work is the condition, without which, the event would not have occurred.
The Supreme Court considered that the causality nexus was never broken, because the break time was necessary and the employee’s use of her 15 minutes was done under fully normal standards. For this reason, the appeal was dismissed and the judgement of the High Court of Justice was confirmed.