Occupational accident: Benefits from the National Social Security Institute for temporary incapacity for work – what do we need to know? 

What is a work accident? 

The work accident is an event that may occur unexpectedly, but have serious consequences for the health and financial security of the worker or employee. The law defines an occupational accident as any sudden injury to health (traumatic and non-traumatic), occurring during and in connection with or on the occasion of the work performed, as well as in any work performed in the interest of the enterprise, when it has caused temporary incapacity for work, permanent reduced working capacity or death.

This includes accidents that occurred during regular or overtime working hours, on business trips and other situations (according to some case law, one can speak of an occupational accident even during team building activities) related to work. There are also hypotheses in which an accident is equated with an occupational accident even if it did not occur at the workplace itself – such as accidents during travel between home and work on the usual route by which the employee goes to and from work; the place where the employee usually eats during the working day, etc. 

When is an accident recognized as work-related? 

For an accident to be recognized as work-related, there must be: 1) an accident (sudden impairment of health); 2) damages (material or non-material – the pain and suffering suffered); 3) a causal link between the injury and the performance of work duties. This means that the injury must be the result of an external impact that occurred during work or is related to work. 

For example, if you are injured while performing your duties or on a business trip, the accident may be classified as work-related. However, if it occurs during an activity unrelated to your work (such as an accountant who arbitrarily repairs a socket in the office), it will not be recognized as such. 

What actions should we take after the incident? 

The most important thing after an accident at work is to seek immediate medical attention. This is important, first of all, for your health, but it is also necessary for proving the accident at work and its determination by the National Social Insurance Institute. Injuries are usually certified with an outpatient certificate from a specialist doctor, and on the basis of this, a sick leave certificate for temporary incapacity for work is issued. In more serious cases, an expert decision from the TELK is required, and in the event of death - a certificate from the civil status authorities by issuing a transcript - an extract from the death certificate, as well as a certificate for heirs, which will serve as a service for the heirs called to inherit. It is important to contact a lawyer with experience in work accidents in order to familiarize yourself with your rights.

How is a work accident declared? 

After the incident, the accident must be declared to the territorial division of the National Social Insurance Institute. This obligation is the employer's and the deadline is five working days from its occurrence. This deadline is instructive and often employers do not comply with it in order to avoid declaring the accident as an occupational accident. 

If the employer fails to comply with this obligation, the employee or his heirs may file a declaration within one year from the date of the work accident. This is an important condition for triggering the investigation procedure and possible receipt of compensation, as this one-year period is preclusive, meaning that proceedings cannot be initiated after its expiry. 

What does the NSSI investigation involve? 

There is a detailed procedure for the investigation of an occupational accident by the National Social Security Institute, regulated in the Regulation for the establishment, investigation, registration and reporting of occupational accidents. In the case of more serious occupational accidents - with more than three injured workers, caused disability or death, or injuries that are likely to lead to disability or death, the National Social Security Institute and the Labor Inspectorate, as well as the Prosecutor's Office of the Republic of Bulgaria, are notified in order to conduct an investigation. It aims to determine whether the incident is actually of an occupational nature. 

After collecting the necessary evidence, a competent person from the National Social Security Institute issues an order to recognize (or not) the accident as an occupational accident. A file is created, which is stored in the territorial division of the institute and is accessible to all affected parties - the injured party, the heirs and the employer. 

What benefits does the NSSI pay? 

In the event of a recognized work accident, the injured party is entitled to various forms of compensation from the National Social Security Institute. Most often, this is compensation for temporary incapacity for work, which is paid for the period of absence from work due to illness. 

Depending on the disability, you may also receive rehabilitation assistance, technical aids, or a disability pension. All of these amounts are paid by the social security system, without any intervention by the employer. 

Compensation from the employer in case of an occupational accident – voluntarily or through legal proceedings? 

In addition to the compensation from the National Social Security Institute, the injured party in a work accident has the right to seek compensation from the employer for damages caused - both material (e.g. medical expenses) and non-material (pain, suffering, limited working capacity in the future). The amount of this compensation depends on the circumstances and is reduced by the amounts already received from insurance benefits under mandatory or voluntary "Accident" insurance. . 

Some employers prefer to voluntarily settle the case through an agreement, without going to court. This may be a quick solution, but it carries the risk of underpayment of compensation. Therefore, it is highly recommended that the employee consults with a lawyer before signing anything. 

If no agreement is reached, the right to compensation can be sought through legal proceedings. 

Why is timely legal assistance important? 

Occupational accidents are not only physically and emotionally stressful, but also legally complicated cases. Timely response is crucial for the successful resolution of the situation in the best and most satisfactory way for the employee. 

If you have been injured or suspect that your case falls within the scope of a work accident, do not delay. Contact the team of lawyers at Delikti.bg and you will receive a professional assessment of the case and assistance in obtaining fair compensation.