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On 12 December 2024 (HR-2024-2272-A), the Supreme Court handed down a judgement that concluded that consequential injuries caused by an approved occupational disease should be recognised as occupational injuries, cf. sections 13-3 and 13-4 of the National Insurance Act.
Background to the case
The injured party had had symptoms of ankylosing spondylitis since around 1978, but it was not until 2009 that the diagnosis was finally made. In April 2018, he was diagnosed with lymphatic cancer, which NAV recognised as an occupational disease equivalent to an occupational injury in January 2020.
At the time the lymphoma was detected, he was being treated with the drug Simponi for ankylosing spondylitis with very good effect. However, continued treatment with Simponi was not compatible with the cancer, and treatment with this medicine therefore had to be discontinued. After this, Bekhterev's disease deteriorated rapidly.
The assessment of the Supreme Court
The question the Supreme Court had to decide was whether the deterioration of Bekhterev was a consequential injury from an occupational disease that can be recognised as an occupational injury. The Supreme Court began by referring to sections 13-3 and 13-4 of the National Insurance Act, which basically regulate which injuries and illnesses can be recognised as occupational injuries under certain conditions. To a certain extent, it is possible to recognise sequelae of an occupational injury or disease as an occupational injury. The decisive condition for recognising sequelae as occupational injuries is that the occupational injury must be regarded as the main reason to the worsening of Bekhterev disease.
The Supreme Court made a specific assessment of whether this condition was fulfilled, based in particular on assessments from a specialist in rheumatology. In other words, the cancer must have had an effect on the aggravation of Bekhterev's disease by more than 50 %. The Supreme Court notes that in many cases, the underlying condition (i.e. Bekhterev's disease in this specific case) must be regarded as the main cause of deterioration that occurs after an occupational injury or disease. The special feature of this case was that the injured party did not have any symptoms from his Bekhterev disorder when he was diagnosed with cancer. In practice, he was completely healthy, so the causal contribution from the underlying disorder must be considered modest. The Supreme Court concludes that «the occupational disease lymphoma is the main cause of the deterioration of A's ankylosing spondylitis, and that the deterioration should be recognised as an occupational injury.»
The significance of the judgement
In cases where the injured party has received an approved occupational injury or occupational disease that is the main cause of aggravation of a basic condition, this aggravation may be recognised as an occupational injury with the rights to special benefits found in the National Insurance Act. This could also provide good legal arguments in favour of the consequential injury also providing rights under the Occupational Injury Insurance Act.
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Maja Agnes Simonsen
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