Difference between two systems

Social security law and civil law serve different purposes.

Social security law functions as a safety net. It assesses whether you are still able to work and whether you are entitled to benefits. The focus is on your job, specifically the work you performed before you became unfit for work.

Civil law works differently. Its purpose is full compensation. You should be placed, as much as possible, in the position you would have been in had the accident not occurred. That means not only your work matters, but your life as a whole:

• your work and income

• your household

• your social life

• your hobbies and leisure activities

This difference is crucial. Social security law focuses on work, while civil law focuses on the person as a whole.

What you can still do at work does not automatically reflect what you can handle in life as a whole.

How working hour limitations are assessed

An insurance physician assesses whether a working hour limitation applies. This is usually done based on the “Duurbelastbaarheid in Arbeid” standard.

Three main situations are considered:

• issues with energy, such as fatigue or limited recovery capacity

• preventive reasons, for example to avoid deterioration

• reduced availability, for instance due to medical treatments

The outcome is the number of hours someone is considered able to work. This is often seen as the maximum capacity.

In personal injury cases, this assessment is then used to determine earning capacity. This directly affects the level of compensation.

Where things go wrong in practice

The problem is that this assessment is too narrow for personal injury cases.

Social security law barely takes into account what someone can still do in their private life. Yet this is exactly what matters in civil law.

Imagine this:

You are considered able to work four hours a day. But after those hours, you are completely exhausted:

• you can no longer take care of your family

• you have no energy for social interaction

• your hobbies disappear

• even basic daily activities become difficult

Formally, you are “able to work”. In reality, however, you are no longer functioning in your life as a whole.

And yet, this is often not fully considered.

What case law shows

Case law shows that courts are aware of this issue.

In some cases, judges rule that the assessment of the insurance physician cannot simply be followed. For example, because:

• only work was considered, not the overall situation

• insufficient attention was given to fatigue and pain

• the assessment was too much of a snapshot

At the same time, there are also cases where courts do follow the insurance physician, even when it is clear that work and private life are in conflict.

This makes outcomes in these cases difficult to predict.

Why this matters for you

As a victim, your goal is not just to work as much as possible. You want to regain your life as it was before the accident.

That includes:

• having energy for your family

• maintaining social relationships

• having time for relaxation

• functioning independently in daily life

If all your energy is spent on work, nothing is left for the rest of your life. That contradicts the core principle of civil compensation law.

A broader view on capacity

That is why the assessment of working hour limitations needs to be broader.

Not just focused on work, but on the balance between work and private life. In other words: what is a sustainable and realistic use of your energy?

An insurance physician should therefore also address questions such as:

• what happens in your private life if you work fewer hours

• what happens if you work more hours

• how does work affect your daily functioning

These questions ensure that your situation is assessed as a whole, not just your work capacity.

What this means for victims

The key takeaway is that a working hour limitation from social security law is not automatically decisive in a personal injury case.

It is not just about what you are capable of, but about what is reasonable and sustainable in your overall life.

That is why it is important to clearly demonstrate:

• how you functioned before the accident

• what has changed after the accident

• how work impacts your private life

• where your limits are

Only then can your situation be properly assessed.

What this means for you

A discussion about working hour limitations has a major impact on your compensation. It directly influences your earning capacity.

That is why it is important not to rely solely on standard frameworks, but to focus on your personal situation.

At AVB Law, I always look at the full picture. Because recovery is about more than work alone.