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研究生:陳介然
研究生(外文):Chieh-Jan Chen
論文名稱:受僱者工作傷病補償責任歸屬:司法判決分析與法律醫學專業人士問卷調查
論文名稱(外文):Liability attribution for compensation of employees’work injuries and diseases: An analysis of judicial decisions and a questionnaire survey of legal and medical professionals
指導教授:鄭雅文鄭雅文引用關係
口試委員:吳建昌邱文聰郭浩然陳端容
口試日期:2017-01-19
學位類別:博士
校院名稱:國立臺灣大學
系所名稱:健康政策與管理研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2017
畢業學年度:105
語文別:中文
論文頁數:167
中文關鍵詞:職業傷病政府責任職業傷病類型補償責任歸屬雇主可控制因素
外文關鍵詞:occupational injuries and diseasestypes of occupational injuries and diseasesliability attribution for compensationthe controllable factors of employers
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背景與目的:
「職業傷病」包括因工作引起的急性職業傷害事故以及因職業暴露而導致的慢性職業疾病。在現行制度中,工作者發生的傷病後,是否為「職業傷病」主要認定者為醫師與法官。然而,由於勞動基準法對於職業傷病定義與要件並未加以規定,導致爭執事件發生時,司法判決認定標準不一,造成同樣因工作而受傷,能否得雇主補償卻可能有相異的結果。本研究旨在分析行政與民事關於職業傷病的司法判決,並以問卷調查探討法律與醫學專業人士認定補償責任歸屬狀況與其相關因素。
研究方法:
本研究採混合研究法,進行方式包括:(1)以法源法律網資料庫,利用系統抽樣與滾雪球及立意取樣方式,分析2000年1月1日起至2016年7月31日職業傷病中行政與民事判決共計162件判決,以瞭解主要爭執的職業傷病類型與判決中對於職業傷病定義、立法精神與因果關係等論述;(2)以卡方檢定方式檢視2006年11月17日起至2016年7月31日的79件司法判決「是否考慮雇主可控制因素」與「是否判定為職業傷病」之統計相關。(3)以情境式問卷調查,探討法律與醫學專業人士對於第三人導致事故傷害之補償責任歸屬,以方便取樣方式招募,現職20歲以上之法官339位、律師398位與醫師319位進行問卷調查。
結果:
在行政法院部分,共計分析46件判決,爭執的職業傷病種類方面以「事故傷害」與「疾病」均為20件(43.48%)為最多;民事法院部分,共計分析116件判決,爭執的職業傷病種類方面以「事故傷害」為82件(70.69%)最多;卡方檢定分析顯示,「是否考慮雇主可控制因素」與「是否判定為職業傷病」具有高度相關23.68(p<0.001)。問卷調查部分,醫師對政府責任(government''s responsibility)態度平均值較法官與律師低(醫師:21.43,SD:3.55,法官:22.30,SD:3.01,律師:22.49,SD:3.08);在控制性別、年齡狀況後,對政府責任(government''s responsibility)態度較高的律師,較傾向認為第三人導致工作傷病勞工保險不需補償,法官則與律師相反;在控制性別、年齡狀況後,對政府責任(government''s responsibility)態度較高的法官及律師,較傾向認為第三人導致工作傷病雇主不需補償,醫師則相反。
結論:
司法判決對於是否考慮雇主可控制因素,是影響職業傷病的認定的因素,醫學與法律專業人士對於職業傷病之補償責任歸屬,會因其對政府責任(government''s responsibility)態度不同而有差異。職業傷病認定與補償制度攸關工作者權利與社會安定,若重要守門員彼此間的判定基礎存有差異,則使職業傷病補償制度造成不確定因素,此一不確定因素的後果,全由工作者承擔則顯失公平。
Background and study objectives: Occupational injuries and diseases include acute accidents caused by work and chronic diseases due to occupational exposure. When work-related injuries and diseases occur, doctors and judges are the gatekeepers who determine whether work-related injuries and diseases are occupational injuries and diseases or not under workers’ compensation systems. In Taiwan, the definitions and conditions of occupational injuries and diseases aren''t stipulated in the Labor Standards Act. Therefore, when work injuries and diseases occur, judicial standards may differ among these gatekeepers, leading to different compensation results. This research aimed to understand administrative and civil judicial decisions on occupational injuries and diseases and to investigate the attitude and its related factors of legal and medical professionals concerning liability attribution for compensation of employees’ work injuries and diseases.

Research methods: Mixed-methods were used in this study, including the following: (1) Analyzing 162 administrative and civil judicial decisions on occupational injuries and diseases to understand major categories of occupational injuries and diseases in dispute, their definitions, the legislative spirit and factors that were considered in the decisions and so on, these decisions were determined during the period from January 1, 2000 to July 31, 2016 and were sampled by systematic sampling, snowball sampling and purposive sampling from the data bank of judicial cases; (2) Adopting Chi-Square Test to examine the association between "considering the controllable factors of employers or not" and "whether it is occupational injuries and diseases" of 79 judicial decisions which were determined during the period from November 17, 2006 to July 31, 2016, (3) Conducting a questionnaire survey among 339 judges, 398 lawyers and 319 doctors aged over 20 years old.

Results: Among the 46 decisions from administrative courts,"accidents" and "diseases" were major types of events in dispute, both accounting for 43.48% (20 decisions). Among the 116 decisions from civil courts, accidents accounts for 70.69% (82 decisions), which were the most dominant type of events in dispute. Statistical testing indicated that there was significant association between "considering the controllable factors of employers or not" and "whether it is occupational injuries and diseases". Results from the questionnaire survey showed that the score of the government''s role in social protecton was lower in physican than in judges and lawyers.(doctors:21.43,SD:3.55;judges:22.30,SD:3.01;lawyers:22.49, SD:3.08).Under controling gender and age, there was a higher rate of lawyers who had high government''s responsibility to consider that the third party causing work-related injuries and diseases would had no need to compensate for labor insurance, judges had the opposite results; Under controling gender and age, judges and lawyers who had higher standard of government’s responsibility had a higher rate of considering that employers would had no need to compensate for the work-related injuries and diseases caused by the third party, doctors had the opposite results.

Conclusions: Considering the controllable factors of employers or not affected the desitions of work-related injuries and diseases. Legal and medical professionals had different liability attribution for compensation because of the attitude to the responsibility of the government. The identification and the workers’ compensation systems played an important role in the rights for employees and the stableness of the society. If there is disparity between these significant gatekeepers, there will be uncertain factors about workers’ compensation systems, which will convey unfair if that have to be borne by all employees.
摘要 7
Abstract 9
第一章 緒論 12
第二章 文獻探討 15
第一節 職業傷病定義與要件 15
第一項 國際勞工組織定義 15
第二項 我國法律、行政機關命令與函釋 16
第三項 國內學者定義與要件 19
第二節 職業傷病補償制度 21
第三節 因果關係理論與無過失補償責任 25
第一項 條件理論 26
第二項 相當因果關係說 28
第三項 無過失補償責任 30
第四節 影響職業傷病認定態度的因素 34
第五節 國內職業傷病補償責任歸屬文獻回顧 37
第三章 研究方法 41
第一節 分析架構 41
第二節 研究設計 43
第三節 研究對象 44
第四節 資料收集與分析方法 49
第五節 研究倫理 55
第四章 司法判決分析(162件) 56
第一節 行政法院判決基本描述與內容分析 56
第一項 職業傷病定義、補償本質 59
第二項 職業傷病因果關係 59
第三項 權力分立、行政裁量與判斷餘地 61
第四項 其他重要論述 62
第二節 民事法院判決基本描述與內容分析 64
第一項 職業傷病定義、補償制度本質與立法精神 66
第二項 職業傷病要件與因果關係認定 71
第三項 雇主可控制性 74
第四項 其他重要論述 79
第三節 非雇主可控制因素與職業傷病認定相關(79件) 87
第四節 司法判決分析結論 92
第五章 醫學與法律專業人士職業傷病補償責任問卷調查結果 93
第一節 醫學與法律專業人士描述性統計與卡方檢定 93
第二節 醫學與法律專業人士對政府責任態度變異數分析 96
第三節 醫學與法律專業人士之對政府責任態度與責任歸屬分析 97
第四節 討論與研究限制 99
第六章 結論與建議 107
參考資料 109
附錄1國際勞工組織第121號建議書第5點、第6點原文 117
附錄2行政法院職業傷病判決基本資料 118
附錄3民事法院職業傷病判決基本資料 124
附錄4最高法院89年度第4次民事庭會議 140
附錄5各級法院雇主可控制性與職業傷病認定判決基本資料 141
附錄6「受僱者傷病之補償責任歸屬」調查問卷(醫師版) 146
附錄7「受僱者傷病之補償責任歸屬」調查問卷(法律人士版) 157
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