El subsidio de incapacidad temporal ante un supuesto de baja médica motivada por intervención de cirugía puramente estética

Abstract

The Ruling of the High Court of Justice of Catalonia settles the appeal filed by Mutual Midat Cyclops against the Ruling of the Social Justice Court that sentenced them to pay Temporary Disability Benefit as a consequence of cosmetic surgery undergone by a female employee. The facts that led to the Ruling of the Social Justice Court were based on the situation involving Temporary Disability due to common illness, initially owing to augmentation mammoplasty surgery, which then became more prolonged in time as a result of a respiratory infection that later led to symptoms of anxiety. The Mutua refused to pay the Temporary Disability benefit on the grounds that cosmetic surgery that was not related to an accident, disease or congenital malformation could not be considered as included among its range of healthcare services. The Mutua filed an appeal against the Ruling of the Social Justice Court. The Mutua claims that the worker’s sick leave came about as a result of cosmetic surgery, while there are no medical documents to prove that the employee suffered a respiratory infection and symptoms of anxiety during the time she was on Temporal Disability leave. Accordingly, the Mutua refused payment of Temporal Disability benefit, taking into account the fact that cosmetic surgery is not considered a healthcare service that is included in the social security and public healthcare system, and that no medical document was submitted as proof that the worker suffered a respiratory infection and symptoms of anxiety during the time she was on sick leave. Thus, the High Court of Justice must settle not only the issue regarding payment of the benefit, but also more specifically the question as to whether or not there actually exists a situation of Temporal Disability which in turn led to the suspension of the work relationship as a result of the cosmetic surgery that the worker underwent of her own free will, and who did not suffer any further exacerbation or pathology derived from it, since, as pointed out by the Court itself, no proof of the effective existence of such ailments has been brought forth.