Turkiye Klinikleri Journal of Forensic Medicine and Forensic Sciences

.: ORIGINAL RESEARCH
Maluliyet Oran Hesaplarında Tek Travma Modeli Üzerinden Farklı Cetvellerin Karşılaştırılması: Tanımlayıcı Çalışma
Comparison of Different Regulations on a Single Trauma Model in Disability Rate Calculations: Descriptive Study
Betül YÜRÜRDURMAZa , Ümit ÜNÜVAR GÖÇEOĞLUb , Muazzez Elçin KIYMET ÖZKANc , Yasemin BALCIb
aElazığ Fethi Sekin Şehir Hastanesi, Adli Tıp Kliniği, Elazığ, Türkiye
bMuğla Sıtkı Koçman Üniversitesi Tıp Fakültesi, Adli Tıp AD, Muğla, Türkiye
cGiresun Eğitim ve Araştırma Hastanesi, Adli Tıp Kliniği, Giresun, Türkiye
Turkiye Klinikleri J Foren Sci Leg Med. 2024;21(2):70-8
doi: 10.5336/forensic.2024-101264
Article Language: TR
Full Text
ÖZET
Amaç: Bu çalışmada, maluliyet oranları hesaplamalarında kullanılan yönetmeliklerdeki farklılıkları ve eksiklikleri ortaya koyabilmek için sadece kafa travması sekeli olan olgular ele alınmış, oran karşılaştırması ile farklılıkları, eksiklikleri ortaya koymak ve trafik kazalarına özel ortak kullanılabilecek bir cetvel düzenlenmesi gereğine vurgu yapmak amaçlanmıştır. Gereç ve Yöntemler: Muğla Sıtkı Koçman Üniversitesi Tıp Fakültesi Adli Tıp Ana Bilim Dalında 1 Ocak 2017-31 Aralık 2019 tarihleri arasında düzenlenen maluliyet raporları arasında kafa travması sekeli nedenli maluliyet oran hesabı yapılan raporlar geriye dönük incelenmiş, son muayene bulgularına göre her bir olgunun çalışma gücü kayıp oranı ve tüm vücut engellilik oranı yeniden hesaplanmıştır. Aynı sekel için elde edilen oranlardaki farklılıklar açısından karşılaştırmalı istatistiksel analiz yapılmış, anlamlılık düzeyi p<0,05 olarak kabul edilmiştir. Bulgular: Kafa travmalı 253 olgunun %70'i erkek (n=177) ve çoğunluğu 20-39 yaş aralığındadır (n=126, %49,8). Her iki cetvele göre hesaplanan oranlarda önemli farklılıklar olduğu, her sekelin cetvellerde yer almadığı görülmüştür. Uygulamada hakkaniyet ve farklı cetvellerdeki aynı sekel için oranlar arası bir uyum yakalayabilmek adına takdiren bazı oranda indirim uygulanmıştır. Çalışma Gücü ve Meslekte Kazanma Gücü Kayıp Oranı Tespit İşlemleri Yönetmeliği'ne göre oranı hesaplamalarında daha fazla takdiren indirim olmuştur (%83,4). Sonuç: Yönetmeliklerde ciddi farklılıklar olması, aynı olguda bile farklı oranların çıkması mağduriyetlere yol açmaktadır. Bu nedenle, kişiler hangi cetvelden daha yüksek oran alabilirse o cetvele göre rapor düzenlenmesini talep edebilmektedir, bu da uygulamada birden fazla yerde ve birden fazla rapor düzenlenmesi ile sonuçlanmaktadır. Bu tarz talepler adli tıbbi pratikte de güvenilirlik kaybına yol açmakta ve hekimler için de yıpratıcı olmaktadır. Güncel, travmatik yaralanma modellerine uygun, trafik kazalarına özel ortak bir cetvel geliştirilmesi hukuksal açıdan çok yararlı olacaktır.

Anahtar Kelimeler: Çalışma gücü kaybı; engellilik; maluliyet; kafa travmaları
ABSTRACT
Objective: In this study, to reveal the differences and deficiencies in the regulations used in the calculation of disability rates, only cases with sequelae of head trauma were considered, it was aimed to reveal the differences and deficiencies by comparing the rates and emphasizing the need for a common table that can be used for traffic accidents. Material and Methods: Among the disability reports issued in our department between January 1, 2017 and December 31, 2019, the reports in which disability rate calculation was made due to head trauma sequelae were examined retrospectively, and the loss of working power and whole-body disability rate of each case were recalculated according to the final examination findings. Comparative statistical analysis was performed for the differences in the rates obtained for the same sequelae and the significance level was accepted as p<0.05. Results: Among 253 cases, 70% were male (n=177), and the majority were between 20-39 years of age (n=126, 49.8%). There were significant differences in the rates calculated according to both scales and not all sequelae were included in them. In practice, some discretionary rate reductions were applied for fairness and to achieve harmony between the rates for the same sequelae in different tables. According to the Regulation on the Procedures for the Determination of the Rate of Loss of Work Capacity and Occupational Earning Capacity, there was more discretionary reduction in the rate calculations (83.4%). Conclusion: Serious differences in the regulations, and different rates even in the same case lead to grievances. For this reason, individuals can request a report to be prepared according to which scale they can get a higher rate from, which results in more than one report being issued in more than one center in practice. Such demands lead to a loss of credibility in forensic medical practice and are also wearisome for physicians. It would be very beneficial from a legal point of view to develop a scale specific to traffic accidents, suitable for current traumatic injury models.

Keywords: Loss of working power; disability; disablement; head traumas
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