Disability Retirement
1. Introduction
Disability retirement is a form of income security provided by the social security system to individuals who have worked and been insured throughout their working lives but have significantly lost their ability to work due to severe deterioration in their health . In Turkey, disability retirement is based on the Social Insurance and General Health Insurance Law No. 5510 and aims to protect insured individuals against social risks
This process involves not only medical evaluation but also administrative and legal oversight. Rejection decisions by the Social Security Institution (SGK) often stem from differing interpretations of medical board reports, frequently leading to appeals and legal proceedings
2. What is Disability Retirement?
Disability retirement is a pension granted by the Social Security Institution (SGK) when an insured person loses at least 60% of their working capacity . According to the law, this is determined by a disability assessment , and the disability must have occurred after becoming insured.
In other words, congenital diseases and conditions that existed before the start of insurance coverage and are not progressive are generally not considered for disability retirement.
However, after becoming insured and severely limit the ability to work do entitle the individual to disability retirement.
3. Legal Basis for Disability Retirement
The legal framework for disability retirement is defined by the following regulations:
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Law No. 5510 on Social Security and General Health Insurance (Articles 25, 26, 27, 28)
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Regulation on Disability Determination Procedures
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SGK Circulars and Health Board Instructions
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Decisions of the 10th and 21st Civil Chambers of the Supreme Court of Appeals
These provisions regulate who will be considered disabled, which illnesses will be covered, and which documents will be required.
4. Conditions for Disability Retirement
a. Insurance Period
To be eligible for disability retirement, an insured person must have been insured for at least 10 years . However, the 10-year requirement is waived for insured individuals who have completed the 1800-day premium payment requirement and are disabled to the extent that they require the care of another person .
b. Number of Premium Days
To be eligible for a disability pension, at least 1800 premium days must be accumulated.
These premiums must be from long-term insurance branches (disability, old age, death).
c. Medical Board Report and Loss of Working Capacity
The disability rate at least 60% .
This rate a medical board report and a decision by the SGK Health Board.
d. Disability Occurring After Insurance Coverage
The illness or disability must have started after becoming insured.
In this regard, the Supreme Court considers illnesses that develop after becoming insured as falling within the scope of disability.
The 21st Civil Chamber of the Supreme Court of Appeals, Case No. 2017/3401, Decision No. 2018/5676, ruled:
"If a progressive illness following the commencement of insurance coverage results in disability, the insured person should be considered disabled."
5. Disability Retirement Report Process
1. Application
The insured person applies for disability retirement by contacting the Provincial Social Security Directorate in the province where they reside . After receiving the application, the Social Security Institution refers the person to an authorized hospital.
2. Medical Board Examination
The authorized hospital evaluates the insured person's entire medical history, laboratory and imaging results.
Subsequently, the "rate of loss of working capacity" is determined.
3. SGK Health Board Review
The report obtained from the hospital is sent to the SGK Central Health Board . This board reviews whether the report complies with the regulations and decides whether the person is considered disabled or not
4. Concluding
If the decision is positive, the insured person will be granted a disability pension;
if negative, the rejection decision will be communicated. In case of rejection, the insured person has the right to appeal.
6. Calculating Disability Pension
Disability pension is calculated based on the insured person's number of premium days, the amount of earnings subject to premiums, and the duration of insurance coverage.
The formula is:
Monthly = Average Monthly Earnings × Monthly Binding Rate
The monthly contribution rate varies according to the number of premium days. For insured individuals with at least 1800 days, a rate of 40-50% is generally applied. In addition, a 10% family allowance may be provided if the insured individual has dependents .
7. Appeal Process in Case of SGK Rejection Decision
The Social Security Institution (SGK) often rejects applications .
The procedure to follow in this case is as follows:
1. Application to the Appeals Commission
An appeal against the rejection decision can be filed with the High Health Board of the Social Security Institution within 60 days . The appeal letter may indicate that the report was not properly prepared or that the illness has worsened.
2. Re-examination by the Health Board
The Social Security Institution (SGK) may refer the patient to a new hospital or send the file directly to the High Council of Health.
The High Council's decision is the final administrative decision.
3. Legal Remedy (Filing a Lawsuit)
If the High Council of Health's decision is also negative, then legal recourse is available.
The insured person a lawsuit against the Social Security Institution .
8. Disability Retirement in Light of Supreme Court Decisions
The precedents set by the Supreme Court have provided important interpretations in favor of insured individuals in disability retirement cases.
The 21st Civil Chamber of the Supreme Court of Appeals, Case No. 2019/4830 E., Decision No. 2020/1109 K., stated:
"Illnesses that arise after the start of insurance coverage, are progressive, and lead to loss of working capacity despite treatment should be considered within the scope of disability."
The 10th Civil Chamber of the Supreme Court of Appeals, Case No. 2016/2878, Decision No. 2017/4179, ruled that
"If the Social Security Institution's (SGK) health board reports are insufficient, the court must obtain a new expert report from forensic medicine or university hospitals."
These decisions highlight the importance of expert opinions in legal cases and emphasize that Social Security Institution (SGK) reports should not be considered absolute.
9. Common Mistakes in Practice
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The hospital that received the report is not authorized by the Social Security Institution (SGK).
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Insufficient documentation of the illness (lack of medical discharge summary)
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No objection should be raised even if the disability rate is low.
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Confusing the report date with findings prior to the start of insurance coverage.
These errors often result in a loss of rights. Especially when the appeal period is missed, the possibility of filing a lawsuit may be limited.
10. Legal Proceedings Against a Rejection Decision
a. Competent and Authorized Court
Disability retirement cases in Labor Courts .
The competent court is the Labor Court located where the insured person resides.
b. Petition and Evidence
The following points must be clearly stated in the lawsuit petition:
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Date and number of the SGK decision
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Disability diagnosis
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Examples of health board reports
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Appeal petition and rejection
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Treatment documents, discharge summary, MRI, biopsy reports
c. Expert Examination
The court refers the plaintiff to the Forensic Medicine Institute or the Health Board of a University Hospital . The new report obtained from there determines the course of the case.
If this report refutes the Social Security Institution's decision, the court will rule in favor of recognizing the right to disability retirement
11. Case Study Analysis
Let's examine this through an example:
The plaintiffbecame insured in 2008 and was diagnosed with chronic kidney failure in 2020.
The Social Security Institution (SGK) report indicated a 55% disability rating, therefore the plaintiff was not considered disabled.
The plaintiff appealed to the High Council of Health, but the decision was again negative.
In the case filed in the Labor Court, the Forensic Medicine Institute determined a "70% loss of working capacity."
The court overturned the SGK decision and ruled that the plaintiff was entitled to disability retirement .
(Source: Supreme Court 21st Civil Chamber, Case No. 2021/2556, Decision No. 2022/1183)
This example demonstrates just how crucial a forensic expert report can be.
12. Conclusion and Evaluation
Disability retirement is one of the most sensitive areas of social security law.
The insured person's quality of life and livelihood security directly depend on this process.
Administrative rejection decisions by the Social Security Institution (SGK) may stem from differing interpretations of medical assessments. Therefore, appeals and legal remediesare a constitutional right of the insured person.
In practice, detailed medical and legal files prepared with the support of a lawyer can reverse a large percentage of rejection decisions. Therefore, it is crucial for individuals applying for disability retirement to manage the process consciously and seek expert legal support to avoid losing their rights
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