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Subject   July 2018 - Death from Overwork and its Verifications
Death from Overwork and its Verifications

I. Introduction
An occupational fatality directly related to long working hours is death from overwork. Although it is not a medical or legal term, “death from overwork” is a term used to describe a fatality from cerebral vessel disease or a heart attack (hereinafter referred to as "cerebral vessel or heart disease") caused by physical exhaustion and mental stress. According to data from the Labor Welfare Corporation on April 11, 2018, 1,809 applications were filed for cerebral vessel or heart disease to be determined as death from an occupational illness in 2017, with 589 (32.6%) of these applications approved and 1,220 (67.4%) rejected. In general, cerebral vessel or heart disease is attributed to an individual's personal health, but can be recognized as a work-related fatality if there is a significant causal relationship, in the fatality, between the condition and the work.
According to judicial rulings, cerebral vessel disease can be recognized as an occupational illness if there are some affecting factors related to work performance that cause the disease, even if there already existed some common conditions such as hypertension or hardening of the arteries. The Labor Welfare Corporation Guidelines regulate that judging whether there is a "burden on the work" should consider workload at the time of the incident, accumulation of fatigue over a long period of time and working conditions. They define work hours as a key component, and comprehensively examine all situations related to work such as schedule, exposure to a harmful working environment, physical strength, and mental stress.
In the following section, I will examine concrete examples of laws, guidelines, and judicial rulings related to the burden of proof for fatality from overwork.

II. Related Legal Regulations: Criteria for Determining Fatalities from Cerebral Vessel or Heart Disease as Occupational Accidents
That a worker’s illness (leading to death) was caused by his work-related duties must be verified before determining it as an occupational illness. This burden of proof is divided into three categories:
A. “Sudden and unexpected tension, excitement, horror, surprise or changes in the work environment causing remarkable physiological changes to the employee” means that, within 24 hours before the fatality, the condition of the cerebral vessel or heart disease deteriorated unnaturally, rapidly and noticeably, due to the occurrence of sudden and unexpected incidents or rapid changes in the work environment.
B. “The work burden increases for a short period of time just before the occurrence of the fatality due to the volume of work, time involved, intensity, responsibilities, or changes to the work environment, and causes physical and mental fatigue that can noticeably affect the normal operation of blood vessels in the brain or heart” means that, within one week before the fatality, the volume of work or working hours increased by at least 30% over the average week of the previous twelve months (excluding the week before the fatality), or the intensity, work responsibilities or work environment changed so greatly that a normal person would not be able to adjust. Whether this applies to the employee is estimated by considering the volume of work, time involved, intensity, and responsibilities; rest time like holidays and leave; changes in the type of work and working environment; and other factors such as the employee’s age, gender, etc.
C. “A chronic work burden due to volume of work, time involved, intensity, responsibilities, or changes to the work environment causes physical and mental fatigue that can noticeably affect the normal operation of blood vessels in the brain or heart” means that objective confirmation has been made that physical and mental stress continued more often than during general work duties at least three months before the fatality. In this case, whether “chronic work burden” applies to the employee’s work is estimated by considering the volume of work, time involved, intensity, and responsibilities; rest time like holidays and leave; whether it is shift work or night work or the like; the degree of mental stress; time available for sleep; working environment; and other factors such as the employee’s age, gender, etc. When evaluating the relationship between the working hours/working conditions and the fatality, the following items shall be considered collectively:
(1) If working hours exceeded the average of 60 a week for 12 weeks before the fatality, or 64 a week for 4 weeks before the fatality, the relationship between work and the fatality is considered to be strong.
(2) If the weekly average working hours exceed 52 during the 12 weeks before the fatality, the longer the working hours, the greater the relationship between work and fatality. In particular, when any of the following subparagraphs (factors of weighting workload) apply to the work, it is evaluated that the relationship between work and fatality is strong:
① Work hours not fixed, but change daily; ② Shift work; ③ Work with insufficient off-days; ④ Exposure to harmful working environment (cold, temperature changes, noise); ⑤ Physically-demanding work; ⑥ Frequent business trips with large time lags; ⑦ Work involving significant mental stress.
(3) Even if the working hours do not exceed 52 per week for 12 weeks before the fatality, the relationship between work and fatality increases for tasks where the worker is exposed to a combination of the workload weighting factors in (2) above.

III. Labor Welfare Corporation Guidelines: Substantial Criteria for Recognition of Fatality from Overwork Being Due to an Occupational Illness
1. Sudden incidents or sudden changes in work environment
Sudden incidents and rapid changes in work environment should be of a degree that would reasonably cause tension, excitement, fear, or surprise that could have a significant impact on the normal functioning of the cerebral or heart vessel systems. Therefore, the occurrence of an unexpected accident should be clear in time and place, and should be related to the situation and the outbreak. In other words, when the unexpected situation itself causes a significant physical or mental burden, the fatality usually occurs within 24 hours from the occurrence of the incident. Most of the time, however, it takes time for the condition to deteriorate enough to result in a fatality, so even if it is more than 24 hours from the unexpected and unforeseeable occurrence to the fatality, if a causal relationship between the accident and the occurrence can be determined, the fatality can be determined as from an occupational illness. Examples are given below:
① If you are directly involved in a major personnel accident or other serious accident related to your business, or you are engaged in rescue or accident handling accompanied by an accident;
② In the event of excessive physical or mental stress such as a violent physical confrontation or assault from a supervisor, a colleague or a customer in relation to the work;
③ If you have been working continuously for a long time without sleeping.

2. Short-term business stress
In the event of cerebral vessel or heart disease, there is a high possibility that the workload and intensity of work increased rapidly within a short time (one week) before the occurrence of the illness led to a fatality.
(1) Whether or not the workload or work time has increased by more than 30% over the previous 12 weeks (excluding one week before the fatality) is evaluated as follows. ① Quantify the workload within one week before the onset and compare it with the weekly average workload between 2 and 12 weeks before the fatality. ② If the weekly average work time is less than 40 hours between 2 and 12 weeks before the fatality, compare with

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