Judgment — ECLI:EU:T:2003:42
Date: 2003-02-26
Based on: Merger Treaty (1965)
Subject matter: Staff regulations and employment conditions - EC
Concepts: Act adversely affecting the official;Insurance against accident and occupational disease
Procedure: Staff cases - unfounded;Staff cases - successful

SUMMARY — CASE T-145/01 
Held: The decision of the Commission of 10 August 2000 is 
annulled insofar as it charges to the applicant the fees and 
incidental expenses of the doctor appointed by the 
applicant to the Medical Committee and half of the fees 
and incidental expenses of the third doctor. The remainder 
of the application is dismissed. The parties are ordered to 
bear their own costs. 
Summary 
1. Officials - Social security - Insurance against the risk of occupational disease 
and of accident - Medical expert opinion - Discretion of the Medical Committee 
- Judicial review - Limits - Obligation to state reasons - Scope 
(Staff Regulations, Art. 73; Rules on the insurance of officials of the European 
Communities against the risk of accident and occupational disease, Art. 23(1)) 
2. Officials - Social security - Insurance against accident and occupational 
disease - Determination of the occupational origin of the illness - Multifactorial 
illness - Powers of the Medical Committee - Taking into account the results of an 
epidemiological study 
(Staff Regulations, Art. 73; Rules on the insurance of officials of the European 
Communities against the risk of accident and occupational disease, Arts 3(2), 19 
and 23) 
3. Officials — Social security — Insurance against accident and occupational 
disease - Determination of the occupational origin of the illness - Burden of proof 
on the official - Illness not included in the European List of Occupational Diseases 
- Insufficient evidence of the potential effect of the performance of duties on the 
development of a multifactorial illness 
(Staff Regulations, Art. 73; Rules on the insurance of officials of the European 
Communities against the risk of accident and occupational disease, Art. 3) 
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LATINO v COMMISSION 
4. Officials - Social security - Insurance against accident and occupational 
disease - Medical Committee - Costs - Full payment by the institution in 
exceptional cases - Discretion of the administration - Exercise of discretion while 
observing the duty of care and the principle of sound administration 
(Rules on the insurance of officials of the European Communities against the risk 
of accident and occupational disease. Art. 23(2)) 
5. Officials - Social security - Insurance against accident and occupational 
disease - Determination of the occupational origin of the illness - Rules governing 
insurance against occupational illness - Obligation of the Community institutions 
to make such cover conditional on proof of a merely potential causal link - None 
(Staff Regulations, Art. 73(D) 
6. Officials - Actions -Act adversely affecting an official - Preparatory act -
Reference to Medical Committee - Inadmissibility - Possibility of contesting the 
final decision of the Medical Committee 
(Staff Regulations, Arts 90(2) and 91; Rules on the insurance of officials of 
the European Communities against the risk of accident and occupational disease, 
Art. 21) 
1. Under the Rules on the insurance of officials of the European Communities 
against the risk of accident and occupational disease, the task entrusted to the 
Medical Committee of considering medical questions entirely objectively and 
independently requires that it have all the information likely to be useful to it, and 
that it be allowed complete freedom of appraisal. The medical assessments, properly 
speaking, must be regarded as definitive where they have been issued under proper 
conditions. The Court can only review whether the Medical Committee was 
properly established and operated correctly and whether its opinion was regular, in 
particular whether it contained reasons enabling the reader to assess the 
considerations on which it is based and whether it has established a comprehensible 
link between the medical findings which it contains and the conclusions reached. In 
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SUMMARY — CASE T-145/01 
particular, where the Medical Committee is required to answer complex medical 
questions relating to a difficult diagnosis or to the causal link between the disorder 
from which the official concerned is suffering and the performance of his duties 
with a Community institution, it must indicate in its opinion the factors in the file 
on which it has relied and, in the event of significant discrepancy, its reasons for 
departing from certain relevant medical reports drawn up at an earlier stage which 
were more favourable to the official. 
(see paras 47-48) 
See: T-27/98 Nardone v Commission [1999] ECR-SC I-A-267 and II-1293, paras 30, 68, 
87 and 88; T-300/97 Latino v Commission [1999] ECR-SC I-A-259 and II-1263, para. 
41; T-84/98 C v Council [2000] ECR-SC I-A-113 and II-497, para. 43; T-47/97 Plug v 
Commission [2000] ECR-SC I-A-119 and II-527, para. 117 
2. In so far as a given illness is likely to result from a number of different factors 
(multifactorial illness), recognition of the occupational origin of an official's illness 
does not presuppose that it is caused essentially or preponderantly by the 
performance of his duties in the service of the Communities. Where the illness has 
several causes, occupational and non-occupational, which have each contributed to 
its appearance, it is for the Medical Committee to determine whether the 
performance of his duties - whatever assessment might be made of that factor's 
significance in relation to the non-occupational factors - bears a direct relation to 
the official's illness. 
Where there is a multifactorial illness whose possible occupational origin is, as 
scientific knowledge now stands, difficult or even impossible to prove in an 
individual case, unless there are special circumstances, the Medical Committee is 
entitled to take into consideration, where relevant, the results of an epidemiological 
study that may show, on the basis of statistical data, whether and to what extent 
there is generally a causal link between the performance of a given occupational 
activity and the appearance, aggravation or acceleration of that illness. The Medical 
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LATINO v. COMMISSION 
Committee is fully entitled, where appropriate, and provided that it was conducted 
using rigorous methods, to take the results of such a study as a basis for concluding 
that such a causal link in all probability exists in a particular case. 
Such a medical finding would be sufficient to establish satisfactorily that a causal 
link exists, in accordance with the provisions of Article 3(2) of the Insurance Rules. 
Under the ordinary law of evidence, proof may be furnished by any means, in 
particular by advancing solid, precise and consistent evidence showing that, in the 
case in question, the occupational origin of the condition is objectively likely and 
may reasonably be presumed. 
(see paras 50-52) 
See: T-4/96 S v Court of Justice [1997] ECR II-1125, paras 79 and 80 
3. Where the Medical Committee concludes that it is impossible, as scientific 
knowledge now stands, to prove the occupational origin of the disorder from which 
an official is suffering, the question of whether that condition may nevertheless be 
classed as an occupational disease for the purposes of Article 73 of the Staff 
Regulations is solely a matter for the administration, subject to review by the 
Community judicature. 
Article 3 of the Insurance Rules establishes two sets of rules governing insurance 
for occupational illnesses. 
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SUMMARY - CASE T-145/01 
Article 3(1) provides that, where the illness is contained in the 'European List of 
Occupational Diseases' annexed to the Commission Recommendation of 22 May 
1990 (OJ 1990 L 160, p. 39) or any supplements thereto, it shall be considered an 
occupational disease. It is then sufficient for the official concerned to prove that he 
has been exposed, in the course of his duties with the Communities, to the risk of 
contracting that disease. Any uncertainty as to the causal link between the 
performance of his duties and the disease cannot rebut this presumption in law, 
which derogates from the ordinary law of evidence and may not therefore be given 
a wide interpretation. 
However, under Article 3(2) of the Insurance Rules, it is for the official concerned 
to use all means to furnish evidence that a causal link exists. Although the fact that 
it is in some cases impossible to prove such a link may lead to unfair situations, 
mere proof that the performance of duties with the Communities has a potential 
effect on the appearance, aggravation or acceleration of a multifactorial disorder 
does not permit the inference that the occupational origin of that disorder is 
established with sufficient certainty. In that context, the Court may not assume the 
role of the legislature in accepting that, in the case of certain multifactorial illnesses, 
the official concerned must have the benefit of the doubt where it is objectively 
impossible to determine on the one hand whether the performance of those duties 
did actually influence the deterioration in the official's health, and on the other hand 
to what extent that performance contributed - in relation to any non-occupational 
factors - to that deterioration. 
(see paras 81, 83-84,86-87) 
See: 76/84 Rienzi v Commission [1987] ECR 315, paras 9 to 12; C-185/90 P Commission 
v Gill [1991] ECR I-4779, paras 17 and 18; T-154/89 Vidrányi v Commission [1990] 
ECR II-445, para. 48; T-2/00 N v Commission [2001] ECR-SCI-A-37 and II-135, para. 
41 
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LATINO v COMMISSION 
4. As regards the fees and incidental expenses of doctors who are members of the 
Medical Committee, the last paragraph of Article 23(2) of the Insurance Rules 
provides that, in exceptional cases and by decision of the appointing authority taken 
following the opinion of its appointed doctor, all such fees and incidental expenses 
may be paid by the institution. 
That provision allows the appointing authority a broad discretion. However, in a 
case where there is scientific uncertainty surrounding the origin of the disorder in 
question and where, according to the Medical Committee, its occupational origin 
cannot be excluded and is even 'possible', the duty of care, which requires the 
competent authority to take into consideration the interests not just of the service, 
but also of the official concerned, obliges it to contemplate applying that provision 
in the official's favour. In refraining from obtaining the opinion of the doctor which 
it has appointed to the Medical Committee before deciding to charge the official the 
fees and incidental expenses of the doctor appointed by him and half the fees and 
incidental expenses of the third doctor, the institution fails to comply with the 
obligations arising from its duty of care to the official and the principle of sound 
administration. 
(see paras 92-93) 
5. It is for the legislature to determine the rules governing insurance against 
occupational illness. Article 73(1) of the Staff Regulations refers only to the 
principle of such insurance, subject to rules drawn up by common agreement of the 
institutions. Even if the institutions had the possibility of adopting by common 
agreement an approach that is more favourable to persons suffering from a 
multifactorial illness whose origin cannot be proved with sufficient certainty, making 
such cover dependent, under Article 3(2) of the Insurance Rules, on evidence of the 
probable existence of a causal link between the performance of duties for the 
Communities and the development, acceleration or aggravation of the illness is not 
incompatible with the principle of insurance as set out in Article 73(1) of the Staff 
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SUMMARY - CASE T-145/01 
Regulations, which specifically makes enjoyment of that guarantee subject to the 
conditions defined in the Insurance Rules. 
The Community institutions are not required either by the principle of 
proportionality or by the duty of care to grant benefits intended to cover the risks 
of occupational illness where the existence of only a potential causal link between 
the performance of duties in the service of the Communities and the illness has been 
established, when it is highly probable, as scientific knowledge now stands, that the 
illness results from a cause that has nothing to do with the performance of those 
duties. 
(see paras 95-96) 
6. In the procedure established by the Rules on the insurance of officials against the 
risk of accident and of occupational disease, the interests of an official allegedly 
suffering from an occupational illness are safeguarded by the fact that he is 
examined twice, first by a doctor appointed by the institution and then, in the event 
of disagreement, by a Medical Committee. The institution's decision to refer the 
case of the official concerned to the Medical Committee is a preparatory act which 
cannot be the subject of an action; it is only in connection with an action brought 
against the decision taken at the conclusion of this procedure that the applicant can 
contest the legality of earlier steps which are closely linked to it. Therefore an 
application for the annulment of a final decision of the Medical Committee may not 
be time-barred on the ground that the official concerned has not contested the 
decision to refer his case to the Medical Committee in good time. 
(see paras 100-102) 
See: Z/87 Biedermann v Court of Auditors [1988] ECR 143, para. 10; 78/87 and 220/87 
Santarelli v Commission [1988] ECR 2699, para. 13; T-1/92 Tallarico v Parliament 
[1993] ECR II-107, para. 32 
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