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Occupational Diseases relating to Diseases of the Musculoskeletal System (MSD)

The range of occupational diseases relating to MSDs in accordance with the Occupational Diseases Regulations (BKV)

Employees with an MSD are often unable to return to work in spite of integration and rehabilitation measures. You will find information here on whether compensation is possible under insurance law (occupational disease).

Medical rehabilitation and workplace integration after a long period of illness are in the first place for employees with MSDs as well - key term: workplace integration management (WIM). However, every year around 2000 recognised occupational diseases and regularly over 10 per cent of early retirements in connection with MSDs highlight the limits of this procedure. If a return to work is not possible, or only with restrictions, the focus is then on the compensation process.

What can be done if (re)-integration is unsuccessful? Compensation for occupational diseases relating to diseases of the musculoskeletal system

A whole series of important and familiar causal connections between occupational effects and diseases of the musculoskeletal system they may lead to is known. These are listed in Schedule 1 of the Occupational Diseases Regulations (BKV). Primary importance is attached to occupational diseases BK2101 to BK2114 in Section 2 "Durch physikalische Einwirkungen verursachte Krankheiten" (Diseases caused by physical workloads) - see below. In addition, some occupational diseases caused by chemical effects and by working in compressed air must also be mentioned. There are certain connections to MSDs here as well - see below.

Employers can see by means of the BKV or the list of occupational diseases the the physical workloads for which initiatives for the prevention of MSDs are advisable in particular. In addition, in accordance with s. 3 of the BKV "Maßnahmen gegen Berufskrankheiten, Übergangsleistung" (Measures against occupational diseases, transitional benefit) individual prevention measures can be initiated through the accident insurance providers with which the occurrence of an occupational disease can be prevented in certain circumstances.

Essential legal sources:

  • Seventh Book of the Social Code (SGB VII) of 7 August 1996 (Federal Gazette I p. 1254 and Federal Gazette III 860-7), s. 9 Berufskrankheit
  • Occupational Diseases Regulations (BKV) of 30 October 1997 (Federal Gazette I p. 2623) and (Federal Gazette III 860-7-2), Schedule 1 on the Occupational Diseases Regulations (BKV)

Recognised occupational diseases of the musculoskeletal system

The following diseases of the musculoskeletal system can be recognised as occupational diseases (insured event). However, specific mechanical effects and other preconditions must be verifiably present or satisfied:

  • No 2101: diseases of the tendon sheaths or of the peritenon, as well as of the tendonous or muscular insertions, that have forced the cessation of all activities that were or may be causal for the development, deterioration or resurgence of the disease
  • No 2102: meniscus damage following many years of continuous or frequently recurring activities that put an above average strain on the knee joints
  • No 2103: diseases caused by vibration on work with compressed air tools or tools or machines with similar effects
  • No 2104: circulatory disturbances in the hands caused by vibrations that have forced the cessation of all activities that were or may be causal for the development, deterioration or resurgence of the disease
  • No 2105: chronic diseases of the bursas through constant pressure
  • No 2106: compression damage of the nerves
  • No 2107: avulsion fracture of the spinous processes
  • No 2108: intervertebral disc diseases of the lumbar spine caused by many years of lifting or carrying heavy loads, or many years of work in an extreme stooped position, that have forced the cessation of all activities that were or may be causal for the development, deterioration or resurgence of the disease
  • No 2109: intervertebral disc diseases of the cervical spine caused by many years of carrying heavy loads on the shoulders, that have forced the cessation of all activities that were or may be causal for the development, deterioration or resurgence of the disease
  • No 2110: intervertebral disc diseases of the lumbar spine caused by many years of mainly vertical exposure to whole-body vibration, that have forced the cessation of all activities that were or may be causal for the development, deterioration or resurgence of the disease
  • No 2112: knee osteoarthritis caused by work while kneeling, or comparable knee strain with a cumulative exposure time during working life of not less than 13,000 hours and a minimum exposure time of a total of one hour per shift
  • No 2113: compression damage of the median nerve in the carpal tunnel (carpal tunnel syndrome) through repetitive manual work with bending and stretching of the wrists, increased strain on the hands or hand-arm vibrations
  • No 2114: vascular damage to the hand through exposure to shock-type force (hypothenar hammer syndrome and thenar hammer syndrome)

How do diseases become recognised occupational diseases?

The Medical Experts' Advisory Board "Berufskrankheiten" (Occupational diseases) (ÄSVB) is co-responsible for the inclusion of diseases in the list of occupational diseases. This is an independent advisory body that supports the Federal Ministry of Labour and Social Affairs (Bundesministerium für Arbeit und Soziales - BMAS) in its decision-making in questions of medical science. For this purpose the advisory board inspects and assesses the status of scientific knowledge with regard to both the updating of existing occupational diseases in the Occupational Diseases Regulation (BKV) and to the inclusion of new diseases in the Regulation. Following this, the advisory board draws up recommendations and statements for the ministry on the basis of existing findings.

Further diseases of the musculoskeletal system under discussion

At present, further diseases of the musculoskeletal system in connection with high physical demands are in the "Advisory" stage in the Medical Experts' Advisory Board. This means that a preliminary review has taken place in the framework of preparing a scientific recommendation for a new occupational disease. For two diseases, this has resulted in sufficient scientific verification of a causal connection between a potentially damaging effect and the development of these diseases.


In the framework of the deliberations, the ÄSVB will now examine the general predisposition, that is, the existence of medical science finding on the fundamental causal connectivity between the potentially damaging effect and the development of this disease. Diseases of the musculoskeletal system that are in the advisory phase at present are:

  • osteoarthritis of the hip joint through lifting and carrying heavy loads,
  • musculoskeletal diseases of the shoulders through working above shoulder height.

If the general predisposition has been determined, the existence of a "group-specific risk increase" is examined in the next phase. Here it is determined whether persons who are exposed to the damaging effect in their insured work have a considerably higher risk of disease than the general population.

MSDs and hazardous substances

Musculoskeletal diseases can also be caused by exposure to hazardous substances. This should be noted with the following occupational diseases:

  • No 1104: diseases through cadmium or its compounds
  • No 1109: diseases through phosphorous or its inorganic compounds
  • No 1308: diseases through fluorine or its compounds
  • No 1302: diseases through halogenated hydrocarbons

You can find more information on the subject of occupational diseases and on our current research in this field at "Publications and documents" and "Further information".