Important: Terms and medical sanctions parts
VERY IMPORTANT NOTICE
Here we present the major changes in the deadlines for lower parts of temporary disability to avoid new sanctions for later presentation thereof.
Order ESS / 1187/2015 of 15 June, which develops the Real Decree 625/2015, of 18 July, by which certain aspects of the management and control of the processes of temporary disability are regulated in the first 365 days of its duration.
Order ESS / 1187/2015, dated 15 June aims to develop Royal Decree 625/2014 of 18 July.
Royal Decree 625/2015 established a new regulation on the management of temporary disability. The amendments made by Royal Decree mainly affected the issuing of medical parts of low and high confirmation. Simplifying administrative procedures and adapting them to the estimated duration of each medical procedure.
The ESS / 1187/2015 Order approves the new models of the medical reports of low / high and confirmation, and develops certain aspects of Royal Decree.
1. General Considerations
• 4 types of temporary disability processes based on their estimated duration are distinguished:
– Process Duration short: less than 5 calendar days.
– Process Short Duration: 5 to 30 days.
– Average Process Duration: 31 to 60 days.
– Long process estimated duration: 61 or more calendar days.
• For the purposes of allocating the estimated duration for each process, the practitioner will have tables of optimal duration of the various pathological processes that can generate disabilities as well as tables on the degree of incidence of the same in the various work activities. These tables will be provided and periodically reviewed by the Social Security National Institute (INSS onwards)
2. Medical Parts Low
• The doctor of medical leave for temporary disability shall be issued immediately after the medical examination by the medical worker public health service or by the physician of the cooperating mutual, according to the contingency of the process. It will extend the model approved by the Order.
• When the physician considers that this is a process estimated duration short, issue of the high and low in the same medical procedure and a single medical report. The employee may request to be recognized on the date set for discharge and if the physician considers it appropriate may modify the duration of the process of issuing a confirmation with the new estimated duration will invalidate the above.
• When the physician is satisfied that the process is estimated short or long-term average recorded in the part of the date of the next scheduled medical examination shall not exceed 7 calendar days in the short or medium duration or on the estimated 14 long.
3. Parties confirmation
• will be extended in the form approved by the Order.
Estimated short • Duration: generally not be issued.
Estimated short • Duration: the first part of confirmation will be issued in a maximum of 7 calendar days of sick leave. The second and successive be issued every 14 days maximum.
Estimated average • Duration: the first part of confirmation be issued within a maximum of 14 calendar days of sick leave. The second and successive be issued every 28 days maximum.
• Duration long: the first part of confirmation be issued within a maximum of 14 calendar days of sick leave. The second and successive be issued every 35 days maximum.
• The physician may issue a high cure or improvement by the extent that the worker has recovered its ability to work independently of the estimated initial duration. Also you can change the estimated duration and the initial diagnosis, issuing the following parts according to the new duration.
• When the optional issuing the final confirmation of previous exhaustion of the 365 days of temporary disability notify the worker process control shall hereinafter the INSS.
• When the subsidy is in charge of the INSS Mutual communicate to it that the process has reached 330 days. In the process of professional contingency Mutual may make a non-binding proposal to the INSS before the 345 days. The INSS will make a decision on the matter expressed.
4. Parts High
• The high part is given in the form approved by the Order by the doctor of the public health service or terminate the Mutual and temporary disability on the day of issue.
• When the higher the spread medical inspector of the INSS or Social Marine Institute (hereinafter ISM) shall transmit electronically the party maximum on the first working day following the public health service and mutual if, covering a common contingencies. It will use the same model adopted in the Order.
• Mutual may be made electronically to the INSS or the ISM requests high. The managing body resolved within four days.
• When discharge be granted by inspectors INSS or ISM, only these entities are competent to issue new low for the same or similar pathology within 180 calendar days after discharge.
• compatibility issue medical discharge and continue to provide health care workers is maintained.
5. Rules on processing the medical reports of low / high and confirmation
• Referral of low / high parties and confirmation INSS: The public health service or mutual, where appropriate, refer the low / high and confirmation INSS part, electronically, immediately and in any case, in the first following business day dispatch.
• Delivery of parts of low / high and confirmed the worker: The optional public health service or mutual issuing these parts workers deliver 2 copies, one for the applicant and one for the company.
• The worker is required to submit to the company:
– The copy of the sick leave and confirmation within three days from the date of issue.
– The copy of the sick leave within the following 24 hours dispatch.
– In the process of very short duration estimated the company will present the cup of weak / strong side within 24 hours to the date of discharge.
– If the employment relationship ends during temporary disability, the confirmation parts / High shall submit to the Management / Mutual entity.
• Handling by the company:
– Record on the copy of the sick given by the employee contribution data, in order to determine the calculation basis of the economic presentation for temporary disability. He also entered the key national occupation code, the code of the province’s health center which issued the medical report and generic data established for identification purposes of the process and of the company, defined through the system Referral Electronics Data (RED).
– The company is required to transmit to the National Social Security Institute, the sick leave, confirmation or high submitted to it by the worker, after completing her concerning paragraphs through the RED system with character immediately and in any case within a maximum period of three working days from receipt.
– Models of the copies of the medical reports on paper must be retained by the company for four years from electronic filing.
• Handling by the INSS: In the processes arising from common contingencies, the INSS shall provide the relevant mutual, immediately and in any event on the first business day following receipt, the medical reports of low / high and confirmation workers with regard to covering the financial presentation for temporary disability due to the listed contingencies.
• Processes in progress:
– New models of medical reports will be used in the processes of temporary disability that are in progress as of December 1, 2015 and have not exceeded 365 days.
– The rules set out in this order as well as new models of parts of low / high and low confirmation shall apply to periods of relapse temporary disability processes initiated by December 1, 2015, when the new sick leave is issued after that date.
6. Control of temporary disability
• In common contingency processes the health service or the Inspectorate for Social Security will issue quarterly report on the need to keep down. It shall forward the report in five days to the Mutual and supplementary reports and medical tests performed. There is no indication whether sent electronically or on paper.
7. Temporary incapacity for partial retirement
• It shall be paid direct payment scheme, whatever the contingency, by the management entity or Mutual. Stop operating the scheme voluntary contributor. The company will notify the start of payment of the subsidy scheme for direct payment to workers and their completion.
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