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The general requirements necessary for the right to benefits in the Special Schemes in each case are as follows:
WORKERS EMPLOYED BY ANOTHER PERSON:
The benefit is granted in the same extent, form, terms and conditions as in the General Scheme, with the following difference: It is an essential condition for receiving the subsidy that the worker is working for another person on the date on which the common disease begins or the non-work-related injury occurs, unless he or she is a permanent worker who is unemployed.
SELF-EMPLOYED WORKERS:
As of 1 January 2008, the benefits originated by these workers will be governed by the provisions of the RETA , in accordance with the provisions of Law 18/2007, without prejudice to the particular conditions set forth in the Special Scheme for Self-Employed Agricultural Workers.
Special Scheme for Self-Employed Agricultural Workers.
For contingencies that have obligatory coverage, if a worker opts for the minimum contribution base for the Special Scheme for Self-Employed Workers, the applicable rate will be 18.75 %.
If he or she opts for a higher contribution base than the minimum, the current valid contribution rate for obligatory contingencies under the Special Scheme for Self-Employed Workers will be applied to the excess amount.
For contingencies that have voluntary coverage, the valid rates for the Special Scheme for Self-Employed Workers for these contingencies will be applied to the total amount of the contributions base.
Statement of activity status:
A worker in a situation of temporary disability must submit to the National Institute of the Social Security or the Social Security Mutual Society for Work-Related Injuries and Occupational Diseases with which they have agreed the temporary disability contingency, a declaration on the official form regarding the person who directly manages the commercial, industrial or other establishment of which they are the owners or, where appropriate, the temporary or definitive end of the activity being carried out.
Presentation deadline:
Failure to submit the declaration, within the specified deadline, will cause the suspension of the start of benefit payments, and may automatically initiate the relevant actions to verify the situation of the establishment owned by the beneficiary.
If, as a result of administrative actions, the beneficiary is declared to be ineligible for benefits, and benefits are already being collected, action will take place to ensure the return of these amounts.
The provisions set forth in the previous two paragraphs are understood without prejudice to the fact that, if the declaration is not submitted in time or, as the case may be, the benefits have been collected when ineligible, the appropriate disciplinary proceedings may be started in the cases in which the Managing Body deems necessary, taking into account the concurrent circumstances, duly assessed by the Managing Body.
Option and formalisation of the coverage of this benefit:
At the time of affiliation in the scheme the worker may voluntarily opt for coverage of the benefit for temporary disability due to common and professional contingencies. Once the option has been made in favour of this coverage, it will take effect from the time of affiliation.
The option for the coverage of temporary disability must be made with a Social Security Mutual Society for Work-Related Injuries and Occupational Diseases, which must accept it.
If coverage for the subsidy was not opted for at the time of affiliation in the scheme, it may also be opted for after 3 calendar years from the date of affiliation, in which case, the worker must apply in writing before the first day of the month of October of each year and it will take effect from the first of January of the following year.
After opting for coverage, the rights and obligations are required for a minimum period of 3 years, calculated by complete calendar years, which are extended automatically for periods of the same length, unless expressly renounced by the interested party.
Within the last of the 3 years of each period, the worker who wishes to renounce this option must make an application in writing before the first of October, and this application will take effect from the first of January of the following year. Once the renunciation has been made, the benefit can be opted for again, as long as at least 3 years have passed since the last renunciation took place.
Termination from the scheme implies renouncing the option to this benefit,, without prejudice to continuing to receive the benefit that was being received at the time of termination, until a reason occurs for it to legally expire.
Minimum Contribution Period:
6 months immediately before the causal event in the case of common diseases.
Amount:
The amount is obtained by applying the corresponding percentages to the regulating base:
Base Pension:
This is the contribution base of the worker for the month before the medical certificate is issued, divided by 30. This base will be maintained throughout the illness, including any relapses, unless the interested party has opted for a lower contribution base, in which case, this latter will be used.
Percentages:
Temporary disability and end of activity:
Workers who are receiving the benefit for temporary disability at the time of the end of the activity will continue to receive this benefit until the cause has expired.
More information relating to this Scheme:
As of 1 January 2008, it is obligatory for self-employed workers who did not opt for coverage of temporary disability to be covered, unless they have several jobs and are paying for this benefit through another Scheme.
The benefit is recognised under the same terms and conditions as for the General Social Security Scheme, with the following differences:
Statement of activity status:
In addition to the general requirements, a worker in a situation of TD must must submit to the INSS or the Social Security Mutual Society for Work-Related Injuries and Occupational Diseases with which they have agreed the TD contingency, a declaration on the official form regarding the person who directly manages the commercial, industrial or other establishment of which they are the owners or, where appropriate, the temporary or definitive end of the activity being carried out.
Presentation deadline:
Failure to submit the declaration, within the deadline, will cause the suspension of the start of benefit payments, and may automatically initiate actions to verify the situation of the establishment owned by the beneficiary.
If, as a result of administrative actions, the beneficiary is declared to be ineligible for benefits, and benefits are already being collected, action will take place to ensure the return of these amounts.
The provisions set forth in the previous two paragraphs are understood without prejudice to the fact that, if the declaration is not submitted in time or, as the case may be, the benefits have been collected when ineligible, the appropriate disciplinary proceedings may be started in the cases in which the Managing Body deems necessary, taking into account the concurrent circumstances, duly assessed by the Managing Body.
Option and formalisation of the coverage of this benefit:
When becoming affiliated to the Scheme, it is obligatory for workers to become covered for this benefit with a Social Security Mutual Society for Work-Related Injuries and Occupational Diseases. If they do not choose a Mutual Society, it is obligatory for this contingency to be covered by the National Institute of Social Security.
The option for the coverage of TD , must be made with a Social Security Mutual Society for Work-Related Injuries and Occupational Diseases, which must accept the option as an obligatory requirement. However, any options that had already been made before 1-1-98, will continue to be valid with the Management Body or with the Social Security Mutual Society for Work-Related Injuries and Occupational Diseases with which they were agreed
After opting for coverage, the rights and obligations are required for a minimum period of 3 years, calculated by complete calendar years, which are extended automatically for periods of the same length, unless the method, time periods or conditions of the option are changed, with the established effects.
Within the last of the 3 years of each period, a worker who wishes to renounce this option must make an application in writing before the first of October, and this application will take effect from the first of January of the following year. A renouncement made in this way does not mean that the option cannot be chosen again, provided 3 years have passed since the last renouncement took place.
Termination from the scheme implies renouncing the option to this benefit,, without prejudice to continuing to receive the benefit that was being received at the time of termination, until a reason occurs for it to legally expire.
Professional contingencies:
As of 1-1-04, self-employed workers may voluntarily improve their protective action for contingencies due to work-related injuries and occupational diseases.
The coverage for professional contingencies will be with the same Managing Body or collaborator with which the TD coverage was agreed.
The option for protection against these contingencies and, where appropriate, the waiver of this option shall be carried out in accordance with the method, time periods, conditions and with the effects established for the option and waiver of TD protection, with the following particular conditions:
Improvement in the protection action for professional contingencies leads to an obligation to contribute for these contingencies, on the same base as the contribution for common contingencies and in accordance with the percentages fixed in the list of premiums current in force.
Amount:
The amount is obtained by applying the corresponding percentages to the base pension.
Percentages:
Base Pension:
This is the contribution base of the worker for the month before the medical certificate is issued, divided by 30. This base will be maintained throughout the illness, including any relapses, unless the interested party has opted for a lower contribution base, in which case, this latter will be used.
Economically dependent self-employed workers
Those who perform a for-profit economic or professional activity habitually, personally, directly and mainly for one individual or legal entity, known as the client, on whom they depend economically since they get at least 75% of their income from this work or economic or professional activities.
It is obligatory for economically dependent self-employed workers to be covered by the Social Security for Temporary Disability and Work-Related Injuries and Occupational Diseases within the scope of the protective action of the Social Security.
Temporary disability and end of activity:
Workers who are receiving the benefit for temporary disability at the time the activity ends will continue to receive this benefit until the cause for this has expired.
More information relating to this Scheme:
The benefit is granted with the same scope and under the same terms and conditions as in theGeneral Scheme of the Social Security, but it will start being received from the twenty ninth day, counting from the start date of the disease or day on which the injury occurred.
Temporary disability and end of activity:
Workers who are receiving the benefit for temporary disability at the time of the end of the activity will continue to receive this benefit until the cause has expired.
More information relating to this Scheme:
The benefit is granted under the same terms and conditions as for the General Scheme of the Social Security, with the following particular condition:
Base Pension:
When the disability arises from common contingencies, it is the standardised base that corresponds to the worker at any given time, according to the professional category that they had at the time the situation began.
More information relating to this Scheme:
All workers included under the Special Scheme for Sea Workers are covered against temporary disability, when caused by either common or professional eventualities.
The benefit is granted under the same terms and conditions as for the General Scheme of the Social Security, with the following particular conditions:
For workers in Groups II and III, payment of the subsidy is made directly through the Provincial or Local Departments of the Marine Welfare Institute and is not delegated to companies, although they are responsible for payment from the 4th to the 15th day of sick leave.
In the case of self-employed workers:
More information relating to this Scheme:
Persons included in the scope of application of this Scheme, affiliation, registration and termination and contributions.
Processing
: Provincial Offices and Local Offices of the ISM.
