Management / Applications

Where?

The application for benefit can be submitted at any CAISS:

  • If these are economic benefits, the decision will be made by the Provincial Office of the INSS where the application was handed in.
  • If these are health benefits, the decision will be made by the Provincial Office of the INSS where the health care was given, regardless of the province where the student is registered or where the family home is located.

Time Periods

  • All benefits derived from schooling injury: 1 year.

  • Health benefits must be applied for prior to health care when determining the right, with the following exception: the application may be submitted within 5 years in emergency cases duly certified by the doctor.

  • Economic benefits and burial expenses not derived from school injury: 5 years.

  • Family hardship benefits: 5 years, with a maximum retrospective period of 3 months.

Documents which must accompany the application

PRESENTATION OF THE FOLLOWING ORIGINAL, VALID DOCUMENTS:
  • DNI or Family Book.
  • Foreigners, document showing identity.

PRESENTATION OF THE FOLLOWING DOCUMENTS OR CERTIFIED TRUE COPY OR COPY IN ORDER TO MAKE AN ATTESTED COPY:

  • For non-university students, certificate from the education centre which runs the course and the speciality studied, as well as the School Insurance payments .
  • For university students, receipt of the registration form indicating the course and subjects and the School Insurance payments.
  • The documentation highlighted in the above point, referring to the course prior to the course applied for, in order to show a year's contributions, except in the event of school-related injuries, family hardship benefits and obstetrics (students who, during the previous academic year, were on the last course of studies not included in School Insurance, are exempt from these requirements).
a) Health benefits: 
  1. For school-related injury:
    • Injury report, completed in point 4 of the application.
    • Sick leave certificate.
  2. Surgery, obstetrics, neuropsychiatry, pulmonary and osseous tuberculosis:
    • Official medical certificate naming the doctor who will provide the health care, indicating the professional membership number, address of the centre or clinic, speciality, hospital name and date of admittance, if applicable, diagnosis, prescribed treatment and approximate time required for recovery.
    • The above certificate may be substituted by the emergency medical report, as appropriate.
    • For neuropsychiatry, the psychiatrist must indicate the diagnosis in accordance with the international DSM-III-R or CIE/10 classifications, give a brief description of the patient's current condition, the pharmacological treatment and psychological therapy indicated and whether the latter will be provided by a psychologist or by the psychiatrist him/herself.
  3. In cases of physiotherapy, radiotherapy, cobalt therapy, radiation therapy and dialysis: in addition to the requirements indicated in the point above, the medical record producing the application is required, indicating the number of sessions, their type and the total treatment cost.

The request for these benefits included in points 2 and 3 of this section will be prior to the health care for granting the right. It can only be submitted within a period of 5 years in emergency cases that are duly certified by the doctor.

b) Economic benefits:
  1. Compensation for family hardship: Family Book and certification of large family status, if applicable.
    • Death of the head of household: Death certificate.
    • Bankruptcy: documents that clearly show the causal event of the bankruptcy, as well as the date when it happened.
    • Extension of family hardship benefit: document showing subjects studied during the previous academic year to check that the course was completed.

  2. Compensation for disabilities caused by school injuries:
    • School injury report.
    • Medical certificate specifying what occurred and indicating the permanent after-effects, as well as the reduced capacity of the injured person in relation to the subject studied.
  3. Compensation for burial expenses arising from school or non-school-related injury and disease:
    • Injury report (only if school injury).
    • In the event of death due to disease, a medical report indicating that the beneficiary died as a result of the disease during the two years following the date on which the injury occurred and that the inability to continue with their studies lasted until death.
    • Death certificate in both the case of injury and disease.
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