Temporary disability

If the worker goes on sick leave before the legal strike, they will continue to receive the temporary disability benefit; this shall also apply in the event of a lockout.

However, if the worker goes on sick leave while the legal strike or lockout is in progress, he/she will not receive the benefit until either the strike or lockout has finished. Nonetheless, if the temporary disability is caused by a work-related injury, the benefit will be awarded and paid.

If the strike is considered illegal, the worker will not be entitled to the benefit and will continue to be refused the benefit even if he/she become affiliated to the scheme in question.

Does not apply, when not contributing for this contingency in the Special Agreement situation, except for members and senators of the general courts, European parliament members and members of CCAA parliaments and governments.

Unpaid and/or prescribed contributions are not calculated.

Late contributions will only be valid if they were paid prior to the month of the causal event or, if afterwards, were made within the regulatory period or by virtue of the deferral or instalment granted before the causal event.

The worker responsible for paying the contributions will need to be up-to-date with payments, even if the benefit has been recognized as a result of the reciprocal calculation, in a scheme for workers employed by another person.

For the purposes of whether there is a requirement or not for the worker having to be up-to-date, the last scheme which they were affiliated to will be taken into account before making the benefit:

• If in their last scheme the worker was the person responsible for making the payment, they must have no outstanding debt in any schemes to which they belonged previously to be entitled to the benefit.
  
  
• If in their last scheme the worker was not the person responsible for making the payment, but has belonged to another scheme in which they were, they will be required to be up to date only if the contributions to other schemes affect access to the benefit or its amount.
  

If the worker was not up-to-date with Social Security contribution payments, the application will be rejected and he/she will be invited to make payments.

If, within a period of 30 days effective the date of receipt of the notification, a payment is made to the Treasury General of the Social Security of the amount required to fulfil this requirement, the worker will be considered as being up-to-date and the allowance will be acknowledged.

However, if payment is made after the 30-day period expires, but within the expiration period of 5 years,  the allowance will be paid from the date on which the benefit takes effect, reduced by 20%.

If a work-related injury is caused by a particular activity and the worker, due to their pluri-employment or pluri-activity, is in another company or under another Social Security Scheme, the payments will be recognised in the following way:

a) If the other activity or job is as an employee, it will be considered as a occupational accident.

b) If the other activity is as a self-employed worker:

• If it is an accident, it will be considered as a non-work-related injury.

c) If the other activity is as a self-employed worker, and the worker has not opted for work-related contingency cover:

• If it is a disease covered as a work-related injury (heart attack), it will be considered a common disease.

c) If the other activity is as a self-employed worker, and the worker has opted for work-related contingency cover:

• If it is a disease covered as a work-related injury (heart attack), it will be considered as a work-related injury. Work-related diseases are considered work-related injuries, as long as work-related contingencies are covered in the special scheme for self-employed workers and the concept established for them in article 3.2.c) of Royal Decree 1273/2003 corresponds to that of article 115.2.e) of the General Social Security Act.

PART-TIME WORKERS AND RECIPIENTS OF UNEMPLOYMENT BENEFITS

Work-related injuries suffered by part-time workers who are also recipients of unemployment benefits will be considered as such due to the part-time job but will be derived from common injuries from the point of view of receiving unemployment benefits, as in these types of situation, contribution to Social  Security does not include the payments corresponding to work-related injuries and occupational diseases.

Part-time workers are affiliated to Social Security for all the days in their contract so that if they were to go on sick leave on a non-working day, the |TD  would come into effect as if they were a full-time worker.

If the triggering event for the TD occurs during periods of inactivity, the benefit will not be paid. It is an assimilated contributor situation, and the benefit is paid by the company at the beginning of the campaign as a delegated payment according to the relevant percentage. The calculation of the temporary disability period starts from the sick leave date.

Theoretical contribution days are calculated by dividing the number of hours actually worked by 5, which is equivalent to 1826 hours a year.

The 5 year period covering the contributions is extended by the same amount by which the work day of the job actually carried out is reduced.

To obtain the contribution period required (180 days in the 5 years immediately prior to the date of the causal event) and in addition to the contributions actually made or those expressly assimilated to them, the contribution days or the proportional part of extra payments are also calculable, except payments made by virtue of a training contract, as contributions in this case will be made based on a fixed amount in which the proportional part of the extra payments will not be distributed proportionately.

In this case, only the preceding period will be considered if a period of less than 180 days has elapsed between the medical discharge and the following period of sick leave. 

If more than 180 days have elapsed since the previous process, irrespective of whether the injury in question is the same or not, this would be considered as a new entitlement and it would be necessary to prove payment of contributions for 180 days over the last 5 years for a common disease.

 If the injury in question is different, and even if a period of 180 days has not elapsed, it would be considered as a new entitlement and the aforementioned requirements would have to be fulfilled.

This new period of sick leave would generate a new temporary disability process, with an entitlement to the benefit in the following cases:

• If it is caused by the same or a similar condition and a period of 180 days of work has not elapsed,  the entitlement will only be recognised if it began with a period of sick leave prior to the date of the  rejection of permanent disability status. This new sick leave report should be issued by the Public Health Service (SPS) for common contingencies  or the SPS or Social Security Mutual Society Partner if it involves professional contingencies.
  
  
• If caused by a different condition, the worker is entitled to the benefit provided that he/she meets the general requirements of this benefit (affiliation or status assimilated to affiliation and a contribution period of 180 days over the last 5 years, if caused by a common disease).
  

During the 180 days following the date of said medical discharge issued by the medical inspectors of the INSS, in new processes that may occur, only INSS medical inspectors can issue new sick leave certificates, provided that they are related to the process that gave rise to said medical discharge.

The worker leaving the Special Self-employed Workers' Scheme results in them waiving their right to the |TD  benefit option, without prejudice to keeping the benefit they were receiving when leaving the scheme, until there is a legal cause for terminating this situation.

The contribution basis of the month on leave will be divided by the number of days of the contribution in question.

In the event of a new contract, even if there was a contribution basis in that same company or another the previous month, the contribution basis of the new contract will be divided between the days for which contributions are made for this contract.

If a worker goes on sick leave the same day as they start their job, the base pension will be calculated according to the payments the workers should receive in the month when they had to start work.

The base pension will be the sum of the unemployment contribution bases excluding overtime for the last 180 days on which contributions were made for this benefit during the 6 years prior to the contract's cancellation or, if there was a holiday period not taken (which the company has to pay contributions for), until the end of these holidays.

If there was not a continuous 180 day period of contribution bases for unemployment benefit, we will be able to look for them within the last 6 years until completing the 180 days. If 180 days are not completed, the bases found will be taken and divided by the number of days to which the contribution refers.

The payment will be met by the body that covers the TD (INSS, Mutual or company) from the day after the termination of the working relationship/end of holiday period even if the 16th day of leave has not been reached.

Double calculation must be used:

1. On the one hand, holidays remaining as if the benefit was being received as a delegated payment.
   
   
2. On the other, after the date of the end of the paid holiday period not taken, the benefit will be calculated in the same way as contract termination cases.
   

This is an assimilated contributor situation, so long as contributions were made prior to the company terminating the contract. Since unemployment benefit is not awarded until this period has finished and is used to determine when the benefit begins and how long it lasts, contributions made for these holidays will be taken into account when calculating the base pension.

It needs to be highlighted that:      

If it is the relapse of a previous process when the worker was active: the amount of the TD will be equal to the amount they were receiving while unemployed. The same percentage the unemployment benefit had at that time will be applied. 

If it is not a relapse of a previous process: the benefit will be paid applying 80% of the Public Indicator of Multiple Effect Income (IPREM) excluding the proportional part of the extra payments. Neither the worker's base pension nor their family situation are taken into account.

For a part-time worker, 80% is reduced with the contribution percentage applied by the SPEE when calculating unemployment benefit.

The base pension during the TD  period remains unchanged  unless  the minimum contribution basis were to increase or there were a change in the contribution basis used as a reference for this benefit's base pension as a result of pay increases or similar that are retrospective.

• For common diseases and non-work-related injuries:
  
  The body offering coverage for the TD when the relapse occurs will also pay the allowance, calculating the benefit in line with contribution bases at the time of the relapse,  irrespective of who was covered in the first process.
  
  
• In the event of a WRI  or OD:
  
  
  • If the WRI base pension is equal to or greater than the relapse base pension: the first insurance company will pay the relapse taking the relapse base pension as the base pension. The second insurance company will be exempt from making payments.
    
    
  • If the WRI base pension is lesser than the relapse base pension: the first insurance company will pay the amount according to the base insured in the first WRI and the second company will pay the difference between the first base pension and the relapse base pension.            

This criterion will not be affected, even if more than 180 days elapse without the beneficiary working, as the process is not a cumulative as regards the maximum length of the TD. 

If the worker is unemployed when the relapse occurs and there was no sick leave at this time, the first insurance company will be responsible for the TD according to the base pension of the first process or the injury-related salaries. However, the limitations set out in Art. 222 of the LGSS will apply to the payment.

At the body where the risk is agreed, the INSSor Mutual, where appropriate, a direct payment request for the temporary disability benefit, sick leave, documentation showing that you are up to date with the payment of Social Security contributions, as well as an activity declaration must be submitted.

Self-employed workers have to present a declaration on the person that directly manages the commercial, industrial or other type of establishment or, where appropriate, the temporary or final termination of the activity at the INSS within a period of 15 days from the start of the TDsituation, so that the Administration can verify the situation of the recipient's establishment during the TD situation.       
   
However, sanction procedures will only be initiated if the presentation of the declaration occurs 45 days after sick leave.    
       
Non-presentation of the declaration or an untimely declaration will be considered a minor infringement and penalised with loss of the benefit for one month.

It is an obligatory document, as a result of which it will be possible to continue with the process even if the declaration is not available. If the worker meets all the requirements, the process will be approved but the benefit will not be paid, and the suspension of the payment will be maintained until the declaration is presented.

RD 1060/2022 and Order 2/ISM/2023 modify, respectively, RD 625/2014 and Order EES/1187/2015. From 1 April 2023, the date of entry into force of these amendments, the most important changes are as follows:

• Abolition of the worker's obligation to receive and present the copy of the medical report of TI that was intended for the company.
• The obligation for companies to transmit information to the INSS in successive confirmation and registration reports is abolished. They must only send the INSS the economic data in the sick leave reports.

Through the INSS Companies File (FIE).

There are two ways of downloading the FIE, depending on the means of transmission of the company's Electronic Data Transfer authorisation:

• If the means of transmission of my Electronic Data Transfer Authorisation is the Direct Settlement System: I will be able to use SILTRA. However, I will also be able to access the FIER service of the Online RED system.
• If the means of transmission of my RED Authorisation is the Direct RED system: I will only be able to use the FIER service of the Online RED system.

The INSS will send you a letter by ordinary mail and a text message to the mobile phone that appears in the Social Security database. The letter will also be made available at the Social Security Electronic Office. Likewise, the employer will also be able to know the information of the IT process of its employee through the IMPORTASS portal of the Social Security General Treasury.

However, if the employer has an Electronic Data Transfer Authorisation, they can consult the FIE through SILTRA or the FIER service, depending on the means of transmission of the authorisation.

The download of the FIE via SILTRA can only be done by the main users of the Direct Settlement System (SLD) Electronic Data Transfer authorisations.

Through the FIER Service, the download can be performed by any primary or secondary user of a RED authorisation (either Direct Settlement System or RED Direct).

The FIE is downloaded in .txt format, so it is convenient for companies to automate it in order to integrate the information into their payroll management systems.

Through the FIER service, the RED authorisation user can download the FIE in Excelformat.

It is sent daily whenever the INSS database generates a modification in any of the fields included in the FIE.

The FIER service offers the possibility to download information for a period of time together, with a limit of 15 days and a maximum of 300 records per Excel file.

The structure of the FIE 2.0 message, its content and the description of its fields, as well as their possible values, are included in the record design that can be consulted on the following link,  Technical Instructions.

The FIE is structured in labels that include information on the company, the worker and the Social Security benefits. The labels that include information on Social Security benefits are as follows:

• "Temporary Disability Data” DIT Tag:contains information on the sick leave and discharge reports sent by the Public Health Services and Social Security Mutual Society Partners.
• "Temporary Disability Data 2 “ Data” IT 2 Tag:informs on the date and type of work accident.
• "IT Direct Payment” ITD Tag : It provides information on the IT benefit in the direct payment modality of the INSS and the ISM.
• "Other IT Data” ILO Tag: Informs about other IT data in direct payment mode and the date of exhaustion of the 545 days.
• "Continuation IT Situation” CIT Tag : Reports on the content of the confirmation reports sent by the Public Health Services and Social Security Mutual Society Partners.
• "Permanent Disability Data” DIP Tag: Reports on the recognition of permanent invalidity pensions and LPNI.
• "Retirement Data” JUB Tag: Reports on the recognition of retirement pensions.
• "Other Performance Data” PDO Tag : Information on other benefits paid in direct payment (birth and childcare; risk during pregnancy; risk during breastfeeding; childcare; joint responsibility for infant care).
• "Birth Data” NAC Tag: Reports on births reported by the Ministry of Justice.

The information on the sick leave and discharge reports sent by the Public Health Services or Mutual Societies can be consulted on the following labels:

• DIT "Temporary Disability Data".
• IT2 "Temporary Disability Data 2".

The information on the confirmation reports sent by the Public Health Services or Mutual Insurance Companies can be consulted on the "Continuation of TI situation” CIT label.

Click on the following link,   SILTRA Manuals.

Click on the following link User manuals.

The RED notice 28/11/2022- New service "Consultation/Modification of delegation of reception of ex officio communications" in User Management of Network Authorisations informs of the creation of a service by means of which the main user can delegate to the RED mailboxes of any of its secondary users the reception of messages sent ex officio through this system from the bodies and entities of the Social Security Administration.

The current version of the FIE remains unchanged for the time being. However, the INSS is working on the development of a new version to improve the current version.

The current version of the FIER service remains unchanged for the time being. However, the INSS is working on the development of a new version to increase the limit of records to more than 300 and to allow the user of the RED Authorisation to see all the CCCs/Schemes that depend on their authorisation without the need to filter by a specific CCC/Registration Number.

In order to adapt the sending of IT reports by users of the RED System to the new regulations, a new version - version 6.0 - of the FDI and FRI files has been developed. Likewise, the "Temporary Disability Online" service of the Online RED System will also be adapted to the regulatory modifications.

The documents are published on the Social Security website, with the modifications in grey, and can be consulted by clicking on the following link Technical Instructions.

The obligation to send confirmation and registration forms is no longer required. With regard to the sick leave reports, they must only send the economic data after having received, through the FIE, the information contained in the sick leave report from the Public Health Service or Mutual Society.
For further information, you can consult the RED News Bulletin 2023/3 of 23 February 2023.

In this case, if it is a case of TI due to occupational contingencies, the company is directly responsible for the payment, at its own expense, of the health and financial benefit, and therefore must continue to send the INSS the medical reports of sick leave, confirmation and discharge.

This is the case, for example, of the group of civil servants belonging to the former MUNPAL. In these cases, in the case of a TI process due to common contingencies, companies must also continue to send the INSS the medical reports of sick leave, confirmation and discharge.

• Creation of a new action (table T -34)  DE - Economic Data.
• Creation of a new ODT segment - Other Worker Data.
• Creation of two new fields in the DEC segment: "days contributed in the previous year for overtime" and "days contributed in the previous year for other concepts".
• Creation of a new FUN segment - Description of Functions.

A new type of part called "ECONOMIC DATA REPORT" is created. A series of validations are introduced so that, on the RECORDING REPORTS screen, once the fields Regime, C.C.C., N.A.F., contingency and leave date are filled in and the "Accept" button is clicked, depending on the case in question, the application itself will automatically load the form relating to the economic data report or the possibility of selecting the type of report to be recorded (registration, leave, confirmation) will be provided.

The employer shall communicate the specific job performed by the worker in a free text of not more than 50 positions.

The company must communicate the functions performed by the employee in the company by means of a free text of 268 positions.

In the FDI, the "function description" field has 67 positions, but the label may be repeated up to a maximum of 4 times.