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Direct payment for temporary disability

If you wish to apply for the direct payment of a benefit for temporary disability, you can either fill out the appropriate form online and print it out or print it out and fill it out, and then send it in by ordinary post or hand it in to the appropriate Provincial Directorate.

Application for temporary disability


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
Application for temporary disability Descargar documento Application for temporary disability. The document will open in a new window. Descargar documento Application for temporary disability. The document will open in a new window. (PDF,3593 KB) 17/05/2023
Application for direct payment of Temporary Disability in the Special Scheme for Sea Workers Descargar documento Application for direct payment of Temporary Disability in the Special Scheme for Sea Workers. The document will open in a new window. Descargar documento Application for direct payment of Temporary Disability in the Special Scheme for Sea Workers. The document will open in a new window. (PDF,4119 KB) 23/05/2023

Company Certificate


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
Company Certificate Descargar documento Company Certificate. The document will open in a new window. Descargar documento Company Certificate. The document will open in a new window. (PDF,1746 KB) 10/03/2023
Company certificate for partially retired persons Descargar documento Company certificate for partially retired persons. The document will open in a new window. Descargar documento Company certificate for partially retired persons. The document will open in a new window. (PDF,2162 KB) 05/04/2023
Company certificate for the application for temporary disability from the Special Scheme for Sea Workers Descargar documento Company certificate for the application for temporary disability from the Special Scheme for Sea Workers. The document will open in a new window. Descargar documento Company certificate for the application for temporary disability from the Special Scheme for Sea Workers. The document will open in a new window. (PDF,2211 KB) 12/04/2023
Company certificate on worker labour status-Art.170.2 TRLGSS Descargar documento Company certificate on worker labour status-Art.170.2 TRLGSS. The document will open in a new window. Descargar documento Company certificate on worker labour status-Art.170.2 TRLGSS. The document will open in a new window. (PDF,2280 KB) 17/05/2023

Company Certificate - Special System for Employed Agricultural Workers of the RG


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
Company Certificate. Descargar documento Company Certificate.. The document will open in a new window. Descargar documento Company Certificate.. The document will open in a new window. (PDF,1715 KB) 24/03/2023

Declaration of activity status- self-employed workers.


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
Declaration of Activity Status - Self-Employed Workers. Descargar documento Declaration of Activity Status - Self-Employed Workers.. The document will open in a new window. Descargar documento Declaration of Activity Status - Self-Employed Workers.. The document will open in a new window. (PDF,2492 KB) 07/03/2023
Declaration of economic activities - Self-Employed individuals under the Special Seafarer's Scheme Descargar documento Declaration of economic activities - Self-Employed individuals under the Special Seafarer's Scheme. The document will open in a new window. Descargar documento Declaration of economic activities - Self-Employed individuals under the Special Seafarer's Scheme. The document will open in a new window. (PDF,2609 KB) 11/04/2023

IRPF - Notification of data


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
IRPF - Notification of data Descargar documento IRPF - Notification of data. The document will open in a new window. Descargar documento IRPF - Notification of data. The document will open in a new window. (PDF,1383 KB) 14/05/2012
IRP - Notification of data Special Scheme for Seafarers Descargar documento IRP - Notification of data Special Scheme for Seafarers. The document will open in a new window. Descargar documento IRP - Notification of data Special Scheme for Seafarers. The document will open in a new window. (PDF,1286 KB) 26/04/2023

Personal declaration of dependent children of an applicant for temporary disability benefits


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
Declaración personal de hijos a cargo del solicitante de la prestación de incapacidad temporal Descargar documento Declaración personal de hijos a cargo del solicitante de la prestación de incapacidad temporal. The document will open in a new window. Descargar documento Declaración personal de hijos a cargo del solicitante de la prestación de incapacidad temporal. The document will open in a new window. (PDF,1958 KB) 16/03/2023
Declaration of dependent children - Special Seafarers' Scheme Descargar documento Declaration of dependent children - Special Seafarers' Scheme. The document will open in a new window. Descargar documento Declaration of dependent children - Special Seafarers' Scheme. The document will open in a new window. (PDF,2523 KB) 19/04/2023

Statement of disagreement with the medical discharge certificate issued by the INSS


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
Manifestación disconformidad con alta médica emitida por INSS Descargar documento Manifestación disconformidad con alta médica emitida por INSS. The document will open in a new window. Descargar documento Manifestación disconformidad con alta médica emitida por INSS. The document will open in a new window. (PDF,2622 KB) 02/03/2023

Statement of disagreement with the medical discharge certificate issued by the Social Marine Institute


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
Statement of disagreement with the medical discharge certificate issued by the ISM Descargar documento Statement of disagreement with the medical discharge certificate issued by the ISM. The document will open in a new window. Descargar documento Statement of disagreement with the medical discharge certificate issued by the ISM. The document will open in a new window. (PDF,2820 KB) 26/04/2023

Application for review of medical discharge for occupational contingencies issued by the Mutual Society or participating company.


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
Application for review of medical discharge for occupational contingencies issued by the Mutual Society or participating company Descargar documento Application for review of medical discharge for occupational contingencies issued by the Mutual Society or participating company. The document will open in a new window. Descargar documento Application for review of medical discharge for occupational contingencies issued by the Mutual Society or participating company. The document will open in a new window. (PDF,4503 KB) 02/03/2023
Request for review of medical discharge for occupational contingencies under the Special Scheme for Sea Workers. Descargar documento Request for review of medical discharge for occupational contingencies under the Special Scheme for Sea Workers.. The document will open in a new window. Descargar documento Request for review of medical discharge for occupational contingencies under the Special Scheme for Sea Workers.. The document will open in a new window. (PDF,4637 KB) 17/05/2023

Application for reimbursement of TD benefits paid via delegated payment, which has not been deducted from the contribution forms


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
Application for reimbursement of TD benefits paid via delegated payment, which has not been deducted Descargar documento Application for reimbursement of TD benefits paid via delegated payment, which has not been deducted. The document will open in a new window. Descargar documento Application for reimbursement of TD benefits paid via delegated payment, which has not been deducted. The document will open in a new window. (PDF,2507 KB) 03/04/2023
Request for reimbursement of temporary disability benefits paid and not deducted - Special Seafarers' Scheme Descargar documento Request for reimbursement of temporary disability benefits paid and not deducted - Special Seafarers' Scheme. The document will open in a new window. Descargar documento Request for reimbursement of temporary disability benefits paid and not deducted - Special Seafarers' Scheme. The document will open in a new window. (PDF,2908 KB) 24/05/2023

TD contingency calculation request


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
TD application to determine contingency Descargar documento TD application to determine contingency. The document will open in a new window. Descargar documento TD application to determine contingency. The document will open in a new window. (PDF,3029 KB) 28/02/2023
Application to determine contingency - Special Seafarers' Scheme Descargar documento Application to determine contingency - Special Seafarers' Scheme. The document will open in a new window. Descargar documento Application to determine contingency - Special Seafarers' Scheme. The document will open in a new window. (PDF,3098 KB) 25/05/2023

Employer's certificate for worker applications from the special system of domestic employees.


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
Certificado del empleador para solicitudes de trabajadores del Sistema especial de empleados de hogar Descargar documento Certificado del empleador para solicitudes de trabajadores del Sistema especial de empleados de hogar. The document will open in a new window. Descargar documento Certificado del empleador para solicitudes de trabajadores del Sistema especial de empleados de hogar. The document will open in a new window. (PDF,2274 KB) 17/05/2023

Relapses in temporary disability processes


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
Solicitud de expedición de baja médica por recaída en procesos de IT de duración inferior a 365 días Descargar documento Solicitud de expedición de baja médica por recaída en procesos de IT de duración inferior a 365 días. The document will open in a new window. Descargar documento Solicitud de expedición de baja médica por recaída en procesos de IT de duración inferior a 365 días. The document will open in a new window. (PDF,3119 KB) 01/03/2023
Solicitud de expedición de baja médica por recaídas en procesos de IT a partir de 365 días Descargar documento Solicitud de expedición de baja médica por recaídas en procesos de IT a partir de 365 días. The document will open in a new window. Descargar documento Solicitud de expedición de baja médica por recaídas en procesos de IT a partir de 365 días. The document will open in a new window. (PDF,3310 KB) 01/03/2023
Solicitud de expedicion de baja medica por recaida posterior a la denegación de Incapacidad Permanente en procesos de IT de menos de 545 días Descargar documento Solicitud de expedicion de baja medica por recaida posterior a la denegación de Incapacidad Permanente en procesos de IT de menos de 545 días. The document will open in a new window. Descargar documento Solicitud de expedicion de baja medica por recaida posterior a la denegación de Incapacidad Permanente en procesos de IT de menos de 545 días. The document will open in a new window. (PDF,3795 KB) 02/03/2023
Application for the issuing of sick leave due to a relapse in TD processes lasting less than 365 days. Special Scheme for Seafarers Descargar documento Application for the issuing of sick leave due to a relapse in TD processes lasting less than 365 days. Special Scheme for Seafarers. The document will open in a new window. Descargar documento Application for the issuing of sick leave due to a relapse in TD processes lasting less than 365 days. Special Scheme for Seafarers. The document will open in a new window. (PDF,2971 KB) 16/05/2023
Application for sick leave for relapses in TD processes after 365 days. Special Scheme for Sea Workers. Descargar documento Application for sick leave for relapses in TD processes after 365 days. Special Scheme for Sea Workers.. The document will open in a new window. Descargar documento Application for sick leave for relapses in TD processes after 365 days. Special Scheme for Sea Workers.. The document will open in a new window. (PDF,3875 KB) 16/05/2023
Application for sick leave for relapse after the refusal of Permanent Disability in TD processes of less than 545 days. Special Scheme for Sea Workers. Descargar documento Application for sick leave for relapse after the refusal of Permanent Disability in TD processes of less than 545 days. Special Scheme for Sea Workers.. The document will open in a new window. Descargar documento Application for sick leave for relapse after the refusal of Permanent Disability in TD processes of less than 545 days. Special Scheme for Sea Workers.. The document will open in a new window. (PDF,3788 KB) 16/05/2023

Application for compensation for transportation expenses for medical examination


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
Solicitud de compensación de gastos de transporte por reconocimiento médico Descargar documento Solicitud de compensación de gastos de transporte por reconocimiento médico. The document will open in a new window. Descargar documento Solicitud de compensación de gastos de transporte por reconocimiento médico. The document will open in a new window. (PDF,3144 KB) 28/02/2023

Application for the surcharge on financial benefits derived from work-related injury or occupational disease, due to a lack of occupational health and safety measures.


En la siguiente tabla podrá descargarse los siguientes Documentos.
Documentos Download Fecha
Solicitud de recargo de las prestaciones económicas derivadas de accidente de trabajo o enfermedad profesional, por falta de medias de seguridad y salud laboral Descargar documento Solicitud de recargo de las prestaciones económicas derivadas de accidente de trabajo o enfermedad profesional, por falta de medias de seguridad y salud laboral. The document will open in a new window. Descargar documento Solicitud de recargo de las prestaciones económicas derivadas de accidente de trabajo o enfermedad profesional, por falta de medias de seguridad y salud laboral. The document will open in a new window. (PDF,2948 KB) 12/12/2022
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