Recognition of the Right and Payment

Recognition of the right to benefits

The authority to recognise this right corresponds to:

To the National Social Security Institute (INSS), Social Marine Institute (ISM) or to the Social Security Mutual Society Partner that covers, if applicable, common and/or occupational diseases in the company in question.

Authorised companies that voluntarily collaborate in the management of the General Scheme, when the cause corresponds to the contingencies included in the collaboration agreement. From 1 April 2019, voluntary collaboration may only be carried out on contingencies arising from accidents at work and occupational diseases (occupational contingencies).

1. Companies which, on 31 December 2018, were covered by the collaboration scheme regulated in Article 102.1.b) of the revised text of the General Social Security Act (economic benefits for temporary incapacity derived from common contingencies: common illness and accidents not relating to work), shall cease in said collaboration with effect from 31 March 2019, having to proceed, within the 3 months following the cessation, to carry out the liquidation of the operations related to the collaboration, in accordance with the provisions of Articles 14 and 15c of the Order of 25 November 1966, which regulates the collaboration of companies in the General Social Security System.

Notwithstanding the above paragraph, with regard to temporary disability processes derived from common illness and non-work-related accidents that are in progress at the date of cessation, the responsibility for the payment of the subsidy derived from this will continue to correspond to the collaborating company until the date of extinction of the temporary disability or, where appropriate, the extension of its economic effects, without the company being able, in such cases, to compensate itself in the corresponding liquidations of the Social Security contributions.

2. The companies that cease the collaboration modality foreseen in Article 102.1.b) of the rewritten text of the General Law on Social Security, under the terms established in the first paragraph of the previous section, may opt to formalise the protection of the economic benefit for temporary disability derived from common illness and non-work-related accidents with a mutual collaborator with the Social Security, in accordance with that established in Article 83.1.a), second and third paragraphs of said legal rule, having to exercise said option before 1 April 2019.

Payment

Temporary Disability (TD) benefit is payable by the Spanish National Social Security Institute, Social Marine Institute, Social Security Mutual Society Partner or the authorised management company.

In case of work-related injury or occupational disease, the benefit shall be paid from the day after the worker is on leave from work. The employer has to pay the full salary corresponding to the day of sick leave.

In the case of a common illness or non-work-related injury, the benefit shall be paid from the fourth day of sick leave, but from the fourth to the fifteenth day of sick leave inclusive, the benefit shall be paid by the employer.

In the special situation of Temporary Disability due to secondary incapacitating menstruation, the benefit will be paid by the Social Security from the day of sick leave.

In the special situation of Temporary Disability due to termination of pregnancy, as well as in the special situation of pregnancy from the first day of the 39^th week of pregnancy, the benefit will be paid by the Social Security from the day following the day of sick leave, with the employer paying the full salary corresponding to the day of sick leave.

The company will make the financial benefit payments with the same periodicity as salaries, by virtue of the fact that companies must mandatorily collaborate in the management of the Social Security General System, discounting from the benefit the amount of the IRPF withholding and Social Security contributions.

Compulsory collaboration in the benefit payment will continue until the person concerned is notified of the medical discharge due to recovery, improvement or unjustified failure to attend medical examinations, or until the last day of the month in which the Spanish National Social Security Institute has issued the medical discharge with a proposal for Permanent Disability, or until the maximum period of 545 days has elapsed, ending in any case on this date. The companies collaborating in the Social Security management will continue to pay the benefit at their own expense until the date on which the person concerned is notified of the medical discharge or the decision terminating entitlement to the benefit, including, where applicable, the situation of extension of the economic effects of the Temporary Disability.

When the worker is receiving contributory unemployment benefits and goes on TD, the Public Service of State Employment (SPEE) will pay the TD benefit under the delegated payment scheme until the duration of the unemployment benefit expires, as well as the Social Security contributions. Once the 365 days of TD have elapsed, if the Spanish National Social Security Institute medical inspectorate has issued a proposed report, the obligation to pay the TD benefit under the delegated payment scheme will cease on the last day of the month in which the medical discharge with a proposal for disability was issued. From that moment on, the benefit will be paid by the INSS.

Workers included in the special Scheme for domestic employees:
Effective as of 01/01/12, TD benefit, in the event of common diseases or non-work-related injuries, will be paid starting on the 9th day of leave from work, while the employer will be responsible for paying the benefit to the worker from the 4th to the 8th day of the aforementioned leave, both inclusive.
In the event of occupational illness or accident at work, it shall be paid from the day following the day of sick leave, in the amount provided for in the General Scheme, the employer being responsible for paying the benefit to the worker on the day of sick leave in the amount of the salary.
The payment of the benefit arising from workers included in this special scheme will be paid directly by the body that is responsible for its management, and delegated payment of said benefit shall not apply.

Workers included in the Special system for self-employed agricultural workers:
As of 01/01/12, the benefit shall be paid directly by the Body that is responsible for managing it, and delegated payments shall not apply, except in cases in which people receiving a contributory unemployment benefit acquire TD status, as referred to in articles 283, 284 and 285 of the General Law on Social Security.

Exceptions. In the event of direct payment:
The INSS, Social Marine Institute or Social Security Mutual Society Partner, as appropriate, are responsible for paying the benefit directly in the following cases:

When these are bodies and organisations that are excluded from delegated payment.
When the employer does not fulfil the obligation to make the delegated payment.
Companies with fewer than ten workers and more than six consecutive months of paying the subsidy that request this according to the regulations.
The end of the employment relationship when the worker is in a situation of TD.
Continuation of the TD status after voluntarily leaving the company.
Continuation of the TD status, after the period for collecting unemployment benefits has expired.
Medical discharge of persons receiving unemployment benefit by proposal report.
When these are sales representatives, bullfighting professionals or artists. In this case, when the contract is for no longer than 30 days.
In the event that the TD status ends due to the expiry of the time limit, during the extension of the effects of the benefit until PD is certified.
Due to a PD file being initiated, after 365 days of TD duration due to the Spanish National Social Security Institute medical inspectorate issuing a discharge report with a proposed report.