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 INSS, the ISM, the Social Security Mutual Society Partner or the authorised management company.

In cases of common disease or non-work-related injury, the employer pays the subsidy from the 4th to the 15th day of sick leave, inclusive. From the 16th day of leave, payment becomes the responsibility of the INSS, ISM or Mutual Society, as appropriate, even when the actual payment continues to be made through the employer as a delegated payment.

The company will make the 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.

The obligation of companies to pay TD benefits will end on the last day of the month in which the competent Managing Body issues a decision, expressly extending the leave or opening a permanent disability (PD) file.

Notwithstanding the provisions of the foregoing paragraph, the companies authorised to collaborate in the management of the aforementioned benefit and the local councils with respect to the personnel to whom they were granting and paying TD benefit, shall continue paying the benefit in the situations described in said paragraph, either until the end of the TD situation or until qualification for PD, in accordance with transitional provision five of RD 480/1993, of 2 April.

When the worker is receiving contributory unemployment benefits and they enter a situation of TD, the Public State Employment Service (SPEE) shall pay the TD benefit through delegated payment until the unemployment benefit expires, as well as the Social Security contributions (the employer contribution and the 35% supplement to which the worker contribution is reduced).

In the cases governed by articles 283 , 284 and285 of the LGSS, SPEE will only continue paying the benefit when the managing Body expressly extends said status, up to a maximum limit of the duration of unemployment benefit. 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 LGSS.

Exceptions. In the event of direct payment:

The INSS, ISM or Social Security Mutual Society Partner, as appropriate, are responsible for directly paying the benefit 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 entering the TD extension period after 12 month, following the decision of the managing Body, unless the worker was receiving contributory unemployment benefit when the TD started, in which case, the benefit will is paid by SPEE through delegated payment until the unemployment benefit expires.
Due to opening a PD file, following the managing Body decision.
In the event that the National Social Security Institute issues a decision agreeing the medical discharge, in accordance with the provisions of Art. 170.1 of the General Social Security Law (LGSS), the companies’ obligation to pay the benefit will end on the date the decision is issued, the corresponding allowance being paid directly by the managing body or Social Security Mutual Society Partner during the period between the date of said decision and the notification thereof to the interested party. Companies that collaborate in the management of the Temporary Disability benefit in accordance with the provisions of article 102.1 a) of the LGSS, will also be obliged to directly pay the corresponding allowance for the referred-to period.

Related Information