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Special Schemes

Integration of the Special Agricultural Scheme into the General Scheme:

Employed agricultural workers included in the REA, as well as the employers to whom they provide their services, shall be included, effective as of 01/01/12, in the Social Security General Scheme, through the setting up of a special Scheme for said workers,  with entitlement to Social Security benefits under the same terms and conditions as in the General Scheme (final provision 5) of the Consolidated Text of the LGSS.

Integration of the Special Scheme for Domestic Employees into the General Scheme:

Effective as of 01/01/12, the Special Scheme for Domestic Employees shall be included in the Social Security General Scheme, through the setting up of a special Scheme for said workers, who will be entitled to Social Security benefits under the same terms and conditions as in the General Scheme, with the particular conditions provided for by law (article 251 of the Consolidated Text of the LGSS). 

General requirements demanded

The general requirements to gain entitlement to permanent disability benefits in  the Special Schemes, in each case, are as follows:

  • Being affiliated or assimilated to affiliation in the corresponding Scheme. Nevertheless, the individual may be entitled to an allowance for absolute permanent disability or serious disability arising from common contingencies, when not affiliated.

  • Fulfilling the minimum contributory period required, where applicable.

  • Being up-to-date with all contribution payments for which the workers are directly responsible, even if the benefit is recognised as a consequence of a reciprocal contribution calculation in a scheme for workers employed by another person.
    • To this end, the payment request mechanism provided for in |Art.  28.2 of Decree 2530/1970, of 20 August, will be applied irrespective of the Social Security scheme that the interested party was a part of when accessing the benefit or in which the interested party has gained entitlement.
    • When it is deemed that the interested party is up-to-date with the payment of contributions in order for entitlement to an allowance to be recognised, by virtue of a deferral in the payment of contributions due, but he/she later fails to fulfil the deadlines or conditions of said deferral, he/she will no longer be considered as being up-to-date with payments and, as a result, the allowance to which he/she was entitled will be immediately suspended. Said allowance will only be restored once the debt held with the Social Security Service is credited in full. To this end, the body responsible for managing the allowance may deduct the corresponding contribution due from each instalment payable to the interested party.
    • For the purposes of recognising acknowledgement to an allowance, the contributions that correspond to the month of the allowance's causal event and the preceding two months, for which income still does not appear in the Social Security IT systems, it will be assumed that they have been deposited without the interested party having to provide documentary evidence, provided that the worker proves that the minimum contribution period has been met, excluding the three-month period to this end .
    • In such an event, the managing body will review all allowances recognised during the immediately preceding year on an annual basis, working on the assumption that the individual is up-to-date with all payments, to check the timely and effective payment of said contributions. Failure to do so will result in the immediate suspension of the allowance, with the monthly payments retained serving to repay the contributions due until the debtor balance is settled, with payment of the allowance restored thereafter.

Special Scheme for Self-Employed Workers

The benefit for permanent disability is granted under the same terms and conditions as for the General Scheme of the Social Security, with the following particular conditions. 

Occupational contingencies (WRI and OD):

Self-employed workers can access the benefits  arising from these contingencies, as long as  they have voluntarily increased their coverage to include WRI and OD contingencies, or have compulsory cover for these contingencies and, in addition, either previously or simultaneously,  have opted to accept coverage by the temporary disability benefit.


Concept of a WRI:

A WRI is considered to be an injury that has occurred as a direct and immediate consequence of work carried out as a self-employed worker and which determines its inclusion within the scope of application of this special scheme. They have the following consideration:

  • Those incurred in acts of rescue and of a similar nature, when they are related to the job.
  • Injuries suffered by the worker during working hours and in the place of work, when it is proved that they are connected to the work being carried out as a self-employed person.
  • Diseases, not considered occupational, contracted by the worker as a result of carrying out their work, as long as it is proved that the disease was caused exclusively by this.
  • Diseases or defects suffered by the worker beforehand, which are aggravated as a consequence of an injury caused by the accident.
  • The consequences of the accident that alter in nature, duration, seriousness or termination by intercurrent diseases which constitute complications arising from the pathological process determined by the accident itself or which are a result of diseases acquired in the new environment in which the patient has been situated.
  • Accident in itínere: As of 26-10-2017, an accident at work will also be understood as an accident at work when going to or returning from the place where the economic or professional activity is being carried out. For these purposes, the place of provision shall be understood to be the establishment where the self-employed worker habitually carries out his activity, provided that it does not coincide with his domicile and corresponds to the premises, building or office declared as being assigned to the economic activity for tax purposes. Article 316.2 LGSS 2015, introduced by Law 6/2017 of 24 October. Previously, accidents in itínere were excluded.
  • Accidents of workers who have not opted for occupational contingency protection: Accidents at work of those who have not opted for protection against this risk shall be considered as arising from non-work related injuries.

The following are not considered to be WRIs:

  • Injuries which are due to force majeure outside of the workplace.
  • Injuries which are the result of criminal intent or negligence on the part of the worker.

In the case of TRADEs, WRIs are considered to be all bodily injuries suffered by a TRADE as a result of their professional activity, injuries suffered while travelling to or returning from their place of work or injuries caused by or which are a consequence of carrying out said professional activity. Unless proven otherwise, it is assumed that an injury has no relationship to work when it does not occur while carrying out the relevant professional activity.

Concept of an OD:

This is a disease contracted as a consequence of work carried out as a self-employed worker, by virtue of which, the worker is included in the scope of application of this special scheme,  caused by the action of the elements and substances, and in the activities included  in the list of occupational diseases with the relationships to the main activities capable of producing them, appendix to RD 1299/2006 of 10 November.


Surcharge for lack of preventive measures against work risks:

The surcharge for financial benefits is not applicable in the case of WRI and OD.

Base rate:

  • If the disability arises from a common contingency (common disease or non work-related injury), there is no filling-in of gaps. Therefore, if months were to appear during which there was no obligation to contribute in the calculation period being taken into account, they will not be completed with the minimum bases in force for workers over 18 years of age.
  • If the disability arises from an occupational contingency, it will be equivalent to the contribution base of the worker on the date of the triggering event.

Partial Permanent Disability:

  • If it arises from common contingencies, it is not protected.
  • If it arises from occupational contingencies, it is protected. Partial permanent disability for the usual profession is considered as that which, without reaching the degree of total, causes the worker a reduction no less than 50% of their normal performance for that work without stopping him from carrying out its fundamental tasks.

Total permanent disability:

Percentage:

The pension for total permanent disability for the usual profession, will be increased by 20% of the base pension that is taken into consideration for determining the amount of the pension, as long as the pensioner:

  • Is equal to or older than 55 years of age. If the initial recognition of the pension is made at a lower age, the increase will be applied, following an application by the interested party, from the first day  of the month following that on which the worker reaches 55 years of age, as long as the requirements demanded in the following two points are met.

    if the right to the increase is born in a calendar year later than that in which the initial pension was recognised, it will be increased by 20%, the revaluation which would have taken place from that date will be applied.
  • He does not carry out any paid work, either employed by another person or self-employed, which gives rise to the inclusion in any of the Social Security Schemes. The increase of the pension will be suspended for the period that the worker obtains employment or carries out paid work as a self-employed person which is compatible with the total permanent disability pension he was receiving.
  • They do not own an agricultural or fish farm, or a commercial or industrial establishment as the owner, user or the like. 

Compensation:

The pension for total permanent disability, may be replaced by a lump-sum amount:

  • If it arises from common contingencies, equivalent to 40 monthly payments of the base pension for these contingencies, as long as the interested party exercises this option within 30 days following the declaration of the disability. The option will be understood as made in favour of the life pension when the worker has reached the age of 60 on the date on which the benefit is understood as having been caused.
  • If it arises from occupational contingencies, equivalent to 40 monthly payments of the worker's contribution base on the date of the triggering event of the benefit.

More information on this Scheme:

Special Scheme for Coal Mining

The benefit is recognised under the same terms and conditions as for the General Scheme of the Social Security, with the following particular conditions:

  • Joint evaluation of the condition of the worker for the initial declaration of the permanent disability or its review:

    Both the initial as well as subsequent reviews of the disability classification will be carried out by evaluating the condition of the beneficiary resulting from the whole set of anatomical or functional reductions determined by the different contingencies that may have arisen.
  • Regulatory base:

When permanent disability arises from common contingencies, the regulatory base will be the corresponding base in each case, although the contribution bases to be taken into account will be the standardised bases.

  • In the event of total permanent disability the age allowances are applied, both for the purposes of the special replacement of the life pension for compensation amount up to 20% higher than the relevant total permanent disability benefit.

    These allowances result from applying to the period of time effectively worked in each professional category of coal mining, the corresponding coefficient, in accordance with a scale that runs from 0.05 to 0.50 according to the danger and toxicity of the activity carried out.
  • Amount of the pension for absolute disability and serious disability on reaching retirement age:

    Beneficiaries:

    Pensioners with absolute permanent disability or serious disability in this Special Scheme who meet the following requirements:
  • To have a real age of 65 years or the theoretical age resulting from applying the age reductions referred to in the point above.
  • Not to be the holder of any other Social Security pension or having renounced it.
  • That the pension for absolute permanent disability or outstanding disability has not substituted, by option, the retirement pension that the interested party would receive in this Special Scheme.

Amount:

The new amount will be equivalent to that which would correspond, on the first day of the month following that in which the interested party exercises their right to a specific retirement pension in accordance with certain specific rules, as long as this amount is greater than that they had before.

More information relating to this Scheme:

Special Scheme for Seafarers

This is a lifelong economic benefit for workers who show serious loss of bodily or functional abilities which can be objectively determined and are permanent, which decrease the ability to work or make it impossible after undergoing the prescribed treatment and receiving the medical discharge.

The medical discharge is not required to assess the permanent disability in cases in which permanent damage is present.

Disability that exists following the completion of the maximum duration period established for a temporary disability, will be considered permanent disability in the degree determined, unless it is recommended to suspend the classification due to the clinical situation of the party in question.

The permanent disability is measured initially and is reviewed periodically under the following classification.:

  • Partial permanent disability for usual occupation.
  • Total permanent disability for usual occupation.
  • Absolute permanent disability for any job.
  • Severe disability.

General conditions and requirements : the same as for the General Scheme .

 

More information on this Scheme:

Processing : Provincial Directorates and Local Offices of the ISM.

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