IT.DANA - Temporary disability regulated in article 25 of Royal Decree Law 6/2024, of November 5

Among the urgent response measures to the damage caused by DANA, article 25 establishes a measure that aims to improve the economic benefit to those workers who cause medical leave as consequence of DANA.

Specifically, the measure indicates the following:

“The temporary disability processes produced in the localities of the annex of this royal decree-law, from the October 29 to November 30 of the same year, and initiated as a result of the incidents described in article 1 will be considered, on an exceptional basis, as a situation assimilated to an accident. work, exclusively for the purposes of the economic benefit of temporary disability of the Security system Social. As a consequence of this assimilation, no minimum contribution period will be required in accordance with what is established in article 172 b) of the consolidated text of Social Security.”

From the analysis of this measure, the following conclusions emerge:

When communicating economic data through the FDI files or online service established for these purposes, must communicate as contingency “3” Work accident
Companies must communicate to the INSS the action/type of part “DE” in the same way as it is communicated for any another IT process for common contingencies.
In the case of companies that collaborate voluntarily in accordance with Art. 102 section 1.a) LGSS, they must inform the INSS the action/part type “PB”.

• Healthcare: corresponds to the Public Health Service.
• Grace period: is not required.
• Amount: The amount of the benefit will be equivalent to a temporary disability benefit derived from a work accident. Therefore, 75% will be received from the day following the medical leave.
• Pay: The benefit will be paid as if a typical temporary disability benefit were paid. would try In most cases it will be by delegated payment through the company, except for groups and exceptions provided for in the rule that are paid in direct payment by the Mutual Fund.
• Responsible for payment: The entity that covers the contingencies will be responsible for payment company professionals. In the case of a company that self-insures contingencies professionals, they will be the ones who pay this new benefit.
• Administrative management:
  1. 1. It corresponds to the doctors of the Public Health Service, health care and the issuance of reports discharge, confirmation and discharge doctors.
  2. 2. Medical leaves issued by the Public Health Services that are classified as ITEM.DANA (art. 25 RDL 6/2024) will be sent to companies through the files INSS FIE Companies / FIER Service with the following characteristics:
     • Field 1090. Contingency: “3”Accident.
     • Field 1173. Processes with peculiarities in payment and price: “04” Process ITEM derived from common disease assimilated to AT for economic purposes.

     Note: The Mutual Insurance doctors will not issue any medical report for this type of situations.

  3. 3. Actions in the field of FDI Files and online communication service for termination reports, confirmation and registration:
  4. 4. Additional administrative clarifications:
     • It does not require anything to be processed through Delta.
     • Does not compute in the accident rate of the company, although yes in absenteeism.

Who can this measure affect?

This measure will affect those workers who, between 10/29/2024 and 11/30/2024, begin a process of temporary disability as a result of DANA in any of the locations listed in the annex of the Real Decree-law 6/2024, of November 5.

The self-employed or employed person who is found to be entitled to this exceptional protection may be entitled to this exceptional protection. on the date of the causative event and registered in any of the Social Security regimes.

Are medical leaves resulting from DANA a work accident?

No, not all medical leave that occurs as a result of DANA will be a work accident. Some They will be a work accident and others will not. It is necessary to differentiate between medical leave due to a work accident and sick leave medical assimilated to a work accident.

The issuance of these medical leaves will correspond to the medical services of the Mutual Collaborated with Social Security -or self-insurance company- with whom the company has arranged coverage of professional risks. So Likewise, these medical services will be the ones who will assume the health care that people need. crashed.

1. The first, the medical leave due to work accident will be those that, as a general rule, have occurred on the occasion or as a consequence of the work that was being carried out when the accident occurred. DANA. The classification as a work accident in these cases is governed by the provisions of art. 156 of the General Law of Social Security -for employed workers- or art. 316.2 of the General Law of the Social Security -for self-employed workers-.
2. The second ones, the medical leave assimilated to a work accident(which we will call IT.DANA) They are those that are issued under art. 25 of Royal Decree-Law 6/2024, of November 5. The injuries that reasons for these medical leaves will not have any connection with work, but will be related directly or indirectly with the effects of the DANA under a triple concurrence of requirements:
   1. Temporary requirement: The date of the initial medical leave must occur between 10/29/2024 and 11/30/2024 (although those issued with after 11/30/2024 and are a relapse of a previous IT.DANA).
   2. Geographic requirement: that the temporary disability process has occurred in any of the towns in the annex to Royal Decree-Law 6/2024, of November 5.
   3. Causal requirement: that the origin of the temporary disability began as consequence of the incidents caused by DANA.

It will be the responsibility of the doctors of the Public Health Service to issue these medical leaves and provide the corresponding healthcare.

Finally, those sick leave that cannot be classified as either a work accident (A) or assimilated to an accident of work (B) will be classified as a common contingency and the regulations of said contingency will be applied to them. contingency (without any exception).

How can a company differentiate if a sick leave is a work accident, assimilated to work accident or is it due to another contingency?

The only way the company has to know if a medical leave is derived from a work accident, assimilated to accident at work (IT.DANA) or due to another contingency is analyzing the INSS file Companies FIE / Service FIER.

In these files you will have to look at field 1090 (Contingency) and field 1173 (Peculiarities in payment and quotation).

When is the company notified of a medical leave assimilated to a work accident? Should (IT.DANA) make any communication to Delt@?

No, medical leave assimilated to a work accident are only assimilated for the purposes of the amount of the compensation. economic benefit.
Therefore, they do not entail the rest of the obligations associated with a “real” work accident and, consequently, they do not require neither accident investigation nor notification to Delt@.

Are the improvements in the agreement applicable to medical leave assimilated to an accident? work (IT.DANA)?

The application or not of these improvements will depend on how it has been expressly regulated in each of the agreements.
What jurisprudence has come to clarify is that medical sick leave assimilated to a work accident are not The specific conditions agreed upon for medical leave due to a work accident may apply, since they are not deals with the same contingencies, since the assimilation made by the norm is exclusively for the purposes economical in the provision and nothing more (Supreme Court Ruling 4324/2022, Social Chamber, Section 991, of November 15, 2022, appeal no. 109/2022).

Who is responsible for the monitoring and treatment of medical leave assimilated to work accident (IT.DANA)?

The Public Health Service is responsible for the treatment and healthcare required by the processes. of medical leave assimilated to a work accident.
However, given that these IT.DANA processes have an associated economic benefit from Social Security that managed by the Mutual Insurance Companies Collaborated with Social Security, these may also exercise control and monitoring of said processes; being able to appoint people on medical leave with their own professionals sanitary.