News in the management and control of temporary disability processes in the first 365 days of duration

There have been important modifications in the regulations that regulate the management and control of processes for temporary disability in the first 365 days of duration:

• Royal Decree 1060/2022, of December 27 (BOE of January 5, 2023)
• ISM Order 2/2023, of January 11 (BOE of January 13, 2023)

The first thing to note is that the changes introduced in these standards will come into force from April 1, 2023.

The main modification that is introduced by these standards is the elimination of the copies of the medical reports intended for companies and that people workers no longer have the obligation to present them to their company. Instead, it will be the National Social Security Institute (INSS) that will electronically send companies the information on medical reports for temporary disability, through the file INSS EMPRESAS (FIE or FIER) of the Electronic Data Remission system. (RED).

Those groups not required to join the RED System¹, will receive the communication through the services of the electronic headquarters of the Secretary of State for Social Security and Pensions (SEDESS) or by email.

On the other hand, some modifications are introduced aimed at clarifying some doubts that existed in the management of temporary disability processes. In this sense, it is clarified that the deadlines set for reviews depending on the type of process (very short, short, long or very long), are the maximum HTMLTAG75___ allowed, and the practitioner may establish a lower review deadline when he/she deems it necessary.

The opportunity is also taken to correct an omission that occurred in the standards that are being modified and the physicians of the companies are included. collaborators___ in professional contingency in the competencies associated with issueon of medical parts in said contingency.

The second most relevant modification occurs in changes introduced in the notification models that appear in the annexes of Order ISM 2/2023, of January 11.

On the one hand, the copy intended for companies of the withdrawal/registration and confirmation of withdrawal models is eliminated, in the discharge/discharge medical part a new field is added (Date of withdrawal from the process previous of which it is a relapse) for the cases of relapse and both in the discharge/discharge and confirmation parts an informative note is added indicating that in case of not appearing for the next medical review the discharge may be issued for non-appearance.

HTMLTAG138The most notable changes appear in the model of ANNEX III which contains the information that must be submitted the company:

• All worker information and some additional company information are required.
• Information about the job position and description of the worker's functions is required.
• The obligation to report the code of the province of the health center of the physician/medical inspector who issued the discharge/discharge report is eliminated.
• For contracts that are not part-time / permanent discontinuous, it is required that in common contingencies the amounts quoted the previous year for other concepts/days must also be reported (previously it was only required in contingencies professional).

FE DE ERRATAS

In the medical discharge/discharge report models published in Annex I of Order ISM 2/2023, of January 11, they contain layout errors that affect the contingency options and the causes of discharge. The correction will be published soon in the BOE.

COMMENTS FROM FRATERNIDAD-MUPRESPA…

• The new information requested from companies in relation to the job position and the description of the functions performed by the worker, will be provided to the doctors of the Public Health Service and the Mutual Insurance Companies to optimize the duration of the temporary disability processes.For these reasons, we invite both our mutual members and advisors to provide this information with the greatest possible level of detail.
• In contracts that are not part-time/discontinuous permanent the way of reporting the contribution bases is modified:
  • On the one hand, the contribution base for the previous month must be reported, without incorporating the proration of any non-periodic concept or accrual greater than monthly (as would be done in the event that the contingency was professional).
  • On the other hand, the sum of the contribution bases of the previous year corresponding to non-periodic concepts or those accrued more than monthly (excluding contributions for overtime) must be reported.

It is important that the contribution base is not continued as reported as before to avoid incidents in the delegated payment.

¹ Bullfighting professionals, household employers and certain self-employed sea workers are not required (art. 2.3 of Order ESS/484/2013 of March 26, in the wording derived from Order ESS/214/2018, of March 1).

²Although it is not expressly indicated in the articles or in the explanatory memorandum of the RD 1060/2022, nor the ISM Order 2/2023, at medical.

It seems logical that it is no longer necessary to send to the Administration the same information that has been received from it and that is why RD 1060/2022, of December 27, has modified art.7.2 of RD 625/2014, of July 18, changing its content from:

[…] Companies have the obligation to send ___to the National Social Security Institute, immediately and, in any case, within a maximum period of three business days counted from the receipt of the report presented by the worker, ___through the Electronic Data Submission system (RED), the medical reports of sick leave, confirmation of sick leave and discharge presented to them by the workers, completed with the data that corresponds to the company ___HTMLTA G397___[…]___

by the following wording:

[…] Companies have the obligation to transmit to the National Social Security Institute through the Electronic Data Submission (RED) system, immediately and, in any case, within a maximum period of three business days from receipt of the communication of the medical leave, the data determined by order ministerial. The aforementioned transmission will not be mandatory when the worker belongs to a group for which the company or employer has no obligation to join the RED system

It goes from an express enumeration of the information to be sent (medical reports of discharge, confirmation of discharge and discharge) to information that will be determined by Ministerial Order.

In Order ISM 2/2023, of January 11, art. 11 of the ESS Order 1187/2015, of June 15, which regulated the “Processing of the entrepreneur” passing from the following wording:

2.   The company has the obligation to transmit to the National Social Security Institute, the withdrawal, confirmation or registration report submitted to it by the worker, after completing the sections to it concerning, through the RED system, immediately and, in any case, within a maximum period of three business days from receipt.[…]

To be written as follows:

1.    In compliance with the provisions of article 7.2 of Royal Decree 625/2014, of July 18, ___the company or companies for which it provides services the worker to whom the medical leave relates will transmit it to the National Social Security Institute, through the RED system and within the period established in the aforementioned article, ___the data contained in the annex III___HTML TAG553___.___

Consequently, if art. 7.2 of RD 625/2014, of July 18, has eliminated the express reference to the company's obligation to notify medical reports and limits the notification obligations to what is regulated in a Ministerial Order and this, in turn, limits said obligation to notify through the RED system the data that appears in Annex III in cases of receiving medical leave; It can be concluded that companies no longer have the obligation to notify the information on medical reports through the RED System (or SILTRA). The only obligation is limited to the information in ANNEX III of Order ISM 2/2023, of January 11, which is the information required by the administration to calculate the regulatory basis for the temporary disability benefit.