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 rules will come into force from April 1, 2023.

The main modification that is introduced by these rules is the elimination of copies of medical reports intended for companies and that 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 the medical reports for temporary disability, through the file INSS COMPANIES(FIE or FIER) of the Electronic Data Remission (RED) system.

Those groups not required to join the RED System ¹, they 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 maximums allowed, the physician may establish a shorter review period when he/she deems it necessary.

The opportunity is also taken to correct an omission that occurred in the regulations that are being modified and the physicians of the collaborating companies in professional contingency in the skills associated with broadcastingon 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 the ISM Order 2/2023, of January 11.

On the one hand, the copy intended for companies of the deletion/registration and confirmation of deletion models is eliminated, in the medical discharge/discharge report is added a new field(Date of withdrawal from the process former of which it is a relapse) for the cases of relapse and both in the low/high parts and confirmation An informative note is added indicating that if you do not appear for the next medical examination, the discharge due to non-appearance.

The most notable changes appear in the ANNEX III model which contains the information that must be sent the company:

• All information about the worker and some additional information about the company is required.
• Information on 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 / discontinuous permanent contracts, 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 professional contingencies).

ERRATA

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

Fraternidad-Muprespa'S COMMENTS…

• The new information requested from companies in relation to the job position and job description carried out by the worker, will be provided to the doctors of the Public Health Service and the Mutual Funds 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 level of detail possible.
• In the 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 from the previous year corresponding to non-periodic concepts or those accruing more than monthly (excluding contributions for overtime) must be reported.

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

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

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

It seems logical that it is no longer necessary to send 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 sendto 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 (RED) system, 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[…]

by the following wording:

[…] Companies have the obligation to transmitto the National Social Security Institutethrough the Electronic Data Submission (RED) system,immediately and, in any case, within a maximum period of three business days from the receipt of the communication of the medical leave,the data determined by ministerial order. The aforementioned transmission will not be mandatory when the worker belongs to any group in respect of 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 Order ESS 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 presented to it by the worker, after completing the sections concerning it, through the RED system., immediately and, in any case, within a maximum period of three business days from receipt. […] 

To be worded 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 the worker to whom the medical leave relates provides services 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 Annex III.

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.