PUBLICATION IN THE BOE OF LAW 35/2014 IN RELATION TO THE LEGAL REGIME OF THE SOCIAL SECURITY MUTUAL WORK ACCIDENTS AND PROFESSIONAL ILLNESSES

In the BOE of December 29, 2014, the Law 35/2014, of December 26, which modifies the consolidated text of the General Law of Social Security in relation to the legal regime of the Mutual Insurance Companies for Work Accidents and Occupational Diseases of Social Security.

The aforementioned Law modifies substantial aspects of their organization with the aim of modernizing the operation and management of these private entities, reinforcing the levels of transparency and efficiency, and contributing to a greater extent to the fight against unjustified absenteeism from work and to the sustainability of the Social Security system.

The until now called Social Security Work Accident and Occupational Disease Mutual Funds are now called by this law as Mutual Collaborators with Social Security.

The regulation of the internal structure of the Mutual Collaborators with Social Security is improved by establishing the governing bodies, their composition and functions.

As a novel element, the participation of social agents is articulated through the Control and Monitoring Commissions, to which representation from the professional associations of self-employed workers is incorporated.

The law regulates the economic result and the reserves to be established against it, defining them in detail.

The particularities of the management by Social Security Collaborating Mutual Funds of the economic benefit for temporary disability derived from common contingencies are also regulated. Mutual Insurance Institutions are given the power to carry out control and monitoring activities from medical leave.

The definition and purpose of the Mutual Funds are the following:

1.- Mutual Collaborators with Social Security are private associations of businessmen established through authorization from the Ministry of Employment and Social Security and registration in the special Registry dependent on it, whose purpose is to collaborate in the management of Social Security, under the direction and protection of the same, without profit motive and their associates assuming joint responsibility in the cases and with the scope established in this law.

The Collaborating Mutual Funds with Social Security, once established, acquire legal personality and the capacity to act to fulfill their purposes. Their scope of action extends to the entire territory of the State.

2.- It is the object of the Mutual Collaborators with Social Security to develop, through collaboration with the Ministry of Employment and Social Security, the following Social Security activities:

a) The management of economic benefits and health care, including rehabilitation, included in the protection of contingencies of work accidents and occupational diseases of Social Security, as well as the prevention activities of the same contingencies that the protective action provides.

b) The management of the economic benefit for temporary disability derived from common contingencies.

c) The management of risk benefits during pregnancy and risk during breastfeeding.

d) The management of economic benefits for cessation of activity for self-employed workers, in the terms established in Law 32/2010, of August 5, which establishes a specific system of protection for cessation of activity for self-employed workers.

e) The management of the care benefit for minors affected by cancer or another serious illness.

f) Other Social Security activities that are legally attributed to them.

3.- The benefits and services attributed to the management of the Mutual Collaborators with the Social Security are part of the protective action of the System and will be dispensed in favor of the workers at the service of the associated entrepreneurs and the affiliated self-employed workers in accordance with the rules of the Social Security regime in which they are framed and with the same scope as that dispensed by the Managing Entities in the cases attributed to them, with the following particularities:

a) Regarding professional contingencies, the initial determination of the professional nature of the contingency will be the responsibility of the Mutual Insurance Companies, without prejudice to its possible review or qualification by the competent Managing Entity in accordance with the applicable regulations.
The acts issued by the Mutual Insurance Companies, by which they recognize, suspend, cancel or extinguish rights in the cases attributed to them, will be motivated and formalized in writing, their effectiveness being subject to notification to the interested party. Likewise, the employer will be notified when the beneficiary maintains an employment relationship and they produce effects on it.

The health benefits included in the protection of professional contingencies will be provided through the means and facilities managed by the Mutual Insurance Companies, through agreements with other Mutual Insurance Companies or with Public Health Administrations, as well as through agreements with private media, in the terms established in article 199 and in the regulations governing the operation of the Entities.

b) The management of the economic benefit for temporary disability derived from common contingencies will be carried out under the terms and conditions established in the eleventh additional provision.

c) The preventive activities of the protective action of Social Security are assistance benefits in favor of associated employers and their dependent workers, as well as affiliated self-employed workers, which do not generate subjective rights, aimed at assisting them in the control and, where appropriate, reduction of work accidents and occupational diseases of Social Security. They will also include advisory activities for associated companies and self-employed workers so that they adapt their jobs and structures for the relocation of injured workers or those with pathologies of professional origin, as well as research, development and innovation activities to be carried out directly by the Mutual Insurance Companies, aimed at reducing professional Social Security contingencies.

It will be the responsibility of the management and supervision body of the Mutual Collaborators with Social Security, dependent on the Ministry of Employment and Social Security, to establish the periodic planning of the preventive activities of the Social Security that they will develop, their criteria, content and order of preferences, as well as to supervise their development and evaluate their effectiveness and efficiency. The Autonomous Communities that hold shared execution competence in matters of occupational risk prevention activities, and without prejudice to the provisions of their respective Statutes of Autonomy, may communicate to the mutual protection body the activities that they consider should be developed in their respective territorial areas so that they are incorporated into the planning of Social Security preventive activities.

4.- Claims that have as their object Social Security benefits and services subject to collaboration in their management or that are based on them, including those of a compensatory nature, will be substantiated before the social jurisdictional order in accordance with the provisions of Law 36/2011, of October 10, regulating the Social Jurisdiction.

5.- The financial obligations attributed to the Mutual Funds will be paid from the public resources allocated for the development of the collaboration, without prejudice to the fact that those obligations that have pensions as their object are financed in accordance with the provisions of article 87.3.

6.- The collaboration of Mutual Insurance Companies in the management of Social Security may not serve as a basis for commercial profit operations nor will it include activities to attract associated companies or affiliated workers. Nor may it give rise to the granting of benefits of any kind in favor of the associated businessmen, nor to their replacement in the obligations that correspond to them due to their status as businessmen.

7.- The Social Security Collaborating Mutual Funds are part of the state public sector of an administrative nature, in accordance with the public nature of their functions and the economic resources they manage, without prejudice to the private nature of the entity.

This Law will come into force on January 1, 2015.

Law 35/2014 of December 26

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