Key Benefits:
Translated by the Ministry of Social Security and Labour
REPUBLIC OF LITHUANIA
LAW ON AMENDING OF LAW NO VIII-1509 ON SOCIAL INSURANCE OF
ACCIDENTS AT WORK AND OCCUPATIONAL DISEASES
21 June 2016 No XII-2472
Vilnius
Article 1. The new version of the Law Amending Law No VIII-1509 of the Republic of Lithuania on Social Insurance of Accidents at Work and Occupational Diseases
To amend Law No VIII-1509 of the Republic of Lithuania on Social Insurance of Accidents at Work and Occupational Diseases and to restate it as follows:
“REPUBLIC OF LITHUANIA LAW ON SOCIAL INSURANCE OF
OCCUPATIONAL ACCIDENTS AT WORK AND OCCUPATIONAL DISEASES
Article 1. Purpose of the Law
This Law shall lay down the relations of social insurance of accidents at work, accidents on the way to/from work, and occupational diseases (hereinafter: ‘social insurance of occupational accidents), the categories of the persons who are insured with this type of social insurance and the rights of these persons to such insurance benefits, conditions of awarding, calculation and payment of the benefits, and define insured and non-insured events.
Article 2. Social Insurance of Occupational Accidents
1. In certain cases stipulated by this Law, social insurance of occupational accidents shall compensate persons insured by this type of social insurance for the loss of income incurred due to insured events (occupational accidents at work, accidents on the way to/from work, or occupational diseases), and if they die because of the insured events – shall compensate their family members.
Article 3. Basic Definitions in This Law
1. “Insured person” means a person who is compulsorily insured with social insurance of accidents at work, when the insurer has submitted in accordance with the procedure laid down by legal acts a notification about the said insurance to a regional branch of the State Social Insurance Fund Board or the Branch of Military and Other Similar Structures of the State Social Insurance Fund Board (hereinafter: a ‘regional branch of the State Social Insurance Fund Board’), or when the insurer has paid or had to pay for him contributions of social insurance of occupational accidents.
2. “Insured income of the insured person” means all income and other amounts on which state social insurance contributions were paid or had to be paid to social insurance of occupational accidents, as well as benefits reckoned in because of an accident at work (service), an accident on the way to/from work (service) or an occupational disease as prescribed in this Law, reckoned-in sickness (including the employer's compensation for the first 2 days of sickness), vocational rehabilitation, maternity, paternity, maternity (paternity) benefits as prescribed in the Law on Sickness and Maternity Social Insurance of the Republic of Lithuania (hereinafter – Law on Sickness and Maternity Social Insurance), as well as unemployment social insurance benefits and part-time work benefits which have been reckoned in and are payable to the unemployed under the Law on Unemployment Social Insurance.
3. “Lost capacity for work” means loss of capacity for work as a result of an accident at work (service), an accident on the way to/from work (service) or due to contracting an occupational disease. The incapacity for work shall be expressed in percentages. Should the injured die as a result of an accident at work, an accident on the way to/from work (service) or due to an acute occupational disease, it shall be considered as loss of a 100 per cent capacity for work. The Disability and Working Capacity Assessment Office under the Ministry of Social Security and Labour (hereinafter: the ‘Disability and Working Capacity Assessment Office’) shall, in accordance with the procedure laid down by the Government or an institution authorised by it, establish the loss of capacity for work as a result of an accident at work (service), an accident on the way to/from work (service), or due to contracting an occupational disease.
4. “Coefficient of the lost capacity for work (d)” means the amount expressed in unit parts, calculated by dividing the incapacity for work percentage by 100.
5. “Workstation/place of employment” (hereinafter: a ‘workstation’) means a place where the worker performs or must perform the work agreed under employment contract or performs the function of public administration.
6. “Insurer” means an employer as established in the Labour Code of the Republic of Lithuania, as well as a state or municipal institution or agency and undertaking (hereinafter – undertaking) which pay or must pay state social insurance contributions to the social insurance of occupational accidents.
7. “Compensation Coefficient (k) in the event of a chronic occupational disease” is calculated according to the formula k = (K1· S1 + K2·S2)/(S1+S2), when:
1) K1 and K2 are the coefficients of person’s insured income, applied appropriately for the period until the year 1994 and from the year 1994, calculated in accordance with the procedure laid down by the Republic of Lithuania Law on State Social Insurance Pensions (hereinafter: ‘State Social Insurance Pensions’);
2) S1 is the number of years of the pension insurance record according to which the coefficient K1 is calculated;
3) S2 is the number of years of the pension insurance record, which are counted from the year 1994 and in accordance with the procedure laid down by the Law on State Social Insurance Pensions, in order to calculate work incapacity (disability) or an additional part of the state social insurance for old-age pension.
8. “Compensation coefficient (k) in the event of an accident at work (service), an accident on the way to/from work (service) or an acute occupational disease” is the ratio of individual’s average monthly insured income during the last twelve consecutive months counting backwards from the end of the last but one calendar month before the month in which an accident at work, an accident on the way to/from work or an acute occupational disease was established, to the insured income of the current year in effect at the time of establishing an accident at work, an accident on the way to/from work or occupational disease. This coefficient shall also apply while calculating a periodic compensation for lost capacity for work, when a person to whom a chronic occupational disease is established, is not entitled to incapacity (disability) or old-age pension under the Law on State Social Insurance Pensions.
9. “Limits of the compensation coefficient (k)” applies for calculating benefits fixed by this Law, which are not being less than 0.25 or in excess of 3.
10. “Accident at work/act of service” (hereinafter: ‘occupational accident’) means an event at work/act of service, including traffic accidents, when performing occupational functions or staying in the workstation (during additional, special breaks, or rest or meal breaks when an employee is in the workstation, or the premises of the undertaking), entailing the damage to worker’s health and lost capacity for work at least for one day or resulting in worker’s death, and investigated in accordance with the established procedure and deemed to be an occupational accident. An event pertaining to the performance of the official duties of an official in the course of which the official is exposed to a risk factor (chemical, physics-related, biological, physical or ergonomic) or several factors resulting in the official’s death or damage to his health shall also be deemed to be an occupational accident.
11. “Accident on the way to/from work/place of employment” (hereinafter: an ‘accident on the way to/from work’) means an event, including a traffic accident, on the way to/from work/place of employment which takes place on employee’s working days on the way between an employee’s workplace and:
3) the place outside the workplace, where the employee may be during his rest period or has his meals;
12. “The injured” means the insured person whose health is harmed by reason of an occupational accident, an accident on the way to/from work which are deemed an insured event, or due to an established occupational disease which is deemed an insured event.
13. “Occupational disease” means an acute or chronic health disorder of the employee caused by one or more hazardous and/or dangerous factors in the working environment, deemed an occupational disease in accordance with the established procedure.
Article 4. Persons Covered by Social Insurance of Occupational Accidents
Coverage by social insurance of occupational accidents shall be mandatory to persons referred to in Article 4(1)–(4) and Article 6(4), (5), (8), (9), (10) of the Law on State Social Insurance of Republic of Lithuania (hereinafter: ‘Law on State Social Insurance’).
Article 5. Insurers
The insurers of the persons referred to in Article 4 of the present Law shall be:
5) the undertakings or establishments in which pupils, students or persons sent for training or rehabilitation by the labour exchange are engaged in professional internship;
6) training institutions for penitentiary personnel providing training for persons under vocational training programmes (cadets), vocational training institutions for interior matters providing training or an initial training course for persons who signed a contract for joining the internal service or serving in the military (cadets), military training institutions providing training for persons who are in the military service (military students);
7) the undertakings, establishments, organizations or other organizational structures in which persons engage in voluntary internship in accordance with the Law on Employment of the Republic of Lithuania;
Article 6. Insured events
1. The insured events shall be occupational accidents suffered by or occupational diseases diagnosed to the persons covered by social insurance of occupational accidents referred to in Article 4(1)–(4) of the Law on State Social Insurance, where the investigation reveals that at the time of the occurrence they satisfied all of the following conditions:
1) occurred during work at the working hours set by the insurer, including the working time set by an express instruction from the Insurer, as well as during work while in business trips;
2) occurred while doing the work agreed in an employment contract (including preparation and clearing-up of a workstation), as well as while performing other tasks for the insurer’s benefit assigned by the insurer and related to the insurer’s business or while implementing public administration functions;
2. The insured events shall include the occupational accidents suffered by or occupational diseases diagnosed to the insured persons referred to in Article 6 (4), (5), (8), (9) and (10) of the Law on State Social Insurance (except for the persons studying at the educational institutions providing training to correction officers (cadets) under the vocational training programmes, the persons who had signed contracts on joining the internal service and are studying at the vocational training institutions of the internal affairs sector or are attending introductory training courses of such institutions (cadets), the persons who perform their military service studying at the military training institutions (military students)), where the investigation reveals that at the time of the occurrence they satisfied all of the following conditions:
1) occurred during work at the working hours set by the insurer, including the working time set by an express instruction from the insurer, as well as during work while in business trips;
2) occurred while doing work assigned by the insurer (including preparation and clearing-up of a workstation);
3) occurred while doing work for a salary from which the contributions of the social insurance of occupational accidents are or must be paid or where the contributions of the social insurance of occupational accidents are paid by the managers of appropriations from the state budget listed in the Republic of Lithuania Law on the Budget Structure.
3. The insured events shall also include the events pertaining to the performance of the official duties by an official in the course of which the official is exposed to a risk factor (chemical, physics-related, biological, physical or ergonomic) or several factors resulting in the official’s death or damage to his health. The insured events shall also include the occupational accidents suffered by or occupational diseases diagnosed to the insured persons studying at the educational institutions providing training to the correction officers (cadets) under the vocational training programmes, the persons who had signed contracts on joining the internal service and are studying at the vocational training institutions of the internal affairs sector or are attending introductory training courses of such institutions (cadets) and the persons who perform their military service studying at the military training institutions (military students) during the period of their studies or training.
4. The insured events shall include the diagnosed chronic occupational diseases, where it is established that at the time of entry into force of the present Law, the affected persons were covered by the social insurance of occupational accidents in the same manner as the persons referred to in Article 4 of the present Law.
5. The insured events shall also include the accidents suffered by the insured persons referred to in Article 4 of the present Law, where the investigation reveals that they have occurred:
1) during additional or special breaks or during rest or meal breaks, when the employee was at the workstation, in the premises or in the territory of the company;
3) to an employee seeking a new job during the period of notice on the termination of the employment contract;
6. With regard to the persons working under the remote work contracts, the insured events shall include only such occupational accidents and acute occupational diseases which resulted from or were caused by the materials or work equipment provided by the employer or by the production process while working for the employer’s benefit.
7. The decisions concerning the recognition of the accidents at work, the accidents on the way to/from work and the occupational diseases as the insured events, as justified by the investigation documents and the documents supporting the causes of the accidents at work, the accidents on the way to/from work and the occupational diseases, as well as the decisions regarding the granting and paying the benefits to the affected persons shall be adopted by the regional branch and the branch of military and other similar structures of the State Social Insurance Fund Board in accordance with the present Law and the Regulations regarding Benefits of the Social Insurance of Accidents at Work and Occupational Diseases approved by the Government and other legal acts.
Article 7. Non-insured Events
1. Occupational accidents, accidents on the way to/from work or established occupational diseases shall not be recognised as insured events if upon their investigation it is established that they do not meet the conditions laid down in Article 6 of this Law.
2. Occupational accidents, accidents on the way to/from work or established acute occupational diseases shall not be recognised as insured events even if upon their investigation it is established that they meet the conditions laid down in Article 6 of this Law, but their occurrence satisfies at least one of the following conditions:
1) the insured person was injured through his activities which, as has been established by a pre-trail investigation institution or the court, contained the evidences of criminal act or these activities are related to administrative offences, with the exception of violations of the regulations concerning labour protection or occupational hygiene;
4) the insured person wilfully (without employer’s knowledge) performed work not for employer’s benefit (not in the employer’s interests);
3. When after the investigation of the occupational accidents or acute occupational diseases it is established that the occupational accident happened or the acute occupational disease manifested itself in the adequate, safe, harmless-to-health working conditions and were determined by the insured person’s insobriety (inebriation) or his intoxication with psychotropic substances, such occupation accidents or acute occupational diseases shall not be recognised as insured events. Accidents on the way to/from work shall not be recognised as insured events, if the insured person was drunk or intoxicated with psychotropic substances. The provisions of this paragraph shall not apply if the insured person’s insobriety (inebriation) or his intoxication with psychotropic substances was related to the technological peculiarities of the work assigned by the insurer.
Article 8. The Obligations and Liability of the Insurers
1. The insurers must:
1) ensure that the companies comply with the requirements of the legal acts concerning the occupational safety and health;
2) ensure the medical first aid for the person affected by an occupational accident or an acute occupational disease as well as the transportation of the affected person to a health care institution, if needed;
3) notify the occupational accident, the accident on the way to/from work and the acute occupational disease to the institutions specified in the Republic of Lithuania Law on Safety and Health at Work, and the regional branch of the State Social Insurance Fund Board or the branch of military structures and other similar structures of the State Social Insurance Fund Board;
4) organise investigation of the occupational accidents, the accidents on the way to/from work and participate in the investigation of the occupational diseases in accordance with the procedure laid down by laws or by the Government;
2. If, following an investigation, an occupational accident, an accident on the way to/from work or an occupational disease is not recognised the insured event, the damage to the injured person or the person who got ill with an occupational disease and/or his family members shall be compensated in accordance with the procedure laid down by the Civil Code of the Republic of Lithuania (hereinafter: ‘the Civil Code’).
Article 9. The Rights of the Insured Persons
1. The insured persons, whose health, due to an occupational accident, an accident on the way to/from work or contracting an occupational disease, has suffered damage as a result of an insured event, recognised as such under Article 6, shall be entitled to insurance benefits stipulated in this Law.
2. The insured persons shall have the right to obtain the information from the insurer about the payment of the state social insurance contributions for them, while following an insured event the insured persons and their family members shall have the right to obtain the information from the State Social Insurance Fund Board, its regional branches and the branch of military and other similar structures about the application of the guarantees laid down by the present Law.
Article 10. Duties of Insured Persons
Insured persons must adhere to requirements laid down by the legal acts concerning health and safety at work, and the persons who have got injured as a result of an occupational accident, an accident on the way to/from work, or an occupational disease, must immediately approach a healthcare institution and follow doctor’s recommendations.
Article 11. Benefits of the Social Insurance of Occupational Accidents
1. The benefits provided for in this Article shall fully or partially compensate the loss of income resulting from an insured event to the insured persons or, in the event of death of the latter, to the members of their families.
2. An insured person who, as a result of an event recognised the insured event as set in Article 6 of the present Law, has fully or partially lost the capacity for work shall under the present Law receive the following benefits from the funds earmarked in the budget of the State Social Insurance Fund for the social insurance of occupational accidents:
1) a benefit for illness resulting from an accident at work, an accident on the way to/from work or an occupational disease (hereinafter: ‘the sickness benefit’);
3. If an insured person dies as a result of an insured event, the lump-sum benefit shall be paid to each member of his family as set in Article 27 of this Law.
4. If an insured person dies as a result of an insured event, the periodic insurance benefit shall be paid in equal parts to his family members as set in Article 26 of this Law.
5. As regards the persons convicted with imprisonment, the benefits specified in Subparagraphs 2 and 3 of Paragraph 2 of this Article shall be granted and paid after such persons are released from the penal institutions.
Article 12. The Sickness benefit
1. The sickness benefit shall be granted to the persons referred to in Article 4(1)–(4) and Article 6(4), (5), (10) of the Law on State Social Insurance who temporarily lose their capacity for work as a result of an accident at work, an accident on the way to/from work or an occupational disease recognised the insured events.
2. The sickness benefit shall be granted provided that the entitlement thereto arose during the insurance period.
3. The granting of the sickness benefit shall be based on the certificate on the incapacity for work issued in accordance with the rules approved by the Minister of Health and the Minister of Social Security and Labour on Rules for Issuing Electronic Certificates of Incapacity and Electronic Pregnancy and Childbirth Certificates, as well as on the supporting documents of the insured event.
Article 13. The Compensatory Wage Used for the Calculation of the Sickness Benefits
1. The compensatory wage used for the sickness benefits shall be calculated in accordance with the Regulations Regarding the Benefits of the Social Insurance of Accidents at Work and Occupational Diseases on the basis of the insured income of the insured person during three consecutive calendar months preceding the calendar month before the month in which the temporary incapacity for work was established.
2. A monthly compensatory wage used for the calculation of the sickness benefits shall not exceed the amount equal to two country’s average monthly wage of the quarter preceding the last quarter.
Article 14. The duration of the Payment of the Sickness Benefit
1. The sickness benefit shall be paid for the whole period confirmed in a certificate of incapacity for work, issued in accordance with the Rules Regarding Issuing Electronic Certificates of Incapacity and Electronic Pregnancy and Childbirth Certificates, from the first day of the temporary incapacity for work until the day the capacity for work is recovered or a level of the capacity for work is established, including the period of medical treatment in a healthcare institution providing services of orthopaedics and/or prosthesis. Where the Disability and Working Capacity Assessment Office identifies the need for vocational rehabilitation services, the sickness benefit shall be paid until the first day of participation in the vocational rehabilitation programme.
2. Where the insured person becomes temporarily incapable for work because of the aggravation of an occupational disease or the consequences suffered from an accident at work or an accident on the way to/from work while on annual vacation, the sickness benefit shall be paid for all the days of the temporary incapacity as confirmed in a certificate of incapacity for work.
3. Where the insured person becomes temporarily incapable for work because of the aggravation of an occupational disease or the consequences suffered from an accident at work or an accident on the way to/from work while on unpaid vacation or after an employee has been removed from work, the benefit shall be paid from the day on which the employee must have returned to work after his vacation or after the expiration of the removal.
Article 15. The Amount of the Sickness Benefits
1. The insured person who has become temporarily incapable for work as a result of an event recognised to be the insured event in accordance with Article 6 of the present Law shall receive a sickness benefit in the amount of 100 per cent of the compensatory wage used for the calculation of the sickness benefits. The benefit shall be paid for the period of work based on the person’s working timetable (shifts) at the place of the employment where the occupational accident has occurred or where the occupational disease has been diagnosed.
2. If the investigation of an occupational accident is not completed within 30 days from the date of application to the regional branch of the State Social Insurance Fund Board or the branch of a military or other similar structure, the sickness benefit shall be paid in accordance with the Law on Sickness and Maternity Social Insurance starting with the third day of the temporary incapacity for work. Where the sickness benefit paid out in accordance with the Law on Sickness and Maternity Social Insurance exceeds the sickness benefit payable as a result of an occupational disease and calculated in accordance with the present Law, the disbursed amount shall not be recalculated.
Article 16. Sources of Payment of Sickness Benefits
Having suffered an occupational injury, being injured on the way to/from work or having contracted an occupational disease, sickness benefits shall be paid from the first day of temporary incapacity for work from the funds allocated to social insurance of occupational accidents from the budget of the State Social Insurance Fund.
Article 17. The Conditions Excluding the Payment of the Sickness Benefit
Where during the period of the incapacity for work the persons who are temporarily incapable for work as a result of an insured event violate the rules of conduct established in the Rules for Issuing Electronic Certificates of Incapacity and Electronic Pregnancy and Childbirth Certificates, the regional branch or the office of a military or other similar structure of the State Social Insurance Fund Board shall decide to grant no sickness benefit or to suspend the payment thereof from the date of the violation in accordance with the Regulations on Benefits of Social insurance of Accidents at Work and Occupational Diseases.
Article 18. Posthumous Payment of Benefits to the Person Entitled to Such
Benefits which have not been received prior to the day of death of the person entitled to such shall be paid to the persons to whom the estate of the deceased devolves under the order of succession, and who submit the certificate of the right of inheritance.
Article 19. Lump-sum Compensation for Lost Capacity for Work
1. If the injured has temporarily lost up to 20 per cent of capacity for work due to an insured event, he shall be paid a lump-sum compensation for lost capacity for work, amounting to 10 per cent of his 24-month compensatory salary applied for the calculation of lump-sum compensation.
2. If the injured has temporarily lost over 20 per cent of capacity for work, but less than 30 per cent of capacity for work due to an insured event, he shall be paid a lump-sum compensation for lost capacity for work, amounting to 20 per cent of his 24-month compensatory salary applied for the calculation of lump-sum compensation.
3. If unlimited incapacity for work is established for the injured, as referred to in paragraphs 1 and 2 of this Article, a lump-sum compensation for lost capacity for work shall be three times larger than that indicated in paragraph 1 or 2 of this Article respectively.
4. A monthly compensatory wage for a lump-sum compensation shall be calculated in accordance with the procedure laid down in the Regulations of the Benefits of the Social Insurance of Accidents at Work and Occupational Diseases, according to the injured insured income during twelve consecutive calendar months before the calendar month preceding the month in which an accident at work, an accident on the way to/from work or an occupational disease was established.
5. A monthly compensatory salary used for the calculation of a lump-sum compensation shall not be smaller than 15% of the country’s average monthly wage of the quarter preceding the last quarter and shall not exceed the amount equivalent to two country’s average monthly wages calculated in the month in which the accident at work, the accident on the way to/from work occurred or the acute occupational disease was diagnosed.
6. If the lost capacity for work of the injured person, to whom the lump-sum compensation for the lost capacity for work has already been paid, changes and does not exceed the values set in this Article and where a newly calculated lump-sum compensation exceed the received one, the difference between the newly calculated compensation and the already paid compensation shall be paid.
7. The lump-sum compensation for the lost capacity for work shall be granted after the expiration of the time limit for the appealing against the decision of the Disability and Work Capacity Assessment Office in accordance with the Regulations of the Benefits of the Social Insurance of Accidents at Work and Occupational Diseases.
Article 20. The Periodic Compensation for the Lost Capacity for Work
1. Where it is determined that the injured person has lost from 30 to 45 percent of the capacity for work as a result of an insured event, such person shall receive a periodic compensation for the lost capacity for work. A person who has lost 45 percent or more of the capacity for work as a result of an insured event, shall receive the periodic compensation for the lost capacity for work provided that:
1) the recipient is not entitled to an equivalent or a larger social insurance work incapacity (disability) pension as a result of the same insured event;
2) the recipient receives social insurance work incapacity (disability) pension for the lost capacity for work as a result of the same insured event which is smaller than the calculated periodic compensation for the lost capacity for work. In the latter case, the recipient shall receive a periodic compensation for the lost capacity for work which shall be calculated as the difference between the benefits referred to in this Paragraph.
2. The periodic compensation for the lost capacity for work shall be paid to the affected person on a monthly basis for the previous month. It shall be calculated as half of the product of the coefficient of the lost the capacity for work (d) (Article 3(4) of the present Law), the compensation coefficient (k) (Article 3(7), (8), (9) of the present Law) and country’s average monthly wage of the quarter preceding the last quarter calculated in the month of the payment (D), i.e., according to the formula 0.5 x d x k x D.
Article 21. Payment of Compensations Following a Change in the Incapacity for Work of an Insured Person
1. Should the Disability and Work Capacity Assessment Office establish anew, that the injured who was entitled to a lump-sum compensation for lost capacity for work, has lost 30 or more per cent of capacity for work, the periodic compensations for lost capacity for work shall be paid in accordance with the procedure established in Article 20 of this Law from the day of change in the lost capacity for work.
2. Should the Disability and Work Capacity Assessment Office establish anew that the injured who was entitled to periodic compensations for lost capacity for work (Article 20 of this Law), has lost less than 30 per cent of capacity for work, he shall be paid a lump-sum compensation for lost capacity for work (Article 19 of this Law), while the payment of periodic compensations for lost capacity for work shall be terminated from the day of change in the lost capacity for work.
3. Should the incapacity for work of the injured who is receiving a periodic compensation for lost capacity for work, repeatedly diminish to the levels set out in Article 19 of this Law, a lump-sum compensation for lost capacity for work for the same accident at work, the same accident on the way to/from work or the same occupational disease, shall be paid in accordance with the procedure laid down in paragraph 6 of Article 19 of this Law.
4. Should the lost capacity for work of the injured who received periodic and lump-sum compensations for lost capacity for work (or the difference of the lump-sum compensation), has repeatedly increased up to 30 or more per cent before the end of a 24-month period from the day of the arising of the right to a lump-sum compensation, the part of the lump-sum compensation for lost capacity for work (or its difference) for the remaining part of the 24-month period shall, in accordance with the procedure laid down by the Regulations of the Benefits of the Social Insurance of Accidents at Work and Occupational Diseases, be deducted from the sum of the calculated compensation for lost capacity for work.
Article 22. Duration of Payment of Periodic Compensations for Lost Capacity for Work
Periodic compensations for lost capacity for work shall be paid up to the end of the period of lost capacity for work established by the Disability and Work Capacity Assessment Office.
Article 23. The Reduction in the Amount of the Insurance Benefit
The regional branch of the State Social Insurance Fund Board or the branch of a military or other similar structure of the State Social Insurance Fund Board shall correspondingly reduce the benefits payable to the person affected by an accident at work, an accident on the way to/from work or a diagnosed occupational disease where the Disability or Work Capacity Assessment Office re-determines that the lost capacity for work of the insured person has decreased. If the lost capacity for work as a result of an insured event has been determined by a judicial decision, the insurance benefit in the cases referred to in this Article may be correspondingly reduced only by a judicial decision.
Article 24. Increase in the Amount of an Insurance Benefit
A regional branch of the State Social Insurance Fund Board shall appropriately increase the amount of a benefit for an insured person who has lost capacity for work as a result of an accident at work, an accident on the way to/from work or contracting of occupational diseases, if the Disability and Work Capacity Assessment Office determines anew that the lost capacity for work of the insured person has increased.
Article 25. The Terms for Granting and Paying the Insurance Benefits
1. The sickness benefit shall be granted from the day of establishment of a temporary incapacity for work provided that the affected person claims it within 3 years from the end of a temporary incapacity for work.
2. The lump-sum compensation for the lost capacity for work shall be granted provided that the affected person claims it within 3 years from the day on which the Disability and Work Capacity Assessment Office establishes the incapacity for work.
3. The periodic compensation for the lost capacity for work shall be granted from the day on which the Disability and Work Capacity Assessment Office establishes incapacity for work provided that the affected person claims it within 3 years from the day on which the right to such benefit arose. Where the insured person applies for a periodic compensation for the lost capacity for work after the three years have elapsed, the benefit for the past time shall be paid for the 12 months preceding the day of the claim.
4. Upon the death of the insured person, the periodic insurance benefit shall be paid to the person entitled to such benefit from the day on which the right to such benefit arose provided that the benefit is claimed within 3 years from the day on which the right thereto arose. Should, upon the death of the insured person, the person entitled to the periodic insurance benefit claims it after the 3 years from the day on which the right to such benefit arose have lapsed, the benefit for the past period shall be paid for the 12 months preceding the date of the claim provided that the benefit has not been granted to any of the persons referred to in Article 26(1). Should, upon the death of the insured person, the person entitled to the periodic insurance benefit claims such benefit after it has been granted to other persons entitled to it, the periodic insurance benefit shall be re-calculated and paid to all the recipients from the first day of the month following the month in which the last claim was received.
5. Upon the death of the insured person, the lump-sum insurance benefit shall be granted to the person (-s) entitled to that benefit on the basis of his (their) claim (-s) regarding the lump-sum insurance benefit to be submitted not later than within three months from the date of recognition of the accident at work, the accident on the way to/from work or the acute occupational disease the insured event. Where, upon the death of the insured person, the lump-sum insurance benefit is claimed in favour of the insured person’s child (children) born after the recognition of the accident at work, the accident on the way to/from work or the acute occupational disease the insured event, the claim must be submitted not later than within three months from the birth of the child (children).
Article 26. Periodic Insurance Benefit Upon the Death of an Insured Person
1. If an insured person die as a result of an accident at work, an accident on the way to/from work, or an occupational disease, which have been recognised as insured events, the right to periodic insurance benefit shall belong to the persons with incapacity for work, who had been maintained by the deceased or, on the day of his death, had the right to be maintained by him, also the child (children) of the deceased, born not later than 300 days after his death. The right to periodic insurance benefits shall also belong to the children (adopted children) of the deceased, who had been maintained by the deceased or have acquired the right to be maintained by him after his death. The insurance benefit shall be paid to:
1) to children (adopted children) – until they reach the age of 18 years; also, if they are pupils studying according to the general education curriculum or the formal vocational training programme at educational establishments registered in the prescribed manner as well as if they are students studying according to the full-time study programme or the study programme of a continual form at educational establishments registered in the prescribed manner, until the end of studying or completion of studies according to these programmes, but not longer than until they reach the age of 24 years;
2) the spouse of the deceased or his father (mother), adoptive father (adoptive mother), regardless of their age and capacity for work, if he (she) does not work and is caring for the children (adopted children), grandchildren, brothers or sisters of the deceased, until these reach 8 years of age;
3) the deceased’s spouse who has reached the old-age retirement age fixed by the Law on State Social Insurance Pensions, for the rest of their life;
4) the spouse of the deceased who is recognised as incapable or partially capable of work (prior to 1 July 2005 – invalid), and the children (adopted children) above the age of 18 years who had been recognised as disabled (prior to 1 July 2005 – invalids) before they reached the age of 18, as long as they are incapable or partially capable of work (invalids);
5) other persons who are recognised as incapable or partially capable of work (prior to 1 July 2005 – invalids), or the persons who have reached the old-age retirement age and who were maintained by the deceased, or were entitled to his maintenance on the day of his death. The fact of maintenance of such persons or the right to maintenance shall be proved in the judicial procedure, and the fact of their incapacity for work shall be established by the Disability and Work Capacity Assessment Office or by the judicial procedure.
2. An periodic insurance benefit, equivalent to the periodic compensation for lost capacity for work (Article 20 of this Law), divided by the number of the persons set out in paragraph 1 of this Article increased by one person, shall be paid monthly to the persons specified in paragraph 1 of this Article.
3. The benefit referred to this Article shall be paid irrespective of any other income of the recipients, unless a recipient receives the widows social insurance pension or the orphans social insurance pension as a result of the same insured event:
1) if the recipient of the benefit is entitled to an identical or a larger widows social insurance pension or the orphans social insurance pension as a result of the same insured event, no periodic insurance benefit upon the death of the insured person shall be paid to that recipient;
2) if the widows state social insurance pension or the orphans state social insurance pension paid to the recipient as a result of the same insured event is smaller than the calculated periodic insurance benefit payable upon the death of the insured person, the recipient shall receive the periodic social insurance benefit payable upon the death of the insured person which shall be calculated as the difference between the amounts referred to in this Paragraph.
Article 27. The Lump-sum Insurance Benefit Upon the Death of the Insured Person
1. Where the insured person dies as a result of an accident at work, an accident on the way to/from work or an acute occupational disease recognised the insured event, the family of the deceased shall receive a lump-sum insurance benefit equal to 60 country’s average monthly wages of the quarter preceding the last quarter before the death caused by the accident at work, the accident on the way to/from work or the acute occupational disease. The benefit shall be disbursed in equal parts to each member of the family of the deceased.
2. The family members of the deceased shall be: the spouse; the minor children (adopted children) until they reach 18 years of age as well as the children (adopted children) who are pupils under a comprehensive education programme or a formal vocational training programme or students of a full-time study programme at the duly registered educational establishments – until completing the training or the studies under these programmes, but no longer than until they reach 24 years of age; the children (adopted children) of the deceased older than 18 years of age provided that they had been recognised as disabled (prior to 1 July 2005 – invalids) before reaching the age of 18 years; children of the deceased born after his death; father (adoptive father) and mother (adoptive mother).
Article 28. The funds of the Social Insurance of Occupational Accidents
1. The funds earmarked for the social insurance of occupational accidents shall be allocated into the budget of the State Social Insurance Fund in accordance with the procedure set in laws.
2. The revenues of the social insurance of occupational accidents shall consist of the state social insurance contributions paid for this type of insurance by the insurers in their capacity as the managers of the state budgetary appropriations, the late payment interest, the penalties and the money received by way of recourse from the guilty persons or their insurance companies. The funds of the social insurance of occupational accidents may also include the funds designated from the State Social Insurance Reserve Fund.If during the current year the funds from the State Social Insurance Reserve Fund are used for this type of insurance, then the rate of the state social insurance contribution with regard to this type of insurance shall be increased next year by the amount needed to recover the funds used from the State Social Insurance Reserve Fund.
Article 29. The Rates of Contributions of the Social Insurance of Occupational Accidents
1. The rates of contributions of the social insurance of occupational accidents shall depend on:
1) the violations of safety and health at work legislation determined by the State Labour Inspectorate under the Ministry of Social Security and Labour (hereinafter: ‘State Labour Inspectorate’);
2) the severity of the occupational accidents and the number of the persons injured during such accidents;
3) the number of the persons that have suffered from the acute occupational diseases in that undertaking;
2. The indicators referred to in Subparagraphs 1 and 4 of Paragraph 1 of this Article shall be provided to the State Social Insurance Fund Board by the State Labour Inspectorate in accordance with the procedure laid down by the Government or its authorised body. The indicators referred to in Subparagraphs 2 and 3 of Paragraph 1 of this Article shall be assessed on the basis of the data from the Register of the Republic of Lithuania of the persons covered by the state social insurance and the beneficiaries of the state social insurance benefits.
3. The general national rate of the contributions of the social insurance of occupational accidents, the number of the groups of contribution rates of such insurance and the rates of these groups shall be approved on an annual basis in Law of the Republic of Lithuania on the Approval of Budget Indicators of the State Social Insurance Fund for the Respective Year. The State Social Insurance Fund Board shall, in accordance with the methodology approved by the Government or its authorised body and the indicators referred to in Paragraph 1 of this Article, assess on an annual basis the values of the indicators defining the status of the safety and health at work of the insurers’ employees and shall attribute the insurers to the relevant groups of contribution rates of the social insurance of occupational accidents. The attribution of the insurers to the groups of the contribution rates of the social insurance of occupational accidents shall be approved by the State Social Insurance Fund Council.
Article 30. The Procedure for Paying the State Social Insurance Contributions
The procedure for paying the contributions of the state social insurance of occupational accidents shall be governed by the Law on State Social Insurance.
Article 31. The Recovery of Funds from the Guilty Persons
Where the investigation of an accident at work or an accident on the way to/from work reveals that such accident has occurred due to a third party’s fault, the regional branch of the State Social Insurance Fund Board or the branch of a military or other similar structure of the State Social Insurance Fund Board shall, by the right of recourse, recover the paid benefits from the guilty person in accordance with the procedure laid down in the Civil Code. The amounts of the benefits included into the damage compensation paid under the Law of the Republic of Lithuania on Compulsory Insurance of Civil Liability in Respect of the Use of Motor Vehicles shall be reimbursed to the budget of the State Social Insurance Fund by the insurance companies.
Article 32. Implementation of the Social Insurance of Occupational Accidents
The social insurance of occupational accidents shall be implemented by the State Social Insurance Fund Board, the regional branch of the State Social Insurance Fund Board and the branch of military or other similar structures of the State Social Insurance Fund Board.
Article 33. Dispute Settlement
Any disputes regarding the application of the present Law shall be settled by the procedure established by law.”
Article 2. Entry Into Force
2. The wording of Article 3(7) of the Republic of Lithuania Law on Social Insurance of Accidents at Work and Occupational Diseases set forth in Article 1 of the present Law shall be valid until 31 December 2017.
“7. Compensation coefficient (k) in the event of a chronic occupational disease – the average of the pension points calculated in accordance with the Republic of Lithuania Law on State Social Insurance Pensions during the total counted insurance period (number of years) of the specific person”.
4. The provisions of the present law shall be applied to the newly granted social insurance benefits provided that the insured event occurred after coming into force of the present Law. Where the insured event occurred before the entry into force of the present Law, the benefits shall be calculated and paid under the procedure applied before the entry into force of the present Law, except for the cases specified in Paragraphs 5, 6 and 7 of this Article.
5. Where before the entry into force of the present Law the person was only entitled to a periodic compensation for the lost capacity for work or only entitled to a periodic insurance benefit upon the death of the insured person, such benefits shall be recalculated in accordance with the present Law.
6. Where the periodic compensation for the lost capacity for work payable to a person entitled to such compensation under the present Law would be smaller than the amount equal to the sum of the periodic compensation for the lost capacity for work and social insurance work incapacity (disability) pension payable before the entry into force of the present Law, the benefit payable to such person shall be equal to the sum of the periodic compensation for the lost capacity for work and the social insurance work incapacity (disability) pension paid in December 2016. The above benefit shall not be increased along with the changes in the country’s average monthly wage of the quarter preceding the last quarter or in other cases as long as the periodic compensation for the lost capacity for work payable under the present Law does not exceed the amount equal to the sum of the periodic compensation for the lost capacity for work and the social insurance work incapacity (disability) pension paid in December 2016.
7. Where the periodic insurance benefit upon the death of the insured person payable to the person entitled to such benefit under the present Law would be a smaller than the amount equal to the sum of the periodic insurance benefit upon the death of the insured person and widows and orphans social insurance pension payable before the entry into force of the present Law, the benefit payable to such person shall be equal to the sum of the periodic insurance benefit payable upon the death of the insured person and the widows and orphans social insurance pension paid in December 2016. The above benefit shall not be increased along with the changes in the country’s average monthly salary of the quarter preceding the last quarter or in other cases as long as the periodic insurance benefit upon the death of an insured persons under the present Law does not exceed the sum of the periodic insurance benefit upon the death of the insured person and widows and orphans social insurance pension paid in December 2016.
