Amends Law Nº 16.744, On Social Insurance Against Risks Of Industrial Accidents And Occupational Diseases


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"Sole article.-Introducense the following modifications in the law N ° 16.744: 1." Repeal of the fourth paragraph of article 77, becoming the fifth, fourth paragraph.
2. merge, then 77, following article 77 bis, new article: "article 77 bis.-the worker affected by the rejection of a licence or of a medical rest by agencies of the health services, the health institutions pension or mutual organizations of employers, based in which the claimed condition has or does not have professional origin" , as the case may be, shall attend before the Agency's pension scheme to which it is affiliated, non-which rejected the license or medical rest, which will be required to study it immediately and to give cash or medical benefits that apply, without prejudice to subsequent claims and reimbursement, if they are applicable, which set out in this article.
In the situation referred to in the preceding paragraph, any person or entity interested may apply directly in the Superintendent of Social security by the rejection of the license or the nursing home doctor, having this resolve, with exclusive competence and without further recourse, on the nature of the condition that gave rise to it, in the period of thirty days from the receipt of the records required or from the date on which the worker concerned is any subjected to tests that have that body, if they are later.
If the Superintendent of Social security that benefits had given charge to a pension scheme other than that which is provided, the health service, the Institute for social security standardization, the employers mutual, allocation family box of compensation or pension health institution, as appropriate, shall reimburse the value of those administrator authority the entity that resolved them and the latter carry out the respective requirement. This refund should include the part that should finance the worker in accordance the regime of health insurance scheme to which it is affiliated.
The value of benefits that, in accordance with the preceding subparagraph, appropriate reimbursement, will be expressed in u.f., depending on the value of these at the time of granting, with more current interest for readjustable operations referred to in law No. 18.010, from that time until the date of the respective repayment requirement, having to pay within the period of ten days from the requirement, according to the value of that unit at the time of the cash payment. If such payment is made after the expiration of that time limit, the sums due shall bear 10% annual interest, to be applied daily for the designated order for payment.
In the event that benefits have been granted in accordance with health regimens for common diseases, and the Superintendent of Social Security decides that the condition is of occupational origin, the national health fund, the health service or the welfare health institution which provided them you must return to the worker the part of the reimbursement of the value of the benefits that this has been resolved According to the scheme of health insurance scheme that is affiliated with the readjustments and respective interests. The deadline for payment will be ten days, since the refund was made.
If, on the contrary, the condition is described as common and benefits have been granted as if its origin were professional, the health service or the welfare health institution that made the refund must collect to your affiliate part of the value of the benefits that this is solved, according to the regime of health concerned , for which we only consider the value of those.
For the purposes of refunds provided in the preceding paragraphs, shall be regarded as value of medical benefits equivalent to the entity that gave them charge for them to provide them to individuals. ".".