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Compulsory Social Insurance Against Accidents At Work And Occupational Disease Claims And Calculation Procedure

Original Language Title: Obligātās sociālās apdrošināšanas pret nelaimes gadījumiem darbā un arodslimībām apdrošināšanas atlīdzības piešķiršanas un aprēķināšanas kārtība

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The Cabinet of Ministers of the Republic of Latvia, 1999 February 16. Regulation No. 50 (in Riga. Nr. 12, § 8) compulsory social insurance against accidents at work and occupational disease claims and calculation order Issued in accordance with the law "on compulsory social insurance against accidents at work and occupational diseases", article 8 and article 12, the second paragraph (I). The general question 1. these provisions lay down the procedures for the granting and calculation of compulsory social insurance against accidents at work and occupational diseases (hereinafter-the accident insurance) insurance claims as well as the order in which the average insurance salaries in order to determine the extent of the claims.
II. the granting of claims 2. State social insurance agency (hereinafter Agency) branch by the socially insured persons (hereinafter insured person) appearance of the residence, the question of the assignment of the claims based on: 2.1. insured persons or third party's written request to grant claims;
2.2. the Act concerning the work of the accident or the Latvian Academy of Medicine Paula stradiņa hospitals and clinical occupational radiation Medical Center physician advisory opinion of the Commission on occupational diseases found;
2.3. this rule 11.2.,.,. 21.2 14.2 20.2,.,.,., 21.3 21.4 21.5 21.6. or., 24.2. referred to in documents certifying the right to the insurance indemnity.
3. the Agency's branch within 20 days after this provision referred to in paragraph 2 of document receipt, shall decide on the grant of the claims to the insured person or a third person, shall determine the amount of the claims, its duration and payment on the payment date and notify the applicant in writing. If the request to grant claims is rejected, the applicant is issued a written denial with rejection of motivation.
4. If the insured person or third-person habitually resident outside the Republic of Latvia, the provisions referred to in paragraph 2 of document shall be submitted at the Agency's branch in which the employer is established, which is an accident at work or an occupational disease acquired.
5. If the employer does not submit the State revenue service territorial institution report on State social insurance payments from workers working income that rule 27 or 28 points in the period, the branch of the Agency requires that the employer shall provide a certificate of the insured person's working income in that period. The certificate shall be submitted within three days of receipt of the request.
6. the Agency's affiliate is entitled to inspect the documents and messages provided by employers, insured persons and third parties.
7. If the insured person is entitled to compensation for the loss of functional capacity or to a third party-for the survivors, but insurance for fixing the amount of remuneration will take longer than expected, this provision in paragraph 3, the Agency's branch to the applicant is entitled to be paid in advance, which claims not exceeding the amount of the State social security benefit.
8. If the insured person or a third person in accordance with the law "on compulsory social insurance against accidents at work and occupational diseases" receives the insurance indemnity for the loss or the capacity of survivors, pulling out of the Republic of Latvia to permanent life abroad, claims incurred in the future, if the person concerned has submitted to the Agency before departure branch office after the last habitual residence of the request in writing and stated the Republic of Latvia a credit account that should include the insurance indemnity, as well as provide the passport with a mark on the check-out.
9. This provision 8. persons referred to in point of departure from the Republic of Latvia each year up to December 15 to restore (must be submitted or sent via postal mail), a request for reimbursement of the cost of insurance. The request must be accompanied by not more than 1 year in October approved a notarial testament to that insured person is alive (indicating the person's passport data), as well as other agencies required by an insurance case related documents. The notarial certificate must be legalized if international treaties do not provide otherwise.
10. If a request for reimbursement of the cost of insurance is not renewed or is not filed other documents requested by the Agency, a branch of the Agency by January 1 next year, cutting the cost of claims.
III. Sickness benefits 11. the decision on the grant of sickness benefits based on these provisions 11.1 2.1. and 2.2. documents referred to;
11.2. the inability to page B with the employer's confirmation of the absence of the insured person or the foreign equivalent of incapacity issued identity documents, which certify the legislation.
12. the sickness benefit is granted for calendar days, and the amount of the sickness benefit is calculated using the following formula: x Vd x Dn Ps = 0.8, which Ps-disease benefit;
VD-calendar day, the average insurance contributions wage;
DN-disability period, number of days in the calendar, to be reimbursed in accordance with the law "on compulsory social insurance against accidents at work and occupational diseases".
13. If the Agency has submitted the branch page B, but disability insurance cases, supporting documents within ten days have received sickness benefits, the insured person shall be calculated and paid in accordance with the law "On maternity and sickness insurance". After all the insurance case, evidence of receipt of sickness benefit to the insured person a recalculation in accordance with the law "on compulsory social insurance against accidents at work and occupational diseases".
IV. Remuneration for the loss of functional capacity 14. Decision to grant compensation for the loss of functional capacity shall be adopted on the basis of: these terms 2.1 14.1. and 2.2. documents referred to;
14.2. the extract from the health and integrity of the Commission's medical expertise (hereinafter the Commission) on the capacity loss of the Act (in percentage) and a copy of the certificate of disability.
15. Reimbursement of loss of work capacity is calculated using the following formula: A =-Iz-x Vm------, A-100 which the consideration for the loss of functional capacity;
VM-the insured person's average monthly salary insurance contributions;
Iza-consideration for operational losses (in percentage).
16. The consideration for the capacity loss is determined, taking into account the capacity of those losses (in percent) and the compensation for the loss of functional capacity (in percent) according to the table: the loss of functional capacity (as a percentage) the consideration for the loss of functional capacity (in percentages) 100 80 90-99 75-89 70 80 70 60 65 60-79-69 50-59 55 40-49 50-39 45 30 35 15-24 25-29 30 10-14 25 17. Remuneration for the capacity loss is paid to the insured person for the current month of the branch of the agency within a day.
18. Reimbursement of loss of work capacity conversion if: 18.1. in accordance with Commission decision changes the capacity loss assessment (percentage);
18.2. the insured person is granted an old-age pension;
18.3. the documents submitted are found inaccuracies and preventing them, changing rewards for capacity losses;
18.4. the Court ruling, which a changing rewards for capacity losses;
18.5. the Act of the Commission in the statement of operational losses (in percentage) and/or inquiries about disability indicated that the insured person is unable to collect himself and requires constant assistance of another person or monitoring;
18.6. is specified in the insured person's average insurance contribution wage.
V. unrivaled benefits 19. The insured person, the Commission established the capacity loss of 10-25 percent revisions, without repeating the rewards of integrity loss if the insured person agrees to grant the Agency's branch and paid in a lump sum payment, which is calculated for the insured person for 3-18 months average wages of insurance contributions in accordance with the table: capacity loss (percent) number of months 10-12 3-6 15 13 16-18 19-21 10 14 18 20 22-24. the decision on the award of the single allowance shall be adopted based on these provisions 2.1 20.1. and 2.2. documents referred to;
20.2. the extract from the legislation of the Commission for the loss of functional capacity (in percentage).
Vi. Remuneration for survivors 21. The decision to grant compensation for survivors assumes, on the basis of: this provision 2.1.21.1 and 2.2. documents referred to;
21.2. the hospital's statement on the causes of death of the insured person in connection with the accident at work or an occupational disease;
21.3. the death certificate of the insured person (to be presented);
21.4. documents certifying third party relationship or marriage with insured persons,-the birth certificate and/or marriage certificate (to be presented);
21.5. the disability certificate or certificate of disability (to be presented) if the third party is the specific disability;

21.6. the judgment of the Court on the facts of the dependent if, on the basis of these provisions and 21.5 21.4. documents referred to, it is not possible to establish the facts about the complete or partial dependants.
22. If the remuneration for survivors total amount calculated dependant persons, the former exceeds 80% of the insured person's average monthly wage insurance, each person (keeping the ratio of originating between the remuneration for the survivors of the beginning of the calculation) the reduction in remuneration for the survivors, to the total calculated amount does not exceed the law "on compulsory social insurance against accidents at work and occupational diseases" limit.
23. Compensation for survivors of the insured person is paid for the current month of the branch of the agency within a day.
VII. Burial allowance 24. Decision on granting of death benefit based on: this provision 2.1.24.1 and 2.2. documents referred to;
24.2. specific sample certificate of the fact of death registration, issued by the civil registry department or other authority in which the insured person's death.
25. If the insured person died in a foreign country and an applicant does not have a death benefit that rule 24.2. referred inquiries about the fact of death registration, the applicant shall provide the benefits in place Agency branch notarized death certificate (certificate).
26. the burial benefit is calculated using the following formula: = x 2 x Dv, Md which Pa-death grants;
VD-dead socially insured persons calendar days average salary insurance contributions;
DV-the average number of days this provision during the period defined in paragraph 27.
VIII. The average insurance contributions wage calculation 27. the average insurance contributions wage of the insured person suffered an accident at work or an occupational disease for which an established set of insurance contribution salary for the period of six calendar months, the period ending two calendar months before the month in which the accident occurs.
28. If the insured person diagnosed occupational disease for which the insured person was transferred to another, less paid job or job was completely broken, or the insured person this provision during the period defined in paragraph 27 has not made insurance contributions wage due to temporary incapacity for work, the rewards for the uptime for the calculation of the average losses in insurance contributions wage down from insurance salary for six months in a calendar period (after the insured person's and the Agency's choice) in the period that ends at least two calendar months before the month in which the accident occurs.
29. the insurance payroll includes all insurance salary that the insured person or 27 of these rules laid down in paragraph 28 of the period made as a worker if the employer during that period made or should have made social security contributions work accident insurance.
30. to determine the remuneration for the loss of functional capacity, remuneration for the survivors and the lump sum benefits, the average insurance contributions wage is calculated using the following formula: Vm = (A1 + A2 + ... + A6): (B) where Vm-average monthly salary insurance contributions;
A1, A2, ...-insurance contribution salary amount gained this provision in paragraph 27 or 28 in a certain period in the calendar month and from which the employer made or should have made social security contributions work accident insurance;
(B)-the number of months for which this provision in paragraph 27 or 28 on the specified period or had to make social security contributions work accident insurance.
31. in order to determine sickness and funeral benefits, the average insurance contributions wage is calculated using the following formula: Md = (A1 + A2 + ... + A6): D Vd-which calendar days average salary insurance contributions;
A1, A2, ...-insurance contribution salary amount gained 27 of these regulations. period referred to in the relevant calendar month and from which the employer made or should have made social security contributions work accident insurance;
D-number of days in the calendar, for which this provision in paragraph 27 of the prescribed period or had to make social security contributions work accident insurance.
32. If the insured person or the whole of these provisions 27.28. the period defined in paragraph has not been registered as social insurance contributions for work accident insurance or employer social security contributions work accident insurance is not made law, or the insured person has not benefited the insurance contribution wages due to temporary incapacity for work, maternity leave, parental leave or unpaid leave, then : 32.1. to determine the remuneration for the loss of functional capacity, remuneration for the survivors and the lump sum benefits, assuming that the average insurance salaries in the country's minimum monthly salary (base salary) claims the accession;
32. in order to determine sickness and funeral benefits, calendar days average insurance contributions wage is calculated using the following formula: Vd = Vmin x 6: Dk, which Vd-calendar day, the average insurance contributions wage;
Vmin-the State required minimum monthly salary (salary) claims the accession;
DK-this provision in paragraph 27 of the calendar day period.
33. If the employer, after the lodges of the State revenue service territorial institution report on State social insurance payments from workers ' income, employment or even after checking the tax administration law in the order specified by the income of workers and social security payments, the amount of the granted claims adjustment according to the specified employer.
34. Persons in the Republic of Latvia was insured and lost working an accident at work or occupational diseases due to a June 17, 1940, the average monthly wage of the insurance, and the insurance indemnity is equated with national statistics administration calculated the average wage in 1996 for State and municipal enterprises, institutions, organizations and companies with State or local government capital and amounts to 110 dollars.
IX. final question 35. Be declared unenforceable in the Cabinet of 22 April 1997 Regulations No 150 "compulsory social insurance against accidents at work and occupational diseases, and the use of funds procedure" (Latvian journal, 1997, 1998, 235 104;/105.nr../236.nr.).
 
Prime Minister v. krištopans Welfare Minister v. Makarova in the