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Compulsory Social Insurance Against Accidents At Work And Occupational Diseases, And The Use Of Funds In Order

Original Language Title: Obligātās sociālās apdrošināšanas pret nelaimes gadījumiem darbā un arodslimībām līdzekļu veidošanas un izlietošanas kārtība

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The Cabinet of Ministers of the Republic of Latvia in the 1997 regulation April 22. 150 in Riga (No. 22.14. ¤) compulsory social insurance against accidents at work and occupational diseases, and the use of funds of the order Issued in accordance with the law "on compulsory social insurance against accidents at work and occupational diseases ' article 8 i. General questions 1. these provisions define the compulsory social insurance against accidents at work and occupational diseases (hereinafter work accident insurance) and of the use of funds, insurance and cost of collecting payments made as well as the granting of claims, calculation and payment of the order.
2. the accident insurance funds are managed by the national social insurance fund (hereinafter Fund) and district (municipal) social insurance administration (hereinafter insurance administration).
3. employers, government leaders, civiliestāž training and education institutions, enrolled in the insurance sector, in accordance with the law "on compulsory social insurance against accidents at work and occupational diseases" (hereinafter the law) article 3, paragraph 2 shall be considered as policy holders who must take out employees and training and education institutions students and students employed in jobs or training practice (hereinafter pupils and students).
4. Persons who have employment or civil service relations and insurance administration established after the policyholder's legal address, are considered insured persons under article 3 1, point "a".
5. Students and students who are registered in the insurance sector after the policyholder (training or education authority) registered office is regarded as insured persons in accordance with article 3 of the law of "b".
II. features of the insurance building insurance funds 6:6.1. current insurance payments by the policyholder;
6.2. interest of late and the increase of the principal sum;
6.3. recourse procedures of policy holders who paid the amounts recovered from the accident insurance funds insured persons or third parties, if the policyholder is not made the payments insurance law.
7. insurance payment to the policyholder shall be calculated by applying the Cabinet work accident insurance tariff rate for the year following the payment of insurance objects: 7.1 the earned income of the insured person, if the insured person's employment or civil service relations;
7.2. the Cabinet of Ministers set minimum monthly wages (salary), if the insured person is a pupil or student.
III. Claims assignment, calculation and payment of 8. Insurance Administration after the insured person's place of residence for the granting of the claims on the basis of the Act on working 8.1: the accident that the Insurance Authority within one day after the approval of the measure in question sent the policyholder;
8.2. The Cabinet authorized the Special Commission on the opinion of the doctor found a copy of the occupational insurance headquarters one day sent this Commission.
9. Insurance Administration, based on the documents received, the insurance claim and fund accounting system of personalized information, as well as respecting the law and these rules, within 20 days, decide on the allocation of the insurance indemnity 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.
10. If an insurance claim is rejected, the applicant is issued a written denial with rejection of motivation.
11. If the insured person or third-person habitually resident outside the Republic of Latvia, the receipt of claims required documents and the application must be submitted to the insurance sector, which registered a policyholder.
12. If the Fund's accounting system is not a personalized message that requires the insured person's average monthly earnings in the calculation and determination of claims, policyholder three days after administration of insurance at the request of the certificate is signed and verified by the stamp of the policyholder or his authorised person and an accountant. If a person is insured at more policyholders, the certificate shall be submitted to all policyholders.
13. the Fund is entitled to inspect the documents and messages, which provided the policyholders, insured persons and third parties.
14. 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 earnings for the month, after which the insurance indemnity is equated with State Statistics Committee 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.
15. If the insured person is entitled to the insurance indemnity 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, in paragraph 9 of these regulations, the Insurance Authority is entitled to be paid in advance to the applicant claims not exceeding the expected payable claims per month.
16. If the insured person specific services to be provided for a longer period of time and extra costs for the determination of the amount of time it is not possible to present all the rules referred to in paragraph 41 of the document, the insurance administration is entitled to be paid to the insured person upon request a one-time advance a sum of money not exceeding the Government-set minimum monthly salary (salary).
17. If the insurance administration has brought disability page B, but claims supporting documents within ten days have not been received, the insured person shall be calculated and paid sick leave. After supporting claims and other rules referred to in paragraph 25 of document receipt is calculated and the insured person pays in the future temporary incapacity allowance, as well as the cost of the benefits calculated difference.
18. If, on a temporal incapacity allowance allocation (or after it), it is found that the insurance case, refers to the law "on maternity and sickness benefits ' scope, the disability allowance paid to transitory amount, calculated in accordance with paragraph 17 of these regulations, is cover of the maternity and sickness insurance funds is envisaged.
19. A deduction for the excess of temporary inability to work the amount of benefit or rewards for the loss of functional capacity or the amount of the survivors made from subsequent benefits or payment of remuneration concerned. Deduction amount per month can not exceed 20 percent of the temporary incapacity allowance calculated or rewards of integrity loss or on survivors.
20. Other deductions from these rules referred to in point 19 of the types of claims to be made in the same order as from wages. If the deduction is not possible to do so, submit the claim to the Court.
21. If the insured person or a third person in accordance with the law of the receiving capacity of the insurance indemnity for the loss or for survivors, pulling out of the Republic of Latvia to permanent life abroad, claims incurred in the future, if the person concerned has submitted before departure the insurance sector after the last habitual residence of the request in writing and stated the Republic of Latvia a credit account that you specified in the claims, as well as provide the passport with a mark on the check-out.
22. This provision 21. 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 notary acknowledgment, that person's life (indicate a person's passport data), as well as other funds requested by the insurance case related documents. The notarial certificate must be legalized if international treaties do not provide otherwise.
23. If a request for reimbursement of the cost of insurance is not renewed or is not filed other documents required for the Fund, an insurance administration by January 1 next year, cutting the cost of claims.

24. The insured person's pension capital formation insurance administration of work accident insurance funds in the order of the Cabinet of Ministers made in the law "on State pensions" for insurance contributions for all temporary incapacity allowance calculated amounts and consideration for capacity loss amounts paid to the insured person, if it doesn't work, but no longer than up to the age of the insured person is entitled to old age pension.
IV. Temporary incapacity allowance 25. Decision on the temporary incapacity allowance allocation based on this rule 25.1.8.1. or 8.2. documents referred to;
25.2. the inability to page B with the policyholder's confirmation of the arrival of the insured person does not work;
25.3. the policy statement of the insured person's average monthly earnings if the Fund does not have the required message.
26. If the insured person is employed at the more employers, then that employer with whom the insured person has suffered an accident at work or an occupational disease, developed from its own resources paid to the insured person for the first 14 days of incapacity temporary incapacity allowance is calculated according to law, 80% of the insured person's average monthly earnings. Other employers the cost of the disease of money in General.
V. consideration of capacity loss 27. Decision on remuneration for loss of capacity allocation based on this rule 27.1.8.1. or 8.2. documents referred to;
27.2. the extract from the health and integrity of the expertise of doctors in the State Commission (hereinafter the Commission) on the determination of the percentage of loss of capacity and a copy of the certificate of disability, which the Commission three days sent to the Insurance Authority;
27.3. the policy statement of the insured person's average monthly earnings if the Fund lacks necessary news;
27.4. the insured person's request for compensation for the loss of functional capacity.
28. the compensation for the loss of functional capacity is calculated by the following formula: x I z A = Vm — — — A — 100 where: consideration for the loss of functional capacity, Vm, the insured person's average monthly earnings, Iza-reward percentages.
29. The consideration for the capacity loss is determined on the basis of the following breakdown: loss of compensation Capacity (as a percentage) the percentage of loss of capacity — 99 75 80 100 80 90-89 70 70-79 65 60 69 60 50 49 50 30 59 55 40 — — — — — — — 14 25 30 24 30 10 29 35 15 39 45 25. Consideration for capacity loss the insured person is paid for the current month insurance administration day.
31. Compensation for loss of capacity adjustment in the following cases: 31.1. other capacity laid down by the Commission for the loss of interest;
31.2. increased consumer price index;
31.3. the insured person has reached the age at which it is entitled to a retirement pension;
19.5. the documents submitted found inaccuracies, which affects the amount of remuneration;
31.5. calculation of remuneration found arithmetic error;
19.6. is the Court ruling, which affects the amount of remuneration;
19.7. disability certificate or treating doctor's opinion states that the insured person is unable to collect himself and requires constant assistance of another person or parental supervision.
32. This rule 31.3. in the case referred to in subparagraph where the insured person receives compensation for the loss of functional capacity and five years before the age to which it is entitled to old age pension, not worked, remuneration of 70% of the amount due to the insured person in accordance with the provisions of paragraph 28.
Vi. the lump-sum allowance 33. The insured person the Commission capacity loss within 10 to 24 percent of non-repetitive review remuneration for working loss if the insured person agrees, insurance administration and can be assigned to pay the lump sum payment which is calculated for the insured person's three to eighteen months average earnings, taking into account the following breakdown: Uptime is the percentage of loss in number of months 10-12 3 13 15 6 16 18 10 19 21 14 22 — — — — 24 18 34. Decision on granting the single allowance shall be adopted based on these provisions 8.1.34.1. or 8.2. documents referred to;
21.3. the extract from the Commission concerning the determination of the loss of capacity as a percentage, which the Commission three days sent to the Insurance Authority;
3. the insured person's request for the granting of benefits in a lump sum.
VII. Remuneration for the survivors 35. Decision on the remuneration for the granting of survivors ' based on: this provision 8.1 35.1. or 8.2. documents referred to;
35.2. a statement of the cause of death was related to the accident at work or an occupational disease, which shall be issued, at the request of the insurance regulatory authority of treatment or medical practice;
35.3. the death certificate of the insured person (to be presented);
35.4. from the certificate of family composition and the insured person's dependent former family members (including family);
35.5. a document certifying the marriage to insured persons (to be presented);
35.6. the certificate of insurance of the workers of the deceased insured person's monthly average earnings if the Fund lacks necessary news;
22.2. documents certifying that the insured person's dependants or personal incapacity of former average monthly income amount;
22.2. the request for compensation for the survivors of the award, presented by the minor parties, which was dependent of the insured person and which, under the law are entitled to compensation for the survivors, or guardian.
36. If the claims about survivors total amount calculated dependant persons, the former exceeds 80% of the insured person's average monthly earnings for each person, respectively (the aspect ratio is maintained, originating between the amount of remuneration shall be calculated beginning) reduces the amount of remuneration to the total calculated amount does not exceed the statutory limit.
37. Compensation for the survivors of the adjustment, taking into account the consumer price index increases.
VIII. Death grants 38. Decision on granting of death benefit based on: this rule 38.1.8.1. or 8.2. documents referred to;
38.2. the specific pattern of the death benefit, a statement issued by the civil registry department or other authority in which the insured person's death;
38.3. the policy statement of the insured person's average monthly earnings if the Fund lacks necessary news;
23.9. the insured person's family member or apbedītāj (natural or legal persons) of the death benefit.
IX. Additional expenditure and service charges 39. Foundation of the work accident insurance funds shall be borne by the insured person for additional expenses that it incurred in connection with treatment, medical, social and vocational rehabilitation, including prosthetics, rehabilitation funds to purchase and repair, as well as retraining or other profession, if any costs exceeding the State budget for these purposes the service type of expenditure and the payment of which is guaranteed by law.
40. the Fund shall be borne by the insured person for additional expenses that it incurred in connection with treatment services (doctor) visit: travel expenses, the payment of the patient's Guide, contribution and participation payments.
41. The decision on the extra costs and payment of services based on: 25.5. disability certificate or treating doctor's opinion with a recommendation on the social rehabilitation or health services need of the insured person;
41.2. This provision 8.1. or 8.2. documents referred to;
41.3. extract from the Commission concerning the determination of the percentage of loss of capacity;
25.7. check (cheque), to which is attached the source document (invoice, voucher URu.tml.), also on the contribution and participation of the patient;
25.8. the insured person's request for additional expenses or service charges.
X. closing questions 42 to the law on State social insurance acceptance to work accident insurance funds formation covered Cabinet 11 June 1996 No 206 "the provisions of the law" on social tax "application rules" requirements in the following cases: 42.1. the policyholder upon registration as a taxable person in the social insurance administration and registration of the insured persons who are working or civil relations;
26.2. the policyholder and adjusted the calculation of insurance payments and designing the appropriate payments.
43. Up to 2000 for claims for the loss of functional capacity and the conversion of the survivors each semester, taking into account the consumer price index increases.
Prime Minister a. slice Welfare Minister v. Makarova in the