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Resolution Of August 3, 2009, Of The General Directorate Of Management Of The Social Security, Which Lays Down The Terms For The Implementation To The Mutual Of Accidents And Professional Illnesses Of The Social Security Of...

Original Language Title: Resolución de 3 de agosto de 2009, de la Dirección General de Ordenación de la Seguridad Social, por la que se establecen los términos para la aplicación a las mutuas de accidentes de trabajo y enfermedades profesionales de la Seguridad Social de...

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In Article 24.1 of Order TIN/41/2009 of 20 January 2009 implementing the rules for the contribution of social security contributions, Unemployment, the Guarantee Fund and Vocational Training for the year 2009, it is established that for this year the general coefficient to be applied on the integrated quotas obtained by the companies associated with the mutual work accidents and occupational diseases of the Social Security that have covered with the same the (a) the temporary incapacity resulting from the common contingencies of workers to their service will be 0.059. This percentage may be raised up to 0,061 for each mutual benefit of a population protected by common contingencies higher than the percentage determined in respect of the protected by professional contingencies, or register a the percentage of temporary disability processes by common contingencies with regard to the higher protected population to which it is fixed, or credit the financial insufficiency of the general coefficient as a result of structural circumstances; all in the terms to be determined by the Directorate-General for Ordination of the Social security, by means of a judgment given to the effect, which must be published in the Official Gazette of the State.

With regard to the first reported assumption, the coefficient of 0,061 shall be applicable when the population protected by common contingencies, in respect of workers protected by professional contingencies, exceeds 70%. In addition, to those mutuals who do not reach this percentage, and in order to facilitate access to the 0,061 coefficient, the application of this coefficient may be authorized if an increase of at least 6% is produced in the the proportion of employed persons for whom the provision is made for the economic benefit of temporary incapacity for common contingencies, in respect of the whole of the employed persons protected by contingencies professionals, between the existing situation at the beginning and at the end of the year.

As to the second assumption of application of the coefficient of 0,061 provided for in that Article 24.1 of Order TIN/41/2009 of 20 January 2009, which refers to the case of mutuals registering a certain percentage of processes of temporary incapacity for common contingencies with respect to the protected population, the indicator used as a reference to accredit the concurrency of this requirement is the index of average monthly incidence of disability processes temporary temporary workers ' contingencies for employed persons according to the definition used for the monthly monitoring of these processes (average monthly number of processes started in the year between the average protected population in the year, multiplied by a thousand), so that the entities whose index of the year exceeds the value of 28.21 percent 1 000 may request that the application of the said coefficient of 0,061 be authorised.

Finally, as regards the third assumption of application of the coefficient of 0,061, which relates to mutual funds which show the financial insufficiency of the general coefficient for structural circumstances, it must be taken into account the revenue and expenditure arising from the cooperation in the management of the economic benefit of temporary incapacity for common contingencies of the self-employed persons injured (Article 79.1 of the General Rules of Cooperation) integrate all the effects with the other revenue and expenditure corresponding to the management of the same benefits and contingencies of protected employees (Article 73 of the Regulation). In accordance with the integration of revenue and expenditure mentioned above, the birth of the right to the additional financial supplement requires, as a prerequisite, to apply, in order to address the insufficiency existing in the management of this benefit in respect of the (a) to the extent to which it is necessary to provide the right to the right to the right to the right to the right to the right to the right to the right to the right of the indicated supplement.

The Listing Order for 2009 stated that the terms for the application of the coefficient of 0,061 will be determined by the Directorate-General for Social Security Management. It is therefore for the Directorate-General to determine what is meant by financial insufficiency, a concept which the quoted Order applies exclusively in the field of the management of the economic performance of incapacity. temporary temporary contingencies of the employed employed persons (pursuant to the provisions referred to in Article 24 (1) of the Order of 20 January 2009).

In order to determine the origin of the application of the coefficient of 0,061, in accordance with the provisions of Articles 73 and 79, already mentioned, of the general cooperation regulation, account must be taken of all the the financial resources and expenditure relating to the management of this provision of all the workers ' groups concerned (those of those employed and those of the self-employed), such as the other resources from the management of professional contingencies.

The requirement of financial insufficiency as a consequence of structural circumstances determines that the situations to be met by the financial supplement are those in which the deficit has the highest incidence in the financial situation in this area of management, because, for such circumstances, the set of resources is not sufficient to meet the obligations. Therefore, in order to determine the concurrency of that required requirement and to be able to make the application, it is necessary to estimate the deficit in the area of management of the economic benefit of temporary incapacity for common contingencies. for employees in accordance with the provisions set out in that Order of 20 January 2009.

On the other hand, in order to ensure that the financial supplement resulting from the application of a higher coefficient to the general corresponds to the purpose for which it has been created, which is to adjust the financing to the heterogeneity of structures that exist in these Entities and, simultaneously, do not discourage effective management, it is established as a general requirement to prove that the existence of deficit is due to structural reasons (dimension, main location and Similar circumstances). For these purposes, certain reference parameters are established to allow the assessment and determination of the concurrency of those structural circumstances.

Therefore, it is necessary to provide instructions on the procedure and the conditions to be followed by the applications to be made in order to obtain the corresponding authorisation for the application of the coefficient of 0,061 set out in Article 24.1 for the assumptions provided for therein.

Consequently, in compliance with the provisions of Article 24.1 of Order TIN/41/2009 of 20 January 2009, and in the use of the powers conferred by it, this Directorate-General for the Management of Social Security has resolved the following:

First.

1. In accordance with the provisions of Article 24.1 of Order TIN/41/2009 of 20 January 2009, the share of the quota referred to in Article 71.2 of the General Partnership Regulation, approved by Royal Decree 1993/1995 of 7 December 1995, consist, in general, of the application of the coefficient of 0,059 on the total shares corresponding to the undertakings associated with each other of occupational accidents and occupational diseases of social security which are covered by the with the same the economic benefit due to temporary incapacity arising from common contingencies of the workers at your service.

2. Mutual occupational accidents and occupational diseases of occupational diseases may be subject to the coefficient of 0,061 of the total quotas of their associated undertakings as referred to in Article 24.1 of Order TIN/41/2009 of 20 January 2009. where one of the situations referred to in the second, third and fourth paragraphs of this resolution is present; situations which, for the purposes of applying the said coefficient, are considered to be mutually exclusive.

3. The coefficient of 0,061 shall apply to the full quotas for the year 2009, from 1 January to 31 December.

Second.

1. The mutual benefit of occupational accidents and occupational diseases of the social security system may receive the coefficient of 0,061 of the total shares of their associated enterprises when they credit that in the year 2009 the percentage representing the Population protected by common contingencies, as at 31 December 2009, in respect of workers protected by professional contingencies at the same date, is more than 70%.

2. Each person who does not reach the percentage set out in the preceding heading 1 may receive the coefficient of 0,061 of the total shares of his associated undertakings where the percentage of the employed persons for whom he/she is assume the coverage of the economic benefit of temporary incapacity arising from common contingencies in respect of employed persons protected by professional contingencies, as at 31 December 2009, has increased by 6%, as (a) a minimum, in comparison with the percentage representing the same ratio as at 31 December 2008.

3. Each of the parties in which the requirements laid down in one of the above headings in this paragraph are met and are interested in applying the abovementioned coefficient of 0,061 to them during the year 2009 shall make a corresponding application to this Directorate-General for the purpose of obtaining its authorization, once it has been verified by the concurrence of those requirements on the basis of the existing statistical information. If, before 31 December 2009, mutual associations already reach the values laid down in any of those headings, they may ask the Directorate-General to apply the abovementioned coefficient of 0,061, the authorization of which shall be be subject to the maintenance of the requirements laid down until 31 December 2009.

4. If, after the end of 2009, the conditions laid down in this paragraph are not met, the Directorate-General for Social Security Management shall, on its own initiative, agree to the provision of the additional coefficient applied to the mutual, as well as the return to the General Treasury of Social Security of the difference between the amount received as a result of the application to the quotas of the initially authorized coefficient of 0,061 and the resulting the general coefficient of 0,059.

Third.

1. Mutual occupational accidents and occupational diseases in the field of social security may be able to receive the ratio of 0,061 of the total shares of their associated enterprises when their average monthly incidence rate of incapacity processes temporary in 2009, corresponding to their employed persons protected by common contingencies, is greater than 28.21 per thousand.

The definition of the index will be the one that is used for the monitoring of the management of these processes, whose information is contributed monthly to this Directorate General, that is, the average monthly number of processes started in the elapsed time of the year, divided between the average protected population in the same period and multiplied by a thousand.

2. The mutual funds in which the requirement laid down in the previous heading is met and who are interested in applying the ratio of 0,061 to them during the year 2009 shall make the corresponding application to this Directorate-General for the object of obtaining its authorization, once the concurrency of the aforementioned requirement has been verified. If, before 31 December 2009, mutual funds exceed the value fixed for the index under the previous heading, and it is envisaged to conclude the year with an index above that value, they may apply to this Directorate-General to apply the said coefficient of 0,061, the authorisation of which shall be conditional on the reference rate actually exceeding the value fixed for the reference index at 31 December 2009.

3. If the requirement laid down in this third paragraph is not met once the year 2009 has been concluded in the mutual agreement, the Directorate-General for Social Security Management shall, on its own initiative, agree to the provision of the additional coefficient applied to the mutual, as well as the return to the General Treasury of the Social Security of the difference between the amount received as a result of the application to the quotas of the initially authorized coefficient of 0,061 and the result of applying the general coefficient of 0,059.

Fourth.

1. Mutual occupational accidents and occupational diseases of the social security system may be used for the purposes of applying the coefficient of 0,061 where the application of the general coefficient of 0,059 does not allow for all the obligations arising from the management of the economic performance of temporary incapacity for common contingencies in favour of workers belonging to their associated undertakings, and such insufficiency is caused by structural circumstances of the mutual in this field of management, prior authorization of this Directorate General and in the terms that set out in this Resolution.

2. Financial insufficiency of the general coefficient of 0,059 shall be deemed to exist where the estimate of the revenue for the financial year 2009 for the management of the economic performance of temporary incapacity for common contingencies the employees of the associated enterprises, who have been taken into account in the application of the said coefficient to the contributions concerned, are found to be insufficient to cover the cost of the economic benefits of temporary incapacity of the collective worker in the same period and other expenditure incurred for its management, once the whole of the financial resources and expenditure relating to the management of the economic performance of temporary incapacity arising from common contingencies of all the collectives have been taken into account protected (employed and self-employed persons), as well as the other resources accruing from the management of professional contingencies which, in accordance with the provisions of Article 73 (3) of the Regulation (a) general partnership, may be transferred to the management of the common contingencies, in the terms set out in the following heading 3.

The calculation of the estimate of revenue and expenditure shall be calculated by calculating the forecast of the contributions actually charged during the year 2009 and the expected expenses incurred during the same period.

To perform the above estimate, consideration will be given to the evolution of the contributions and the expenses related to the collaboration in this benefit during the time since 1 January 2009. up to the time of submission of the corresponding application.

3. In order to be able to apply the application of the coefficient of 0,061, it is necessary, in accordance with the above, that the amount of the estimated deficit corresponding to the management of the economic benefit by common contingencies of the employees who are employed in accordance with the provisions of the previous heading cannot be compensated by the result of the management of this benefit in respect of the self-employed, or by the application of the reserve for the stabilisation of temporary incapacity as constituted on 1 January 2009, or with the resources corresponding to the management of professional contingencies which, in accordance with Article 73.3 of the General Partnership Regulation, may be intended to compensate for the deficit referred to above.

This calculation will be used exclusively to determine the concurrency of the expressed requirement, without in any case suppose to modify the rules on calculation and endowment of the cited reservation.

4. The structural origin of the insufficiency of the ordinary financial resources will be assessed through the analysis of the evolution experienced by the management indicators relating to the economic performance of the workers ' reference. (a) the number of persons employed, such as the average duration of the processes of discharge, the incidence and prevalence rates of the processes and the average expenditure on the economic performance, and their comparison with the average values for all the mutual.

5. The coefficient of 0,061 authorised in the case of the circumstances and the requirements laid down in the preceding paragraphs which make up the existence of financial insufficiency of structural origin of the general coefficient, apply to the full quotas for the year 2009 from 1 January to 31 December, without prejudice to the estimates to which reference has been made are used to determine the origin of the application in the application stage.

6. The mutual interest in the application of the coefficient of 0,061 as a result of the concurrency of the financial insufficiency of the general coefficient by structural circumstances as laid down in the headings they must submit their applications by 15 September 2009, to which they shall accompany the following documents:

(a) a forecast of results based on the evolution of the revenue obtained by the application of the general coefficient of 0,059 and of the expenditure relating to the management of the economic performance; referred to in the year 2009, in accordance with the details set out in models 1 to 3, which are included in the Annex to this Resolution, completed on paper and in computer support.

b) Detailed report on the structural circumstances of the 2009 results estimate. The collective protected by mutual benefit shall also be detailed by completing the model 4 of the Annex, both on paper and in computerised form.

(c) Final settlement of accounts collecting the revenue, expenditure and result of this year's 2008 management and implementation of this year, with models 1 to 3 of the Annex being completed, both on paper and in support computer.

(d) Amounts constituted and levels of allocation of the reserves of immediate obligations, stabilisation and stabilisation of temporary incapacity existing as at 1 January 2009, after the results of the financial year 2008.

e) Detailed report on the circumstances of a structural nature which, if necessary, have been able to give rise to the result of the 2008 financial year referred to under heading (c) above, with model 4 of the Annex, both on paper and on computer support.

7. Each mutual, within 15 days of the submission of their accounts for the financial year 2009, shall submit to the Directorate-General for Social Security the supporting documentation of the requirements of the financial insufficiency and structural causes as set out in paragraphs 2, 3 and 4 of this paragraph, which shall be based on the accounts rendered.

For the above purposes, the mutuals shall complete models 1 to 5 of the Annex, both on paper and on computer support.

The Directorate-General, after analysing the information and documentation provided, will agree with a definitive nature of the origin of the additional coefficient applied or, in case of not having attended the 2009 financial year, the (a) a requirement of financial insufficiency of structural origin, shall determine that the mutual benefit of the Member State is to give the General Treasury of the Social Security the difference between the amount received as a result of the application of the coefficient of initially authorised 0,061 and the result of applying the coefficient general of 0.059.

Fifth.

The instruction and resolution of the files will be subject to the provisions of Law 30/1992, of 26 November, of the Legal Regime of Public Administrations and of the Common Administrative Procedure, as amended by Law 4/1999 of 13 January 1999, the time limit for a decision of a general nature of three months, from the date on which the application has entered the register of the body responsible for processing, without prejudice to the circumstances of the case of suspension or of legal extension provided for by law.

In addition, at any time prior to the formulation of the proposed resolution, the instructor body may collect the information and documentation it deems appropriate, in order to be considered sufficiently justified. the concurrency of the established requirements.

Madrid, 3 August 2009.-The Director General of Social Security Management, Miguel Ángel Díaz Peña.

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