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Royal Decree 375/2003 Of 28 March, Which Approves The General Regulation Of The Administrative Mutualism.

Original Language Title: Real Decreto 375/2003, de 28 de marzo, por el que se aprueba el Reglamento General del Mutualismo Administrativo.

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TEXT

The third final provision of the recast text of the Law on Social Security of Civil Servants of the State, approved by Royal Legislative Decree 4/2000 of 23 June, empowers the Minister of Public Administration, prior to the report, if appropriate, from the Ministries of Finance and Labour and Social Affairs, within the scope of their respective powers, to dictate or propose to the Government, as appropriate, the rules of application and development of the law.

Therefore, since the publication of the aforementioned text, a new general executive regulation of the standard is pending, having continued in force-in whatever way it does not object to the recast text-the General Regulation of the Administrative Mutualism, approved by Decree 843/1976 of 18 March.

If the need for a new regulatory standard for the sole circumstance of time since the entry into force of the current regulation is not evident, that rule would be fully justified by its own Appeals of the recast text to regulatory developments which, of course, cannot be adequately answered by the application of rules, in some cases, pre-existing to the legal provisions which have been recast in the approved text by Royal Decree-Law 4/2000 of 23 June, and in others, clearly out of date.

As a normative technique used for the elaboration of the regulation, the criterion has been followed to offer a regulatory development with the same systematic and ordination of materials as the text recast and amplitude similar to the previous. This is because, unlike the tendency of the most recent legal bodies, the old law 29/1975, of 27 June, on Social Security of Civil Servants of the State, fundamental core of the recast text, presents a little regulation. It has been extended and censated to the main contents in the prestational and organizational areas of this special regime, finally having and in a way express a reference of the law in favor of the regulation.

In its virtue, on the proposal of the Minister of Public Administrations, with the precept report of the Ministries of Finance and Labor and Social Affairs, according to the Council of State and after deliberation of the Council of Ministers at their meeting on 28 March 2003,

D I S P O N G O:

Single item. Approval of the General Regulation of Administrative Mutualism.

The General Regulation of Administrative Mutualism is approved, the text of which is inserted below.

REPEAL PROVISION

Unica. Provisions to be repealed.

1. The following provisions are repealed:

a) In full:

1. Decree 843/1976, of March 18, for which the General Regulation of Administrative Mutualism is approved.

2. The Royal Decree 630/1982, of 26 March, establishing the provision of death aid in the General Mutuality of Civil Servants of the State (MUFACE).

3. The Royal Decree 606/1983, of 16 March, which regulates death and retirement benefits in the General Mutuality of Civil Servants of the State.

4. The Royal Decree 278/1984, of 8 February, for which the death allowance is regulated by the General Mutuality of Civil Servants of the State.

b) Partially:

1. The first and second final provisions of Royal Decree 1190/1985 of 17 July 1985, which regulates the promotion of studies carried out by MUFACE.

2. Articles 1. 3 and 3. of Royal Decree 383/1981 of 27 February, for which rules for the implementation and development of the fifth additional provision of the State General Budget Law for 1981 are dictated.

2. All the provisions of the same or lower rank as soon as they object to this regulation are also repealed and have not been for the recast text that they develop.

FINAL DISPOSITION

Unica. Entry into force.

This royal decree and the regulations it approves will enter into force on the day following its publication in the "Official State Gazette".

Dado en Madrid, a 28 de marzo de 2003.

JOHN CARLOS R.

The Minister of Public Administration,

JAVIER ARENAS BOCANEGRA

GENERAL REGULATION OF ADMINISTRATIVE MUTUALISM

CHAPTER I

General provisions

Article 1. Object.

This regulation aims at the development and implementation of the recast text of the Law on Social Security of Civil Servants of the State, approved by the Royal Legislative Decree 4/2000, of 23 June (hereinafter: recast).

Article 2. Legal regime of administrative mutualism.

Administrative mutualism, a mechanism for the coverage of the Social Security Special Regime of the Civil Servants of the State integrated into the Social Security System, provided for in Article 2 (b) of the text recast, is governed by the provisions of this Regulation and other implementing and development provisions.

Article 3. Field of application of administrative mutualism.

1. They are included in the field of application of administrative mutualism:

a) The career civil servants of the State Civil Administration.

(b) Officials in practice, in the form that is determined in Article 13 of this Regulation.

(c) The officials specified in the special framing assumptions referred to in paragraph 1 of the first provision and in the fourth additional provision of the recast text.

d) Officials from the extinguished Inspection and Advisory Service of the Local Corporations referred to in Royal Decree 2856/1978 of 1 December 1978 and their supplementary rules, as from 1 September 1979.

2. The officials referred to in paragraph 3 of the first paragraph of the recast text, as well as the pensioners referred to in paragraph 2 of that additional provision, may optionally be incorporated.

3. They shall be excluded from this special scheme and shall be governed by their specific rules:

a) Local Administration officials.

b) Officials of autonomous bodies.

c) Military Administration officials.

d) Officials of the Administration of Justice.

e) Social Security Administration officials.

f) New income and practice officials from the Autonomous Communities.

g) Civil administration officials of the State transferred to the Autonomous Communities, who have entered or voluntarily enter into bodies or scales of their own, any other autonomous community of destination, any that is the access system.

h) The management and service personnel of the universities.

Article 4. Nature of the General Mutuality of Civil Servants of the State.

1. The General Mutuality of Civil Servants of the State (MUFACE) is a public body, with distinct public legal personality, its own assets and treasury and autonomy of management in terms of the recast text. the management of administrative mutualism for officials included in its field of application is a unitary matter.

2. No other entity may use the name "General Civil Servants Mutuality" or the acronym MUFACE.

Article 5. Governance and organization of the mutual society.

The organs of government, administration, and representation of the General Mutuality of Civil Servants of the State are the ones that are established, in the same way as the social security agencies, by royal decree, where its composition, operation and attributions are determined. Similarly, and in accordance with the rules on competences and procedures in the field of organization, by royal decree, on the proposal of the Minister of Public Administrations, and by order of the Minister are established, respectively, the structures of its core services and its peripheral services.

CHAPTER II

Incorporation into the mutuality

SECTION 1 MUTUAL SOCIETIES: MEMBERSHIP REGIME, HIGH AND LOW

Article 6. Mutualists.

They have the status of mutualists, with the rights and obligations outlined in the recast text and in this regulation:

(a) The officials listed in Article 3 (1) and (2) of this Regulation, who shall retain the status of mutualists when they are declared retired and meet the requirements set out in the Article 9.3.

(b) Officials who have become retirement pensioners referred to in paragraph 2 of the first provision of the recast text, under the conditions and with the requirements set out in that paragraph.

Article 7. Incorporation into the Mutuality: affiliation.

The initial incorporation into the General Mutuality of Civil Servants of the State is mandatory for officials within its scope of application from the time of the inauguration or, where appropriate, from the beginning of the period of practice. Such incorporation, of a single and permanent nature, shall have an effect on the system of social security, without prejudice to the ups and downs, as well as any variations which may arise after it.

Article 8. Membership document.

1. The status of the General Mutuality is credited by the corresponding membership document, which will be issued by MUFACE.

2. The document shall contain the personal data of the official required for identification as a mutualist and his/her membership number, which is of a permanent nature and of this special social security scheme.

Article 9. Highs.

1. Officials in the active duty situation shall be obliged to be in the general mutual benefit from the moment of the taking of possession, either when they acquire the status of an official, or when they are rehabilitated in that condition, or reenter the active service.

2. They shall retain the status of a compulsory mutualist, with the same rights and obligations as in the active service situation, officials when they pass on to one of the following situations:

(a) Special services, except as provided for in paragraph 1 (c) and in Article 8 (3) of the recast text.

b) Services in stand-alone communities.

c) Target expectation.

d) Forcible exceding.

e) Care for family care.

f) Provisional or firm suspension of functions.

3. Officials shall also be subject to compulsory discharge in respect of officials when they are declared retired, in any of the following cases:

(a) That they come from the administrative situations referred to in paragraphs 1 and 2 above.

(b) They have maintained the high voluntary as referred to in Article 10 (2) of this Regulation.

(c) To receive pension from the Passive Classes Scheme caused by their status as officials falling within the scope of this regulation.

Article 10. Low, optional maintenance and suspension in the discharge situation.

1. They cause low as compulsory mutualists:

(a) Officials who move on to the situation of voluntary leave in any of its modalities.

b) Officials who lose such a condition, whatever the cause.

(c) Officials exercising the right of transfer provided for in Article 11.2 of Annex VIII to the Staff Regulations of Officials of the European Communities, approved by Council Regulation 259/1968 of 29 June 1968, February.

d) Officials who are compulsorily affiliated with the Special Regime of the Social Security of the Armed Forces, pursuant to the transitional provision of Law 17/1999, of 18 May, of the Regime of the Personnel of the Armed Forces, as long as the cause that gave rise to this affiliation persists.

2. By way of derogation from the preceding paragraph, they may maintain the status of a voluntary mutual benefit, with equal rights, the officials referred to in paragraphs (a), (b) and (c) of the preceding paragraph, provided that they pay exclusively in charge of the official and the State.

3. The right of choice must be exercised by the person concerned himself, before the General Mutuality, within one month of the date of receipt of the notification, or of the date of effect if it is later, of the agreement or declaration of voluntary leave, loss of official status, or the exercise of the right of transfer provided for in Article 11.2 of Annex VIII to the Staff Regulations of Officials of the European Communities, approved by the Regulation 259/1968, of the Council of 29 February, causing a failure to exercise the same date of effect of the corresponding administrative acts.

4. If the right of choice is not exercised within the period prescribed or subsequently lost, by way of waiver or non-payment of the quotas as provided for in Article 33 (2) of this Regulation, the condition of mutualist on a voluntary basis.

5. It shall not be the right of choice for officials who are on a voluntary basis as a result of the transfer to another body or scale of the State Civil Administration falling within the scope of this Regulation.

6. They may choose to suspend the discharge in the General Mutuality and to cease their rights and obligations in respect of the same, the officials referred to in Article 8 (3) of the recast text, leaving the suspension to take effect when the situation that prompted it.

Article 11. Pension pensioners of the system of passive rights.

They will have the consideration of voluntary mutualists, with the rights and obligations provided for in this regulation, the retirement pensioners who are incorporated into the mutual fund under those established in the paragraph 2 of the first provision of the recast text.

Article 12. Change of body and affiliation to more than one Social Security regime.

1. In the event that a mutualist enters or reenters another body or scale falling within the scope of this Regulation, it will maintain its status as high in the mutuality, recording the variations inherent in such a change for the purposes of the official contribution of the official.

2. Where an official occupies several places which are legally established, their compatibility shall be high through that for which they receive the basic remuneration.

3. Where a single provision of services is the cause of the compulsory inclusion of a public official in the special social security scheme of civil servants of the State and in another system of the social security system, it may to opt, for one time, for belonging exclusively to the special social security scheme of civil servants of the State. If double affiliation affects two special schemes of civil servants, it may also be eligible for membership of only one of them.

4. For the purposes of determining the rights which may be caused by the mutualists passing from this special scheme to another social security scheme or for their family members, in the course of their professional life, the rights of the mutual benefit shall be determined by the provisions in force on the reciprocal calculation of contributions between the different social security schemes, and in particular the provisions of Article 58 of this Regulation, as well as the provisions of Article 10 in respect of maintenance In the case of death, separation, divorce or invalidity, the person who is a member of the State of the marriage of the mutualist.

Article 13. Officials in practice.

1. Officials in practices who aspire to enter the bodies of the Civil Administration of the State will be included in the scope of administrative mutualism under the same conditions as career officials to date. of their inauguration as such, and shall be affiliated with MUFACE with effect from the day of commencement of the traineeship, unless they already have the status of mutualists.

2. Officials in practices who do not reach the status of career officials will cause a low level of mutual benefit, with the exception referred to in the previous paragraph.

Article 14. Membership processing, ups and downs.

1. Membership shall be carried out on its own initiative and, failing that, at the request of the person concerned. The same procedure will be followed for the high, low, and administrative situation changes.

2. The competent bodies in the field of personnel who formalise the takeover of career officials falling within the scope of administrative mutualism, the appointment of officials in practice included in the same (a) scope, as well as the change of administrative situation, retirement and, in general, administrative acts which alter or modify data relating to the affiliation to MUFACE, shall immediately account for such administrative acts in the a maximum of one month.

3. Rights and obligations in respect of the General Mutual Agreement shall in any event be construed as referring to the date of effect of the acts and situations referred to in the preceding paragraph. Casualties shall also be construed as referring to that date.

4. The persons concerned may directly promote their affiliation, either high or low, to the General Mutuality, and shall communicate their change of administrative situation or move to retirement in the event that, for any circumstance, they have not taken place ex officio within the time limit laid down in paragraph 2 of this Article.

5. The membership or the continuing situation of the voluntary mutualists will be promoted directly to MUFACE by the interested parties.

SECTION 2. OTHER SUBJECTS PROTECTED BY ADMINISTRATIVE MUTUALISM

Article 15. Beneficiaries of the mutualists.

1. Family members or persons treated as members of a mutual insurance fund may be included as beneficiaries of administrative mutualism, who, in accordance with the requirements set out in paragraph 2 of this Article, are listed below:

(a) The spouse of the mutualist, as well as the person living with the mutualist in a similar relationship of affectivity to that of the spouse with the requirements laid down in the General System of Social Security.

b) Descendants, adopted children and siblings. The descendants and the adopted children may be of both spouses or of any of them, and the children also of the person living with the mutualist in analogous relationship of affectivity to the spouse with the requirements laid down in the Regime General of Social Security. Exceptionally, the families referred to in fact are treated as such, after agreement, in each case, of the General Mutual Agreement.

c) Ascendants, whatever their legal status, and even adopters, both of the mutualist and of their spouse, and the spouses for subsequent nuptials of such ascendants.

(d) Any other person related to the mutualist who is determined in accordance with the provisions of the General System of Social Security.

2. The requirements referred to in the previous paragraph are as follows:

a) Living with the rightholder and at his expense. There will be no lack of coexistence in cases of transient and occasional separation for reasons of work, inability to find housing at the new point of destination and other similar circumstances.

(b) Do not receive income from income from work, including those of a borrowing nature, and/or capital and property, exceeding twice the minimum interprofessional salary.

(c) Not to be protected, by a different degree, through any of the Regimenes that integrate the Spanish Social Security system with an extension and contents analogous to those established in the General Regime.

Article 16. Beneficiaries in case of death, separation, divorce or marriage annulment of the mutualist.

1. In the event of the death of the mutualist on the discharge, the widowers and orphans of mutualists, assets and pensioners, and of the officials and pensioners referred to in paragraphs 2 and 3 of the additional third provision of the recast text, if they comply with the requirement referred to in paragraph 2 (c) of the previous Article.

For the purposes of this paragraph, widowers are deemed to be treated as persons who receive a pension for the purpose of the Passive Classes because they have been the legitimate spouses of officials in the field of application of the administrative mutualism, and the orphan is equated to the minor child of age or incapacitated who has been abandoned by a parent or a mutual mother.

2. They may also retain the status of beneficiaries of administrative mutualism, with the same requirement referred to in the preceding paragraph, the spouse who is living separately from a mutualist on the high or whose marriage has been declared null or void. dissolved by divorce, and the children who live with it.

Article 17. Recognition and maintenance of the right of beneficiaries.

1. Recognition of the condition of the beneficiary is a matter for the General Mutuality.

2. The request for recognition of the status of beneficiary of the family members or persons treated as such as the holder of the right shall be made by him at the time of the initial or higher membership or at any time back when you want to include a new payee.

3. The requirements to be a beneficiary referred to in this Section should be held at the time of the recognition of the right and maintained throughout the period in order to preserve that condition. The right shall be extinguished if one of the conditions required to be a beneficiary is no longer met, death and, in any case, when the holder of the right who derives is extant, unless, by the death of the mutualist, he is subsist as provided for in this regulation.

4. Changes in family circumstances affecting the right of beneficiaries shall be communicated by the mutualists or assimilated to the General Mutual Fund within the month following the date on which they occur. If the variation leads to the absence of a beneficiary, the costs arising from the mutual maintenance of the beneficiary as such above the time limit shall be considered, unless justified, as undue, in which case they shall apply. Articles 55 and 56 of this Regulation.

5. The General Mutuality may verify the degree of kinship and other circumstances of the beneficiaries by any means admitted in law and, in particular, through the Civil Registry, Municipal Register or competent body, which shall issue free of charge, free of charge.

Article 18. Accreditation of beneficiaries.

1. The condition of a beneficiary in charge of a mutualist is credited by the beneficiary document issued by MUFACE. This document, which shall include the personal data of the beneficiaries for identification as such, shall be valid only if it is accompanied by the membership document corresponding to the mutualist.

2. In the case of death, separation, divorce or invalidity of marriage of the mutualist, MUFACE shall issue in favour of the beneficiary a document assimilated to that of affiliation provided for in Article 8 of this Regulation. If there are several beneficiaries of the same causative, it shall have the status of the holder of such document, including the remainder in the beneficiary's document and, if the holder loses the right to be a beneficiary of the mutualism (a) the administrative authority shall become the holder of the document other than the beneficiaries who retain the right. The beneficiary document shall be valid only if it is accompanied by the holder's document.

Article 19. Incompatibilities.

1. The status of beneficiary in the field of administrative mutualism is incompatible with the person who owns it with:

a) A new recognition or maintenance of that same condition as a derivative of another mutualist in the same scope.

b) The mandatory mutualist condition.

c) Membership of another system of the Social Security System, either as a holder or a beneficiary.

2. The incompatibility will be absolute in cases of belonging in title to the administrative mutualism or to another system of the Social Security System. However, the person who may have the status of a beneficiary as a result of more than one mutualist in the field of administrative mutualism, or who may have that status, both in that area and in another system of the System of the Social security, you will have to exercise your inclusion option with respect to a single right holder.

SECTION 3. PERSONAL CHARACTER DATA

Article 20. Provision of information.

1. The General Mutuality shall have the information provided to it by the bodies and registers referred to in the eighth additional provision of the recast text, with the amendment referred to in Article 45 (2) and (3) of the Law. 53/2002 of 30 December 2002, of fiscal, administrative and social measures. The provision of the information shall be made in the terms provided for in that provision by the bodies and registers referred to therein.

2. The mutualists are obliged to communicate the data as well as the variations in the data and to act in the database of MUFACE for affecting their relationship of administrative mutualism, both those relating to themselves and their beneficiaries. On the other hand, the General Mutuality may collect from the interested parties the contribution of the data that is appropriate, necessary or relevant in relation to the scope and purposes of the mutual society, being those obliged to facilitate them. The same obligations under this paragraph shall fall on beneficiaries who are not in charge of a mutual member.

3. The data referred to in the preceding paragraphs shall, in any case, identify the name, identity document, date of birth, domicile and, for the mutual officials, destination and body or scale determined by the MUFACE membership.

Article 21. Obligations and rights relating to information.

1. The General Mutuality must keep the data relative to the affiliated persons up to date, in accordance with what is set out in the previous article.

2. The mutualists will have the right to be informed about the data relating to them concerning the computerized files and files of the General Mutuality. Similarly, persons who have a personal and direct interest, derived from the provisions of the recast text and in this regulation, and subject to personal data protection legislation, shall enjoy the same right.

3. The data obtained in any automated file, file or file of the General Mutuality may only be processed and transferred in accordance with the provisions of the legislation in force regarding the protection of personal data and their development provisions.

CHAPTER III

Quote

SECTION 1. GENERAL PROVISIONS

Article 22. The obligation to quote: object.

1. The general mutual contribution is compulsory.

2. The contribution comprises two contributions:

a) The individual quota for each mutualist.

b) State input.

3. These contributions shall finance the benefits referred to in Article 47 of this Regulation, with the exception of the provision referred to in paragraph (h) of that Article.

SECTION 2 INDIVIDUAL MUTUAL CONTRIBUTION OF THE MUTUALIST

Article 23. Subject to compliance with the obligation to list.

1. Member States are obliged to list the mutualists in their field of application and who are in one of the following administrative situations, to the administrative mutual insurance scheme:

(a) Active service, taking into consideration this situation the enjoyment of licenses, including the status of temporary incapacity.

(b) Special services, taking into account the provisions of Article 9 (2) (a) of this Regulation.

c) Services in stand-alone communities.

d) Target expectation.

e) Forcible exceding.

f) Provisional or firm suspension of functions.

2. Except for the obligation to list:

a) Retired mutualists.

(b) Officials who are in the situation of surplus to care for the care of children or family members.

3. Voluntary mutualists are obliged to list as long as they are in a highly optional situation, in the form in which they are determined in the recast text and in this regulation.

Article 24. Birth, duration and extinction of the obligation to list.

1. The obligation to list is born from the date of discharge of the official in the mutual society.

2. The obligation to list shall be maintained throughout the period in which the official is discharged, without prejudice to the provisions of paragraph 2 (b) of Article 23 (2), and shall be extinguished by the absence of the official in the mutual society. The communication to the General Mutuality of the discharge or the discharge outside the time limit referred to in Article 14 of this Regulation shall take back the effects of the contribution to the date on which the alleged determinants of those contributions have occurred.

3. The contribution of the voluntary mutualists shall be taken back to the day following the day of the low date as compulsory mutualists.

4. The exemption from the listing of retired mutualists shall have effect from the month following that of the date of retirement.

Article 25. Content of the obligation to list.

1. The fee expresses the amount of the obligation to list the General Mutuality during the liquidation period. This amount is the result of the liquidation of the rate of contribution to the total or reduced contribution base determined in accordance with Article 10 of the recast text.

2. The contribution shall be monthly for the mutualists on the high and the accrual shall take place on the last day of each month and, in the case of the mutualist's absence, on the date of its effects, unless it is due to death.

3. The settlement period shall be referred to in full natural terms, even if the accrual and/or the payment of the fees are made for a period other than the month.

4. The following shall be taken into account in order to obtain the monthly settlement:

(a) The regulatory basis shall be reduced by the same proportion as the remuneration, with the same date of effect of the reduction of the remuneration, in the case of officials to whom any rule authorizes the provision of services under reduced working time, for a period of time which is not likely to be lower than the year.

(b) Monthly liquidations referred to mutualists in the month in which they are compulsory and in the month of absence as compulsory mutualists, provided that they are not due to death, shall be calculated for days. The same criterion shall be adopted for mutualists who move on to the situation of leave to attend to the care of children or family members and, in the month, from that situation, to another with an obligation to list.

(c) It shall be taken as the basis for the listing of officials in practice who already have the status of mutualistas in discharge corresponding to the option exercised by the official to receive the remuneration of the former or of the new body, in accordance with the remuneration legislation of those officials.

5. In order to obtain the share of the voluntary mutualists, account shall be taken of the provisions of the recast text and Article 29 of this Regulation, with the share of the fee corresponding to the payments being apportioned at each settlement. extraordinary.

Article 26. Compliance with the obligation to list.

1. The mutualist is the subject obliged to pay the individual fee.

2. The fee shall be paid by applying the general or individual contribution scheme, as appropriate in accordance with the provisions of this Regulation.

Article 27. General listing arrangements.

1. The general listing arrangements for compulsory mutualists whose ratings or paying offices retain the amount of the share of the mutual benefit are subject to the general levy.

2. The ratings or paying offices existing in the services of the various public administrations, constitutional bodies and other public sector bodies and entities, where the officials included in the field of application of this special scheme, will deduct, monthly, on the payroll the individual quotas corresponding to the officials in active service, or who are in the situations of services in autonomous communities, expectation of destination, enforced leave or temporary suspension of duties.

3. Also, the ratings or the paying offices will retain the amount of the individual quota of all those officials who are in a situation of special services and high in the mutual society. In the event that such officials are not brought back the fee for the remuneration of their post or effective post, the retention shall be made by the habilitation or office of origin payable to the persons concerned. trienes, if they are perceived to be sufficient. If not, the payment shall be made by means of the special levy scheme referred to in the following Article of this Regulation.

4. The obligation to list for compulsory mutualists is suspended in the following situations:

a) When you are licensed for your own affairs.

b) When they are in the situation of firm suspension.

5. However, the contributions of the compulsory mutualists for the periods referred to in the preceding paragraph shall be made from the date on which they are repayable to give their remuneration, after each month, to the total extinction of the debit, a current quota and another overdue. If, from these situations, they are on a voluntary basis, or any other situation or condition which does not entail the obligation to list, the contributions due must be entered. The entry of these quotas must be made within one month, from the notification of the settlement and the requirement for payment by the mutual benefit, and, in the event of non-compliance, the levy will be charged by way of a prize.

Article 28. Special rate of contribution.

1. They are subject to the special levy scheme:

(a) Compulsory mutualists who are in a situation of special services to whom they are not required to retain their share in the remuneration of their post or effective post which they carry out, and who do not receive their origin destination, or they receive it in an insufficient amount to cover the relevant contribution.

(b) Mutualists who request optional maintenance of discharge.

2. The special scheme consists in the payment of the quotas directly by the mutualist by means of the procedure established by the mutual society.

Article 29. Payment of the fees during the optional maintenance of the discharge.

In the case of mutualists applying for optional maintenance of discharge in accordance with the provisions of Article 10 of this Regulation, the payment of the fee shall be made on the basis of the causative event and shall include the contribution corresponding to the mutualist and the State's contribution.

SECTION 3 VOLUNTARY PERIOD COLLECTION OF QUOTAS

Article 30. Competence.

The management of the fees corresponding to the individual contribution is a matter for the General Mutual Fund, in accordance with the provisions of this regulation and the rules to be laid down by the Minister of State Public.

Article 31. Subjects responsible for the entry of the quotas.

1. In the cases referred to in Article 27 of this Regulation, they shall be responsible for the entry of the quota:

(a) The Paying Fund of the Directorate General of the Treasury and Financial Policy and the Paying Banks of the Economy and Finance Delegations, depending on their respective territorial scope, in relation to the officials mutualists for the General Administration of the State.

b) The competent bodies of the Administrations of the Autonomous Communities, with respect to the mutual civil servants in service in those communities.

(c) Enabling or paying agencies, in the case of mutual civil servants providing services in public sector bodies or entities.

2. In the cases referred to in Article 28 of this Regulation, the mutualists themselves shall be responsible.

Article 32. Time of entry.

The income of the quotas shall be carried out by means of payment due and in a single act, and shall be carried out within the month following that of the corresponding settlement and deduction in payroll, in the case of the general system of contributions, and within the month following the period to which the entry corresponds, in the case of the single trading scheme.

Article 33. Surcharge.

1. The fees paid out of time by the obliged persons referred to in Article 28 (1) (b) shall have the following default:

(a) Five per cent, if they are paid within two calendar months of the expiry of the statutory deadline.

b) Twenty percent, if the previous deadline is paid and before the award path is started.

2. Six months after the expiry of the period of entry referred to in Article 32, without the voluntary mutualist having entered the quotas due with corresponding surcharges, it shall cause a reduction in the general mutual benefit, without prejudice to the obligation to pay the fees due.

Article 34. Place of entry.

The General Mutual Fund shall determine the credit institutions through which the income of the contributions referred to in Articles 27 and 28 of this Regulation shall be channelled, to the end of which it shall establish concerts.

Article 35. Documentation of the revenue.

1. The income of the fees withheld by the ratings or paying offices shall be carried out with the completion of the requirements to be established by the General Mutual Fund. The information which, on a monthly basis, must be provided by the payment system and the payer shall be made on the support and with the technical specifications to be indicated and shall express at least the number of contributions, discounts or discounts made to each of them, including the name, last name and identification code of each listing determined by the mutuality, which shall include the identity card number. It shall also contain details of the ratings or paying offices to which the amount entered in each case corresponds.

2. The revenue from the contributions to be made directly by the mutualists to which the special contribution scheme applies shall be documented by justification determining the mutual benefit.

Article 36. Proof of payment.

1. The persons who are bound by direct income in the mutual fund shall keep the supporting documents for a minimum period of four years.

2. The amount of discounted contributions to the mutualists shall necessarily be specified in the payroll to be made by the paying offices.

3. The paying offices shall keep the listing documents for the period referred to in paragraph 1.

Article 37. Control of the collection.

1. The control of the revenue shall be carried out by the General Mutuality.

2. The fees payable to the General Mutual Fund under the control referred to in the preceding paragraph shall result in their being liquidated and paid by the subject liable for payment.

SECTION 4. COLLECTION ON AN EXECUTIVE WAY

Article 38. Procedure.

1. The collection of the quotas on the basis of the payment, with the arrears of arrears payable as provided for in Article 33 (1) of this Regulation, shall be carried out in accordance with the provisions of the general rules for the collection of taxes, approved by Royal Decree 1684/1990 of 20 December 1990, and additional provisions.

2. The certificates of discovery authorized by the General Directorate of MUFACE will have the consideration of executive titles.

3. The costs and expenses incurred by the recovery shall be borne by the debtor and subject to the corresponding liquidation.

Article 39. Requirements.

Before issuing the corresponding discovered certification, the Directorate-General of MUFACE will send a request to the debtor, so that, within 15 days of its notification in form, it will proceed to the payment of the the contributions due and the surcharge applicable. After this period has not occurred, the certificate of discovery shall be completed.

SECTION 5. COMMON RULES FOR INDIVIDUAL CONTRIBUTIONS

Article 40. Quota return.

1. Mutualists who are obliged to pay contributions shall be entitled to the full or partial refund of the quotas or the excess of the quotas. The period for exercising this right shall be four years from the date on which they were made effective. They shall form part of the contribution to return the surcharges, interest and costs which were satisfied when the undue income was made by way of a prize, as well as the legal interest applied, where appropriate, to the amounts paid.

2. Requests for repayment of quotas shall be made by those concerned with the General Mutual Fund. The return may also be automatically agreed upon by the General Mutuality.

Article 41. Prescription.

The obligation to pay the contributions to the mutual benefit shall be prescribed by the four years from the date on which they were required to be entered.

The prescription will be interrupted by the ordinary causes and, in any case, by any administrative action carried out with formal knowledge of the obligation to pay the contribution to the liquidation or collection of the debt and, in particular, the debtor's requirement.

Article 42. Ranking of credits.

1. The appropriations for individual contributions to the Mutual Fund and, where appropriate, the surcharges or interest which it shall carry out shall, in respect of the whole of the appropriations, be equal to the same order of preference as the appropriations referred to in paragraph 1. 1. Article 1924 of the Civil Code and paragraph (D) of paragraph 1.or of Article 913 of the Trade Code.

2. The other appropriations of the administrative mutual fund shall be the same order of preference as laid down in paragraph 2 (E) of Article 1924 of the Civil Code and in paragraph (D) of Article 913 of the Trade Code.

SECTION 6. STATE CONTRIBUTION

Article 43. Amount.

1. The State shall permanently enter into its budgets the contributions it grants annually to the General Mutual Fund of Civil Servants of the State for the financing of the benefits referred to in Article 12 of the recast text, except as referred to in paragraph (h) of that Article.

2. The amount of State contributions shall be determined by a percentage of the regulatory assets for the purposes of the contribution of liabilities, which shall be fixed annually in the General Budget Law of the State.

3. These State contributions are independent of the grants referred to in Article 35 (3) of the recast text.

Article 44. Procedure.

1. The State's contribution shall be made to the General Mutual Fund by monthly instalments, starting in January of each financial year, on account of the final settlement.

2. The procedure for fixing the amount of the deliveries referred to in the previous paragraph shall be established by the Order of the Minister of Public Administration, subject to the Ministry of Finance's report.

CHAPTER IV

General rules for protective action

SECTION 1. PERFORMANCE STATUS

Article 45. Regulatory standards.

The protective action of the administrative mutualism and the conditions and conditions required to cause entitlement to the benefits which it comprises shall be governed by the provisions of the recast text, in this Regulation and in the other provisions for its implementation and development.

Article 46. Protected contingencies.

The mutualists and, where appropriate, the relatives and assimilated to their position, are specifically protected, in accordance with the provisions of the recast text and in this regulation, in the following contingencies:

a) Need for healthcare.

(b) Temporary inability, arising, either from a common or professional illness, or from a common accident or act of service or as a result of it.

c) Permanent inability in the same assumptions of the previous paragraph.

d) Family loads.

Article 47. Benefits.

The benefits to which the mutualists or their beneficiaries are entitled, when they are in the legally established assumptions, are as follows:

a) Healthcare.

b) Temporary and risk disability benefits during pregnancy.

c) Recovery by permanent incapacity total, absolute and great invalidity.

d) Provision for the remuneration of the person in charge of the assistance of the invalid grand.

e) Compensation for injuries, mutilations or deformities caused by occupational disease or in service or as a result of it.

f) Social services.

g) Social assistance.

h) Family benefits per child in a disabled capacity.

i) Economic aid in cases of multiple birth.

Article 48. Characters of the capabilities.

1. Benefits comprising the protective action of administrative mutualism may not be withheld, without prejudice to the provisions of paragraph 3 of this Article, total or partial disposal, compensation or discount, except in the two cases following:

(a) In order to comply with the maintenance obligations in favor of the spouse and children.

(b) In the case of obligations incurred by the beneficiary within the administrative mutualism.

2. In the matter of the embargo, it will be established in the Law of Civil Procedure.

3. Perceptions arising from the protective action of administrative mutualism shall be subject to taxation in the terms laid down in the regulatory rules of each tax.

4. No price may be required for the information or certifications to be provided by the General Mutuality in relation to the benefits referred to in the previous Article.

Article 49. Conditions of entitlement to benefits.

1. Mutualists shall be entitled to benefits if, in addition to meeting the conditions laid down for each of them, they are in the general mutual or in a situation similar to that in which the contingency or situation arises. protected.

2. They shall be considered to be in a situation similar to that of discharge, for the purposes of implementing the General Mutual Mutual Action:

(a) Those who have chosen to maintain their status as voluntary mutualists, in accordance with the provisions of Article 10 of this Regulation.

(b) Pensioners who have been incorporated as voluntary mutualists as required by paragraph 2 of the additional first provision of the recast text, with the rights set out in this Regulation.

Article 50. Recognition of entitlement to benefits.

1. Recognition of the right to benefits of General Mutuality shall be carried out by the Director-General of MUFACE, without prejudice to any delegations that may be granted.

2. The procedure for the recognition of the right shall be initiated at the request of the person concerned, or of his legal representative, by himself or by means of the authorised representative in form, who must accompany the documents and information required by the rules applicable to the procedure in question, and other evidence in which it is based on its right.

3. However, the procedure may be initiated on its own initiative, either exceptionally in a singular form or by means of a call approved by the Director-General of the Mutual Society, which shall specify the conditions and conditions for granting the the provision in question.

Article 51. Adoption of precautionary measures in the maintenance of the right to receive benefits.

Non-compliance by the beneficiaries or the cause of the economic benefits of the administrative Mutualism of the obligation to present, within the prescribed legal deadlines, prescriptive declarations or documents, a background, supporting evidence or data which does not exist in the General Mutuality, where required, as well as the failure to appear, unless justified, to the medical examinations ordered by it in the cases thus established, provided that may affect the preservation of the right to benefits, which may give rise to the The necessary preventive measures must be taken, by means of the precautionary suspension of the payment of the said benefits, until duly accredited by the beneficiaries or the persons concerned that the legal requirements are met. essential for the maintenance of the right to these.

Article 52. Succession in the exercise of rights.

1. If an administrative procedure for the recognition of a given benefit is initiated by law, the person concerned during his or her processing, and the continuation of the proceedings is instituted, shall be completed by the end of the declaration. which corresponds to, where appropriate, the heirs in civil law of the amounts due.

2. For the purposes referred to in paragraph 1, the procedure shall be presumed to be initiated on a regulatory basis on the date of the event causing the benefit, if its continuation is to be justified on the basis of the following cases:

(a) In the case of recognition of the right to full or partial reimbursement of the costs actually incurred by the deceased.

(b) When the situation of temporary incapacity or the risk of pregnancy was initiated during pregnancy, the deceased would have died before applying for recognition of the allowance corresponding to each monthly allowance, without due cause imputable. In such a case, the requirements and effects shall be those set out in Chapter VI of this Regulation.

3. If the beneficiary of any provision of the administrative mutualism dies, the economic amount in which it is established, payable and unperceived, shall be paid to the heirs by civil law, at the request of a legitimate party. The exercise of the action by one of the heirs shall be in the interests of the others who may exist.

4. The application for succession in the exercise of rights shall be made within a period of five years from the day following that of the death of the person concerned, except in the case of the presumptions laid down in paragraph 2 of this Article. Article 1, in which case the time limit shall be based on the fact that the benefit has been provided. In the case of benefits subject to public notice, such a request shall be made, in any event, within the time limits laid down in each call.

Article 53. Limitation of the right to the recognition of benefits.

1. The right to the recognition of benefits shall be limited to five years from the day following that in which the event causing the benefit in question takes place, without prejudice to the exceptions provided for in that provision. regulation. The prescription will be interrupted, in addition to the complaint to the General Mutuality, for the ordinary causes established in Article 1973 of the Civil Code.

2. The right or, where appropriate, the expectation of the right to the recognition of benefits subject to public notice, with specific time limits for their exercise, shall lapse.

Article 54. Expiration of the right to receive benefits.

1. The right to receive the benefit already recognised will expire in the year. The time limit shall be counted from the date of notification of the recognition of the benefit.

2. In the case of periodic benefits, the right to the receipt of each monthly payment shall expire in the year in which it is due, except in the case of monthly allowances for the recognition, in which case, for the calculation of the time limit, the provided in the previous section.

Article 55. Drawback of undue benefits.

1. Mutualists and other persons who have received undue benefits from the General Mutual Fund and their successors in title shall be obliged to reintegrate their amount, without prejudice to the responsibilities of another order in which they have been could incur.

2. Those who, by default or act, have contributed to the misperception of a benefit shall be liable, with the exception of the recipients, with the exception of proven good faith, of the obligation to reintegrate as laid down in the preceding paragraph, where the person concerned does not have the right to receive benefits, or if he has received them in excess of the amount or content of the benefit in question, in accordance with the rules governing the provision that he/she is entitled to treat.

3. For the reimbursement of these benefits, the award procedure referred to in Article 38 of this Regulation shall apply where appropriate.

4. Failure to recover the undue receipt shall not be required without prior review or reform of the act or agreement which would have resulted in the payment of such amounts.

5. The General Mutual Fund may amend or amend at any time, by reasoned agreement, acts which, subject to periodic review, to the fulfilment of certain conditions or requirements, or agreed on a provisional basis, shall be disclosed. not due as a result of such review or of the non-compliance with the condition or requirement concerned, or its elevation to definitive. The reviewable, conditional or provisional nature of the acts must be expressly stated in the act itself or provided for in a general provision. The processing of the procedure shall in any event ensure the right of the person concerned to be heard.

Article 56. Prescription of the drawback obligation.

The obligation to refund the amount of the benefits unduly received will be prescribed at the age of four, counted from the date of its recovery, or since it was possible to exercise the action to demand its return, with independence of the cause which led to the misperception, including the assumptions for the review of the performance by mistake attributable to the mutual benefit.

Article 57. Deferral and fractionation of the debt.

The deferral and fractionation of the payment for debts with the administrative mutualism will be governed by the provisions of the General Tax Collection Regulation, corresponding to the General Directorate of Mutual processing and resolution of requests made during a voluntary payment period.

Article 58. Periods of contribution conditional on entitlement to benefits.

1. In order to be entitled to economic benefits for which a minimum period of contribution is required, the periods of insurance provided for in other schemes may be combined, provided that they do not overlap with those of this special scheme and that those benefits or other similar purposes are included in the protective action of the scheme whose contribution periods are taken into account to cause such a right.

2. Minimum periods of contribution shall not be required for the right to benefits arising from an accident in the event of a service or a professional illness.

SECTION 2. CONCEPT OF CONTINGENCIES

Article 59. Concept of accident in act of service.

1. An accident shall be understood as an act of service on the occasion or as a result of the activities of the service to the Administration.

2. For the purposes of determining the cases in which the special scheme is to be regarded as an accident at the service or as a result of the accident, and for the presumptions applicable in this respect, the General Conditions of Employment shall be subject to the provisions of the General Staff Regulations. Social security in relation to the concept of an accident at work, without prejudice to any specific characteristics that may arise from the provision of the public service.

Article 60. Concept of occupational disease.

Professional sickness shall be understood by the mutualist as a result of the provision of his services to the Administration, in the activities specified in the regulations of the General Regime of the Social security or other rules to be applied, provided that it is caused by the action of the elements or substances determined in those rules for each occupational disease.

Article 61. Recognition of rights arising from occupational disease and accident at the service.

1. The recognition of rights deriving from occupational disease and accident at the service or as a result of it, for the purposes of administrative mutualism, shall be carried out by the General Mutuality, either prior to or at the same time as the the granting of benefits arising from such contingencies.

2. The procedure for the recognition of these rights will be used on the basis of a dossier aimed at finding out the causes that gave rise to the injuries or the circumstances in which the pathology started, as well as to establish the of causality between them and the service or task performed by the mutualist. Such a file, which shall be initiated at the request of the person concerned or on his own initiative by the body responsible for issuing, where appropriate, the sick leave of the mutual official concerned, shall be instructed by that body in accordance with the rules laid down by the (a) to be established on the order of the Minister of Public Administration, which shall also determine the specifications to be contained in the report resulting from the instruction, including the possibility of the said body carrying out complementary actions.

Article 62. Concept of common accident and disease.

Common accident and disease shall be considered to be the injury and health disturbance which, subject to the foregoing articles, cannot be qualified, neither as an accident in service, nor as a professional disease.

Article 63. Legal concept of the remaining contingencies.

It shall be that which results from the conditions required for the recognition of the right to benefits granted under consideration to each of them.

Article 64. Catastrophic risks.

In no case shall the General Mutual Protection be subject to the risks declared catastrophic under its special legislation.

CHAPTER V

Healthcare

SECTION 1. GENERAL PROVISIONS

Article 65. Object and capability.

1. Health care is intended to provide medical, surgical and pharmaceutical services conducive to the preservation or restoration of the health of beneficiaries of this special scheme, as well as their suitability for work.

2. It will also provide the appropriate services to complete medical and pharmaceutical services and, in a special way, will address the physical rehabilitation for the professional recovery of the disabled entitled to it.

3. Health care will be provided in accordance with the provisions of the recast text, in this regulation and, as far as it is applicable, in Law 14/1986 of 25 April, General of Health and other current health regulations, the content of the service portfolio of the National Health System, as well as the guarantees on accessibility, mobility, quality, security, information and time collected in those standards.

Article 66. Protected contingencies.

Contingencies covered by the provision of health care are those of common or occupational disease and injuries caused by a common accident or act of service or as a result of accident or accident, or specific risk of the charge, as well as the pregnancy, delivery and puerperium, in the extension and terms that are set out in this regulation.

SECTION 2. BENEFICIARIES OF HEALTHCARE

Article 67. Beneficiaries of health care by common illness and accident.

1. All mutualists falling within the scope of this special scheme, retired mutualists, and family members or persons treated as members of the mutual insurance scheme, are beneficiaries of the health care by sickness and accident. Article 15 (1) and meeting the requirements laid down in paragraph 2 of that Article.

2. In addition, the persons referred to in Article 16 may be beneficiaries of the health care and shall comply with the requirement set out in that Article.

Article 68. Beneficiaries of health care by accident in the event of service and occupational disease.

1. Health care workers are entitled to an accident in the event of a service and occupational disease to those who suffer any change in their health as a result of the contingencies provided for in Articles 59 and 60 of this Regulation. rules.

2. The mutualists referred to in the preceding paragraph shall be considered, in full, in a situation of discharge for the purpose of health care by accident in the event of service and occupational disease, even if their affiliation or their affiliation has not been processed. high in General Mutuality.

Article 69. Beneficiaries of maternity health care.

They are beneficiaries of maternity healthcare:

(a) Mutualists and other beneficiaries of health care by common sickness and accident, determined as provided for in this Regulation.

(b) The spouses of the mutualists and those who have been living with them in a similar relationship of affectivity to that of the spouse, even if they are not subject to protection under Article 15 of this regulation.

Article 70. Documentation.

In order to receive healthcare it will be essential to display documents that determine the General Mutuality.

SECTION 3 RULES ON THE BIRTH, DURATION AND EXTINCTION OF THE RIGHT TO HEALTH CARE

Article 71. Birth and effectiveness of the right to healthcare.

1. The right to health care is born and produces its effects on the day of affiliation or discharge, both for the holder and for his or her family members or similar beneficiaries. For family members or persons treated as beneficiaries whose inclusion as beneficiaries occurs at a later date, the effectiveness of the right to health care shall be on the date of application for recognition of their status as beneficiaries, except in the case of the newborn who, irrespective of that date, shall be entitled to the appropriate health care during the first month from the time of delivery.

2. For the purposes of the exception referred to in the preceding paragraph, the newborn shall be subject to the adoption or acceptance, both preadoptive and permanent, of the first month, either on the basis of the administrative or judicial decision of the (a) the right of establishment, or the right of the court to take such a decision.

3. Where, by any circumstance, the incorporation into the mutual benefit of an official in a situation leading to the condition of a compulsory mutualist, as laid down in this Regulation, has not occurred and shall be incurred as a result of health assistance to that or its beneficiaries during the period between the date of incorporation and the date of its formalisation, the mutualist may request the reimbursement of such costs.

Article 72. Duration of healthcare.

Health care shall be provided from the day on which, by meeting the conditions required for its effectiveness, is requested from the relevant optional, as long as the requirements laid down for retain the right to receive it.

Article 73. Duration of health care by accident in service and occupational disease.

By way of derogation from the foregoing Articles, health care by accident at the event of service and occupational disease shall be provided to the person concerned from the time of the accident or the diagnosis of the accident. occupational disease, and for as long as the pathological condition produced by such contingencies requires it.

SECTION 4. HEALTHCARE CONTENT

Article 74. Content of health care by common illness and accident.

Health care by common sickness and accident shall have an extension and content similar to those laid down for the General Social Security Regime and shall comprise:

(a) Primary care, which will, in general, include healthcare in outpatient, home and emergency care, and preventive primary care programs.

b) Specialized care, including:

1. The assistance specialized in outpatient and hospital treatment, including day hospital and home hospitalization, as well as urgent care, both hospital and extra-hospital.

2. Psychiatric Care in an outpatient regimen, including individual, group or family psychotherapy, and hospitalization of acute and chronic processes.

3. Cosmetic Surgery, provided that it is related to accident, disease, or congenital malformation.

4. The preventive programs for specialized care.

5. º Any new diagnostic or treatment technique that is carried out by public health administrations in one of the own or concerted centers of the National Health System.

(c) The pharmaceutical supply, which includes proprietary medicinal products, pharmaceutical products, pharmaceutical effects and accessories, and other medical devices, with the extent determined for the beneficiaries of the scheme General of Social Security, under the conditions set out in this regulation.

d) The complementary benefits required to achieve comprehensive and appropriate healthcare, such as:

1. Health transport.

2. º Oxygen therapy at home.

3. The complex dietoterapic treatments and enteral diets.

4. º Orthoprosthetic Capabilities.

5. Other Health Benefits.

e) Any other benefit to be determined in the scope of the General Social Security Regime.

Article 75. Content of maternity health care.

Maternity healthcare includes:

a) Preparation for delivery.

b) Care in the outpatient, hospital and emergency care of pregnancy, delivery and puerperium, as well as the obstetric pathology that may occur in such situations.

c) The pharmaceutical and complementary benefits arising from such contingencies.

Article 76. Content of health care by accident at the event of service and occupational disease.

Health care by accident at service and occupational disease includes:

(a) All health treatments and actions deemed necessary and with the same content as specified in Article 74 of this Regulation.

b) The cosmetic surgery that is related to the accident in the act of service or professional illness.

(c) All types of prostheses and orthotheses and other complementary services deemed necessary in relation to the pathological process arising from the accident in the event of service or occupational disease.

(d) The pharmaceutical supply, in the terms set out in Article 82.

SECTION 5. ACCESS TO HEALTHCARE

Article 77. Healthcare provided by either own or concerted means.

1. Health care shall be provided by the General Mutuality directly or in concert with other public or private entities or establishments, preferably with Social Security institutions. Where the assistance is provided by means of a concert, the mutualists may choose either at the time of their membership or at the time of their membership, either within the period specified for the purpose, by the public or private establishment or establishment through which they are to receive the provision of such assistance.

2. The concerts shall stipulate the reciprocal rights and obligations of the parties, as well as the modalities, form, conditions of the assistance and the causes for which it shall be provided to the beneficiaries entitled to it.

Article 78. Healthcare provided by outside media.

1. The beneficiary who, by his own decision or his family members, uses health services other than those which correspond to him, shall, without entitlement to reimbursement, pay the costs which may be incurred, without prejudice to the provisions of the paragraphs following:

(a) Where the mutuality directly facilitates healthcare and the beneficiary uses health services other than those assigned by an unjustified refusal of health care or urgent assistance of a vital nature, it shall be responsible for that decision in order to proceed, where appropriate, to the reimbursement of expenses, provided that in the second case the mutual benefit is notified within 15 days of the commencement of such assistance.

(b) Where a beneficiary is assigned to a private entity arranged by the mutual fund, it may use health services other than that of that entity in the following circumstances:

1. If the requested health care has been denied to you by that entity and this refusal has been unjustified, as stipulated in the concerts in force at any time. In this case you will be able to make use of health services other than those that correspond to you and claim the reimbursement of expenses incurred by them.

2. If the use of such health services has been due to emergency assistance of a vital nature. In this case, the person concerned may claim the reimbursement of the costs incurred by the person concerned, and it is essential that the commencement of health care be notified to the beneficiary's membership in the time, terms and conditions to be established at the appropriate concerts.

In the event of a discrepancy on the origin of the refund in the circumstances provided for in the two preceding cases, it is for the mutual benefit to be assessed and resolved, without prejudice to the possible procedures of claim by the beneficiaries provided for in the respective concerts.

2. However, where a beneficiary is assigned for health care purposes to a public body and makes use of health services other than those that correspond to it, it shall be subject to the legal and procedural rules of the the body has available for situations of use of other means of use, as well as its judicial system.

SECTION 6 PHARMACEUTICAL DELIVERY

Article 79. Content of the benefit.

1. The pharmaceutical supply consists in the supply of health care recipients, through the procedures provided for in this regulation, of proprietary medicinal products, masterways, effects and pharmaceutical accessories. and other medical devices, recognized by the legislation in force, and with the extension determined for the beneficiaries of the General Social Security System. The benefit shall be provided by the General Mutual Fund and by the economic contribution of the beneficiaries themselves, who, where appropriate, shall correspond.

2. In any event, cosmetic or cosmetic products, dietary and product products, mineral waters, bucodental elixirs, toothpastes, medicinal products for use in the manufacture of medicinal products, soaps, etc., are excluded from the pharmaceutical supply. medicinal products, proprietary medicinal products and other similar products, as well as all those which, in accordance with the health regulations in force at any time, are or are excluded from the financing by the Social Security Fund or State funds affected by the Health.

Article 80. Prescription of medications.

1. Within the scope of application referred to in the preceding Article, the health care provider may prescribe, in accordance with the instructions set out by the General Directorate of the Mutual Society, the health care provider, any proprietary medicinal products, masterways, pharmaceutical effects and accessories and other medical devices recognised by existing health legislation which are suitable for the recovery of the health of their patients.

2. The prescription shall be made in the model of official prescription established by the mutuality, and subject to the provisions of Royal Decree 1910/1984 of 26 September 1984, of a medical prescription, its subsequent modifications and other implementing rules, without prejudice to the specific characteristics of this special scheme.

Article 81. Dispensing of medications.

1. The supply of medicinal products shall be:

(a) through the healthcare facilities to which the provision of health care or other means of the public or private entities or establishments responsible for such assistance is concerned, provided that Article 103 of Law 14/1986 of 25 April, General of Health and Article 3 of the Law of the Drug.

(b) In the cases not referred to in the previous paragraph, directly by the mutual fund or through the legally established pharmacy offices. To this end, the General Mutuality may hold the appropriate concerts, which will establish the form and conditions of billing and payment in which the dispensation will be carried out.

2. The supply of foreign medicinal products, the import of which has been authorized by the Ministry of Health and Consumer Affairs, shall be carried out by means of the procedure laid down for that purpose.

3. The dispensation may be subject to the fulfilment of the prerequisites laid down by the mutuality and shall be carried out in accordance with the provisions of the health legislation in force and, in particular, Article 94.6 of Law 25/1990 of 20 December 1990. December, of the Medication.

Article 82. Type of financial contribution.

1. Medication dispensing will be free at:

(a) The treatments performed in the health facilities and other means provided for in paragraph 1 (a) of the previous Article.

(b) The medicinal products to be supplied by the hospital pharmacy services.

(c) Those treatments that have their origin in an accident in service or professional illness. In the latter case, if any amount has been paid, it will be refunded.

2. In other cases, the beneficiaries shall participate by payment of 30% of the selling price to the public of the medicinal products and other medical devices, without prejudice to those cases in which the existing health legislation establishes another percentage or a maximum amount of participation in the dispensation.

3. These percentages and amounts may be reviewed by the Government, on the proposal of the Minister of Public Administration and after report of the Ministries of Finance, Labor and Social Affairs and Health and Consumer Affairs.

Article 83. Obligation for the preservation, custody and legitimate use of prescription talonaries.

1. The preservation, safekeeping and use of medical prescription talonaries is the responsibility of the mutualist.

2. The loss or subtraction of the prescription talonaries, the latter duly reported, shall immediately be communicated to the General Mutuality, seeking the appropriate justification for having carried out the communication.

3. The conservation, safekeeping and use of prescription and narcotic drug talonaries shall be in compliance with the particular obligations laid down in their special legislation.

Article 84. Monitoring and monitoring of drug use.

1. The General Mutuality shall ensure that the prescription and dispensing of medicinal products are carried out in accordance with the basic criteria of rational use referred to in Law 25/1990 of 20 December of the Medication and its provisions of development.

2. To this end, it will promote the conduct, on a regular basis, of the necessary actions in order to detect rational indications of drug abuse and the use of prescriptions above the limits estimated as such. usual.

3. Without prejudice to the specific measures which, in each case, should be taken, if any type of criminal liability is involved in the investigation, it shall be brought to the attention of the Prosecutor's Office.

SECTION 7 USE OF HEALTH SERVICES OUTSIDE THE NATIONAL TERRITORY

Article 85. Healthcare provided outside the national territory.

The use of health services abroad will entitle, under conditions of equivalence with the health care provided within the national territory, to the coverage of the expenses incurred in connection with the assistance, in terms, conditions and forms of management to be established by the mutual society.

Article 86. Health care for mutualists posted abroad.

1. In the case of mutualists abroad and their beneficiaries, the General Mutual Fund shall lay down the arrangements for the provision of health care to which it is responsible, subject to a report, if appropriate, by the Ministry of External.

2. The General Mutual Fund may extend the form of health care provided for in the preceding paragraph to other cases of mutualists and beneficiaries with residence abroad.

Article 87. Health care for mutualists and beneficiaries temporarily moving abroad.

1. Where a mutualist or beneficiary moves abroad for any cause and receives health care, he shall be entitled to the reimbursement of expenses incurred for such assistance, with the exception of the following exceptions:

(a) That the assistance received or the expenses claimed are included in some form of health coverage abroad, in charge of a public or private entity, national or foreign.

(b) The purpose of the assessment of the pathology in question and other circumstances of any concurrent order shall be to establish an intended purpose of the mutualist or beneficiary to circumvent the relevant health services, using the offset to use media other than these.

2. It shall be for the mutualist or his beneficiary to inform himself of the conditions and procedures to be followed in order to receive the health care he may need in the country where he is to be displaced.

3. It is up to the General Mutuality to define the limits of the temporary nature of the displacement, as well as the documentation to be provided to request the reimbursement of expenses.

CHAPTER VI

Temporary and risk disability benefits during pregnancy

SECTION 1. TEMPORARY DISABILITY SITUATION

Article 88. Protected contingencies.

1. They have the consideration of states or situations of temporary incapacity:

(a) Due to common or professional illness and accident, whether or not in service, while the mutual official receives health care and is prevented from carrying out his duties administrative.

(b) The periods of observation for occupational disease in which the discharge is prescribed during service during these periods.

2. They do not have the consideration of temporary incapacity for the permits or licenses for childbirth, adoption or acceptance, both pre-adopted and permanent, as laid down in Article 30 (3) of Law 30/1984 of 2 August of Measures for Reform of the Civil Service. If at the end of the birth permit the impossibility of joining the work continues, the licenses that give rise to the temporary incapacity will be initiated.

3. The risk situation during pregnancy shall be governed by the provisions of Section 3 of this Chapter. The temporary disability situation will be interrupted if the risk situation is initiated during pregnancy.

Article 89. Temporary disability status.

1. Officials who, in accordance with Article 69 of the text of the Law on Civil Servants of the State, approved by Decree 315/1964 of 7 February, have obtained licences for sickness or accident which prevent the normal performance of public functions, they will be in the situation of temporary incapacity.

2. In addition, officials who have been licensed as a result of medical observation in the event of occupational diseases shall be in such a situation.

Article 90. Actions of the staff bodies.

1. The granting of licences and the control of licences shall be the responsibility of the administrative bodies determined by the rules of competence in the field of personnel management, with the optional advice which, where appropriate, they deem appropriate.

2. For the purposes of the carry-overs provided for in the following Article, the competent body shall obtain the appropriate optional report stating the circumstances required in each case for granting it.

3. At any time when it is expected that the disease or injury by accident shall definitely prevent the performance of the public functions and, in any event, before the time limit referred to in paragraph 1 of the following Article has elapsed, the retirement procedure for permanent incapacity for service shall be initiated by the competent retirement authority, either on its own initiative or at the request of the person concerned. The Minister for Public Administration shall establish the mechanisms necessary to coordinate the actions of the mutual society and those of the retirement organ.

Article 91. Duration of the temporary disability situation.

1. The duration of the temporary disability situation shall be that laid down for the General Social Security Scheme.

2. The temporary incapacity referred to in Article 88 (1) (a) of this Regulation shall be for a maximum duration of 12 months, which may be extended for a further six months if the official is presumed to be discharged. medical by cure.

3. The periods of observation referred to in Article 88 (1) (b) shall be for a maximum duration of six months, which may be extended for a further six months where it is deemed necessary for the study and diagnosis of the disease.

4. For the purposes of calculating time limits, a new disease shall be deemed to exist where the pathological process is different and, in any case, where the granting of licences has been interrupted for a minimum of one year. The different and successive pathologies shall entitle the beginning of a new period of temporary incapacity, which, if any, shall end the period in progress.

5. The duration of the first and successive licences shall be for the time predictably necessary for the cure, with the maximum of one month each.

6. The periods of relapse in the situation of temporary incapacity shall be taken into account for the maximum duration of the temporary incapacity. It will be understood that there is a relapse and therefore a new situation of temporary incapacity is not started, when the mutualist, whose sick leave has concluded, will need health care and to be incapacitated for the service within a period of one year after the completion of the said sick leave and as a result of the same pathological process as the previous incapacity or similar process.

7. The periods of observation prior to diagnosis shall be computed for the duration of the temporary incapacity, whether the medical diagnosis confirms the existence of a professional disease or a common disease. At the end of the maximum period of the periods of observation, including extensions, the official shall either proceed to the situation or continue in temporary incapacity.

Article 92. Extinction of the temporary disability situation.

1. The situation of temporary incapacity is extinguished, in accordance with the provisions of the General Social Security Regime:

(a) For the duration of the maximum time limits laid down in the previous Article, including extensions, if they proceed.

b) By the end of the sick leave that is in progress.

c) By the permanent disability retirement declaration for the service.

d) By the official or voluntary retirement of the official.

e) For the death of the official.

2. Where the termination of the temporary incapacity is due to the maximum period laid down, the effects of the temporary incapacity situation shall be extended until the time of the retirement declaration for permanent incapacity, without this being able to take place, in no case, once the 30 months after the first sick leave has been granted.

3. Also, in those cases where, continuing the need for medical treatment, the clinical situation of the person concerned would make it advisable to delay the possible qualification of the state of the official as incapacitated on a permanent basis for the functions of his/her body or scale, such qualification may be delayed for the period specified, without exceeding the time limit set out in the previous paragraph.

Article 93. Economic performance.

1. In the situation of temporary incapacity, the official shall have the following economic rights:

(a) For the first three months, it shall be entitled to the receipt of all economic rights, in accordance with Article 69 of the text of the Law of Civil Servants of the State.

b) From the fourth month onwards, and for the duration of the said situation, he shall be entitled to the basic remuneration, the benefit of the child in charge, if any, and a temporary disability allowance in charge of the mutual benefit General of Civil Servants of the State, fixed and invariable, which shall be calculated in accordance with the provisions of this Regulation.

2. For the purposes of this Article, the remuneration to be paid by the official referred to in the preceding paragraph shall be paid out of the same budgetary concepts for which they were received at the time of the be granted the first sick leave.

SECTION 2. TEMPORARY DISABILITY ALLOWANCE

Article 94. Beneficiaries of temporary disability allowance.

They are beneficiaries of the temporary disability allowance, the mutualistic officials who, finding themselves in that situation, have an accredited six-month contribution period, unless they are covered by this contingency. Social security scheme, body or institution, for the same service relationship.

Article 95. Birth and duration of entitlement to the allowance.

1. The right to temporary disability allowance is born from the day on which the three-month period referred to in Article 69 (1) of the text of the Law on Civil Servants of the State is completed.

2. The allowance shall be paid as long as the beneficiary is in a situation of temporary incapacity and during the extension of the effects of this situation.

Article 96. Extinction of entitlement to allowance.

The right to temporary disability allowance is extinguished:

(a) For the reasons set out in Article 92 (1) (b), (c), (d) and (e) of this Regulation.

b) By failing to meet the requirements required to be a beneficiary of the benefit.

c) By the start of a new temporary disability situation.

(d) In any case, for the duration of the maximum period of 30 months from the date on which the temporary incapacity situation has been initiated.

Article 97. Cancellation and suspension of entitlement to the allowance.

1. Entitlement to temporary disability allowance may be cancelled or suspended:

(a) Where the beneficiary has acted fraudulently to obtain or retain such benefit.

b) When the beneficiary is self-employed or employed during the temporary disability situation.

2. The right to the allowance may also be suspended where the beneficiary, without reasonable cause, refuses or abandons the treatment indicated to him.

3. In such cases, the General Mutuality shall transfer the resolution back to the body of staff which has granted the licence, for all the effects which may have taken place.

Article 98. Amount of allowance.

1. The amount of the temporary disability allowance shall be fixed and unchanged for the duration of the temporary incapacity allowance and shall consist of the largest of the following two amounts:

(a) 80 percent of the basic remuneration for the first month of leave. The basic remuneration includes the salary, triennial and grade, if any, increased in the sixth part of an extraordinary pay.

(b) 75 percent of the additional remuneration due in the first month of the license.

2. Such remuneration, basic and supplementary, shall be deemed to have been paid in the first month for which they are to be charged to that month by virtue of a provision or administrative act which recognises it, irrespective of the time when it is produce your perception.

3. If additional remuneration is credited on a regular basis higher than the monthly payment, the allowance shall be calculated for the month in which the first licence was initiated, the aliquot part of the remuneration.

4. The total amount of the subsidy, calculated in accordance with the preceding paragraphs, considered as a monthly calculation, may not give rise to the remuneration that the official continues to receive from his/her destination, which is considered in the amounts to be credited in the first month of the temporary incapacity situation, resulting in a result exceeding the total amount of total perceptions accrued and imputed to the first month of leave.

5. Without prejudice to their payment, in accordance with their regulatory rules, they shall not be taken into account for the calculation of the subsidy:

(a) Bonuses for extraordinary services provided for in Article 23.3.d) of Law 30/1984 of 2 August of Measures for the Reform of the Civil Service.

(b) The allowance for regulated residence in Decree 361/1971 of 18 February and in Royal Decree 3393/1981 of 29 December 1981.

(c) The compensation for the service referred to in Royal Decree 462/2002 of 24 May.

6. In cases where the licence does not include a full calendar month, the amount of the subsidy shall be the proportional share equivalent to the days of its concession.

Article 99. Payment of the allowance.

1. The payment of the temporary disability allowance shall be borne by the General Mutual Fund, subject to certification of the remuneration of the official referred to by the relevant rating.

2. In general, and without prejudice to the provisions of Article 98 (6) of this Regulation for the calculation of the subsidy, the payment shall be made by natural means, irrespective of the date on which the order of business materializes. payment for General Mutuality.

Article 100. Scheme of incompatibilities of temporary disability allowance.

1. The temporary disability allowance from the General Mutual Fund shall be unique and incompatible with any other that may be generated by the same service relationship, under any public social security scheme.

2. The provisions relating to temporary incapacity in Article 5.2 of Law 35/1995 of 11 December 1995 on aid and assistance to victims of violent crime and against freedom shall apply for the purposes of incompatibilities. sexual.

SECTION 3 RISK SITUATION DURING PREGNANCY

Article 101. Risk situation during pregnancy.

1. It shall have the same consideration and effects as the temporary incapacity, the situation of the woman who has obtained a risk licence during pregnancy, as provided for in Article 22 of the recast text and has complied with the period of (a) the absence of a temporary disability allowance referred to in Article 94 of this Regulation for temporary incapacity for sickness and accident.

2. The risk situation during pregnancy shall end when the last licence is concluded for such a contingency, as the birth permit referred to in Article 30.3 of Law 30/1984 of 2 August of Measures for the Reform of the Public function, either because the official function is to be reinstated to its normal function or to another compatible with its status, or already by declaration of the situation of temporary incapacity.

CHAPTER VII

Permanent disability benefits

SECTION 1 PERMANENT DISABILITY: CONCEPT AND DEGREES

Article 102. Concept and degrees of permanent disability.

1. Permanent incapacity is the situation of the official who, after having been subject to the prescribed treatment and medically discharged, has serious anatomic or functional reductions which reduce or nullify his/her capacity to the service. The possibility of recovery of the work capacity of the incapacitated shall not be such as to prevent such a qualification from being medically deemed to be uncertain or long-term. The permanent incapacity will have to be derived, whatever its cause, from the situation of temporary incapacity.

2. The definition and classification of the various degrees of permanent incapacity are those identified in Article 23 of the recast text.

Article 103. Declaration, effects and benefits of partial permanent incapacity.

1. The mutual official shall be declared in a situation of partial permanent incapacity for the usual function when he suffers a limitation for the performance of the functions of his body, scale or square, determined by the assessment body competent, which reaches the values referred to in Article 137 (3) of the recast text of the General Law on Social Security, approved by the Royal Legislative Decree 1/1994 of 20 June.

2. Where the partial permanent incapacity has its origin in common sickness or accident, the effects of its recognition shall be, on the one hand, that the official shall receive all the assets corresponding to the job which he or she it is actually performing and, on the other hand, that, if there are reasonable possibilities for recovery, it will be obliged to undergo the professional recovery processes, which will consist of:

(a) The appropriate health treatment, in particular the physical and functional rehabilitation referred to in Article 65 (2) of this Regulation.

(b) Other recovery benefits for the professional rehabilitation of the official, which may be implemented by the General Mutuality, taking into account those established for the General System of Social Security.

3. Where the cause of the partial permanent incapacity is an accident at the service or as a result of the accident, or a occupational disease, the official shall, in addition to applying it to the above paragraph, be entitled to receive the compensation as provided for in paragraph (b) of Article 110 of this Regulation.

4. The declaration of the situation of partial permanent incapacity, carried out by the General Mutual Fund, shall be automatically cancelled when the retirement is recognised as permanent incapacity for service by the competent bodies of the State Passive Classes regime.

Likewise, after the recognition of a situation of permanent incapacity for the service by the competent organs of the State Passive Classes Regime, the General Mutuality will not proceed with the assessment of the degree of partial permanent incapacity.

SECTION 2. GRAND INVALIDITY

Article 104. The determinants of the great invalidity.

The great invalidity is the situation in which the retired mutualist for permanent disability for the service is affected by one of the following circumstances:

a) The total loss of vision for both eyes.

b) The anatomic or functional loss, total or in its essential parts, of the two upper extremities or of the two lower extremities, conceptualizing as essential parts the foot and the hand.

(c) Any other anatomical or functional loss that behaves the need for the mutualist to be assisted by another person to perform the most essential acts of life, such as dressing, scrolling, eating, or analogues.

Article 105. Declaration and review of the major invalidity.

1. Where the cause of the invalidity is at the time of retirement of the official for permanent incapacity for the service, the declaration of invalidity shall be in accordance with the age limit requirements laid down in Article 1 (1) of the Directive. account for declaring such a retirement.

2. If the invalidity is exceeded after retirement due to permanent incapacity for service, the declaration may be made as long as the mutualist has not complied with the age legally laid down for the compulsory retirement of the officials of his/her body, scale or square, or while in the period of failure to complete the extension of the active service, which has been granted to him in accordance with the provisions of Article 28.2 (a), second subparagraph, of the Royal Decree No 670/1987 of 30 April 1987 approving the recast of the Law on Classes State passive.

3. The decisions to be taken in matters of declaration and revision of the grand invalidity shall be reasoned and shall state the period from which the amendment of the situation may be proposed.

This time limit will be without effect if the new procedure is based on anatomic or functional reductions other than those that prompted the previous resolution, as well as in the cases where there was an error of diagnosis.

4. In the event that an application for a declaration of great invalidity has been resolved in a manner which has been dismissed, and that there is an aggravation in the anatomical or functional reductions on which such a procedure has been made, no appeal may be made. once again, the statement of the declaration until such time as the time limit specified in the resolution is not passed.

5. The review of the declaration of great invalidity can be carried out as a result of an improvement in the anatomic or functional reductions which gave rise to the great invalidity or diagnostic error, while the mutualist is in any of the temporary circumstances referred to in paragraph 2, and provided that the time limit set out in the decision for which the major invalidity was declared has elapsed.

In the case of rehabilitation of the mutualist in his capacity as an official, due to the disappearance of the cause of retirement due to permanent incapacity for the service, the right to the benefit of a great invalidity shall be extinguished. automatically, with the effects of such rehabilitation.

Article 106. Invalidity benefit.

1. The declared invalid mutualist shall be entitled to an economic benefit of a monthly nature, including two extraordinary payments per year, in charge of the General Mutual Fund, to be paid to the person in charge of his assistance, equivalent 50 percent of the retirement pension that corresponds to you according to the full amount that is credited to you in payroll by the State Passive Classes Regime at any time.

In the event that this pension of the Passive Classes Scheme would have been reduced by concurrence with other public pensions, to determine the amount of the benefit of great invalidity, it will be taken as the basis for each time the mutualist as a pension of such a regime, unilaterally considered, taking into account that the latter may never exceed the ceiling laid down for public pensions by the corresponding General Budget Law of the Status.

2. The mutualist who is not entitled to a permanent disability pension for the service under the Passive Classes Scheme, in addition to having the remaining requirements, will have to prove a previous period of nine-year contribution, for have the right to be declared invalid and to the consequent benefit.

3. In the case referred to in the preceding paragraph, the percentage referred to in paragraph 1 of this Article shall be applied to the full amount credited at each time by the public social security scheme concerned, in the form of a pension equivalent to that of permanent incapacity for the service, excluding, if there were, the increase in invalidity. By default, this percentage shall be calculated on the basis of the result of dividing by 12 the sum of the salaries, trienes actually completed and extraordinary payments corresponding to one year, valued in accordance with the amounts in force in the month in which the retirement has occurred or, if it has not been active in that month, which it would have been appropriate to credit.

Article 107. Economic effects of the benefit by great invalidity.

1. If the existence of the great invalidity is at the time of the permanent incapacity for service, the invalidity benefit shall be paid with the economic effects of that pension.

In the event that the recognition of the invalidity is established after five years from the day following the receipt of the notification concerning the retirement declaration for permanent incapacity for work the service, the economic effects of the invalidity benefit shall be produced from the first day of the month following the month in which the application was lodged.

2. Where the invalidity is not present at the time of the permanent incapacity for service, the economic effects of the service shall be produced on the first day of the month following the date on which the application for recognition was lodged. of the great invalidity.

In the event that the opinion of the competent assessment body accredits as the date of consolidation of the pathology which gave rise to the great invalidity one that is before the date of the submission of the application for recognition of the this degree of permanent incapacity, the economic effects of the benefit shall be rolled back to the first day of the third month preceding the date of submission of the application.

3. If the recognition of the invalidity is not to be effected, for reasons attributable to the person concerned, within five years from the date of the filing of the application, the economic effects of the invalidity benefit shall be they shall produce from the first day of the month following the date on which the data subject has remedied the defects to the imputable.

Article 108. System of incompatibilities.

1. Without prejudice to other general or specific situations of incompatibility set out in this Regulation, the economic performance for the remuneration of the person in charge of the assistance to the large invalid shall be incompatible with any other benefit or pension for the same purpose, granted by a public social security scheme.

2. However, there shall be no incompatibility where the person concerned has caused a permanent disability pension for the service in this special scheme and another, of an equivalent nature, in another public social security scheme, and in both the right to have the degree of great invalidity recognised.

SECTION 3 NONINVALIDATING PERMANENT INJURIES

Article 109. Concept.

Injuries, mutilations and deformities, as well as limitations for the performance of the functions of the body, scale or square to which the mutualist belongs caused by occupational disease or act of service or as the result of the accident, whether by accident or by specific risk of the charge, which are final and which, without having to assume the retirement of the official for permanent incapacity for the service, constitute an alteration or reduction of the the physical integrity of the latter, will give the right to the perception, for one time, of compensation, an agreement with the quantities set out in the following Article.

Article 110. Benefit.

Non-invalidating permanent injury compensation consists of the payment of one of the following two amounts, for one time, as appropriate:

(a) The amount corresponding as a result of the application of the scale established for the General Social Security Scheme, provided that these injuries do not constitute permanent incapacity in any of its degrees and appear in this.

b) If the injury is a partial permanent incapacity for the normal function, the amount to be paid shall be the equivalent of 24 monthly contributions from the contribution base to the administrative mutual fund in force in the month of the first sick leave or, failing that, in the month in which the accident occurred or the disease which resulted in the anatomical or functional reductions was diagnosed.

For the calculation of the amount of this allowance, the contribution bases corresponding to the extraordinary pages of June and December will be prorated.

Article 111. Compatibilities.

If, as a result of an accident in service or of a professional illness, injuries or deformities of the regulated in this section have occurred, which are totally independent of those that produced the anatomical or functional reductions that were taken into account to declare retirement for permanent incapacity for the service, the compensation corresponding to the aforementioned injuries or deformities will be compatible with the pension arising from such permanent incapacity and, where appropriate, the benefit of the remuneration of the person in charge of assistance to the great invalid of administrative mutualism.

Article 112. Prescription.

Without prejudice to Article 53 of this Regulation in respect of the general limitation period for the right to benefits, in cases of recognition of the rights arising from occupational or occupational disease accident at the service or as a result of the accident and in recognition of the non-invalidating permanent injury compensation, the time limit shall start from the day following that in which the injuries, mutilations or deformities have reached the character of definitive.

SECTION 4. COMMON RULES TO THE WHOLE CHAPTER

Article 113. Concept of habitual function for the purpose of permanent disability benefits.

For the purposes of this Chapter, it shall be understood by normal function, in the event of an accident, whether or not in service, that the official normally performs at the time of his/her suffering, and in the case of a disease, common or professional, that to which the official would have dedicated his or her fundamental activity during the 12 months prior to the date of initiation of the temporary incapacity from which the permanent incapacity is derived or, failing that, during the 12 months prior to the date on which the disease was diagnosed which led to the anatomic or functional.

Article 114. Beneficiaries of permanent disability benefits.

In addition to the general requirements referred to in Article 49 of this Regulation, to cause entitlement to the benefits referred to in this Chapter, mutual officials shall meet the requirements of paragraph 1. of Article 102. However, the source of the temporary disability situation shall not be required to cause the right to the non-invalidating permanent injury benefit referred to in Section 3 of this Chapter.

Article 115. Termination of entitlement to permanent disability benefits.

Permanent disability benefits will be extinguished to the extent recognized:

a) By review of the situation, either with extinction of permanent incapacity or with loss of previously assigned grade.

b) By exercise of the option made by the beneficiary in case of incompatibility with other benefits to which he may be entitled.

c) By death of the payee.

Article 116. Statement and review of degrees of permanent disability. Recognition, cancellation and suspension of entitlement to benefits.

1. The declaration and revision of the degrees of permanent incapacity developed in this chapter will correspond to the General Mutuality.

Likewise, it will be for the General Mutuality to recognize, annul and suspend the right to benefits derived from such degrees of permanent incapacity.

2. Entitlement to benefits may be cancelled or suspended:

a) When the beneficiary has acted fraudulently to obtain or retain the right to them.

(b) Where the permanent incapacity is due or has been aggravated as a result of having refused or abandoned the beneficiary, without reasonable cause, the health treatment that would have been indicated to him during the situations of temporary incapacity or permanent disability itself.

c) When the beneficiary, without reasonable cause, has rejected or abandoned the treatments or processes of recovery and rehabilitation.

Article 117. Payment of permanent disability benefits.

The payment of the permanent incapacity for economic benefits in charge of the General Mutuality may be periodic, in which case it shall be made effective by natural circumstances due, or only once, as appropriate.

CHAPTER VIII.

Family protection capabilities

SECTION 1. CAPABILITIES

Article 118. Modalities of the capabilities.

General Mutuality, in the field of family protection, will provide the following benefits:

(a) Family benefits for a disabled child, which shall be payable on a regular basis.

(b) Economic aid in cases of multiple birth, single payment, consisting of a special maternity allowance and an economic benefit.

SECTION 2. CHILD BENEFIT IN DISABLED CHARGE

Article 119. Features.

1. The provision for a disabled child shall be recognised on the same terms and conditions as those laid down for the General Social Security Scheme, corresponding to the General Mutual State of Civil Servants of the State, in the field of its collective, the recognition of the right to it and its management.

2. In the case of the provision referred to in the additional ninth provision of the recast text, the amount of which is higher than that which was recognised for the same beneficiary in accordance with the preceding paragraph, the latter shall retain its excess and will be absorbed by increases that occur in the provision per child in a disabled capacity.

SECTION 3 SPECIAL MATERNITY ALLOWANCE IN THE CASE OF MULTIPLE CHILDBIRTH

Article 120. Features.

1. Mutualists, in cases of maternity by multiple births, shall be entitled to a subsidy, in the amount referred to in Article 122 of this Regulation.

2. They will cause this allowance:

(a) Children born in the same birth, when their number is equal to or greater than two.

(b) minors who, concurrently, have been adopted or accepted, both in their pre-adopted and permanent form, provided that their number is equal to or greater than two, and that the circumstances in which they are indicated are Article 30.3 of the Law on Measures for the Reform of the Civil Service.

3. The date of the cause of the birth is considered. In the case of adoption, that of the judicial decision making the same and, in the case of a reception, both preadopted and permanent, that of the administrative or judicial decision establishing the reception.

Article 121. Beneficiaries of the allowance.

1. In the case of childbirth, both the mother and the father may be the beneficiary, in accordance with the option chosen by the mother, provided that both parents are mutualists and have completed a minimum period of contribution to MUFACE of six months, with a prior to the occurrence of the causative event.

2. In the case of multiple adoption or acceptance, the beneficiary of the allowance shall be freely decided by both adopters or welcoming persons, provided that they are both mutualists and, in accordance with the conditions laid down in the preceding paragraph, right to such a subsidy. In the absence of agreement, the mother will benefit.

3. In both cases, it must be expressly stated who will be a beneficiary, when one of the parents has the consideration of a MUFACE mutualist and the other may be entitled to the allowance through a public scheme. Social Security.

4. It may also be the beneficiary of the grant, the parent, adopter or welcoming, provided that it complies with the membership requirements set out in paragraph 1, in the following cases:

a) When the mother, adopter or welcoming, was not entitled to the allowance through some public Social Security scheme.

(b) Where the death of the mother, adopter or welcoming, has occurred before she has applied for the allowance or has indicated her choice in favour of the parent, adopter or welcoming. In this case, the parent, adopter or welcoming, shall undertake not to exercise such right on behalf of the deceased.

5. The right to be a beneficiary of this allowance shall not be limited by the administrative situation in which the mutualist is located.

Article 122. Amount of allowance.

The amount of the subsidy shall be 100 per cent of the contribution basis to the General Mutual Fund corresponding to the day of the causative event, applied to the period of six weeks of compulsory rest and calculated on the basis of the number of children in the same birth or adopted or accepted at the same time, starting from the second.

SECTION 4. SINGLE ECONOMIC BENEFIT FOR SINGLE PAYMENT, BY MULTIPLE DELIVERY

Article 123. Features.

1. In the case of multiple births, the General Mutuality shall grant a single payment, in the amount set out in Article 125.

2. The persons referred to in Article 120 (2) of this Regulation shall be responsible for this benefit, with the exception of those who are not eligible, both on a pre-adopted and permanent basis.

3. It is considered the date of the cause of the birth and, in the case of adoption, the date of the judicial decision making the same.

Article 124. Beneficiaries of the benefit.

1. A single parent or adopter shall be a beneficiary, who shall be a mutualist on the date of the causative event.

2. If both parents meet the necessary requirements and live together, the beneficiary shall be the beneficiary of the agreement, which shall be expressed by express declaration at the time of the request. In the absence of agreement, the mother would benefit, and if the circumstance of coexistence did not exist, the person who was in charge of the mother's custody and custody of the children would be a beneficiary.

3. Where the responsible subjects are orphans of father and mother or are abandoned, it shall be the beneficiary who is legally responsible for taking care of them.

Article 125. Amount of benefit.

1. The amount of the economic benefit by multiple births shall be determined by applying the following table:

# of causing children

No. of times the monthly amount of the interprofessional minimum

2

4

3

8

4 and more

12

2. The amount of the interprofessional minimum wage shall be that in force at the date of the causative event.

SECTION 5 GENERAL RULES FOR FAMILY PROTECTION BENEFITS

Article 126. Payment of financial aid in cases of multiple births.

The payment of one or, if any, of both financial assistance will be made cash in a single credit.

Article 127. Compatibilities.

The two economic aids in multiple birth cases, caused by the same subjects, are compatible with each other. In addition, both aids are compatible, where appropriate, with the disabled child benefits which they may correspond to.

Article 128. Incompatibilities.

The same causative event will, for a single time, only result in each of the types of economic aid in the case of multiple births, both under this special scheme and any other scheme of the Social Security System.

CHAPTER IX

Social services and social assistance

SECTION 1. SOCIAL services

Article 129. Concept.

1. Social services are defined as the set of protective measures of this special scheme which cater for ordinary situations of need not covered by other benefits.

2. Such protective measures shall include, inter alia, the following social services:

a) Formative action.

b) Assistance to the pensioner.

c) Prstations for death.

d) Social-health programs.

3. The protective action of this special scheme may include any other social services which are provided through the services of social security or which, not covered by the preceding paragraphs, are established in the system of social security. Social Security.

4. The incorporation of the social services referred to in the previous paragraph shall be determined by the order of the Minister of Public Administration, after a report by the Ministry of Labour and Social Affairs, in which its scope and regime shall be regulated. financial.

Article 130. Training action.

1. It is intended to enable social and cultural promotion, through university studies, mutual societies and their children and orphans, by means of financial contributions in the form of study grants for mutual societies and grants of residence. for children and orphans of mutualists, among other possible modalities.

2. The details of the procedures, the specific conditions of access to them, the number of grants or grants within each of them, as well as the corresponding amounts, shall be fixed for each academic year, taking into account the entered for that purpose in the general mutual budget and by means of a timely public call, which shall be carried out by resolution of the Directorate-General of MUFACE and shall be published in the Official Gazette of the State.

Article 131. Assistance to the pensioner.

1. Mutualists who retire on a compulsory basis by reason of age or permanent incapacity for service and who, at the time of retirement, are in one of the administrative situations referred to in paragraphs 1 and 2 of the Article 9 of this Regulation, with the exception of firm sussants, shall be entitled to a retirement allowance in charge of the General Mutual Fund.

2. The economic benefit shall be the amount resulting from multiplying the total amount of a normal monthly payment of the basic remuneration corresponding to the official at the time of his retirement by a coefficient, which shall be fixed and revised, where appropriate, by order of the Minister of Public Administrations, on the basis of the availability and economic forecasts of the General Mutual Fund.

3. In accordance with the above premises, and also by order of the Minister for Public Administrations, the scope of the persons responsible for the retirement allowance may be extended as well as other possible services or aid for assistance. to the pensioner.

Article 132. Death benefits.

1. They shall include, among other possible measures and aid,

following:

a) Death Allowance.

b) Sepelium help.

2. Such aid shall be limited to the appropriations entered for that purpose in the general mutual budget.

Article 133. Death allowance.

1. The death of a mutualista shall entitle the person to receive a death allowance for one time only, the amount of which shall be determined according to the age of the deceased, applying a multiplier module, and with a minimum guaranteed.

2. Members of the family and similar persons who are listed in Article 15 (1) of this Regulation may benefit from the allowance provided that they satisfy the requirement laid down in paragraph 2 (a) of that Article.

3. According to the Minister of Public Administration the specific requirements for receiving the subsidy, the specific rules for establishing the priority of the beneficiaries, as well as the multiplier module, its updating and the minimum guaranteed amount.

Article 134. Help from Sepelium.

1. The death of a beneficiary or of the holder of a document assimilated to that of affiliation shall cause the right to receive, for one time, an aid intended to contribute to the costs of the funeral, the amount of which shall be fixed and, in its case, will be updated by order of the Minister of Public Administrations.

2. For these purposes, the condition of the beneficiary shall be presumed and, therefore, the child of a mutualist who, meeting the requirements to have been discharged as a beneficiary of health care, shall be entitled to the receipt of this aid, deceased before a month has elapsed since the date of birth.

It may also cause the right to the aid of sepelium, provided that expenses have been incurred for this concept, the fetus which, not yet meeting the conditions laid down in Article 30 of the Civil Code, would have remained in the maternal breast for at least 180 days.

3. The holder of the affiliation document or document treated as a member of the affiliation to which the person concerned was or would have been responsible shall be the recipient of the aid.

In the event of the death of the holder of a document assimilated to that of affiliation, the beneficiary shall be the recipient, if any, that happens to the holder.

Article 135. Social-health programs.

1. The social and health programmes will address the needs of older people, people with disabilities, drug addicts, chronic psychiatric patients, as well as other people in a situation of dependency.

Such programs may be modified according to the social demands of the group of affiliates and beneficiaries of the General Mutuality.

2. The modification of the programmes, the implementation of the arrangements, the specific conditions of access to them, the number of aid within each of them, if necessary, and the corresponding amounts, will be determined by agreement with the credit entered for that purpose in the general mutual budget for each financial year, by means of a timely public call, which shall be carried out by resolution of the Director General of MUFACE and shall be published in the " Bulletin State Officer. "

Article 136. Incompatibilities of benefits for social services.

Without prejudice to the general system of incompatibilities and to the particular rules laid down in the implementing rules, the social services provided by the General Mutual Fund shall be incompatible, at least in the a tranche of its matching amount, with other benefits provided or financed from public funds, provided that they are intended for the same purpose and that there is a coincidence in terms of subject and cause.

SECTION 2. SOCIAL ASSISTANCE

Article 137. Concept.

1. Social assistance shall be provided by the general mutual benefit of the economic services and aid which are considered to be necessary to deal with the states and situations of need in which the related causes may be found. next item.

2. Social assistance will be carried out, among other possibilities, through aid, in order to be granted, in order to ensure that the person concerned does not have sufficient resources. Such aids shall include:

(a) Those that are dispensed by special treatment or intervention, in exceptional cases, by a given optional, where they are not covered by the provision of health care.

(b) Those determined by non-existence, loss or insufficiency of benefits in specific cases.

(c) Due to urgent expenditure in cases of exceptional and duly justified importance.

(d) In general, any other analogous whose perception has not been regulated in the rules applicable to this special scheme.

3. The care provided in this section is independent of those provided for in Article 67 (1) of the text of the Law of Civil Servants of the State, approved by Decree 315/1964 of 7 February.

Article 138. Causes and beneficiaries of social assistance.

1. They may be entitled to the benefits provided for in this Section, provided that they fulfil the conditions in each case required, the mutualists and their family members or similar persons referred to in Articles 15 and 16 of this Regulation, The requirements set out in those Articles must be met.

2. They may be recipients of the benefits referred to in this Section, the mutualists and the holders of documents assimilated to that of affiliation.

Article 139. Incompatibilities of welfare benefits.

Without prejudice to the general system of incompatibilities and to the particular provisions laid down in the implementing rules, the social assistance benefits granted by the General Mutual Fund shall be incompatible, at least in the a tranche of its matching amount, with other benefits provided or financed from public funds, provided that they are intended for the same purpose and that there is a coincidence in terms of subject and cause.

CHAPTER X

Economic and financial regime

SECTION 1. GENERAL PROVISIONS

Article 140. Legal regime.

The General Mutual Agreement, in accordance with the provisions of Article 5 of the recast text, shall be governed by the economic and financial, patrimonial, budgetary, accounting and intervention arrangements and financial control of the (a) benefits, as well as in respect of the arrangements for concerts for the provision of healthcare and pharmaceutical services, by the recast text, by this regulation and other regulatory standards which develop the provisions of the cited by the General Budget Law on matters which are applicable and, In addition, by Law 6/1997 of 14 April, of the Organization and the Functioning of the General Administration of the State.

SECTION 2. ECONOMIC REGIME

Article 141. Heritage of the mutual society.

The shares, assets, rights, actions and resources of any other gender of the General Mutuality constitute the unique patrimony affected by its purposes, other than the State Heritage.

Article 142. Economic resources.

For the fulfilment of its purposes, the economic resources of the General Mutuality of Civil Servants of the State shall consist of:

(a) The economic contributions of the State referred to in Article 22 (2) (b) of this Regulation.

b) The quotas of the mutualists.

(c) State subsidies and other public resources of a different nature that correspond to them in accordance with current regulations.

(d) The assets, rights and actions of the mutual societies and the montepios integrated into the Special Fund of the General Mutuality of Civil Servants of the State.

e) The fruits, incomes, interests, and any other products of their property.

f) Any other private resources that are obtained for the fulfillment of their purposes.

Article 143. Financial system.

1. The financial system of administrative mutualism is the system of distribution, and its quota revisable periodically.

2. In cases where the nature of the benefits so requires, guarantee funds shall also be provided to cover potential contribution deficits or abnormal cases of claims.

Article 144. Investment.

1. The guarantee funds, and any other funds that are not immediately allocated to the fulfilment of regulatory obligations, will be invested in such a way as to coordinate the social objectives with the acquisition of the largest (a) profitability compatible with the security of investment and liquidity to the extent appropriate to the purposes for which those are to be met.

2. The Minister of Public Administration, prior to the report of the Ministry of Finance, will propose to the Council of Ministers the norms that with rank of royal decree have to be promulgated for the investment of such funds.

SECTION 3 BUDGETARY, ACCOUNTING, INTERVENTION AND CONTROL ARRANGEMENTS

Article 145. Budgets.

1. Within the institutional framework of the General Budget of the State, the mutual fund will draw up the preliminary draft budget, in accordance with the general rules on the matter, by ordering the credits organically and functionally, according to the economic classification in force, collecting the necessary allocations to cover the protective action and the means necessary to carry it out, financing the expenditure with the economic resources described in Article 142 of this Regulation.

2. The budgetary regime of the General Mutual Fund is governed by the provisions of the recast text of the General Budget Law and its implementing rules, without prejudice to its specific characteristics as regards the rules on expenditure, payments, intervention and accounting, to the end of which the Minister of Public Administration, with a favourable report from the Ministry of Finance, will dictate the appropriate rules.

Article 146. Treasury

The income and payments to be made by the General Mutuality will be channelled through the accounts opened in the Banco de España, as set out in Law 13/1994, of 1 June, of Autonomy of the Banco de España, and in other credit institutions, with which the mutual benefit, for reasons of agility in management and economic efficiency, considers it necessary to contract the provision of the service. Of these contracts, which shall be carried out by negotiated procedure with a minimum of three tenders, and without the need to require the provision of a final guarantee, as well as the opening of the resulting accounts, the Directorate-General shall be given a Treasury General and Financial Policy.

Article 147. Extensible credits.

They are considered to be extensible, in the amount resulting from the obligations that are recognized and settled according to the provisions in each applicable case, the credits which, affections to the management of the administrative mutualism, are specify as such in the annual State General Budget laws.

Article 148. Short-term credit operations.

The General Mutuality, within the limits set in its budget, with the authorization of the Government, on the proposal of the Minister of Public Administration, and after the report of the Ministry of Finance, will be able to agree Short-term and cash-flow credit. The latter must be cancelled in the lifetime of the budget.

Article 149. Administration expenses.

The appropriations for administrative expenditure of the General Mutual Fund shall not exceed 5% of the economic resources provided for the corresponding economic year.

Article 150. Annual accounts.

The General Mutual Fund shall form and render its accounts in accordance with the accounting principles and standards set out in the General Public Accounting Plan and its implementing rules, as well as in the general provisions contained in the recast text of the General Budget Law.

SECTION 4. CONTRACTING REGIME

Article 151. Recruitment.

1. The regime of hiring the General Mutuality of Civil Servants of the State will conform to the provisions of the autonomous organizations in the recast text of the Law of Contracts of Public Administrations, approved by the Royal Decree Regulation 2/2000 of 16 June 2000 and its supplementary rules, with the particularity provided for in the following paragraph 3, in accordance with Article 5 (2) of the recast of the Law on the Social Security of the Civil servants of the State in respect of the arrangements for the provision of services Health and pharmaceutical assistance.

2. The Director-General of MUFACE is the contracting authority of the body and is entitled to conclude on its behalf contracts in the field of its competence, without prejudice, where appropriate, to the authorisations resulting from it Article 12 of the recast text of the Law on Public Administrations Contracts.

3. The provision of care services by public entities, medical societies, pharmaceutical colleges, and other entities or companies that are accurate for the purpose of the protection of the general mutual benefit of officials Civil servants of the Member State, whatever their amount and the form they review (conventions, concerts, policies, or other similar arrangements), shall be agreed directly between the mutual and the institution concerned, with a prior report of the State law of the Ministry of Public Administrations and of the Intervention delegated to the body on the draft convention, concert, policy or document in which the conditions for the provision are made.

SECTION 5 ACQUISITION, MANAGEMENT AND DISPOSAL OF ASSETS

Article 152. Applicable rules.

Without prejudice to the provisions of Article 48 of Law 6/1997, of 14 April, of the Organization and the Functioning of the General Administration of the State, the acquisition, administration and disposal of property assets governed by the provisions of this section and, as not provided for in the section, by the Law of State Heritage and its implementing rules, it is understood that the competences that in this legislation are attributed to the Ministry of Finance and the Directorate General of the State Heritage are referred to the Ministry of Public Administrations and the Directorate-General for General Mutuality, irrespective of its possible delegation or deconcentration in other higher or managerial bodies and of the powers corresponding to the General Council of the General Mutuality of Civil Servants of the State.

Article 153. Acquisition for consideration of real estate.

The acquisition for consideration of real estate by the General Mutual State of Civil Servants of the State for the fulfillment of its purposes will be carried out, after a favorable report by the Ministry of Finance, by means of a competition public, except that, in the light of the peculiarity of the need to satisfy or the urgency of the acquisition to be carried out, the Minister of Public Administrations authorizes the direct acquisition.

Article 154. Leases.

The leases of real estate to be performed by the General Mutuality of Civil Servants of the State for the installation of their services, as well as the lease of their real estate, will be arranged by public tender, except in cases where, in the opinion of the Minister of Public Administration, it is necessary or appropriate to arrange them in a direct manner.

Article 155. Disposal of real estate.

1. The disposal of the immovable property of the General Mutuality shall be carried out in accordance with the following rules:

(a) Statement of alienation and agreement to dispose of the goods: the General Mutual State of Civil Servants of the State may dispose of its own property when it is unnecessary for the fulfillment of its purposes, report of the General Council of MUFACE and statement of alienation and alienation agreement adopted by the Minister of Public Administration. Where the value of the goods exceeds the amount determined in accordance with Article 62 of Decree 1022/1964 of 15 April 1964, approving the text of the Law on State Heritage, the authorization to sell the immovable property shall be approved by the Council of Ministers.

b) Physical and legal purification of the goods: before proceeding to their disposal, the physical and legal treatment of the properties that are intended to be used will be carried out.

(c) Communication to the Ministry of Finance: with a view to its disposal, the General Mutuality of Civil Servants of the State shall communicate the declaration of alienation of the building to the Ministry of Finance, which may to choose to incorporate the assets into the State Heritage to affect them to any other service of the Administration or its public bodies. After three months from the notification to the Ministry of Finance without having received a reply, it shall be understood that the Ministry does not choose to incorporate the assets into the State Heritage.

(d) The valuation of assets: prior to the disposal of any immovable property, it will be necessary to carry out an expert assessment, either by technical services of the administration or, exceptionally, by services. external valuation. The approval of the assessment corresponds to the Director General of MUFACE.

2. The disposal procedures shall be the public auction, the swap and the direct disposal, which shall be applicable in accordance with the rules in force.

3. In the case of direct sales of buildings, as well as sales made by auction, the deferred payment of the selling price, for a period not exceeding 10 years, may be allowed under the conditions laid down in Decree 1022/1964 of 15 April 1994. The text of the Law on State Heritage Bases and its provisions for development is approved.

CHAPTER XI

Resources and jurisdictional status

Article 156. Judicial remedies and remedies.

1. The acts and resolutions of the Director General of the General Mutuality of Civil Servants of the State do not put an end to the administrative route, with the Minister of Public Administrations being able to use it.

Exhausted the administrative route, may be used in the administrative-administrative dispute in accordance with its regulatory law.

2. They shall be exempt from the provisions of the preceding paragraph and shall, in any event, put an end to the administrative procedure, the decisions referred to in paragraphs (a) and (b) of Article 109 of Law No 30/1992 of 26 November 1992. Public administrations and the Common Administrative Procedure, and those given by the Director General of Mutual Affairs. In these cases, the replacement resource shall proceed, with the potential, where appropriate, and the administrative dispute in accordance with its regulatory law.

3. The extraordinary review appeal may be brought in the form determined by Article 118 of the Law on the Legal Regime of Public Administrations and the Common Administrative Procedure referred to in the previous paragraph.

4. Prior complaints, in civil and labor matters, will be resolved by the Director-General of the General Mutuality of Civil Servants of the State.

Article 157. Deadlines for resolving and reporting.

1. Acts and resolutions on administrative mutualisms shall take place within the time limits which, in order to resolve and to notify, are laid down for each of the procedures in the rules in force, to which end it shall be for information purposes. interested parties to the official publication of the relationship of procedures of the General Administration of the State.

2. In the event of no express resolution, the application may be deemed to be estimated or dismissed according to the effects provided for in the laws for administrative silence and indicated in the publication referred to in the preceding paragraph.

CHAPTER XII

Violations and penalties

Article 158. General provisions.

1. In accordance with the provisions of Article 44 of Law 53/2002 of 30 December 2002, the infringements and penalties in the field of social security to be applied in the field of administrative mutualism shall be those laid down in this Regulation, According to the predetermination established in the recast text of the Law on Violations and Sanctions in the Social Order, approved by the Royal Legislative Decree 5/2000 of 4 August. The power to sanction infringements committed in that area shall be the responsibility of the bodies referred to in paragraph 3.

2. Mutualists and beneficiaries falling within the scope of this special scheme, as well as staff at the service of public administrations which is obliged to act in the field of administrative mutualism, shall be responsible for the actions or omissions to which they are imputable, as set out in the following Articles.

3. They are competent bodies to punish the offending behaviour of the mutualists and beneficiaries:

(a) The Minister of Public Administrations, on a proposal from the General Mutuality of Civil Servants of the State, for very serious infractions.

b) The Secretary of State for Public Administration, on a proposal, also, of the General Mutuality of Civil Servants of the State, for serious infractions.

c) The Director General of the mutual benefit, for minor infractions.

4. In the case of offences allegedly committed by staff at the service of public administrations which is obliged to act in the field of administrative mutualism, the General Mutuality shall communicate it to the organs of the Ministry of the body of destination, for the determination of the consequent liability and, where appropriate, proposal to the competent body, as provided for in the preceding paragraph, of the sanction to be applied.

Article 159. Infringements of mutualists and beneficiaries.

According to the provisions of Articles 24, 25 and 26 of the recast of the law on infringements and sanctions in the social order, they are considered to be:

1. Minor infractions:

a) Not to facilitate General Mutuality, when required, the data necessary for affiliation or discharge.

(b) Not to communicate any changes in relation to the data referred to in the preceding paragraph, and in general the failure to comply with the duties of an informative nature.

2. Serious breaches:

(a) To carry out self-employment or other work during the collection of benefits, where there is legal or regulatory incompatibility established.

(b) Failure to appear, unless justified, to the medical examinations resulting from them, as well as not to present the records, supporting documents or data which do not exist in the mutual society, where they are required and affect the right continuity in the perception of the benefit without the mutual access of the mutual benefit to them directly.

(c) Failure to communicate, with the exception of justified reasons, the loss of benefits at the time when the right to suspend or extinguishing the right occurs, or when the requirements for the right to his or her rights are no longer met. perception, where the benefit has been unduly perceived by any of those causes.

3. Very serious breaches:

(a) Fraudulently act in order to obtain undue or superior benefits to which they correspond, or to unduly prolong their enjoyment by providing false data or documents.

b) Simulate the administrative situation in which the official is located.

c) Skip legally binding statements or other defaults that may cause fraudulent perceptions.

Article 160. Penalties for mutualists and beneficiaries.

1. Infringements shall be punished:

(a) Mild, with loss of benefit, allowance or pension for up to one month.

(b) Serious, with loss of benefit, allowance or pension up to a period of three months.

c) The very serious, with loss of the benefit up to a period of six months or with extinction of the same. They may also be excluded from the right to receive any economic benefit up to one year.

2. The penalty applicable in each of the abovementioned cases shall be graduated taking into account the circumstances of the infringement, as well as, where appropriate, the recidivism.

3. Notwithstanding the above sanctions, in the event that the transgression of the obligations affects the fulfilment and preservation of the requirements which give entitlement to the benefit, the General Mutuality may suspend the same, until the administrative decision is final.

4. The penalties referred to in this Article are without prejudice to the drawback of the amounts unduly paid.

Article 161. Infringements of staff at the service of public administrations acting in the field of administrative mutualism.

According to the provisions of Articles 21, 22 and 23 of the recast of the law on infringements and sanctions in the social order, they are considered to be:

1. Minor infractions:

(a) Do not retain, for four years, the documentation or the records or computer media in which the relevant data have been transmitted which demonstrate compliance with the obligations of membership, (a) a reduction or variation which, where appropriate, is produced in relation to those materials, as well as documents and receipts supporting the entry of the contributions.

(b) Not to communicate in the established time the casualties, as well as any other variations affecting the administrative situation of the officials included in this special scheme.

(c) Not to provide the General Mutuality with the data, certifications and statements that they are required to provide, or omit, or enter them inaccurately.

2. Serious breaches:

a) Do not communicate in time and form the initial affiliation or discharge of the officials included in this special scheme.

(b) Not to enter, in the form and time limit, the corresponding quotas or not to make the income in the amount due, provided that the lack of income does not obey an extraordinary situation.

3. Very serious breaches:

(a) To hold unduly, not entering it within a period of time, the share of the General Mutuality discounted to the officials, or to make discounts, not entering them, superior to the legally established ones.

b) Falsifying documents for officials to obtain or fraudulently enjoy benefits.

c) Make statements or record false or inaccurate data in the quotation documents that cause fraudulent deductions from the quotas to satisfy the General Mutuality.

(d) Not to provide general mutual recognition with the identification of economic benefit holders, as well as, as soon as they determine or condition the right to receive them, those of the beneficiaries, spouses and other members of the family unit, or those of their amounts.

4. For the implementation of the possible sanctions, the provisions of Article 158 (3) of this Regulation shall be applied.

Article 162. Procedure.

1. For the purposes of applying the penalties provided for in this chapter, the penalty procedure provided for in Law 30/1992 of 26 November 1992 on the Legal Regime of Public Administrations and the Rules of Procedure shall be followed. Common Administrative and its implementing rules.

2. In the case of penalties for infringements of staff at the service of public administrations acting in the field of administrative mutualism, the legislation in force on disciplinary matters shall apply, taking into account the provisions of the Article 158 (4).

3. The provisions of the preceding paragraphs shall be without prejudice to the procedures to be followed in the courts.

Article 163. Resources and prescription.

1. Decisions on sanctioning and disciplinary proceedings may be brought against the legal and administrative resources which are legally applicable.

2. For the limitation of infringements and penalties of mutualists and beneficiaries, the provisions of the sanctioning procedure provided for in Law 30/1992 referred to in paragraph 1 of the previous Article and, in the case of infringements of the (a) in the case of public administrations acting in the field of administrative mutualism, the prescription provided for in the disciplinary or judicial procedure corresponding to the public administration to which the public authorities are responsible shall apply; belongs to the responsible subject.

ADDITIONAL PROVISIONS

First. Special fund.

1. Where benefits for general mutual benefit have been established, which are of the same nature and purpose and are in the same situation or contingency as those which may be granted under the special fund, they shall apply automatically. those of General Mutuality, for the mutualists belonging to it.

In such cases, the benefits of the Special Fund shall be without effect if they are equal or lower.

If the benefit in question for the Special Fund is higher than the amount, the difference shall be paid. In the case of aid for studies or the like of mutual societies in the Special Fund, only those of the General Mutual Fund shall apply, irrespective of the amount, and provided that the beneficiary of the mutual funds belongs to the Mutual Fund. General.

2. The trienes perfected after 31 December 1978 shall not be counted for the purposes of determining the regulatory basis for the benefits of the Special Fund.

3. The time during which the special fund has been paid after 31 December 1978 shall be taken into account only where the seniority serves as a basis for the fixing of percentages in the calculation of benefits and, only, effect.

4. To the partners and beneficiaries of the mutual societies in the MUFACE Special Fund referred to in the sixth supplementary provision of the recast text, which continue to be voluntarily listed, the special scheme of the Article 28 of this Regulation also applies to the rules contained in Chapter III concerning the listing of voluntary mutualists, in particular the provisions of Article 33.2 as regards the non-payment of quotas.

5. Without prejudice to the provisions of the respective regulations, pensions and other benefits of mutual societies within the MUFAF Special Fund shall apply to them, on an additional basis, and on the basis of general rules of the protective action contained in this regulation.

6. MUFACE may ask the pension holders of the Special Fund for the justification of those extremes which give rise to the legal aptitude for the receipt of such pensions, and may agree to suspend the payment of such pensions, in the case of receive adequate response to your requirement.

7. The financial institution which carries out the pensions shall be responsible for the return to MUFACE of the assets which may, if necessary, be paid from the month following the date of death of the pension holder, reintegrating to MUFACE, within one month, the amounts unduly paid.

In the same period, the financial institution will proceed to reintegrate these assets, when it is MUFACE that makes its claim as a consequence of the knowledge of the extinction of the right to the pension.

Second. Officials who have caused a discharge for the legal exercise of the right of choice.

Officials who, by virtue of a legal disposition, have chosen to be covered by the General Social Security Regime, with a fall in the Special Social Security Regime of Civil Servants of the State, they are to be discharged again, or when they are in retirement, unless the circumstance referred to in the fourth additional provision of the recast text is concerned.

Third. Passive class pensioners.

Retirement pension mutualists, referred to in paragraph 2 of the first provision of the recast text, shall be entitled to health care, social services and social assistance benefits, provided that they meet the specific requirements for them.

Fourth. Collegiate in professional schools.

For the purposes of Article 15 (2) (c) of this Regulation, it shall be understood that they are protected by a different degree from those who exercise the option of belonging to a social security mutual benefit a professional college, provided for in the third subparagraph of Article 15 (1), third subparagraph, of Law 30/1995 of 8 November 1995 on the Management and Supervision of Private Insurance.

Fifth. Officials who have exercised the right of transfer to the European Union for the purposes of passive rights.

Officials who have caused a loss of mutual benefit as a result of the provisions of Article 8 (1) (c) of the recast text shall have a compulsory high level of mutual benefit when they are in a situation administrative provisions referred to in Article 7 of the recast text.

Sixth. Concepts equivalent to sick leave or accident.

To be deemed to be equivalent to the sickness or accident licences provided for in Section 1 of Chapter VI of this Regulation, those other concepts which are equivalent, in accordance with the system of the Civil Service applicable.

Seventh. Family benefits by disability to be extinguished.

The family benefits by disability referred to in the additional ninth provision of the recast text, and different from those mentioned in Chapter VIII of this Regulation, shall be maintained with the character of the extinguishing. Such benefits shall be compatible, where appropriate, with financial aid in cases of multiple births, as defined also in Chapter VIII, where both benefits may flow.

Eighth. Homogenisation criteria for the granting of aid aid.

Without prejudice to the competence of the Provincial Commissions of MUFACE to establish criteria for granting aid, the Directorate-General of MUFACE, following a report of the General Council, may establish parameters and other complementary rules, in order to homogenise and balance these aids in the whole of the national territory, which must be taken into account by the relevant provincial committees.

Ninth. Transfer of data between the Mutuality and the Autonomous Communities.

1. In order to keep records of the collective of the General Mutuality of Civil Servants of the State up to date, the Autonomous Communities shall report monthly to this General Mutuality of the situation of their officials included in the field. application of the administrative mutualism managed by the same.

2. With the same periodicity, the autonomous communities and the General Mutuality will exchange the information corresponding to the collectives that, by virtue of the concerts subscribed to the effect with institutions of the Social Security, receive assistance health services through the health services of each autonomous community.

The data provided pursuant to this Article shall be the subject of the security measures provided for in Organic Law 15/1999 of 13 December on the Protection of Personal Data and their development standards.

TRANSIENT DISPOSITION

Unica. Application of the single trading scheme.

For the purposes of the application of the special contribution scheme provided for in the first provision, the General Mutual Fund shall give the relevant rules within six months of the entry into force of the said procedure. rules.

FINAL PROVISIONS

First. Application of the Regulation.

The regulation contained in this regulation will be of general application to all public administrations in relation to the officials included in its scope, in accordance with the provisions of Article 149.1.17. 18. th of the Constitution.

Second. Regulatory development.

By the Minister of Public Administration the provisions laid down in this regulation and those that are necessary for its development will be dictated, as long as it is not expressly attributed to another organ.