Area: Poslovni SOS
Competent authority: MDDSZ, MZ, ZPIZ, ZZZS
EZU URL: .nan
Initiative ID: 635
Initiative accepted and completed: '2015-08-20'
Initiative classified in EZU: .nan
Initiative forwarded in response: '2015-08-03'
Initiative published: '2015-08-03'
Initiative submitted: '2015-07-24'
Response from the competent authority: 'REFERENCE FROM THE MINISTRY OF HEALTH: The
  case in question concerns the procedure for deregistration of a worker whose employment
  contract has been terminated as a result of a final decision of the Social Insurance
  Institution (ZPIZ) on the recognition of a category I disability. The employment
  contract is therefore terminated by law as of the date of the final decision on
  category I of invalidity (see Article 119(1) of the Social Insurance Act).In the
  event of termination of the employment contract, the employer, as the person liable
  for registration, must deregister the worker from compulsory social insurance within
  8 days of the termination of the employment contract.The employer must provide proof
  at the time of deregistration of the employee, which shows the date on which the
  decision on category I of disability became final.This may be:- a decision on category
  I of disability stamped with the stamp of final validity, or- a certificate from
  the Social Insurance Institution for Social Insurance stating the date on which
  the decision on category I of disability became final.In the light of the above,
  we do not consider it necessary to include the measure in the Single Document, as
  there has been a misunderstanding as to the finality of the decision.RESPONSE OF
  THE MINISTRY OF LABOUR, FAMILY, SOCIAL AFFAIRS AND EQUAL OPPORTUNITIES: From the
  point of view of pension and invalidity insurance, we would like to clarify that
  the rights under this insurance are decided or exercised in accordance with the
  law governing the general administrative procedure, unless otherwise provided for
  in the Law on Pension and Invalidity Insurance (Official Gazette of the Republic
  of Slovenia; No 96/12 and amendments, hereinafter referred to as the Law on Pension
  and Invalidity Insurance (hereinafter referred to as the Law on Pension and Invalidity
  Insurance; No 96/12 and amendments, hereinafter referred to as the Law on Pension
  and Invalidity Insurance; No 96/12 and amendments, hereinafter as the Law on Pension
  and Invalidity Insurance - ZPIZ-2)). The ZPIZ-2 specifically regulates the right
  to initiate proceedings to claim rights under the compulsory invalidity insurance,
  whereby, in addition to the insured person, the insured person''s personal physician
  or a designated physician, or, in agreement with the personal physician, an occupational
  health care provider, may also submit a proposal to initiate proceedings. The duration
  of the procedure itself is also subject to specific rules, as the institution must
  issue a decision within four months of the date on which the procedure is initiated
  (when the institution receives the request, together with the insured person''s
  complete work record and medical documentation on his/her state of health and ability
  to work). The time limit for issuing a decision may be longer than that laid down
  by the general rules (2 months from receipt of the application), taking into account
  the fact that, in cases where the insured person''s disability and the rights based
  on it are established, the expert opinion of the institution''s expert bodies must
  be obtained in order to decide the case itself. As regards the time-limit for appeal
  itself, we note that there are no specific provisions in the ZPIZ-2, which means
  that the institution is obliged to issue a decision at second instance within two
  months of receipt of the appeal. With regard to the procedure, it is also provided
  that a decision on the right to an invalidity pension becomes enforceable on the
  day on which it becomes final. Article 108, paragraph 2, of the ZPIZ-2 provides
  that the condition for obtaining a pension is the cessation of compulsory insurance,
  except for beneficiaries of pensions referred to in Article 25, paragraph 4, of
  the ZPIZ-2. According to Article 111(1) of the ZPIZ-2, the pension is paid from
  the first day following the termination of insurance.The Labour Relations Act (Official
  Gazette of the Republic of Slovenia, No 21/13 and amendments, hereinafter referred
  to as ''ZDR-1'') in the second paragraph of Article 119(2) of the Act provides that
  the pension is to be paid from the first day following the termination of insurance.
  Article 119 (2) of the Employment Contract Act provides that the employment contract
  shall terminate by operation of law when the decision on the establishment of a
  category I disability or on the acquisition of the right to an invalidity pension
  served on the employee has become final.From the above, and taking into account
  the allegations in the letter, we conclude that the employment contract of the employee
  in question has not yet been terminated.Article 119 (2) of the Employment Contract
  Act provides that the employment contract of the employee in question shall not
  terminate by operation of law. The condition for withdrawal from the pension and
  invalidity insurance is the termination of the legal relationship by virtue of which
  the individual is covered by the compulsory insurance. Thus, in the light of the
  foregoing, the Social Insurance Institution could not yet deregister such a worker,
  since the grounds for such deregistration had not yet arisen. We would like to clarify
  that it is not possible to extract the exact information from the letter, which
  is why we explain the reasons below, assuming that the employer and the insured
  person received the decision on the first category of invalidity and the award of
  the invalidity pension on 20.7.2015. From that date onwards, the time limit for
  appeal runs, which means that on that date the decision is not yet final and conclusive,
  but must wait for such an effect. Given that the ZPIZ-2 does not contain specific
  provisions on finality and finality, this is examined in accordance with the Act
  on General Administrative Procedure (Official Journal of the Republic of Slovenia,
  No 24/06-upb and amendments, hereinafter referred to as the ZUP). The ZUP stipulates
  that a first-instance decision becomes final if it can no longer be challenged in
  an administrative dispute. The possibility of challenging a decision in an administrative
  procedure is conditional, inter alia, on the prior exercise of remedies in the administrative
  procedure, i.e. the prior exercise of the right to appeal. If the parties do not
  pursue an appeal, the decision thus becomes final on the expiry of the time-limit
  for appeal, or even if all parties waive their right to appeal. Pursuant to Article
  225(5) of the CPA, a certificate of finality or finality shall be issued at the
  request of a party. The authorities may not request such a certificate from the
  parties, but must, if necessary, themselves obtain information on finality or finality
  from the competent authority.The decision of the ZPIZ could, according to the above,
  be final only if the parties waived their appeal against it, otherwise it would
  not be final, which means that the employment relationship would not have been terminated
  on the basis of the law itself. 24.7.2015. The termination of the employment relationship
  under the Act itself is based on a final decision on the existence of a Grade I
  invalidity or on the acquisition of an invalidity pension, which the parties prove
  by obtaining a certificate of final validity from the authority which issued the
  decision.We thus clarify that, in the present case, the withdrawal from insurance
  would not have taken place as of 1.4.2015, since the insured person did not yet
  have a final decision granting the right to an invalidity pension at that time,
  but within a reasonable period after receipt of that decision, depending on whether
  that decision is contested or not and whether the parties have waived their right
  to appeal. We consider that the employer did not have the final decision in its
  possession on the date on which it wished to deregister the employee, and we therefore
  advise the employer to obtain a certificate of the finality of the decision establishing
  the first degree of invalidity and granting the right to an invalidity pension,
  which it shall submit to the Social Insurance Institution at the time when it wishes
  to deregister the employee from the insurance scheme. Only a final decision is a
  ground for termination of the employment relationship by operation of law, and thus
  also for termination of the legal relationship which is the basis for inclusion
  in the compulsory insurance, and the employer must, on this basis, within 8 days
  after the termination of the legal relationship which is the basis for compulsory
  insurance, file a withdrawal from the compulsory pension and invalidity insurance.RESPONSE
  OF THE PENSION AND DISABILITY INSURANCE INSTITUTE:According to Article 182(3) of
  the Pension and Disability Insurance Act of the Republic of Slovenia, No 96/12 and
  39/13, hereinafter referred to as ZPIZ-2, a decision on the right to an invalidity
  pension becomes enforceable on the day on which it becomes final and enforceable.
  The ZZZS, as the registration and withdrawal service, was therefore not yet in possession
  of the notice of final effect on 24.07.2015.  We would like to clarify that in order
  to deregister from the insurance with the competent authority - the EHIC - it is
  necessary to have a notice of the final decision. A notice of the final validity
  of a decision granting the insured person the right to an invalidity pension is
  issued in a special procedure after it has been established that the decision issued
  by the Pension and Invalidity Insurance Institute of Slovenia (hereinafter referred
  to as the Institute) has become final. In the case of a decision issued at first
  instance, the notification is issued by the regional unit of the Zavod, and in the
  case of a decision issued in an appeal procedure, the notification of final status
  is issued by the second-instance body - the professional employee who conducted
  the appeal procedure - after verifying that the decision in question has not been
  challenged before the Labour and Social Court in Ljubljana. The notification of
  the final validity of the decision granting the right to an invalidity pension shall
  be forwarded by the regional unit of the Institute, or by the appeal officer who
  conducted the second instance procedure, to the ZZZS, the personal physician of
  the insured person and to the employer, insofar as the insured person who has been
  granted the right to an invalidity pension is an employee. As the insured person
  in the present case is an employee, we also draw attention to Article 119(1) of
  the Labour Relations Act (Official Gazette of the Republic of Slovenia, No 21/13
  and 78/13, as amended), which provides that the employment contract shall cease
  to have effect by operation of law when a decision on the establishment of a category
  I disability or on the acquisition of the right to an invalidity pension, which
  has been served on the employee, becomes final.In the present case, the four-month
  time limit for the issuance of the decision has been exceeded by one month.In the
  present case, the time limit for the issuance of the decision has been exceeded
  by one month.In the present case, the time limit for the issuance of the decision
  has been exceeded by one month. It should be noted that the legislator had already
  provided for a legal remedy in the event of failure by the authority to issue a
  decision within the prescribed time limit. Article 222(4) of the General Administrative
  Procedure Act provides that if the competent authority against whose decision an
  appeal is allowed fails to issue a decision and to serve it on the party within
  the prescribed time-limit, the party has the right to appeal as if his claim had
  been rejected. In the above case, the parties to the proceedings did not avail themselves
  of this remedy.The lengthening of proceedings is influenced by factors such as the
  reduction in the number of staff and the resulting increased workload, as well as
  by additional activities such as, for example, the implementation of the decision
  of the Constitutional Court of the Republic of Slovenia, No. U-I-239/14-10, Up-1169/12-24
  of 26.3.2015.In the following case, the parties to the proceedings did not avail
  themselves of this remedy. In accordance with the Risk Management Instruction No.
  0071-4/2013/(01000) dated 6.12.2013, the risk register of the Disability Insurance
  Department identifies the timely settlement of claims as an objective that is pursued
  at all times. In the annual report on the audit of the risk register for the period
  from 1.6.2014 to 31.5.2015, it was noted that the lack of sufficient professional
  staff had created a risk for the achievement of timely claims settlement. In this
  respect, a measure was also taken to work on a full-time basis.With regard to the
  issue of claims settlement within the statutory deadline, in accordance with Instruction
  No 0071-27/2014 (01000) of 31.12.2014, the Ljubljana OE also monitors the claims
  settlement time on an ongoing basis. On the basis of the monitoring of pending cases,
  written orders on pending cases are issued to individuals every three months with
  a deadline by which the cases have to be closed.'
Text file: 635.txt
Title: ZPIZ retrospective decision - deadlines
URL: https://www.stopbirokraciji.gov.si/pobuda/?st=635
