Como se Pagan las INCAPACIDADES laborales en COLOMBIA

Name: Como se Pagan las INCAPACIDADES laborales en COLOMBIA
Uploaded: 2020-05-02T05:55:34.000Z
Duration: 52 min

Understanding Medical Disabilities and Labor Inabilities

Introduction to Medical Disabilities

The video begins with a cordial greeting to viewers, introducing the topic of medical disabilities and labor incapacity.

The concept of incapacity is discussed, noting that while it may not be explicitly defined in law, the Constitutional Court provides a detailed definition in ruling 279 of 2012.

Definition of Incapacity

According to ruling 279 of 2012, incapacity is described as a physical or mental state that temporarily prevents an individual from performing their usual profession or job.

It also includes economic subsidies provided by health administrators when workers face such situations.

Key Aspects of Incapacity

Three critical points about incapacity are highlighted:

It refers to an employee's inability to perform normal work functions.

This inability can be either physical or mental.

Economic support is available for affected workers through specific programs.

Types of Incapacities

The speaker outlines three types of incapacities:

Temporary Incapacity: Common among workers, typically lasting up to 58 days.

Permanent Partial Incapacity: Defined as a permanent reduction in work capacity between 5% and 50%.

Permanent Total Incapacity: When the loss exceeds 50%, qualifying individuals for disability pensions.

Legal Context and Rights

The court emphasizes that payments for labor incapacities serve as salary substitutes.

It clarifies that legal actions (like tutela actions) can be appropriate if non-payment affects the minimum vital needs of individuals.

Understanding the Constitutional Court's Recognition of Worker Rights

Key Aspects of Worker Rights Recognized by the Constitutional Court

The first aspect discussed is that payments for medical incapacity substitute a worker's salary during their inability to perform due to medical reasons, emphasizing that these payments are crucial for ensuring the worker's minimum vital needs.

The court equates incapacity payments with salary, highlighting that actions like tutela (legal action) serve as effective means to protect economic rights and ensure workers can maintain their minimum vital standards.

Secondly, the court states that medical incapacity payments guarantee workers' right to health, allowing them to recover without the pressure of returning prematurely to work.

Without financial support during recovery periods (15-20 days), workers may feel compelled to return too soon, disregarding medical advice and potentially jeopardizing their health.

The third aspect emphasizes principles of human dignity and equality, mandating special treatment for workers in manifest weakness due to illness or incapacity, protecting them from exploitation by employers.

Origins of Incapacities

Types of Incapacities

There are two origins for incapacities: labor-related and common. Labor-related incapacities arise from workplace accidents or occupational diseases, while common incapacities stem from general illnesses or non-work-related accidents.

Responsibilities and Payment Procedures

For labor-related incapacities, payment responsibility lies with labor risk administrators (ARLs), who must begin compensation from the day after an accident occurs or when a disease is diagnosed as work-related.

Payments continue until full rehabilitation is achieved; ARLs cover costs until the worker is deemed fit for reintegration into their job role.

If a worker’s condition leads to partial permanent incapacity after multiple extensions of leave (e.g., 15-day increments), they may be assessed for loss of work capacity based on specific criteria set by ARLs.

Compensation Criteria

Workers will receive compensation until they are fully rehabilitated. If deemed partially permanently incapable (less than 50% but more than 5%), they will receive indemnification based on established tables correlating disability percentage with monetary compensation.

In cases where loss of capacity exceeds 50%, individuals may qualify for invalidity pensions if no favorable recovery prognosis exists following an accident leading to prolonged incapacity.

Common Origin Incapacities

Complexity in Payment Responsibility

Common origin incapacities involve more complexity regarding payment responsibilities. It’s essential to clarify that these do not equate directly with salary; instead, they provide economic assistance distinct from regular wage structures during periods of incapacity.

Understanding Economic Assistance for Incapacity

Overview of Payment Responsibilities

The discussion begins with the clarification that after 180 days of incapacity, payments transition to a subsidy rather than a salary.

For the first two days of incapacity, the employer is responsible for payment; from day three to day 180, the EPS (Health Promotion Entity) takes over this responsibility.

Workers may wonder how to claim their economic assistance; however, it is emphasized that employers are obligated to handle these claims without requiring additional effort from employees.

Employers must manage all necessary processes with the EPS to ensure timely payments for incapacity benefits.

Scenarios Post-Day 180

After 180 days, if an employee's rehabilitation concept is issued by the EPS, three scenarios can unfold regarding their incapacity status.

If the rehabilitation concept is unfavorable, indicating low chances of recovery, employees must initiate a process with their pension fund to assess their loss of work capacity.

Depending on the assessment results (5% - 50% or greater than 50%), different types of permanent incapacity classifications will apply.

Payment Continuation and Legal Framework

From day 181 onward, if an unfavorable concept is issued by the EPS, it becomes the pension fund's responsibility to continue paying incapacity subsidies until a final decision is made.

Reference is made to legal precedent (sentence T246 of 2018), which outlines payment responsibilities during various periods of incapacity clearly and effectively.

Consequences of No Rehabilitation Concept Issued

If no rehabilitation concept has been issued by day 180—neither favorable nor unfavorable—the law dictates that it remains the EPS's duty to continue paying benefits until they issue a decision.

This situation emphasizes that if there’s no response from the EPS regarding rehabilitation concepts, they bear continued financial responsibility for incapacitated workers.

Long-Term Implications and Legislative Changes

Should a favorable rehabilitation concept be issued post-day 540, payments will still be managed by either entity depending on circumstances surrounding recovery assessments.

The discussion highlights significant changes brought about by Law 1753 in June 2015 aimed at clarifying responsibilities between entities involved in managing incapacity payments.

Understanding the Minimum Vital Right and Disability Payments

Overview of Law 1753 and Its Implications

The discussion begins with the introduction of Law 1753 in 2015, which addresses the minimum vital right for individuals lacking funds to cover their usual expenses. The law mandates that the state, through the Ministry of Health, will be responsible for disability payments after day 540.

Clarification is provided on how payments will be processed: individuals will receive direct payments from their EPS (Health Promotion Entities), which will then recover costs from the state.

Payment Responsibilities and Timelines

According to Constitutional Court ruling 361, payment responsibilities are outlined based on the nature of disabilities—whether they stem from work-related illnesses or common diseases. Payments continue until full rehabilitation is confirmed.

For temporary disabilities classified as partial permanent incapacity or those exceeding a 50% loss of capacity, employers are responsible for covering payments during specific periods.

From days 3 to 180 post-disability onset, EPS must provide economic assistance; from days 181 to 540, this responsibility shifts to pension funds.

Exceptions and Legal Framework

An exception exists where if an EPS does not issue a rehabilitation concept, it remains liable for subsidy payments until such a concept is provided.

Prior to Law 1753's enactment in 2015, there was a recognized gap in protection for workers with less than a 50% loss of capacity who remained incapacitated beyond day 540. This led to confusion between pension funds and EPS regarding payment responsibilities.

Legislative Solutions Post-Law Enactment

The Constitutional Court identified issues due to lack of applicable norms leading to worker hardships. Consequently, Law 1753 aimed at resolving these deficits by clarifying financial responsibilities related to disability benefits.

Article 67 of Law 1753 specifies that resources within the general social security system are allocated towards recognizing and paying health benefits—including long-term disability payments exceeding day 540.

Future Discussions on Disability Claims

The speaker concludes by indicating plans for further videos exploring various aspects related to incapacity claims—such as obligations of medical professionals in issuing disability certifications and implications when certifications come from private doctors rather than affiliated ones.