The first thing to keep in mind is that the issuance of the disability certificate occurs from the moment of the event that causes it, which is issued by a health professional, who will determine the period of disability, which may be for a maximum of 30 days, a period that may be extended according to clinical criteria.
Work-related disabilities will be recognized by each entity according to their duration, as follows:
- Disability period of 1 to 2 days: the employer will pay.
- Disability period of 3 to 180 days: the EPS will pay.
- Disability period of 181 to 540 days: the pension fund will pay.
- Disability period of 541 days and beyond: the EPS/pension fund will pay.
It should be noted that the requirements to request this recognition and payment of the disability of common origin will be:
- Be affiliated to the General System of Social Security in Health (SGSSS), as a contributor.
- Have effectively contributed to the (SGSSS) for at least (4) four weeks prior to the start of the disability.
- Have the disability certificate issued by the health promoting entity.
Now, what is the process to request payment of these disabilities?
- The worker who has an ailment not associated with their work must see a doctor from the EPS to issue the disability certificate.
- Then, the worker must report the disability to the employer.
- The employer must verify the information and validate the possibility of making the salary payment to the worker during their disability.
- Additionally, the employer must carry out the transcription procedure before the EPS, when the disability is issued by a private doctor or one that is not part of the network of providers associated with the EPS, to then make the reimbursement of the money paid to the worker.
Once the employer has filed the disabilities, they may make the reimbursement for the worker's disability before the EPS. According to Law 1438 of 2011, for this they have a period of three years counted from when the payment of the economic aid for disability was made to the worker, and if necessary, the transcription must be available.
According to the above, it should be noted that the EPS may suspend the payment of an already recognized disability or not recognize a disability from the beginning under the following grounds:
- When the EPS or the entities obliged to compensate (EOC) or the competent authority, as the case may be, determines that any of the grounds for abuse of rights, set forth in article 2.2.3.7.1. of Decree 780 of 2016, have occurred.
- When the contributor does not meet the requirements of section 2.1.13.4 of this decree, such as having contributed to the (SGSSS) for at least (4) four weeks.
- When the contributor is in default as established in articles 2.1.9.1 and 2.1.9.3. of Decree 780 of 2016.
At this point, it is important to note that if the employer has not timely paid Social Security contributions, the worker is not affected by that default, since the employer must in any case pay the disabilities directly to the worker, and then make the claim to the EPS.
- When the disability due to general illness originates from treatments for aesthetic purposes and their complications, or derives from treatments that meet the exclusion criteria referred to in article 15 of Law 1751 of 2015.
Finally, it should be noted that the worker has the right to maintain stability in their employment contract and their source of income while they overcome their health problems, with regard to medical disabilities. Likewise, the worker acquires the responsibility to report disabilities to the employer in a timely manner.