Occupational disease
Legal basis: article 36-41 Regulation 883/2004
The answer to this question is the same, mutatis mutandis, as that to question 1.1 under the keyword accidents at work.
The answer to this question is the same, mutatis mutandis, as that question 1.2 under the keyword accidents at work.
When you have, under the legislation of two or more Member States, pursued an activity which by its nature is likely to cause the occupational disease from which you suffer, you are entitled to benefits only under the legislation of the last of those States whose conditions are satisfied.
The notification of the occupational disease must be sent to the competent institution of the last Member State under whose legislation you pursued an activity likely to cause your disease.
When this institution finds that such an activity was last pursued under the legislation of another Member State, it shall forward your notification and all accompanying documents to the institution of that State.
When the institution of the last State where you pursued the activity liable to cause your disease believes that you do not fulfil the conditions of its legislation (e.g. because it argues that you have never pursued such an activity under its legislation or because it does not recognise the occupational nature of your disease), it will immediately forward the notification as well as all accompanying documents and medical reports to the institution of the State under whose legislation you previously performed an activity likely to cause your occupational disease. If necessary, this process is repeated until the file is sent to the institution of the first State where you pursued such an activity.
If the institution to which you (or another institution) sent the notification declines your claim, it must notify you of that decision, indicating the reasons for refusal, the remedies and periods allowed for appeals.
You may decide to appeal the decision rejecting the benefits. In that case, the institution which took the decision must inform the institution of the Member State to which it sent the notification upon rejection of your claim. (It shall do likewise when a final decision is reached on your appeal). Pending the appeal, the second institution will make advance payments to you, provided you fulfil the conditions for entitlement under its legislation. In case your appeal is successful, the first institution will reimburse these advance payments to the second and the amount will be deducted from the benefits due to you.
If the legislation of a Member State under which you pursued an activity which by its nature is likely to cause the occupational disease makes the granting of benefits subject to the condition that the disease in question was first diagnosed in that country, whereas your disease was diagnosed in another State, such condition is deemed to be satisfied. Likewise, if this legislation provides that benefits are only granted either when the disease in question was diagnosed within a specific time limit following cessation of the last activity likely to cause the disease in question or when the activity likely to cause the disease was pursued for a certain length of time, then the competent institution, when assessing the fulfilment of those conditions, also has to take account of similar activities or periods which you pursued under the legislation of any other Member State. These are all applications of the principle of equal treatment of facts and events or assimilation of facts (see the relevant keyword).
The answer to this question depends on whether or not you have pursued, while receiving these benefits, under the legislation of another Member State, an activity likely to cause or aggravate your disease.
If you did not, the institution which pays out the benefits has to meet the additional costs linked to the aggravation.
If, on the other hand, there has been further relevant exposure under the legislation of another Member State, the institution which pays out the benefit continues to do so, without, however, taking into account the aggravation. A supplement will be granted by the competent institution of the State under whose legislation you were further exposed. The amount of that supplement shall be equal to the difference between the amount of benefits due after the aggravation and the amount which would have been due prior to the aggravation according to the legislation of that State, had the disease in question occurred under the legislation of that State. The institutions of the States concerned cannot apply anti-accumulation rules in respect of the benefits (i.e. initial benefit and supplement) received from the other State.
Please note that you are under the obligation to provide the institution from which you are claiming benefits with details concerning benefits previously granted for the occupational disease in question. That institution may contact any other previously competent institution in order to obtain the information it considers necessary.
Yes, there is. If an occupational disease occurs in a Member State other than the competent State, you must send a declaration or notification of the disease to the competent institution. This declaration or notification shall be carried out in accordance with the legislation of the competent State, even though relevant provisions in the legislation of the State where the disease occurred also remain applicable.
Moreover, the institution of the place of residence or stay must forward to the competent institution the medical certificate together with any relevant information which the competent institution may request.
After you have followed medical treatment, and at the request of the competent institution, a detailed report accompanied by medical certificates relating to the longer term consequences of the disease, in particular your present state and the recovery or stabilisation of injuries, will be sent. In turn, the competent institution will inform the institution of the place of residence or stay, at the latter’s request, of its decision setting the date of recovery or stabilisation of injuries or, where appropriate, its decision to grant a pension.
Old-age pensions
Legal basis: article 50-60 Regulation 883/2004
The coordination rules governing old-age pensions are intended to prevent migrant workers from losing insurance periods and acquired pension rights, as a result of their migration within Europe, and thus being placed at a disadvantage in relation to the position in which they would have been had they completed their entire career in only one Member State.
These rules, which are very similar to those governing other long-term benefits such as invalidity pensions in situations of insurance under at least one type B system (see the keyword invalidity pensions) or survivors’ pensions, imply that each of the States where a person has worked will preserve his/her insurance record until s/he reaches pensionable age. Contributions paid in a Member State will neither be transferred to another State nor paid out to the worker when s/he stops working in the former State to take up employment or self-employment in the latter. Insurance periods will instead be “stored” and will “revive” once the person reaches pensionable age.
The coordination rules ensure that a migrant worker, upon his/her retirement, will receive from each State where s/he has been insured for more than one year (see question 46.9) an old-age pension proportionate to the insurance record completed there. The longer the insurance period in a State, the higher the pension payable by that State will be.
These rules are not just in the interest of the migrant worker, but also in the interest of the Member States, in that they provide for an equal distribution of the pension charges, proportionate to the period during which contributions or taxes were collected.
There is no need to make a separate claim to the institution of each of the Member States where you have worked. You must submit an application for an old-age pension to the institution of the State of residence or to the institution of the State to whose legislation you were last subject. In case you have never been subject to the legislation of the State where you reside and you submitted a claim for old-age pension to the institution of that State, that institution must forward it to the institution of the State to whose legislation you were last subject. The institution to which you submitted the claim – or to which it must be forwarded – is called the contact institution. The contact institution will play a central role in the process of handling your claim for old-age pension. It has to ensure, throughout the process, that all the relevant information is forwarded to all the institutions involved. It will promote the exchange of data, the communication of decisions and the operations necessary for the investigation of your claim. It is also this institution which, upon your request, must provide you with any information relevant to the Community aspects of the investigation and keep you informed of its progress.
The date of submission of the claim will apply in all the institutions to whose legislation you have been subject. If, however, you fail to notify, despite having been asked to do so, the fact that you worked or resided in other Member States, the date of completion of the initial claim or of the new claim will be considered as the date of submission, save more favourable provisions of the legislation applied by the contact institution. In this context it should also be noted that such a deferral of the claim of benefits which could already be claimed (because you do not give all the necessary information) must not cause additional burdens for a Member State. So in case a recipient of a means-tested benefit of Member State A does not claim, or does not give the necessary information on, a benefit which could be granted under the legislation of Member State B because he does not want to lose additional benefits linked to the means-tested benefit (e.g. free public transportation, exemption from cost-sharing for health care benefits etc.) Member State A could apply the sanctions provided under its national legislation including e.g. the taking into account of the benefit from Member State B as if it were granted.
The claim must be submitted in accordance with the legislation of the contact institution and be accompanied by the supporting documents required by that legislation. In particular, you must supply all available relevant information and supporting documents regarding periods of insurance (institutions), employment (employer) or self-employment (nature and place of activity) and residence (addresses) completed under the legislation of other Member States, including the length of those periods. Should you wish to postpone the award of an old-age pension to which you would be entitled under the legislation of one or more Member States, you must state this in your claim and specify the legislation under which the deferment is requested (see also question 46.7). Incidentally, the institutions concerned have a duty to provide you, upon your request, with all the information available to them so as to allow you to assess the consequences of concurrent or successive awards of benefits.
Submission of your claim automatically triggers the examination of your pension rights in all the States where you have been insured (and in respect of which you did not request postponement), insofar as you satisfy the conditions for entitlement to an old-age pension provided for in the legislation of these States (notably having reached pensionable age).
The contact institution will send your claim for an old-age pension and all relevant documents to the other institutions to whose legislation you have been subject, allowing them to start the investigation of the claim at the same time. All the institutions involved will mutually notify each other about your insurance history under their legislation.
At the end of the process, each of the institutions to whose legislation you have been subject will notify you its decision concerning the pension claim, specifying the remedies and periods allowed for appeal under the relevant national legislation. Once the contact institution has received all decisions taken by the institutions involved, it will send you and the other institutions a summary of these decisions. This “summary note” (portable document P1) is drafted in the language of the contact institution or, at your request, in any other official EU language. Receipt of this summary note, which gives you an overview of the way the different institutions have dealt with the periods completed in the corresponding States, triggers another right of review. If you believe that your rights are adversely affected by the interaction of two or more decisions taken by institutions, you can ask these institutions to review the decision. The time limits to request this review are those fixed by the legislation applied by the institutions involved. It commences on the date of receipt of the summary note.
Example: Ms. Z has worked in Member State A for 10 years. After that, she worked for 3 years in Member State B. Immediately afterwards, she started working in State C for a period of 2 years. All the legislations involved subject entitlement to an old-age pension to a qualifying period of 10 years. On the basis of national legislation alone, Ms. Z is not entitled to an old-age pension from States B and C.
For the purposes of establishing entitlement to an old-age pension under the legislation of the States where you have been insured, you can make use of the principle of aggregation of periods (see the relevant keyword). The institutions of these States will have to take account of periods of insurance or residence completed in any other Member State, if this is necessary for entitlement to an old-age pension under their legislation.
It should be noted that it is not necessary to have worked for the duration of the sum of these qualifying periods, in order to meet the qualifying periods in all the Member States where you have worked. It suffices that the total duration of insurance periods in all the Member States where you have worked equals the duration of the longest qualifying period in one of these States.
Let us return to our example. The principle described above helps Ms. Z to meet the qualifying period in State B and C. The regulation indeed obliges both State B and State C to effect a separate aggregation, by taking into account the whole of insurance periods completed by Ms. Z (15 years), to assess whether their 10-year qualifying period is met.
Note that overlapping periods are taken into account only once. In principle in such a case every Member State takes into account his own periods. Only in cases these periods are not so beneficial for entitlement or calculation of the pension as the overlapping periods of another Member State these more beneficial periods have to be taken into account. So for instance if (compulsory) insurance periods under the legislation of one Member State coincide with periods treated as such (e.g. during military service) or voluntary or continued optional insurance periods under the legislation of another Member State, only the compulsory insurance periods will be considered.
Suppose that Ms. Z, upon commencing employment in State C, would have continued to pay optional contributions in State B for a period of 2 years, with a view to increasing her future pension from that State. In that case, these continued optional insurance periods would not be taken into account for the purposes of aggregation if the overlapping periods are more beneficial for the person concerned.
Nevertheless, such periods of voluntary insurance are not lost. The Member State concerned has to grant a specific part of its pension corresponding to these periods.
No, you do not. If any of the institutions to whose legislation you have been subject establishes, during the investigation of your claim, that you satisfy the conditions for entitlement to old-age pension under its legislation, without recourse to the principle of aggregation of periods, it will pay you an independent benefit immediately. If the amount might be affected by the result of the investigation procedure, that payment will be considered provisional.
From the moment it becomes apparent that you are entitled to a pro-rata pension from a given institution, that institution will make an advance payment of an amount as close as possible to the pro-rata pension that will eventually be paid.
The institution(s) making these provisional or advance payments have a duty to inform you without delay, specifically drawing your attention to the provisional nature of these payments and of any rights of appeal under the relevant legislation.
If your entitlement to old-age pension under these States’ legislation is established – for which purpose you can rely on the principle of aggregation of periods (see question 46.3) – you will receive a pension from each of these States. These “partial” pensions are calculated according to the technique of proratisation, which is also used for calculating survivors’ pensions and invalidity pensions in cases of insurance under at least one type B system (see the keywords survivors’ benefits and invalidity pensions).
The States under whose legislation you have been insured for old-age proceed as follows.
- Those States where you qualify for entitlement to old-age pension on the basis of national law, without having recourse to the arrangements set out above, calculate a national or independent benefit, i.e. the pension to which you would be entitled by virtue of national legislation alone, without taking account of periods of insurance or residence completed in the other States;
- Each State proceeds to the calculation of a theoretical pension, i.e. the pension that would be due from the State concerned if all periods of residence or insurance completed under the legislation of the States to which you were subject, had been completed in that State. In other words, this is the pension that you would receive from the State concerned if you had worked your entire career there;
- On the basis of this theoretical pension, each State will calculate a pro-rata pension. This will be done by applying to the theoretical amount the ratio between the duration of periods completed before materialisation of the risk in the State concerned and the total duration of periods completed before materialisation of the risk under the legislation of all Member States concerned;
- If a national pension was calculated, the State concerned will compare it with the pro-rata pension which it established. You will receive the highest amount of the two. Those States (or that State) where you did not qualify for entitlement without having recourse to the abovementioned arrangements will pay you the pro-rata pension
Note that in some well-defined cases, which are listed in an annex to the regulation (Part 1 of Annex VIII to Regulation 883/2004), and provided certain conditions are met, the institution concerned may forego the calculation of the theoretical and pro-rata pension. In these cases, the amount resulting from the calculation would be equal to or lower than the amount of the national pension, entitlement to which exists even without application of the arrangements set out in the answer to the question 46.3.
Moreover, the calculation of the theoretical and pro-rata pension does not apply to schemes in respect of which periods of time are of no relevance to the calculation, i.e. defined contribution schemes and funded (non-pay-as-you-go) defined benefit schemes but also pay-as-you-go schemes if they try to calculate the pension in the same way as a funded scheme (pension account schemes), provided these schemes are listed in Part 2 of Annex VIII to Regulation 883/2004. In these cases, you will be entitled to the benefit calculated in accordance with the legislation of the State in question.
The social security systems of the Member States are not harmonised. Each Member State is free to determine the conditions for entitlement to old-age pension under its legislation, as long as it does not discriminate, directly or indirectly, against nationals of other Member States. It is therefore not surprising that there are differences in pensionable age between the Member States. These differences may be significant, with pensionable ages in the Member States ranging from 58 to 67. It is thus quite possible that, when you submit a claim for old-age pension, you may not have reached the requisite age in all the Member States where you have been insured.
If this is the case, only the Member State(s) whose conditions for entitlement to old-age pension (including having reached pensionable age) you fulfill – where appropriate after application of the principle of aggregation of periods, including those periods completed under the legislation of the Member State(s) whose conditions you do not (yet) fulfill – will proceed to calculate the amount of pension due. When performing this calculation, the periods completed under the legislation(s) whose conditions have not been satisfied are not taken into account when this would result in a lower amount of benefit.
As you reach the requisite pensionable age in the other State(s), this State (or these States) will also proceed to calculating the amount of pension due. At this point, the State(s) which is (are) already paying a pension must recalculate this pension, in accordance with the precise rules set out in the regulation.
Please note that the above arrangements also apply, mutatis mutandis, if you expressly requested the postponement (deferment) of the award of old-age pension under the legislation of one or more Member States (e.g. to be able to keep working or to earn increments leading to a higher pension).
To answer the question, it is necessary to distinguish between two kinds of situations, i.e. overlapping of benefits of the same kind and overlapping of benefits of a different kind.
Benefits of the same kind are invalidity, old-age and survivors’ benefits awarded on the basis of periods completed by one and the same person. In respect of overlapping of these types of benefits, national anti-accumulation rules may be applied in very limited circumstances only. They cannot, in principle, be applied to old-age pensions which you draw under the legislation of different Member States. The benefits to which national anti-accumulation rules may be applied are listed in an annex to the regulation (Annex IX to Regulation 883/2004) and include invalidity pensions acquired under risk systems (whether type A or type B, see the keyword invalidity pensions) and invalidity, old-age or survivors’ benefits which include future (credited) periods in the calculation. For instance, if you receive invalidity pension from Member State A (risk system) and old-age pension from Member State B, State A may possibly reduce the invalidity pension, but only within the limit of the old-age pension paid by State B. In any case, national anti-accumulation rules cannot be applied to pro-rata pensions, only to independent benefits.
If, on the other hand, you receive benefits of a different kind or other income under the legislation of two or more Member States, national anti-accumulation rules may be applied in a greater number of cases. The application of these rules is, however, subject to specific limitations, intended to prevent states from reducing benefits in the event of overlapping without taking account of similar anti-accumulation rules applied in another Member State. Such limitations consist, for instance, in the division of the amount of the benefit concerned by the number of benefits subject to the anti-accumulation rules.
The regulation provides that, as a rule, Member States are not obliged to award benefits in respect of periods of less than one year completed under their legislation. However, there are two exceptions to this rule.
First, if by virtue of the legislation of the Member State(s) concerned, a right to benefit is acquired in respect of a period of less than one year, without any aggregation of periods, the benefit must be awarded.
Second, if the effect of applying this rule would be to relieve all Member States where you have been insured of their obligation to pay old-age pension, you will receive a pension from the last of the Member States where you were insured and whose conditions for entitlement are satisfied once all periods are aggregated.
Example: Ms. X was insured in Member State A for less than one year. She then moved to Member State B where she was insured for less than one year. Finally, she took up employment in Member State C where again she was insured for less than one year. Without aggregation, Ms. X does not fulfill the conditions for entitlement in any of these States. Suppose that, with aggregation, Ms. X would be eligible for benefit in States A and B. In that case, a pension is payable in State B.
Note that, even though States are not as a rule obliged to award benefits in respect of insurance periods of less than one year, such periods are taken into account for the purposes of calculating the theoretical pension (but not the pro-rata pension). This results de facto in proportionate consideration of these periods in the calculation of the benefit of all the Member States which have to pay benefits after aggregation. So if only two Member States are involved the Member State which has to grant a benefit includes the periods shorter than 12 months of the other Member State as if they were its own periods.
See questions 41.7-41.8 under the keyword medical care.
It is possible that, during the investigation of your claim for old-age pension, you cease to be entitled to medical care under the legislation of the Member State where you have last worked. In that case, you and your family members may obtain medical care in the Member State where you reside, in accordance with the legislation of that State, provided you satisfy the conditions for entitlement to medical care under the legislation of the State that will pay for the care once the pension is awarded (generally speaking, that is the State of residence provided you receive a pension from that State, otherwise the State where you worked or where you worked for the longest period). The benefits are provided at the expense of the institution of that State. See the keyword medical care.
Automatic adjustments, due to an increase in the cost of living or changes in the level of wages, leading to increases in pensions by a fixed percentage or amount, may be applied directly to pensions. In other words, alterations in benefits which are unconnected with the personal circumstances of the insured and stem from the general evolution of the economic and social situation in a Member State do not require a new calculation in accordance with the rules set out in the answer to the question 46.5. If, for instance, State A has increased pensions due to indexation, State B may not recalculate the benefits it pays in response.
On the other hand, recalculation is necessary if, as a result of legal change, the method for determining pensions or the rules for calculating them have altered. In that case, the calculation is the same as described in the answer to question 46.5. Recalculation must also take place if changes occur in your personal situation (e.g. transition from the “household” to the “single” category or taking up employment) which, under the relevant legislation, would lead to an adjustment of the benefit amount.