Disability insurance

Regulation

The Pension and Disability Insurance Act entered into force on 1 January 2013 (Official Journal of the RS, No 96/12, hereinafter: ZPIZ-2).

Definition of disability under ZPIZ-2

Definition of disability is based on the Article 1 of the Convention No 159 of the International Labour Organization, stipulating that "a disabled person" is an individual whose prospects of securing and retaining suitable employment have substantially been reduced due to physical or mental impairment. The same definition of "a disabled person" is given in the Recommendation No 168 of the International Labour Organization.

The definition of disability covers the entire general and occupational work capacity of the insured. The absolute definition of disability is specified as the loss of work capacity for any organized gainful activity as well as the impairment or loss of capacity to work in one’s own occupation, taking into account the level of qualifications, additional training, work experience and the possibility of occupational rehabilitation.

Disability is the consequence of changes in one’s health condition which cannot be remedied by treatment or medical rehabilitation. An insured person's own occupation is the work performed at one’s post or the activity which serves as a base for their insurance and which corresponds to their physical or mental capacities and for which they have been qualified, additionally trained or gained required work experience according to the regulations or collective agreements.

Apart from the definition of insured person's own occupation, the definition of remaining work capacity under Article 64, ZPIZ-2 (defining the category II and II) is taken into account when establishing disability under Article 63, ZPIZ-2.

ZPIZ-2 defines "another job" as the job an insured person can perform considering their remaining work capacity. Another job has to correspond to their heath condition or the nature of the change in their health condition and must not cause the impairment of their disability. The choice of another job depends on:

• the evaluation of remaining work capacity,
• general and professional qualification of an insured person, work experience, personal characteristics, and their willingness to perform a certain job,
• working conditions provided by one’s employer, workplace equipment, adequacy of working environment.

The job for which an insured person has been trained in the course of occupational rehabilitation prior to their transference is regarded as a suitable job.

There are three categories of disability under ZPIZ-2:

• Category I – where an insured person is not able to perform organized gainful activity or carry out their job, with no remaining work capacity;
• Category II – where an insured person's work capacity to perform their job has been reduced by 50% or more;
• Category III – where an insured person is not able to perform their job on a full-time basis, yet can work part-time for at least four hours a day, or their capacity to work in their occupation has been reduced by less than 50%, or they can still work in their occupation full-time, yet not at their current job.

Self-employed persons, partners in a private company or institution, or farmers are regarded as disabled if they are not able to perform the activities subject to insurance coverage on a full-time basis.

Upon a request, work or activity performed for at least one year in the last two years prior to the occurrence of disability can be taken into account in disability assessment with insured persons not covered by compulsory insurance scheme when disability occurred.