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Entitlement to disability allowance for physical impairment

Disability allowance is a monthly cash benefit received by an insured person as a result of a specific physical impairment that occurs in the course of an insurance period.

 

You are not entitled to disability allowance for physical impairment if you were covered for a narrower scope of entitlement for most of the insurance period prior to the impairment.

 

Who can make a claim and what should be enclosed?

When am I entitled to disability allowance for physical impairment?

The amount of disability allowance

From when am I entitled to the allowance?

Change in the amount and scope of the entitlement

 

Who can make a claim and what should be enclosed?

A claim for the entitlement (form) may be filed:

  • by your doctor (if you live in Slovenia) or
  • by yourself or by your legal or authorised representative;  relevant medical documentation (which must be certified by your doctor if the originals are not submitted) should be enclosed.

The opinion on the existence and type or degree of physical impairment is given by the disability commission.

ZPIZ decides on the entitlement by decision, on the basis of an expert opinion issued by the disability commission.

The statutory deadline for a decision on the existence of physical impairment and the entitlement to disability allowance is four months from the day the procedure started.

 

When am I entitled to disability allowance for physical impairment?

For the entitlement to a disability allowance due to physical impairment as a result of an accident at work or an occupational disease, the following conditions must be met:

  • the physical impairment is of a certain type and degree of at least 30%,
  • the impairment occurred during a coverage period,
  • the impairment occurred as a result of an accident at work or an occupational disease, and
  • an insured person was covered for an extended scope of rights for most of the coverage period. 

 

For the entitlement to a disability allowance due to physical impairment as a result of a disease or an off-the-job injury, the following conditions must be met:

  • the physical impairment is at least 50%,
  • an insured person has completed pension qualifying years required for the entitlement to a disability pension by the time a physical impairment occurred, whether or not such an impairment leads to disability,
  • an insured person was covered for an extended scope of rights for most of the coverage period. 

 

Types of physical impairment

Physical impairments are classed with regard to eight degrees of severity. The lowest physical impairment (eighth degree) is 30 % and the highest (first degree) is 100 %.

 

Occurrence of physical impairment

As a rule, disability allowance can only be acquired for physical impairment that occurs during a coverage period.

 

EXCEPTIONS

An exception is applied to physical impairment that occurs prior to joining compulsory insurance and deteriorates during the insurance period. In such a case, the insured person is entitled to disability allowance only for that part of the physical impairment caused by the deterioration.

 

A similar exception is also applied to the impairment of a paired organ that occurred before joining an insurance scheme. If, during that period, the insured person already had a damaged eye, ear, hand, foot or other paired organ and, during the insurance period, another paired organ got damaged, they receive disability allowance for the impairment of both organs.

 

Amount of the disability allowance

Depending on the degree of physical impairment, the allowance is paid in eight different amounts. Furthermore, the allowance for physical impairment follows the indexation rules set in the Act Regulating Adjustments of Transfers to Individuals and Households in the Republic of Slovenia.

From when am I entitled to the allowance?

You are entitled to disability allowance for physical impairment from the day the physical impairment occurred and until the impairment lasts.

Disability allowance is also payable from the day the physical impairment occurs, if it was established after the claim was lodged. If the physical impairment occurred before the claim was lodged, disability allowance may be paid at the latest from the first day of the month after the claim was lodged, backdated for 6 months.

 

Change in the amount and scope of the entitlement

Changes in the state of health that affect the amount and scope of the entitlement take effect the day after they occur. The new amount is paid no later than the first day of the month after the claim was lodged, backdated for 6 months.

 

 

Pension and Disability Insurance Institute of Slovenia, Kolodvorska 15, Ljubljana
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