Explanatory Memorandum to COM(1981)615 - - Main contents
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This page contains a limited version of this dossier in the EU Monitor.
| dossier | COM(1981)615 - . |
|---|---|
| source | COM(1981)615  |
| date | 23-10-1981 |
Introduction . • ■> \ > w
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1. ' Regulation (EEC) No 1408/71,of the Council of 14 June 1971 on the
application of social security schemes to employed persons and their .
families moving within the Community and Regulation (EEC) No 574/72 ' -. p ' . ', ' - ■ ■
of the Council of 21 March 1972 laying down the procedure for ,
• ' *' . • ' ■ " • • .
* implementing Regulation No 1408/71 are at present applicable only
to employed persons. - , ,
2. In its Proposal of 31 December 1977^, the Commission proposed as •
. a first step that Regulation No 1408/71 be adapted with a view to
its application to self-employed persons and members of their
; . families. Following the Opinions delivered by the European Parliament-
and the Economic and Social Committee, the Commission amended its ,
• ' 4 ■ ■ . ■ > ■ ■ ■ " ' •
Proposal so that it would also cover non-employed persons. . ' '
3. On 12 May 1981, the Council adopted a Regulation extending Council Regulation No 1408/71 to self-employed persons. The Council was unable
' to adopt the Commission's proposals / •/ ' relating to the coverage of non -employed persons owing to differences of opinion concerning -the scope of the EEC Treaty and the use of its Article 235. ,
4. The effect of Regulation (EEC) No 1390 is to extend to self-employed
> ' ' ' . ' , . . s '
persons the majority of provisions, applicable to employed persons,
' taking account where necessary of peculiarities resulting from the nature of the occupational activities and of the characteristics of ' the relevant social security schemes. Jt should 'be noted here that *■ this extension also covers workers who have been successively engaged in employed activities and self-employed activities. ■ - :
r- <\l PO sf m
O.J, No L 149 of 5.7.1971 (codified version : L 138 of -9.6.1980)
O.J. No L 74 of 27.3.1972 (codified version : L 138 of 9.6.1980)
O.J. No C 14 of 18.1.1973 . - :/
O.J. No C 246 of 17.10.1978
Council Regulation (EEC) No 1390/81 - O.J. NoL143 of 29.5.1981 ,
5. The provisions of Regulation No 1408/71 relating to the payment of family benefits for family members residing in a Member State other than the country of employment are not applicable to self-employed persons. Profound differences of opinion between the Member States concerning the standardization of the system for employed persons prevented the Council from applying the provisions at present in force to self-employed persons and from laying down special arrangements. .
6. In spite of this shortcoming,, the extension of Regulation No 1408/71 to self-employed persons constitutes an extremely important step towards the social protection of all persons who, for professional or other reasons, move within the Community. Only certain categories of non-employed persons who are not family members of an employed or . self-employed person and who cannot give evidence of occupational
activities are still excluded from the Community rules and regulations. The Member States have stated that they will- take the necessary measures at national level to ensure that such persons are covered by sickness insurance in the: case of..a temporary stay in another Member State.
Analysis of the Proposal for a Regulation
7„ Regulation (EEC) No 574/72 lays down the procedure for implementing Regulation No 1408/71. An effective'implementation of the provisions of Regulation No 1408/71 to self-employed persons consequently calls for the^necessary amendments to be made to Regulation No 574/72.
This is the purpose of this Proposal,. The purpose of this proposal is thus essentially technical and does not present any particular difficulties. ; . • . .
8. The only point to w,hich attention needs to be drawn concerns the absence of measures for the application of Article 14c(1)(b) of the amended Regulation No 1408/71^.
See Article 1(8) of Regulation No 1390
Under this provision, workers who are employed simultaneously in the territory of one Member State and self-employed in the territory of another Member State shall be subject to the legislation of each of these Member States. This provision which is an exception to the general principle that only one legislation is applicable presents difficult coordination problems, the resolution of which will take some time. In order to prevent delays in the entry into force of this new Regulation for all self-employed persons, it is intended ■' that the Commission will submit a proposal on this matter at a later date. ■ ' ' - ■ ’ ' ’
9. As regards the form of this proposal, it is thought that presenting ' the textsof the amended provisions in their entirety would facilitate reading of this regulation once it has been adopted... In order to accelerate the procedure for the adoption of the Proposal, the Commission is hereby submitting a separate proposal for the corpus of the regulation and will subsequently submit, as soon as possible, a separate proposal for the Annexes ; the regulation to be finally~ adopted will, of course, be based on the two proposals.
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10. The amended Regulation No 1408/71 and the amended Regulation
No 574/72 will enter into force six months after the last-mentioned Regulation has been published fn the Official Journal. The extension-
of the relevant Community rules and regulations to self-employed persons will take effect from that date. ..
This period is necessary for the revision of the forms required for the application of this new Regulation. '
PROPOSAL FOR . A
•• COUNCIL REGULATION (EEC)
Contents
- EXTENDING REGULATION (EEC) NO 574/72 TO SELF-EMPLOYED PERSONS
- Article 6
- Article 8
- Rules a.pplicable in the case of overlapping of rights to unemployment benefits
- 7. Article 10 shall be replaced by the following s
- Rules applicable in the case of overlapping of rights to family benefits or family allowances for employed or self-employed persons
- 1. Entitlement to family benefits or family allowances due under the
- 2. If an employed person subject to the legislation of a Member
- Article 10a
- If an employed or self-emp!
- ded for by
- or family allowances shall be granted In proportion to the length of time during which the person concerned has been subject to the
- 8. Article 11 shall be replaced by the following ?
- Article 11
- 1. The institution designated by the competent authority of the
- Special provisions concerning insurance of employed persons under the German social security scheme
- States
- 4. . For the purposes of Article 14 (2) (b) (ii) of the Regulation an
- Article 13 shall be replaced by the following : '
- 4. Where the person concerned has opted for German legislation to
- Article 15
- 2. Periods of insurance or residence completed under the legislation
- 3. When periods of insiirance completed under the legislation of one
- the application of the preceding rules shall r.ot have the effect of producing, for- the sum total of the periods of insurance completed
- IMPLEMENTATION OF ARTICLE 18 OF THE REGULATION
- 2. This certified statement shall be issued at the request of the
- 19 -
- Benefits in kind in the case of residence in a Member State other than the competent State
- 1. In order to receive benefits in kind under Article 19 of the
- However, when the said certified statement has been issued hy a French institution, it shall only he valid for six months following the date
- 9. Two or more Member States or the competent authorities of those
- 15. Article 18 shall be replaced by the following x
- Cash benefits' in the case of residence in a Member State other than the competent State
- 9. Two or more Member States, or the competent authorities of those
- 16. Article 20 shall be replaced by the following : l
- Article 20
- hail, as soon as possible, submit to the institution of the
- 6. Benefits in kind provided by virtue of the presumption made in
- Article 21
- 1. In order(to receive benefits in kind under Article 22 (l) (a)(i)
- 18. Article 22 shall be replaced by the following s
- employed persons who transfer their f residence, and for employed or'
- Benefits in kind for employed or selfresidence or return to their country o self-employed persons authorised to go
- 1. In order to r'-.ceiyo
- 3. Paragraphs 1 and 2 shall apply by analogy in respect of the
- . -
- Cash benefits for employed or self-employed persons in the case of a stay in a Member State other than the competent State
- Article 25
- Article 32a
- Article 33
- Article 34
- 3. Where major expenses are involved, the competent institution
- Article 35
- 1. In order to receive benefits under Articles 37p 38 and 39 of the
- 3- The provisions of paragraph 2 shall not apply In the case referred
- Documents and, information which should accompany claims to the benefits
- The submission of the claims referred to in Article 36 of the Implementing Regulation shall be subject to the following rules s
- Investigation of claims for invalidity benefits in the case where, the employed or self-employed person has been subject exclusively to the legislations specified in Annex IV of the Regulation
- 28. Article 42 shall be replaced by the following ?
- Forms to be used for the investigation of claims for benefits
- 1. When investigating claims for benefits the investigating institution
- 2. These forms, when forwarded to the institution of any other Member
- Procedure to be followed by the institutions concerned in the investigation .of a claim •
- 1. The investigating institution shall enter on the form provided
- 30. Article 44 shall be replaced by the following s
- Institution empowered to take a decision relating to the degree of invalidity
- Article 51
- Article 60 shall be replaced by the following s
- 4. Upon each application for benefits in kind, the person concerned
- 3. In the event of hospitalization the institution of the place of
- 6. The institution of the place of residence shall notify the compe
- 7. The person concerned shall inform the institution of the place of
- Cash benefits other than pensions in the case of residence in a Member State other than the competent State
- 1. In order to receive cash benefits other than pensions under
- 2. If the doctors providing treatment in the country of residence dc
- certificate shall state the probable duration of the incapacity end shall
- 6. If the competent institution decides to withhold the cash benefits
- 9. Two or more Member States or the competent authorities of those
- IMPLEMENTATION OF ARTICLE 55 OF THE REGULATION
- Benefits in kind in the case of a stay in a Member State other than the
- 1. In order to receive benefits in kind, a person employed in inter
- of the competent institution whether the person concerned satisfies the
- 3. The competent institution shall send its reply to the institution of
- . The provisions of Article 60 (5), (6) and (9) of the Implementing
- 1. In order to receive benefits in kind under Article 55 (l) (b) (i)
- 3. Paragraphs 1 and 2 shall apply by analogy in respect of the provision
- 37 . Article 64 shall be replaced by the following j
- Disputes concerning the occupational nature of the accident or disea.se
- IMPLEMENTATION OF ARTICLE 60 OF THE REGULATION
- 4. In the case referred to in the second sentence of Article 60 (2) (b)
- Article 72
- 1. In order to assess the degree of incapacity in the case referred
- 3. The competent institution may apply to any other institution which
- Article 73
- 1. In the cases referred to in Article 62 (l) of the Regulation
- 2 o Where the benefits provided under the special scheme for workers
- EXCLUDING PENSIONS IN RESPECT OF OCCUPATIONAL DISEASES COVERED BY ARTICLE 57 OF THE REGULATION
- 1. In order to receive a pension or supplementary allowance
- 2. The competent institution shall notify the claimant of its
- Certified statement of periods
- IMPLEMENTATION OF ARTICLE 67 OF THE REGULATION
- Article 82
- 1. In order to invoke the provisions or Article 68 (2) of the
- 3. Where the institution issuing the certified, statement referred to
- IMPLEMENTATION OF ARTICLE 72 OF THE REGULATION
- 1. In order to invoke the provisions of Article 72 of the Regulation
- AND (b) OF THE REGULATION
- 1. In order to receive family benefits under Article 73 (l) of
- 3. Where the legislation of the competent State provides that the
- 5. An employed person shall inform the competent institution where
- Article 87
- 1. In order to receive family allowances under Article 73 (2) of
- 4, If the legislation of the Member State in whose territory the
- Refund of sickness and maternity insurance benefits other than those provided for in Articles 94 and 95 of the Implementing Regulation
- 5, The provision of paragraphs 1 and 2 shall apply by analogy to
- 3. The factors necessary for the calculation of the said-lump-sum
- shall be determined according to the following rules s
- receive family allowances paid by a.n institution of another Member State in whose territory they are residing."
- Proof of status of seasonal worker
- Article 109
- Recovery of benefits in kind provided but not due to persons employed in international transport
- Transitional provisions relating to family benefits
- Article 2
- Article 3
- Article 4
- If, however, the amount calculated in pursuance of the provisions referred to in (a) above ' is greater than that calculated in pursuance
- Article 5
- This Regulation shall be binding in its entirety and directly applicable in all Member States. '
- 2. Provided that the amount of the family benefits referred to in
- 3. Where the family benefits have to be paid under Article 73 (2) of
AND MEMBERS OF THEIR FAMILIES
THE COUNCIL OF THE EUROPEAN COMMUNITIES, •
Having regard to the Treaty establishing tne European Economic Community, and in particular Article s 2, 7,. 51 and 235 thereof:
Having regard to . Council Regulation (EEC) No 1408/71 of 14 June 1971 on the
application of social security schemes to employed persons and their families moving
1 '-2 within the Community , as last amended by Regulation (EEC) N° 2793'/8i , and in
particular Article 97 thereof;
Having regard to the proposal from the Commission drawn up after consultation of' \ ' 1 '
the Administrative Commission on Social Security for Migrant Workers;
■ " ' 4
Having regard to the opinion of the European Parliament ;
Having regard to the Opinion of the Economic and Social Committee ;
■ ■ , / , ’ . - : :'
p. 2 p.1
O.J. N° L 149 of 5.7.1971 , 'O.J. N° ,L 275/ 29.9.1981/ *O.J. N°
lO.J. N° .
5O.J. N°
Whereas the Council adopted on 12 May 1981 Regulation (EEC) No 1390/81^ extending Regulation (EEC) No 1408/71 to self-employed persons and members of their families; whereas the provisions of Council Regulation (EEC) No 574/72 , as last amended by Regulation (EEC) No 2793/81, laying down the procedure for implementing Regulation (EEC) No 1408/71 should be adapted accordingly;
Whereas there are difficulties inherent in formulating a procedure for implementing the rule under which persons who are simultaneously employed in the territory of one Member State and self-employed in the territory of another Member State are, in some cases, subject simultaneously to the legislation of each of those Member States; whereas it is therefore necessary to lay down the implementing procedure for this particular case in a subsequent regulation;
HAS ADOPTED THIS REGULATION:
60J No L 143, 29.5.1981, p.1 70J No L 74, 27.3.1972, p.1
Article 1 - ’ •
Regulation (EEC) N° 374/72 shall be amended as follows s
1. The title shall be replaced by the following s .
^COUNCIL REGULATION (EEC) N° 374/72 . -
of 21 March 1972 ^
.laying down the procedure for implementing Regulation (EEC) N° 1408/71 - on the application of social security schemes to employed and self-employed persons and members of their families moving within
the Community a
2. In Article 4 s -
(a) in - ' paragraph 8, "Article 10 (2) (d)” shall be .
replaced by "Article 10a (l) (d)"% , .
, . ' '• . • . ■ •
(b) paragraph 10 shall be replaced by the following : , ,
'*~10. Annex 10 lists the institutions or bodies designated by the competent authorities pursuant, in particular, to the following .
- provisions : -• . ,
(a) Regulation s Article 14 d (2), Article 17;
(b) Implementing Regulation i Article 6 (l). Article 11 (l).
Article 11a, -Article 12a,, Article 13 (2) and (3), Article 14 (l), (2) and (3), Article 38 (l). Article 70 (l), Article 80 (2), Article 81, Article 82 (2), Article 83 (2), Article 86 (2), Article 89 (l), Article 91 (2), Article 102 (2), Article 110,
' . Article 113 (2)-^; ■
(c) the following paragraph shall be added ; , '
"-11. Annex 11 lists the scheme or schemes referred to in Article 33 (2) of the Regulation.-<' o
. ■ ' „ ...
Article 6 shall he replaced hy the following :
3.
^IMPLEMENTATION OF ARTICLE 9 OF THE REGULATION
Admission to voluntary or optional continued insurance
1. If, hy virtue of Articles 9 and 15 (3) of the Regulation, a person satisfies the conditions for admission to a voluntary or optional continued insurance in respect of invalidity, old age and death (pensions) in several schemes under the legislation of one Member State, and if he has not Leen subject to compulsory insurance under one of those schemes hy virtue of his last employment or self-employment he may, under the said Articles, join the voluntary or optional continued insurance scheme specified hy the legislation of that Member State or, failing that, the scheme of his choice.
2. In order to invoke the provisions of Article 9 (2) of the Regulation, a person shall submit to the institution of the Member State in question a certified statement relading to the insurance periods or periods of residence completed under the legislation of any other Member State. Such certified statement shall he issued, at the request of the person concerned, hy the institution or institutions who administer the legislations tinder which he has completed those periods.--* □
4. Article 5 shall he replaced hy the following ■*!
Rules applicable in the ca.se of overlapping of rights to sickness or maternity benefits under the legislation of several Member States
1, If an employed or self-employed person or a member of his family is entitled to claim maternity benefits under the legislations of two or more Member States, those benefits shall be granted exclusively under the legislation of the Member State in whose territory the confinement took place or, if the confinement did not take place in the territory of one
of these Member States, exclusively under the legislation of the Member Sta.te to which the employed or self-employed person was last subject.
2. If an employed or self-employed person is entitled to claim sickness benefits under the legislations of Ireland and the United Kingdom for the same period of incapacity for work, those benefits shall be granted exclusively under the legislation of the Member State to which the person concerned was last subject?** □ •
5. Article 8a shall be replaced by the following 1
^Article 8a .
Rules applicable in the case of overlapping of rights to sickness benefits, benefits with respect to accidents at work or occupational disease under Hellenic legislation and the legislation of one or more other Member States
If during the same period an employed or self-employed person or member of his family Is entitled to claim sickness benefits, benefits with respect to accidents at work or occupational disease under Hellenic legislation and under the legislation of one or more Member States, these benefits shall be granted exclusively under the legislation to ’which the person concerned was last subject r* □
6. Article 9a shall be replaced by the following %
Article 9a> .
If an employed or self-employed person, entitled to unemployment benefits
' f ’
under the legislation of a Member State to 'which he was subject during his last employment or setf-employrr-ent pursuant to Article 69 of the Regulation, gees to Greece
where he is also entitled to unemployment "benefits by virtue of a period of insurance^ employment or self-employment previously completed under Hellenic legislation, the right to benefits under Hellenic legislation shall be suspended for the period laid down in Article 69 (1) (c) of the Regulation, o
“-Article 10
/
Rules applicable in the case of overlapping of rights to family benefits or family allowances for employed or self-employed persons
legislation of a Member State, according to which acquisition of the right to those benefits or allowances is not subject to conditions of insurance, employment, or self-employment, shall be suspended when, during the same period and for the same member of the family ;
(a) benefits are due in pursuance of Article 73 or Article 7^ of the Regulation,, If, however, the spouse of the employed or unemployed person referred to in those Articles exercises a professional or trade activity in the territory of the said Member State, the right to family benefits or family allowances due in pursuance of the said Articles shall be suspended; and only those family benefits or family allowances of the Member State in whose territory the member of the family is residing shall be paid, the cost to be borne by that Member Skate;
(b) benefits axe due in pursuance of Article 77 ox Article 73 of the Regulation o If, however, a pensioner who is entitled to benefits under Article 77 of the Regulation, his spouse or the person looking after the orphans to whom benefits are due under Article 78 of the Regulation, exercises a professional or trade activity in the territory of the said Member State t entitlement to family allowances due in pursuance of Article 77 or Article 78 of the Regulation under the legislation of
another Member State shall be suspended* where this is the case, the person concerned shall he entitled to the family benefits or family allowances of the Member State in whose territory the children reside, the cost to be borne by that Member State, and, where appropriate, to benefits other than the family allowances referred to in Article 77 or Article 78 of the Regulation, the cost to be borne by the competent State as defined by those Articles.
State is entitled to family allowances by virtue of periods of insurance or employment previously completed under Hellenic legislation, this right shall be suspended where, during the same period and for the same member of the family, family benefits or allowances are due under the legislation of the first Member State pursuant to Articles 73 and 7^ of the Regulation?* □
Rules applicable when during the same period or part of a period the employed or self-employed person is successively subject to the legislation of several Member States ■
eyed, person has been subject succes
sively to the legislation two dates for the payment
of two Member States during the period separating of family benefits or family allowances as provi
States concerned,
the legislation
of cns or both of the Membi
the following rules shall apply j
the person concerned gislaticn of each one of daily benefits or Where these legislations s, the family benefits
toe family benefits or family allowances which may claim by virtue of being subject to the le; cf these States shall correspond to the number allowances due under the relevant legislation, do not provide for daily benefits or allowance;
or family allowances shall be granted In proportion to the length of time during which the person concerned has been subject to the
legislation of each one of the Member States in relation to the period fixed by the legislation concerned;
(D) WHERE THE FAMILY BENEFITS OR FAMILY ALLOWANCES HAVE BEEN PROVIDED BY AN INSTITUTION DURING A PERIOD WHEN THEY SHOULD HAVE BEEN PROVIDED BY ANOTHER INSTITUTION, THERE SHALL BE AN ADJUSTMENT OF ACCOUNTS BETWEEN THE SA.ID INSTITUTIONS;
(c) for the pur-poses of subparagraphs (a) and (b) where periods of employment or self-employment completed under the legislation of one Member State are expressed in units different from those which are used in the calculation of family benefits or family a.llowances under the legislation of another Member State to which the person concerned has also been subject during the same period, the conversion shall be carried out in accordance with the provisions of Article 15 (3) of the Implementing Regulation;
(d) notwithstanding the provisions of subparagraph (a.), in respect of dealings
between the Member States listed in Annex 8 to the Implementing Regulation, the institution bearing the costs of the family benefits or family allowances by reason of the first employment or self-employment during the period concerned, shall bear their cost throughout the whole of the current period. ,
►IMPLEMENTATION OF ARTICLES 13 to 17 OF THE REGULATION
Formalities in the case of the posting elsewhere of an employed
person pursuant to .Article ll (l) and Article lib (l)__and in the case of Aorgements concluded under Article 17 of the Regulation
Member State whose legislation is to remain applicable shall issue a certificate stating that an employed person shall remain subject to that legislation up to a specified date,, .
(a) at the request of the employed person or his employer in cases referred to 3m Article ll (l) and Article lib (l) of the Regulation?
(b) in. cases where Article 17 of the Regulation applies.
2' The consent provided for in Article ll (l) (b) of the Regulation
shall be requested by the employer,-* □ .
Article 11a .
Formalities pursuant to Article lla. (l) and Article lib (2) and in the case of ^concluded junde r Article 17 of the Peculation in the case of work carried out in the territory of a Member State other than that in which the oerson concerned is normaU.y self"employed
1', Toe institution desigca&ed by the competent authority of the Member
State whose legislation is to remain applicable shall issue a certificate stating that the self-employed person shall remain subject to that legislation up to a specified date,
(a) at the request of the self-employed person in cases referred to in Article 14a (l) and Article 14b (2) of the Regulation;
(D) in cases where Article 17 of the Regulation applies
2. The consent provided for in Article 14a (1)(b) of the Regulation shall be requested by the self-employed person."
9. Article 12 shall he replaced by the following %
,? ' ""-Article 12
’ I'
•v
Special provisions concerning insurance of employed persons under the German social security scheme
Where, under the terms of .Article 13 (2) (a). Article 14 (l) and (2; or Article l4b (l) of the Regulation, or under an agreement concluded pursuant to Article 17 of the Regulation, German legislation applies to a person employed by an undertaking or employer whose registered office or place of business is not situated on German territory, and the person concerned has no fixed job on German territory, this legislation shall apply as if the person concerned were employed in his place of residence on German territory.
If the person concerned has no residence on German territory,
German legislation shall apply as If he were employed In a place for which the Allgemeine Oriskrankenkasse Bonn. (General Sickness Fund of Bonn), Bonn is competent.-* □
10. Article 12a shall be replaced by the following’ s
^Article 12a
Rules applicable in respect of the persons x*eferred to in Article 14 (2) (b) and in Article l4a (2) to (4) of the Regulation who normally engage in employment or self-employment in the territory of two or more Member
1. For the purposes of Article 14 (2) (b) (i), the first sentence of paragraph 2 and paragraph 4 of Article 14a of the Regulation a person who normally pursues his activity in the territory of two or more Member States or in an undertaking which has its registered office or place of business in the territory of one Member State and which straddles the . common frontier of two Member States shall notify this fact to the institution designated by the competent authority of the Member State in the territory of which he resides.
2. : Subject to paragraph 3 • that institution shall - ,
issue to the person concerned a certificate stating that he is subject .
to the legislation of that Member State and shall-send a copy thereof to the institution designated by the competent authority of any other Member State ; . • . . .
(a) in the territory of which the said person pursues a part of his activity; and/or : ' :
(b) if he is an employed person, in the territory of which an undertaking ,
' or an employer by whom he is employed has its registered office or
place of business. . ’ . . . •
This latter institution shall, where necessary,- send to the' '
institution designated by the competent authority of the Member State whose legislation is applicable the information necessary to assess the contributions for which the employer or employers and/or the employed person.are _ liable by virtue of that legislation. '
• , ^ 1 i ' ' ‘
3- In a case to which Article 14a (4) applies, the institution desi-
_ gnated in accordance with paragraph 1 shall inform the competent authorities ' of the ether Member States concerned accordingly irr order to determine . the legislation applicable to the person concerned; the information which is to be supplied by virtue of paragraph 2 shall be sent to the institution designated by the competent authority of the Member State whose legislation is determined to be applicable. , _ ’ . d .
employed person who normally pursues his activity in the territory of two or more Member States shall notify this fact to the institution designated by the competent authority of the Member State in the territory of which the •undertaking or employer employing the person concerned ha.s its registered office or place of business.
The provisions of paragraph 2, subparagraph (a) shall apply by analogy. .However, the person concerned may obtain the certificate in question through the institution designated by the competent authority of the Member State in the territory of which he resides.
5' (a) For the purposes of the provisions of Article l4a(2), second
sentence, of the Regulation, a person normally self-employed in the territory of two or more Member .
States shall inform the institution designated by the competent authority of one of these Member States of that situation. The said institution or any other institution that has been informed of that situation sh3.ll forthwith inform the institutions designated by the competent authorities of the other Member States concerned.
00 The competent authorities of the Member States concerned or the institutions designated by these competent authorities shall by common agreement determine the legislation applicable to the person concerned, account being taken of the provisions of subparagraph (d)p within a period of not more than six months counting from the day on which the situation of the person concerned had been notified to one of the institutions concerned.
(c) Trie institution administering the legislation that has been determined as being applicable to the person concerned;, taking account where appropriate of the provisions of Article l4a(4) of the Regulation, shall issue a certificate to that person showing that he is subject to that legislation, and shall send a copy thereof to the other institutions concerned.
” ' * -M|
(&) For t\.i purpose of del*-;-' c-ining. in pursuance of Ar+.'cie l4a(2>„. third sar xence, of the1 Seouli i or,. tin-. pr iricipal activity the person ccoxs-med account shall he taken firsc and foremost of the locality ir which the fixed and permanent premises from which the person concerned pursue* his activities if. situated. Failing' this, account shall he taken of criteria such as the usual nature or the duration of the activities pursued, tic number of services rendered arid +b.e income arising from those activities.
(e) Tile institutions concerned shall exchange all information necessary to determine "both the principal activity of the person concerned and the contributions payable under the legislation -that has been designated as being applicable to him,?— c
Article 13
by diplomatic missions
Sx excise of the right of option by perse is employed and consular posts .
1. fhe right of option provided for in Article 16 (2) of the regulation riot be exercised in the first instance within the three months following bba date on which the employed person was engaged by the diplomatic mission c r consular post concerned, or on which he entered into the personal service
of agents of such mission cr post The option shall take effect on the date of entry info employment. ■
When the person concerned renews his right of option at the end of a calendar year, the option shall take effect on the first day of the following calendar ya-r.
2.. rphe person concerned who exercises his right of option shell inform the- instr -ation designated by the competent authority of the .bomber State f.v' chose legislation he has opted, at the same time notifying his employer uit-xof, The salt institution shall, where necessary, forward errh infonna-to all other institutions of the same Member State, in s-cccrd-v.oe with
directives issued by the competent authority of that Member State.
3. The institution designated by the competent authority of the Member State for whose legislation the person concerned has opted, shall issue to him a certificate testifying that he is subject to the legislation of that Member State while he is employed by the diplomatic mission or consular post in question or in the personal service of agents of such mission or post.
be applied the provisions of such legislation shall be applied as though he were employed in the place where the German Government has its seat. The competent authority shall designate the competent sickness insurance institution.6- □
12. Article 15 shall be replaced by the following :
1. In the cases referred to in Article 18 (l), Article 38, Article 45 (l) to (3), Article 64, and Article 67 (l) and (2) of the Regulation, aggregation of periods shall be effected in accordance with the following rules :
(a) to periods of insurance.or residence completed under the legislation of one Member State shall be added periods of insurance or residence completed under the legislation of any other Member State, to the extent that this Is necessary to have recourse thereto in order to supplement periods of insurance or residence completed under the legislation of the first Member State for ohe purpose of acquiring, retaining, or recovering the rights to benefitsp provided that such periods of insurance or residence do not overlap„ Where benefits in respect of invalidity, old age or heath (pensions; one to be awarded by the institutions of two c.: more Member States in accordance with the provisions of Article 46 (2) of the Regulation, each of the institutions
concerned shall effect a separate aggregation, by taking into account the whole of the periods of insurance or residence completed by the employed or self-employed person under the legislations of all the Member States to which he has been subject, without prejudice, where ^ appropriate, to the provisions of Article 45 (2) and (3) and Article 46 (2) (c) of the Regulation;
(b) when a period of insurance or residence completed under compulsory insurance under the legislation of one Member State coincides with a period of insurance completed under voluntary or optional continued insurance under the legislation of another Member State, only the period completed under compulsory insurance shall be taken into account;
(c) when a period of insurance or residence, other than a period treated as such, completed under the legislation of one Member State coincides with a period treated as such under the legislation of another Member State, only the period other than a period treated as such shall be taken into account;
(d) any period treated as such under the legislations of two or more Member States, shall be taken into account only by the institution of the Member State under whose legislation the insured person was last compulsorily
insuredfprior to the said period; where the insured person has not been
%
compulsorily insured under the legislation of a Member State before the said period, the latter shall be taken into account by the institution of the Member State under whose legislation he was compulsorily insured for the first time after the said period;
(e) where it is not possible to determine accurately the period of time in which certain periods of insurance or residence were completed under the legislation of one Member State, such periods shall be presumed not to overlap with periods of insurance or residence completed under the legislation of another Member State and shall, where advantageous, be taken into account;
(f) where under the legislation of one Member State, certain periods of insurance or residence are taken into account only if they have been
completed within a specified time limit, the institution which administers such legislation shall : .
(i) only take into account periods of insurance or residence completed under the legislation of another Member State if they were completed within the said time limit; or
(ii) extend such time limit for the duration of periods of insurance or residence completed wholly or partly within the said time limit under the legislation of another Member State, where the periods of insurance or residence involved under the legislation of the second Member State give rise only to the suspension of the time limit within which the periods of insurance or residence must be completed.
of a Member State to which the Regulation does not apply, but which are taken into account under the legislation of that Member State to which the Regulation does apply, shall be considered as periods of insurance or residence to be taken into account for the pur-poses of aggregation.
Member State are expressed in units different from those used hy the legislation of another Member State, the conversion necessary for the purposes of aggregation shall be carried out according to the following rules :
(a) where the person concerned is an employed person who has been subject to a six-day week or if he is self-employed 1
(i) one day shall be equivalent to eight hours and vice versa;
(ii) six days shall be equivalent to one week and vice versa;
(in.) 26 days shall be equivalent to one month and vice versa;
(iv) three months or 13 weeks or days shall be equivalent to one quarter and vice versa;
for the conversion of weeks into months: and vice versa the weeks and months siia.il be converted into days;
the application of the preceding rules shall r.ot have the effect of producing, for- the sum total of the periods of insurance completed
during one calendar year* a total exceeding 312 days or 52 weeks or 12 months or four quarters;
(b) if the person concerned is an employed person who has been subject to
a five-day week : '
(i) one day shall be equivalent to nine hours and vice versa;
(ii) five days shall be equivalent to one week and vice-versa;
(iii) 22 days shall be equivalent to one month and vice versa; ‘ “~~"'
(iv) three months or 13 weeks or 66 days shall be equivalent to one quarter and vice versa;
(v) for the conversion of weeks into months and vice versa, the weeks and the months shall be converted into days;
(vi) the application of the preceding rules shall not have the effect of producing;, for the sum total of the periods of insurance completed during one calendar year* a total exceeding 264 days or 52 weeks or 12 months or four quarters.
13. Article 16 shall be replaced by the following ;
Article 16
Certification of periods of insurance
p_
1., -in order to invoke the provisions of Article 18 of the Regulation,
an employed or self-employed person shall submit to the competent institution a certified statement specifying the periods of insurance completed under the legislation to which he was last subject.
employed or self-employed person by the institution or institutions of the Member State to whose legislation he was last subject. If he does not submit the said certified statement, the competent institution shall obtain it from the institution or institutions concerned.
3, The provisions of paragraph 1 and 2 shall apply hy analogy,
if it is necessary to take into account periods of insurance previously completed under the legislation of any other Member State in order to satisfy the conditions of the legislation of the competent State.-"* G
14. Article 17 shall be replaced by the following :
s*- IMPLEMENTATION OF ARTICLE 19 OF THE REGULATION
Article 1?
Regulation, an employed or self-employed person must register himself and the members of his family with the institution of his place of residence by submitting a certified statement testifying that he and the members of his family are entitled to the said benefits. This certified statement, based upon information supplied by the employer, where appropriate , shall be issued by the competent institution. If the employed or self-employed person or the member’s of his family do not submit the said certified statement the institution of the place of residence shall obtain it from the competent institutions.
2. That certified statement shall remain valid until the institution of the place of residence receives notification of its cancellation.
However, when the said certified statement has been issued hy a French institution, it shall only he valid for six months following the date
of its issue a,nd must be renewed every six months.
3. If the person concerned is a, seasonal worker, the certified statement referred to in paragraph 1 shall he valid for the whole of the expected duration of the seasonal work unless, in the meanwhile, the competent institution notifies the institution of the place of residence of its cancellation.
- 20 -
4. The institution of the plaoe of residenoe shall inform the '
competent institution of every registration effected in accordance with the provisions of paragraph 1. .
5. Upon each, application for "benefits in kind, the person concerned
shall submit the supporting documents required for the granting of benefits in kind under the legislation of the Member State in whose territory he resides. .
6. In the event of hospitalization, the institution of the place of
residence shall,, within three days of becoming aware of the fact, notify the competent institution of the date of entry into hospital, the probable duration of hospitalization and the date of leaving hospital. Notification shall be unnecessary, however, when the costs of the benefits in kind are . '
repaid in a lump stun to the institution of the place of residence. '.
7. The institution of the place of residence shall notify the competent
institution in advance of any decision relating to the' granting of benefits in kind where the likely or actual cost exceeds a lump sum which is fixed and periodically reviewed by the Administrative Commission. The competent institution shell have 15 days from the day on which such informat ion is sent within which to raise any objection and to state the reasons on which such objection is based; if, at the endof that period, no such objection has been'raised, the institution of the place of residence shall grant the benefits in kind. Where such benefits have to be granted in a case of extreme urgency, the institution of the place of resi~ dence shall forthwith inform the competent institution thereof. However, notification of Its objection, stating the reasons on which such objection . is based, shall be unnecessary when the costs of the benefits in kind are .
repaid in a lump sum to the institution of the place of residence. .
8. The employed or self-employed person or the members of his family
shall inform the institution of the place of residence of any change in their situation which is likely_to alter their entitlement to benefits in kind, in particular any cessation or change of the employment or self-• employment, of the person concerned or any transfer of residence or stay of the employed or self-employed person or of a member of his family. Likewise, should the employed or self-employed person cease to be insured
or cease to "be entitled to benefits in kind, the competent institution shall inform the institution of the place of residence accordingly.
Tne institution of the place of residence may, .at any time, request the competent institution to supply it with any information relating to the employed or self-employed personas insurance or to his entitlement to benefits in kind. '
Member States may, having received the opinion of the Administrative Commission, agree on other implementing provisionsr* □
►Article 18
1. In order to receive cash benefits under Article 19 (l) (b) of the Regulation an employed or self-employed person shall, within three days of commencement of the incapacity for work, apply to the institution of the place of residence by submitting a notification of having ceased work or, if the legislation administered by the competent institution or by the institution of the place of residence so provides, a certificate of incapacity for work issued by the doctor providing treatment for the person concerned.
2. Where the doctors providing treatment in the country of residence do not issue certificates of incapacity for work, the person concerned shall apply directly to the institution of the place of residence within the time limit fixed by the legislation which it administers,
That institution shall immediately have the incapacity for work medically confirmed and the certificate referred to in paragraph 1 drawn up„ Such certificate shall state the probable duration of the incapacity and shall be forwarded to the competent institution forthwith.
3. In cases where paragraph 2 does not apply,' the ' institution of the place of residence shall, as soon as possible and in any event within the three days following the date on which the person concerned applied to it, have him medically examined as if he were insured with that institution.
Hie report of the examining doctor shall indicate, in particular," the probable duration of the incapacity for work, and shall be forwarded to the . competent institution by the institution of the place of residence within the three days following the date.of the examination.
4. The institution of the place of residence shall subsequently carry out any necessary administrative checks or medical examinations of the person concerned as if he were insured with that institution. As soon as it establishes that the person concerned is fit to resume work, it shall forthwith notify him and the competent institution accordingly, stating the date . on which his incapacity for work ceased,' Without prejudice to the provisions of paragraph 6/ the notification to the person concerned shall be treated as
.•a decision taken on behalf of the competent institution.
5. In all cases the competent institution shall reserve the right to
have the person concerned examined by a doctor of its own choice. '
6. If the competent institution decides to withhold the cash benefits because the person concerned has not completed the formalities laid down-by the legislation of the country of residence/ or if it establishes that the person concerned is fit to resume work, it shall notify the person concerned of its decision and shall simultaneously send a copy of such decision to the institution of the place of residence..
7. When the person concerned resumes work, he shall notify the com- .
petent institution accordingly, if such notification is required by the ‘ legislation administered by that institution. 1 •
8. The competent institution shall pay cash benefits by the appropriate
method, in particular by international money order, and shall inform the institution of the place of residence and the person concerned accordingly.
Where cash benefits are paid by the institution of the place of residence on behalf of the competent institution, the latter shall inform the person concerned of his rights and shall notify the institution of the place of residence of the amount of the cash benefits, the dates for payment, and the maximum period during which they should be granted, in accordance with the legislation of the competent State.
Member States may, having received the opinion of the Administrative Commission, agree on other implementing provisions.-a □
► IMPLEMENTATION OF ARTICLE 22 OF THE REGULATION
Benefits in kind in the case of a stay in a Member State other than the competent State - special case of persons employed in international' ”* transport- and members of their families
±,
±n order to receive benefits in Rind for himself or for members
of his family who accompany him, a person employed in international transport, covered by Article 14 (2) (a.) of the Regulation, who in the course of his employment goes to the territory of a Member State other than the compe
tent Sta/te,
place of stay, a special certified statement issued by the employer or by his agent during the current calendar month or during the two calendar months preceding its submission„ Such certified statement shall stare in particular the date from which the person concerned has been employed by the said employer, and the name and address of the competent institution; if, however, under the legislation of the competent State the employer is not required, to know the competent institution, the person, concerned shall provide in writing the name and address of that institution when submitting his application to the institution of the place of stay.
A person who has submitted such certified statement shall be presumed to have satisfied the conditions for acquisition of the right to benefits in kind. If a person is unable to contact the institution of the place of stay before receiving medical treatment, he shall nevertheless receive such treatment on presentation of the said certified statement as if he were insured with that institution.
2. The institution of the place of stay shall within three days inquire of the competent institution whether the person concerned satisfies the conditions for acquisition of the right to benefits in kind.
The institution of the place of stay shall provide the benefits in kind until it receives a reply from the competent institution, but for not more than 30 days. ,
3. The competent institution shall send its reply to the institution of the place of stay within 10 days of the receipt of the request from that institution. If that reply is in the affirmative, the competent institution shall indicate, if necessary, the maximum period during which the benefits in kind may be granted, in accordance with the legislation which it administers, and the institution of the place of stay shall continue to provide the said benefits.
4. In place of the certified statement provided for in paragraph 1, a person covered by that paragraph may submit to the institution of the place of stay a certified statement stating that the conditions for acquisition of the right to benefits in kind have been satisfied. This certified statement, which shall be issued by the competent institution, shall specify in particular, where necessary, the maximum period during which benefits
in kind may be granted in accordance with the legislation of the competent State. In such a case paragraphs.' 1, 2 .and 3 shall not apply.
5. The provisions of Article 17 (6), (7) and (9) of the Implementing Regulation shall apply by analogy.
- paragraph 1 shall be reimbursed as provided for in Article 36 (l) of the Regulation.^- □ '
17. Article 21 shall be replaced by tho following' '
Benefits :ln kind in the case of a stay in a Member State other than the competent Ptate - Employed or self-employed persons other than those covered by Article 20 of the Implementing Regulation
of the Regulation, save in the case referred to in Article 20 of the Implementing Regulation, an employed or self-employed person shall submit to the institution of the place of cty a certified statement stating that he is entitled to benefits in kind. Such certified statement, which snail be issued by the competent.institution at the request of the person concerned, if possible before he ‘leaves the territory of the Member State in which ho resides, shall specify in particular, where necessary, the maximum period during which benefits in kind may be granted, in accordance with the legislation of the competent State. If the employed or self-employed person does not submit the said certified statement, the institution of the place of stay’ shall obtain it from the competent institution. ,
2. Hie provisions of Article 17 (6), (?) and (9) of the Implementing Regulation shall apply by analogy.-* a
\ t
► Article 22
* o a- >other Member Stable for medical
Benefits in kind for employed or selfresidence or return to their country o self-employed persons authorised to go
treatment
of the Regulation, an employ-
benefits ie kind under Article 22 (l) (b) (i) •d or StIf-employed person shall submit to the
*7 ris*f.^y n t n on of the place of resmence a certified statement testifying I'lcii h© is entitled, to continue receiving the said "benefits. Tills certified statement, which shall "be issued by the competent institution, shall specify in particular , Khere necessary, the maximum period during which such benefits may continue to be provided, in accordance with the provisions of the legislation of the competent State. The certified statement may, at the request of the person concerned, be issued after his departure if, for reasons of 'force majeure', it cannot be drawn up beforehand.
2. The provisions of Article 17 (6), (7) and (9) of the Implementing Regulation shall apply by analogy.
provision of benefits in kind in the case referred to in Article 22 (l) (c) (i) of the Regulation.-* □ .
19. Article 24 shall be replaced by the following :
if *
►Article 24
Cash benefits for employed or self-employed persons in the case of a stay in a Member State other than the competent State
The provisions of Article 18 of the Implementing Regulation shall apply by analogy in respect of the receipt of cash benefits under Article 22 (l)
(a) (ii) of the Regulation. However, without prejudice to the obligation to submit a certificate of incapacity for work, an employed or self-employed person who is staying in the territory of a Member State, without pursuing any professional or trade activity there, shall not be required to submit the notification of having ceased work referred to in Article 18 (l) of the Implementing Regulation.□ .
► IMPLEMENTATION OF ARTICLE 23 (3) OF THE REGULATION
Certified statement relating to the members of the family to be taken
into account in the calculation of cash benefits
1. In order to receive' benefits under the provisions of Article 23 • (3) of the Regulation,, an employed or self-employed person shall submit
to the competent institution a certified statement relating to the members of his family who are resident in the territory of a Member State other than that wherein the said institution is situated.
2. This certified statement shall be issued by the institution of the place of residence of the members of the family.
It shall be valid for the 12 months following the date of its issue. It may be renewed; in such a. case, it shall be valid from the date of its renewal.
The person concerned shall immediately notify the competent institution of any occurrence necessitating an amendment to the said certified statement. Such amendment shall take effect from the date of such occurrence.
3. In place of the certified statement provided for In paragraph 1,
the competent institution may require the person concerned to produce recent civil status documents relating to the members of his family who are resident in the territory of a Member State other than that wherein the said institution is situated,-^ □
^IMPLEMENTATION OF ARTICLE 35 (2) OF THE REGULATION
Special schemes applying to certain self-employed persons
Annex 11 lists the scheme or schemes referred to in Article 35 (2) of the Regulation. o
22. Article 33 shall be replaced by the following :
► IMPLEMENTATION OF ARTICLE 35 (4) OF THE REGULATION
Taking account of the period during which benefits have already been provided by the institution of another Member State
For the purposes of implementing the provisions of Article 35 CO of the Regulation, the institutions of a Member State called upon to provide benefits may request the institution of another Member State to supply it with information relating to the period during which the latter insti tution has.already provided benefits for the same case of sickness or maternity. □ .
► REFUND BY THE COMPETENT INSTITUTION OF ONE MEMBER STATE OF EXPENSES INCURRED DURING A STAY IN ANOTHER MEMBER STATE
1. IT it is not possible during an employed or self-employed person's stay in a Member State other than the competent State to complete the formalities provided for in Article 20 (l) and (4) and Articles 21, 23 and 31 of the Implementing Regulation, his expenses shall, upon his application, be refunded by the competent institution in accordance with the refund rates administered by the institution of the place of stay.
2. The institution of the place of stay shall, at the request of the competent institution, supply it with the necessary information about such rates.
If the institution of the place of stay and the competent institution are bound by an. agreement providing either that no refund, or that a lump-sum refund of benefits provided, in pursuance of Article 22 (l)
(a) (i) and Article 31 of the Regulation, be made, the institution of the place of stay shall, in addition, be required to transfer to the competent institution the amount to be refunded to the person concerned in pursuance of the provisions of paragraph 1.
may pay an appropriate advance to the person concerned as soon as that person submits to the said institution the claim for refund.□
► SUBMISSION AND INVESTIGATION OF CLAIMS FOR BENEFITS
Claims for invalidity benefits where the employed or self-employed person has been subject exclusively to the legislation specified in .Annex IV of the Regulation,, and in the case referred to in Article 40 (2) of the Regulation
Regulation* including the cases referred to in Articles 40 (2)„ 4l (l) and 42 (2) of the Regulation* an employed or self-employed person shall submit a claim either to the institution of the Member State to whose legislation he was subject at the time of occurence of the incapacity for work followed by invalidity or the aggravation of such invalidity,, or to the Institution of the place cf residence* which shall then forward the claim to the first institution* Indicating the date on which It was submitted; this date shall, be regarded a.s the date of the submission of the claim to the first^, institution. However* If sickness insurance cash benefits have been granted* the date on which such cash benefits ceased to be granted must* where appropriate* be regarded as the date of submission of the pension claim.
2. In the case referred to in Article 4l (l) (b) of the Regulation* the
Institution with which the claimant was last insured shall notify the amount and the operative date of the benefits due under the legislation which it administers to the institution initially responsible for payment of the benefits. Kith effect from that date, the benefits due prior to the aggravation of the Invalidity snail bs cancelled or reduced to an amount net exceeding the supplement referred to In Article 4l (l) (c) of the Regulation,.
to in Article 4l (l) (d)- of the Regulation. In this case,, the institution with which the claimant was last insured shall apply to the Netherlands institution in order to ascertain the amount due from that institution.-'* □
^Article 36
Claims for old-age and survivors’ benefits (excluding orphans’ benefits) and
- invalidity benefits in cases not referred to in Article 35 of the Implementing Regulation
1. In order to receive benefits under Articles 40 and 51 of the Regulation, except in the cases referred to in Article 35 of the Implementing Regulation, the person concerned shall submit a claim to the institution of the place of residence in accordance with the procedure provided for by the legislation administered by that institution. If the employed or seif-employed person has not been subject to that legislation, the institution of the place of residence shall forward the claim to the institution of the Member State
to whose legislation he was last subject, indicating the date on which the claim was submitted. That date shall be regarded as the date on which the claim was submitted to the latter institution.
2. Where a claimant resides in the territory of a Member State to whose legislation the employed or self-employed person has not been subject, he may submit his claim, to the institution of the Member State to whose legislation the employed or self-employed person was last subject.
3. Where a claimant resides in the territory of a State which is not a Member State, he shall submit his claim to the competent institution of'fhsTt Member State to whose legislation the employed or self-employed person was
1
last subject.
Should the claimant submit his claim to the institution of the Member State of which he is a national, the latter sha.ll forward such claim to the competent institution.
4. A claim for benefits sent to the institution of one Member State shall automatically involve the concurrent award of benefits under the legislation of all the Member States in question whose conditions the claimant satisfies except where, under Article 44 (2) of the Regulation, the claimant asks for postponement of any old age benefits to which he would be entitled under the legislation of one or more Member States.► □
► Article 37
referred to in Article J6 of the Implementing Regulation
The submission of the claims referred to in Article 36 of the Implementing Regulation shall be subject to the following rules s
(a) the claim must be accompanied by the required supporting documents and must be made on the form provided for by the legislation s
(i) of the Member State in whose territory the claimant resides, in the
case referred to In Article 36 (l)? •
(ii) of the Member State to which the employed or self-employed person was last subject, in the cases referred to in Article 36 (2) and (3);
(•b) the accuracy of the information supplied by the claimant must be established by official documents attached to the claim form, or confirmed by the competent bodies of the Member Sta,te in whose territory the claimant resides; _ ■ .
(c) the claimant must indicate, in so far as is possible, either the institution ox' institutions administering insurance in respect of invalidity, old age or death (pensions) of any Member State with which the employed or self-employed person has been insured, cr in the case of an employed person the employer or employers for whom lie has worked in the territory of any Member State, by producing any employment certificates which he may have in his possession;
(d) if, under Article Mi- (2) cf the Regulation, the claimant asks for the postponement of the award of any old age benefits to which be would be entitled under the legislation of one or more Member States he must specify the legislation under which he is claiming benefits .-*' □
"—Article 39
Investigation of claims for invalidity benefits in the case where, the employed or self-employed person has been subject exclusively to the legislations specified in Annex IV of the Regulation
1. If an employed or self-employed person has submitted a claim for invalidity benefits, and the institution establishes that the provisions of Article 37 (l) of the Regulation supply, that institution shall, where necessary, obtain from the institution with which the person concerned was last insured a certified statement of the periods of insurance completed by him under the legislation administered by that last institution.
2. Where it is necessary to take into account periods of insurance previously completed under the legislation of any other Member State in order to satisfy the conditions of the legislation of the competent State, the provisions of paragraph 1 shall apply by analogy.
'
3. In the case referred to in Article 39 (3) of the Regulation, the institution which has investigated the claimant’s case shall forward his file to the institution with which the person concerned was last insured.
4. Articles 4l to 50 of the Implementing Regulation shall not apply to the investigation of claims referred to in paragraphs 1, 2 and 3.-* □
•Article 42
shall use a form which will include, in particular, a statement and a
summary of the periods of insurance or residence completed "by the employed or self-employed person under the legislation of all the Member States concerned.
State, shall take the place of supporting documents□
29. Article 43 shall be replaced by the following :
► Article 43
for in Article 42 (l) of the Implementing Regulation the periods of insurance or residence completed under the legislation which it administers and it shall forward a copy of that form to the institution administering insurance in respect of invalidity, old age or death (pensions) of any Member State with which the employed or self-employed person has been insured enclosing, where appropriate, any employment certificates produced by the claimant.
2. Where only one other institution is involved, that institution shall complete the said form by indicating :
(a) the periods of insurance or residence completed under the legislation which it administers;
(b) the amount of benefit which the claimant could claim in respect of those periods of insurance or residence only;
(c) the theoretical amount and the actual amount of benefits calculated in accordance with the provisions or Article 46 (2) of the Regulation.
The form, thus completed, shall be returned to the investigating institution.
If a right to "benefits is acquired taking into account only the periods ' *'’*-*'• of insurance or residence completed under the legislation administered by the institution of the second Member State, and if the amount of benefit corresponding to those periods can be established without delay, whereas the calculation procedure referred to in subparagraph (c) requires an appreciably longer period of t5.me, the form shall be returned to the investigating institution with the information referred to in subparagraphs (a) and (b); the information referred to in subparagraph (c) shall be forwarded to the investigating institution as soon a.s possible.
3. If two or more other institutions are involved, each one of those institutions shall complete the said form by indicating the periods of insurance or residence completed under the legislation which it administers, and shall return it to the investigating institution.
If a right to benefits is acquired taking into account only the periods of insurance or residence completed under the legislation administered by one or more of those institutions, and if the amount of benefit corresponding to those periods can be determined without delay, the investigating institution shall' "be simultaneously notified of that amount and of the periods of insurance or residence; if the determination of the said amount involves some delay, the investigating institution shall be notified of that amount as soon as it has been determined.
On receipt of all the forms giving information concerning periods of insurance or residence and, where appropriate, the amount or amounts due under the legislation of one or more of the Member States concerned, the investigating institution shall forward a copy of the forms thus completed to each of the institutions concerned which shall specify thereon the theoretical amount and the..actual amount .of. the'benefits, calculated . in accordance with the provisions of Article 46'..(2). of. the Regulation,'and shall return-the^ . form to; the’ investigating institution.
4. As soon as the investigating institution, upon receipt of the information referred to in paragraphs 2 or 3' establishes the fact that the provisions of Article 40 (2) or Articl.e 48 (2) or (3) of the Regulation should be applied, it shall inform the other institutions concerned accordingly.
5. In the case provided for in Article 37 (d) of the Implementing
Regulation, the institutions of the Member States to -whose legislation the claimant has been subject but to whom he has applied for postponement of the award of the benefits,' shall enter on the form provided for in A-H-.icie 42 (l) of the Implementing Regulation only the periods of insurance or residence completed by the claimant -under the legislation which they administer .► □
Article 44
1. Subject to the provisions of paragraphs 2 and 3' only the investi-gatiiig institution shall be empowered to take the decision referred to in Article 40 (4) of the Regulation concerning the degree of invalidity of ^he claimant. It shall take such a. decision as soon as it is in a position to determine whether, taking account, where appropriate, of the provisions of Article 45 of the Regulation, the conditions for entitlement fixed by the legislation which it administers are fulfilled. It shall notify such decision forthwith to the other institutions concerned.
2. If, taking account of the provisions of Article 45 of the Regulation, the conditions for entitlement, other than those relating to the degree of invalidity, laid down by the legislation administered by the investigating institution are not fulfilled, that Institution shall immediately notify the competent institution in respect of ini’alidity of the ether Member State to whose- legislation the employed or self-employed person was last subject.
This institution shall, if the conditions for entitlement laid down by the legislation which it administers are fulfilled, be empowered to take the decision relating to the degree of invalidity of the claimant; it shall forthwith notify that decision to the other institutions concerned.
3. Where necessary, the matter may have to be referred back, under the
same conditions, to the competent institution in respect of invalidity of the Member State to whose legislation the employed or self-employed person was first subject.► □ - '
" 1. (a) (i) ’’Where an employed or self-employed person who is a national
of one Member State becomes subject to the legislation of another Member State, the competent institution in respect of pensions of the latter Member State shall, using all the means at its disposal and at the time of registration of the person concerned, forward to the body designated by the competent authority of that same Member State [country of employment] , all information relating to the identification of the person concerned [the date on which he commenced employment] and the name of the said competent institution and the insurance number allotted by the latter.
(ii) Moreover, the competent institution referred to insubparagraph (i) shall also, as far as possible, forward to the body designated under the provi s ions of subparagraph C i) any other informat ion which may facilitate and accelerate the ultimate award of the pensions.
(iii) Such information shall be forwarded, under conditions fixed by
the Administrative Commission, to the body designa/ted by the competent authority of the Member State concerned.
(iv) For the implementation of the provisions of subparagraphs (i), (ii) and (iii), stateless persons and refugees shall be deemed to be nationals of the Member Sta/te to whose legislation they were first subject.
(b) The institutions concerned shall, at the request of the person concerned or of the institution with which he is currently insured, draw up his insurance history starting not later than one year before the date on which he will reach pensionable age."
► ADMINISTRATIVE CHECKS AND MEDICAL EXAMINATIONS
1. When a person in receipt of benefits, in particular :
(a) invalidity benefits;
(b) old age benefits awarded in the event of unfitness for work;
(c) old age benefits awarded to elderly..unemployed persons;
(d) old age benefits awarded in the event of cessation of a professional or trade activity;
(e) survivors' benefits awarded in the event of invalidity or unfitness for work;
(f) benefits awarded on condition that the means of the recipient do not exceed a prescribed limit,
Is staying or residing in the territory of a Member State other than the State in which the institution responsible for payment is situated, administrative checks and medical examinations shall be carried out, at the request of that institution, by the institution of the place of stay or residence of the recipient in accordance with the procedures land down by the legislation administered by the latter institution. The institution responsible for payment shall, however, reserve the right to have the recipient examined by a, doctor of its own choice.
2. If It is established that the recipient referred to in paragraph 1 is employed or self-employed or has means in excess of the prescribed ‘limit while receiving benefits, the institution of the place of stay or residence shall send a report to the institution responsible for payment which has requested the check or examination. This report shall indicate in particular the nature of the employment or self-employment pursued by the person ■
concerned, the amount of earnings or means which he has had during the last complst® quarter, th© normal earning© obtained in the same area by an employed person at the same level as the person concerned in the occupation which he followed before becoming an invalid over a reference period to be determined by the institution responsible for payment and. where appropriate, the opinion of a medical expert on the state of health of the. person concerned .-*' □ ■ .
^IMPLEMENTATION,OF ARTICLES 52 AND 53 OF THE REGULATION , Article 60
Benefits in kind in the case of residence in a Member State other than the competent State .
1. In order to receive benefits in kind under Article 52 (a) of the Regulation, an employed or self-employed person shall submit to the institution of the place of residence a certified statement testifying that he is entitled to such benefits in kind. This certified statement, based upon information supplied by the employer, where appropriate, shall be issued by the competent institution. Moreover, if the legislation of the competent Stat so provides, the employed or self-employed person shall submit to the institu tion of the place of residence a receipt from the competent institution of notification of an accident at work or of an occupational disease. If the person concerned does not submit such documents, the institution of the place of residence shall obtain them fro;.; the competent institution and, pending their arrival, it shall grant him the benefits in kind under sickness insurance, provided that he satisfies trie conditions for entitlement thereto.
2. That certified statement shs.ll remain, valid until the institution of the place of residence receives notification of its cancellation. However, when the said certified statement has been issued by a French institution, it shall only be valid for six months following the date of its issue, and must be renewed every six months'.
3. If the person concerned is a soasonal worker, the certified statement raf'errad to in paragraph 1 shall be valid fan the whole of the expected duration of the seasonal work unless, in the meanwhile,
the competent institution notifies the institution of the place of residence of its cancellation.
shall submit the supporting documents required for the granting of benefits in kind under the legislation of the Member State in whose territory he resides. .
' '' '
residence shall, within three days of becoming aware of the fact, notify
the competent institution of the date of entry into hospital, the probable
duration of hospitalization and the da,te of lea,ving hospital.
tent institution in advance of any decision relating to the granting of benefits in kind where the likely or actual cost exceeds a Lump sum which is fixed and periodically reviewed by the Administrative Commission. The competent institution shall have 15 days from the day on which such information is sent within which to raise any objection and to state the reasons on which such objection is based? if, at the end of that period, no such objection has been raised, the institution of the place of residence shall grant the benefits in kind. Where such benefits in kind have to be granted in a case of extreme urgency, the institution of the place of residence shall forthwith inform the competent Institution thereof.
residence of any change in his situation which Is likely to alter his entitlement to benefits in kind, in particular any cessation or change of employment or self-employment or any transfer of residence or stay. Likewise, should the person concerned cease to be insured or cease to be entitled to benefits in kind the competent institution shall inform the institution of the place of residence accordingly. The institution of the place of residence may, at any time, request the competent institution to supply it with any information relating to the insurance of the person concerned or to his entitlement to benefits in kind. -
8. In the case of frontier workers, medicinal products, "bandages, spectacles and small appliances may he issued, and laboratory analyses and tests carried out, only in the territory of the Member State in which they were prescribed in accordance with the provisions of the legislation of that Member State.
9. Two or more Member States or the competent authorities of these Member States may, having received the opinion of the Administrateive Commission, agree on the implementing provisions.®- a
3*K Article 6l shall be replaced by the following :
-<* Article 6l
Cash benefits other than pensions in the case of residence in a Member State other than the competent State
Article 52 (b) of the Regulation, an employed or self-employed person shall, within three days of commencement of the incapacity for work, apply to the institution of the place of residence by submitting a notification of having ceased work or, if the legislation ad.miuistered by the competent institution or by the institution of the place of residence so provides, a certificate of incapacity for work, issued by the doctor providing treatment for the person concerned.
not issue certificates of incapacity for work, the person concerned shall apply directly to the institution of the place of' residence witrin the time limit fixed by the legislation which it administers.
That institution shall immediately have the Incapacity for work medically confirmed and the certificate referred to In paragraph! drawn up. Such
* ^
be forwarded to the competent institution forthwith.
42
3. In cases where paragraph 2 does not apply, the institution of the place of residence shall, as soon as possible and in any event within the three days following the date on which the person concerned applied to it, have him medically examined as if he were insured with that institution.
The report of the examining doctor shall indicate, in particular, the probable duration of the incapacity for work, and shall be forwarded to the competent institution by the institution of the place of residence within the three days following the date of the examination.
4. The institution of the place of residence shall subsequently carry out any necessary administrative checks or medical examinations of the person concerned as if he were insured with that institution. As soon as it establishes that he is fit to resume work it shall forthwith notify the person concerned and the competent institution accordingly, stating the date on which the incapacity for work ceased. Without prejudice to the provisions
•of paragraph 6, the notification to the person concerned shall, be treated as a decision taken on behalf of the competent institution.
5* In all cases, the competent institution shall reserve the right to
have the person concerned examined by a doctor of its own choice.
because the person concerned has not completed the formalities laid down by the legislation of the country of residence, or if it establishes that the person concerned is fit to resume work, it shall notify the person concerned of its decision and shall simultaneously send a copy of such decision to the institution of the place of residence..
7. When the person concerned resumes work, he shall notify the competent institution accordingly if such notification is required by the legislation administered by that institution.
8* The competent institution shall pay cash benefits by the appropriate
method, in particular by international money order, and shall inform the institution of the place of residence and the person concerned accordingly. Where cash benefits are paid by the institution of the place of residence on behalf of the competent institution, the latter shall inform the parson concerned of his rights and shall notify the institution of the place of
residence of the amount of the cash benefits, the dates for payment and the maximum period dinring which they should he granted, in accordance with the legislation of the competent State.
Member States may, having received the opinion of the Administrative Commission, agree on other implementing provisions.► □
35. Article 62 shall be replaced by the following :
j; •
’ • •
. Article 62 ' ‘
competent State ■
national transport covered by Article iPr (2) (a) of the Regulation who, in the course of his employment, goes to the territory of a Member State other than the competent State, shall, as soon as possible, submit to the institution of the place of stay a special certified statement issued by the employer or by his agent during the current calendar month or during the two calendar months preceding Its submission. Such certified statement shall state in particular the date from which the person concerned has been employed by the said employer and the name and address of the competent institution. If the person concerned has submitted such certified statement, he shall be presumed to have satisfied the conditions for acquisition of the right to benefits in kind. If the person concerned is unable to contact the institution of the place of stay before receiving medical treatment he shall nevertheless receive such treatment on presentation of the said certified statement as if he were insured with that institution. ‘
2. The institution of• the place of stay shall within three days inquire
44
conditions for acquisition of the right to benefits in kind... The institution oi tbs place of stay shall provide the benefits in kind until if receives a reply from the competent institutions but for not more than 30 days,
the place of suay within 10 days of ,he receipt of the request from that institution. If that reply is in the affirmative, the competent institution shall indicate, if necessary, the maximum period during which the benefits in kind may be granted, in accordance with the legislation which it administers and the institution of the place of stay shall continue to provide the said benefits.
k. Benefits in kind provided by virtue of the presumption made in
paragraph 1 shall be reimbursed as provided for in Article 36 (l) of the Regulation. -
5" In p3a.ce of the certified statement provided for in paragraph 1,
the person concerned may submit to the institution of th$ place of stay a certified statement as provided for in paragraph 6.
6. In. order to receive benefits in kind under Article 35 (l) (a) (i)
oi' the Regulation, except in cases where a presumption is made under paragraph 1, the employed or self-employed person shall submit to the institution of the place of stay a certified statement staking that he is entitled to oenefitfa in kind. Such certified statement, which shall be issued by trie competent institution, if possible before the person concerned leaves the territory of the Member State in which he resides, shall specify in particular, where necessary, the maximum pericu during which benefits in kind may be granted, in accordance with the legislation of the competent State. If the person concerned does not submit the said certified statement, the institution of the place of stay shall obtain it from the competent institution.
egulation shall apply by analogy.*- □
—' Article 63 '
Benefits in kind for employed or self-employed persons who transfer their residence or return to their country of residence, and for employed or self-employed persons authorized to go to another Member State for medical treatment .
of the Regulation, an employed or self-employed person shall submit to the institution of the place of residence a certified sta.tement testifying that he is entitled to continue receiving the said benefits. This certified statement, which shall be issued by the competent institution, shall specify in particular, where necessary, the maximum period during which such benefits may continue to be provided, in accordance with the provisions of the legislation of the competent State, The certified statement may,, at the request of the person concerned, be issued after his departure if, for reasons of "force majeure", It cannot be drawn up beforehand.
2. The provisions of Article 60 (5), (6) and (9) of the Implementing Regulation shall a,pply by analogy.
of benefits in kind in the case referred to in Article 55 (l) (c) (i) of the Regulation. □
Article 64
Gash benefits other tha.n pensions in the case of a stay in a Member State other than the competent State
Ttis provisions of Article 61 of the Ivpleveniivig Regulation shall apply Uy analogy in rcc.pcot ci’ the- re',:oirt of" each bonOi'iia f o+-h-;^ th".n pensions,
under Article 55 (l) (a) (ii) of the Regulation. However, without prejudice to the obligation to submit a certificate of incapacity for work, an employed or self-employed, person who is staying in the territory of a Member State without pursuing any professional or trade activity there shall not be required to submit the notification of having ces.sed work referred to in Article 6l (l) of the Implementing Regulation.*— □
38. Article 66 shall be replaced by the following :
-*Article 66
1. When, in the cases referred to in Article 52 or 55 (l) of the Regulation, the competent institution disputes the application of the legislation relating to accidents at work or occupational diseases, it shall forthwith notify that fact to the institution of the place of residence or institution of the place of stay which provided the benefits in kind; those benefits shall then be considered, as coming under sickness insurance and shall continue to be provided thereunder upon presentation of the certificates or certified statements referred to in Articles 20 and 21 of the ImplementIng Regulation„
2. When a final decision has been reached cn this subject, the competent institution shall forthwith notify the fact to the institution of the place of residence or to the institution of the place of stay which provided the benefits in kind. Where the case is net one of an accident at work or an occupational disease that institution shall continue to provide the said benefits in kind under sickness insurance if the employed or _ self-employed person is entitledthereto. In other cases, the benefits in kind received by the person concerned under sickness insurance shall be considered as benefits for an accident at work or an occupational disease.—- □
Article 71
Aggravation of an occupational disease
1. In the cases covered by Article 60 (l) of the Regulation, the claimant shall supply the institution of the Member State from which he is claiming rights to benefits with all information relating to benefits previously granted in respect of the occupational disease in question.
That institution may apply to any other institution which has previously been competent in order to obtain any information which it considers necessary.
2. In the case covered by Article 60 (l) (c) of the Regulation, the competent institution required to pay the cash benefits shall notify the other institution concerned, for its approval, of the amount of costs to
be borne by the latter institution as a result of the aggravation, together with appropriate supporting evidence. At the end of each calendar year, the first institution shall send the second institution a statement of the cash benefits paid during the financial year in question, showing the amount due from the latter institution which shall make the refund to the first institution as soon as possible, and within three months at the latest.
3. In the case referred to in the first sentence of Article 60 (2) (b) of the Regulation, the Institution responsible for payment of cash benefits shall notify the competent institutions concerned, for their approval, of the changes made in the previous apportionment of costs, together with the appropriate supporting evidence.
of the Regulation, the provisions of paragraph 2 shall apply by analogy. *— □
— IMPLEMENTATION OF ARTICLE 6l (5) OF THE REGULATION •
Assessment of the degree of incapacity in the case of an accident at work sustained previously or an occupational disease diagnosed previously
to in Article 61 (5) of the Regulation, a claimant shall supply the competent institution of the Member State to whose legislation he was subject at the time when the accident at work was sustained or the occupational disease was first diagnosed, with all information on previous accidents at work sustained or occupational diseases contracted by him when he was subject to the legislation of any other Member State, whatever the degree of incapacity caused by those previous cases.
2„ In accordance with the legislation which it administers in respect
of the acquisition of the right to benefit, and the determination of the amount of benefit, the competent institution shall take into account the degree of incapacity caused by those previous cases,
was previously competent in order to obtain any information which it considers necessary o
When a previous incapacity for work was caused by an accident sustained while the person concerned was subject to the legislation of a Member State which makes no distinction as tc the origin of the incapacity for work, the competent institution in respect of the previous incapacity for work or the body designated by the competent author5.ty of the Member State concerned shall, at the request of the competent institution of another Member State,
. * -v
supply information on the degree of the previous incapacity for work and, as far as possible, any information which would make it possible to determine whether the incapacity was the result of an accident at work within the meaning of the legislation administered by the institution of the second Member State-Where such is the case, the provisions of paragraph 2 shall apply by analogy.*- □
— IMPLEMENTATION OF ARTICLE 62 (l) OF THE REGULATION
Institutions to which workers in mines and similar undertakings may apply when staying or residing in a Member State other than the competent State
and where, in the country of stay or residence, the benefits provided under the insurance scheme for accidents at work and occupational diseases covering manual workers in the steel industry are equivalent to those provided under the special scheme for workers in mines and similar undertakings, workers belonging to the latter category may apply to the nearest institution in the territory of the Member State in which they are staying or residing specified in Annex 3 of the Implementing Regulation, even if the latter is an institution of the scheme applicable to manual workers in the steel industry, which institution shall then provide such benefits.
in mines and similar undertakings are more advantageous, such workers shall have the option of applying either to the Institution responsible for the administration of that scheme, or to the nearest institution in the territory of the Member State in which they axe staying or residing, which administers the scheme for manual workers in the steel Industry.
In the latter case the Institution in question shall draw the attention, of the person concerned to the fact that by applying to the Institution responsible for the administration of the abovementioned special scheme, he will obtain more advantageous benefits; it must, furthermore, inform him of the name and address of such institution.s— □
— SUBMISSION AND INVESTIGATION OF TENSION CLAIMS,
Article 75
under the legislation of a Member State, an employed or self-employed^ person or his survivors residing In the territory of another Member State shall make a claim either to the competent institution, or to the institution of the place of residence, which shall forward such claim to the competent institution. The submission of the claim shall be subject to the following rules s
(a) the- claim must be accompanied by the required supporting documents and made on the form provided for by the legislation administered by the competent institution;
(b) the accuracy of the information supplied by the claimant must be established by official documents attached to the claim form, or confirmed by the competent bodies of the Member State in whose territory the claimant resides.
decision directly or through the liaison body of the competent State; it shall send a copy of that decision to the liaison body of the Member State in whose" territory the claimant resides. ► □
—'Article 79
1. In order to invoke the provisions of Article 64 of the Regulation, a claimant shall submit to the competent institution a certified statement specifying the periods of Insurance or residence completed by the employed or self-employed person under the legislation to which he was last subject.
2. This certified statement shall'be issued, at the request of the claimant by the sickness insurance or the old age insurance institution, as the case may be, with which the employed or self-employed person was
.‘last insured. If the claimant does not submit the said certified statement, the competent institution shall obtain it from one or other of the aforementioned institutions.
3. The provisions of paragraphs 1 and 2 shall apply by analogy if, in order to satisfy the conditions of the legislation of the competent State, it is necessary to take into account periods of insurance or residence previously completed under the legislation of any other Member State.*—
44. Article 80 shall be replaced by the following ;
Article 80
Certified statement of periods of insurance or employment
1. In order to invoke the provisions or Article 67 (l), (2) or (4) of the Regulation, the person concerned shall submit to the competent institution a certified statement specifying the periods of insurance or employment completed previously.as an employed person under the legislation to which he was last subject, together with any further information required by the legislation administered by that institution.
2. This certified statement shall be issued, at the request of the person concerned, either by the competent institution in respect of unemployment of the Member State to whose legislation he was last subject, or by another institution designated by the competent authority of the said Member State. If he does not submit the said certified statement, the competent institution shall obtain it from one or other of the aforementioned institutions.
3. The provisions of paragraphs 1 and 2 shall apply hy analogy if, in order to satisfy the conditions of the legislation of the .competent State, it is necessary to take into account periods of insurance or employment previously completed under the legislation of any other Member State.□
^5. Article 82 shall he replaced by the following s
Certified statement relating to the members of the family to be taken into consideration for the calculation of benefits
Regulation^ a person shall submit to the competent institution a certified
• '
statement relating to the members of his family who are resident in the territory of a Member State other than the one in which the said institution is situated.
2. This certified statement shall he issued hy the institution designated by the competent authority of the Member State in whose territory those members of the family reside , It must certify that the members of the family are rot taler, into consideration for the calculation of unemployment benefits due to another person under the legislation of the said Member State.
The certified statement shall be valid for the 12 months following the ?
date of its issue. It may be renewed; in such es^se, it shall be valid from the date of its renewal. The person concerned shall immediately notify the competent institution of any occurence necessitating an amendment to the said certified statement. Such amendment shall take effect from the date of such occurrence,
in paragraph 1 is not in a position to certify that the members of the family are not taken into consideration for the calculation of unemployment benefits due to another person under the legislation of the Member State in whose territory they reside, the person concerned shall, when submitting the cert3.fied statement to the competent institution, supplement the said certified statement by a declaration to that effect.
The provisions of paragraph 2, second subparagraph shall apply by analogy to that declaration,®- □
Article 85 shall be replaced by the following s
Article 85
Certified statement of periods of employment or self-employment
a person shall submit to the competent institution a certified statement specifying the periods of employment or self-employment completed under
the legislation to which he was last subject.
2. That certified statement shall be issued, at the request of the person concerned, either by the competent institution in respect of family benefits of the Member State with which he was last insured, or by another institution designated by the competent authority of the said Member State. If he does not submit the said certified statement, the competent institution shall obtain it from one or other of the abovementioned institutions unless the sickness insurance institution -is able to forward him a copy of the certified statement provided for in Article 16 (l) of the Implementing Regulation.
3. The provisions of paragraphs 1 and 2 shall apply by analogy if, in order to satisfy the conditions of the legislation of the competent State, it is necessary to take into account periods of employment or self-employment completed previously under the legislation of any other Member State. ► □
L# . Article 86 shall be replaced by the following :
. ► IMPLEMENTATION OF ARTICLE 73 (l) AND ARTICLE'75 (l) (a)
Article 86
Employed persons subject to the legislation of a Member State other than France
the Regulation, an employed person shall submit a claim to the competent institution, where necessary through his employer. .
2. In support of his claim, the employed person shall submit a certificate relating to members of his family residing in the territory of a Member State other than that in which the competent institution is situated.
Such certificate shall he issued., either by the authorities competent in civil status matters in the country of residence of those members of the family, or by the competent institution in respect of sickness insurance in the place of residence of those members of the family, or by another institution designated by the competent authority of the Member State in whose territory those members of the family reside. Such a certificate must be renewed every year.
family benefits may or must be paid to a person other than the employed person, the latter shall also submit in support of his claim, information identifying the individual to whom the family benefits are to be paid in the country of residence (name, forename, full address).-
\ 4. The competent authorities of two or more Member States may agree
on special procedures for the payment of family benefits, in'particular with a view to facilitating the implementation of Article 75 (l) (a) and (b) of the Regulation. Such agreements shall be communicated to the Administrative Commission,
necessary through his employer :
- of any change in the situation of the members of his family which ' might alter entitlement to family benefits,
- of any change in the number of members of his family for whom family benefits are due,
- of any transfer of residence or stay of such members of the family,
- of any pursuit of a professional or trade activity by virtue of which
family benefits are also due under the legislation of the Member State in whose territory the members of the family are resident.-* □
-'IMPLEMENTATION OF ARTICLE 73 (2) OF THE REGULATION
Employed persons subject to French legislation
the Regulation, an employed person shall submit a claim to the competent institution which shall issue him with a certified statement testifying that he is subject to French legislation and is entitled to receive family allowances. At the same time, the person concerned shall sign a declaration certifying that no right to family allowances exists under the legislation of the country of residence of the members of the family, by virtue of a professions,! or trade activity. .
The members of the family shall be registered with the institution of their place of residence on presentation of that certified statement and of the supporting documents required by the legislation administered by that institution for the granting of family allowances.
If the members of the family do not submit the said certified statement, the institution of the place of residence shall obtain it from the competent institution. ■
2. The certified statement provided for in paragraph 1 shall remain valid for a period of three months following the date of its issue, and must be renewed automatically every three months by the competent institution.
3. In the case of a seasonal worker, the certified statement provided for in paragraph 1 shall be vaj.id for the expected duration of seasonal vrork unless, in the meantime, the competent institution notifies the institution of the place of residence of Its cancellation.
members of the family reside provides for the granting of allowances for a number of days corresponding to the number of days of employment completed, while French legislation provides for entitlement to family allowances to last for one month, the family allowances shall be granted for one month.
5. In the case referred to in paragraph 4, when the periods completed under French legislation are expressed in. units different from those which are used for the calculation of family allowances under the legislation of the Member State in whose territory the members of the family reside, the conversion shall be carried out in accordance with the previsions of Article 15 (3) of the Implementing Regulation.
6. The competent institution sha,ll immediately inform the institution of the place of residence of the members of the family of the date on which the person concerned ceases to be entitled to family allowances or on which he transfers his residence from the territory of one Member State to that of another Member Statec
The institution of the place of residence of the members of the family may, at any time, request the competent institution to supply it with any information relating to the entitlement of the person concerned to family allowances .
If the competent institution considers it necessary, the institution of the place of residence shall, at its request, verify the declaration referred to in the first subparagraph of paragraph 1. .
7. Trie members of the family shall inform the institution of their place of residence of any change in their situation which is likely to alter their entitlement to family allowances, in particular any transfer of residence.-* a
49. In Article 89, paragraph 2 * Article 87 (2) to (8)* shall be replaced
by * Article 87 (2) to (7)*
50. Article 90 (1) to .(3) shaLl be reolaced by the following:
" 1. In order to receive benefits under Article 77 or 78 of the
Regulation, a claimant shall submit a claim to the institution of his place of residence, in accordance with the procedures laid down by the legislation administered by that institution.
2. If, however, the claimant does not reside in the territory of the Member State in which the competent institution is situated, he may submit his claim either to the competent institution or to the institution of his place of residence, which shall then forward the claim to the competent institution, indicating the date on which it was submitted. The
date shall be considered as the date of submission of the claim to the competent institution.
3. If the competent institution referred to in paragraph 2 finds
that there is no entitlement under the legislation which it administers, it shall forward the claim forthwith, together with all necessary documents and information, to the institution of the Member State to whose legislation the employed or self-employed person was subject for the longest period of time. '
Where necessary the matter may have to be referred back, under the same conditions, to the institution of the Member State under whose legislation the person concerned completed the shortest of his periods of insurance or residence . "
- 59 -
51. Article 93 shall be replaced by the following :
► Article 93 .
Refund of sickness and maternity insurance benefits other than those provided for in Articles 94 and 95 of the Implementing Regulation
1. Hie actual amount of benefits in kind provided under Article 19 (l) and (2) of the Regulation to employed and self-employed persons and to members of their: families residing- in the territory of the same Member State, and benefits in kind provided under Articles 21 (2), 22, 25 (l), (3) and (4), 26, 29 (l) or 31 of the Regulation, shall be refunded by the competent institution to the institution which provided the said benefits as shown in the accounts of that institution.
2. In the cases referred to in the second subparagraph of Article 21 (2), the second subparagraph of Article 22 (3) and in Articles 29 (l) and 31 of the Regulation, and for the purposes of implementing paragraph 1, the institution of the place of residence of the members of the family or of the pensioner, as the case may be, shall be considered the competent institution.
3. If the actual amount of the benefits referred to in paragraph 1 is not shown in the accounts of the institution which has provided them, and no agreement has been concluded under paragraph. 6, the amount to be refunded sha.ll be determined on the basis of a lump-sum payment calculated from all the appropriate references obtained from, the da,ta available. The Administrative Commission shall assess the bases to be used for the calculation of the lump-sum payments and shall decide the amount thereof,
4. For the purposes of the refund, rates higher than those applicable to the benefits in kina provided to employed or self-employed persons who are subject to the legislation administered by the institution which provided the benefits referred to in paragraph 1 may not be taken into ancount.
the refund of cash benefits paid in accordance with the provisions of the second sentence of Article 18 (8) of the Implementing Regulation.
6 „ Two or more Member States or the competent authorities of those
Member States may, having received the Opinion of the Administrative Commission, agree to other methods of assessing the amounts to be refunded, in particular on the basis of lump sums.► □
5 2, Article 94 shall be replaced by uhe following :
► Article 94
Refund of benefits in kind provided under sickness and maternity insurance to the ■ embers of the family of an employed or self-employed person not residing 5n the same Member State as the latter
1, The amount of benefits in kind provided under Article 19 (2) of the Regulation to the members of the family of an employed'or self-employed person who are not residing in the territory of the same Member State as the person concerned shall be refunded by the competent institutions to the institutions which provided tne said- benefits on the basis of a lump •sum in respect of each calendar year which is as close as possible to the actual expenditure incurred.
2. The lump-sum payment shall be determined by multiplying the average annual cost per family by the average annual number of families to be taken into account and by reducing the resultant amount by 20 %.
shall he determined as follows j
(a) the average annual cost per family shall he obtained, for each Member State, by dividing the annual expenditure on all the benefits in kind provided by the institutions of that Member State to all the members of the families of employed or self-employed persons who are subject to the legislation of the said Member State, under the social security schemes to be taken into consideration, by the average annual number of such employed or self-employed persons with members of the family; the social security schemes to be taken into consideration for that purpose are specified in Annex 9;
00 in dealings between the institutions of two Member States, the average annual number of families to be taken into account shall be equal to the average annual number of employed or self-employed persons who are subject to the legislation of one of those Member States and the members of whose families are entitled to benefits in kind to be provided by an institution, of the other Member State. '
^• The number of families to be taken into account in accordance with
the provisions of paragraph 3 (b) shall be determined by means of a list kept for that purpose by the institution of the place of residence, based upon documentary evidence supplied by the competent institution of the rights of the persons concerned. In the event of any dispute, the observations of the institutions involved shall be submitted to the Audit Board provided for in Article 101 (3) of the Implementing Regulation.
5. The Administrative Commission shall lay down the methods and procedures for determining the calculation factors referred to in. paragraphs 3 and 4.
6. Two or more Member States or the competent authorities of those Member States may, having received the opinion of the Administrative Commission, agree on other methods of assessing the amounts to be refunded.*— □
53. In Article 98, the heading and paragraphs (1) to (3) shall be replaced by the following:
" Members of the families ox employed persons subject to French legislation or of unemployed persons receiving •unemployment benefits under French legislation ■
1. The actual amount of the family allowances paid under Articles 73 (2) and 7^ (2) of the Regulation shall be refunded by the competent French institution to the institution which has paid those family allowances;, as shown in the accounts of the latter institution.
2. France and each of the other Member States or the competent authorities of France and those of each of the other Member States may,
by mutual agreement? provide for lump-sum refund of those family allowances. In the case of a lump-sum refund, such lump-sum shall be determined by multiplying the average annual cost per family by the average annual number of families to be taken into account. -
3. The factors necessary f<jr the calculation of the said lump- sum
‘(a) the average annual cost per family shall be obtained by dividing the total annual cost of the family allowances paid by the institutions of the Member State in whose territory the members of the family are residing, in respect of all the members of the families of employed or unemployed persons residing in the territory cf that Member State by the average annual number of families entitled to benefits;
(b; the average annual numoer of families to be taken into account shall be equal to the average annual number of employed persons subject to the legislation of the competent State and, where appropriate, of unemployed -persons receiving unemployment benefits at the expense of an institution of that competent State, the members of whose family are entitled to
S3
receive family allowances paid by a.n institution of another Member State in whose territory they are residing."
\ 5^. Article 108 shall be replaced by the following :
► Article 108
In order to prove that he is a seasonal worker, the employed person covered by Article 1 (c) .of the Regulation shall be required to submit his contract of employment stamped by the employment services of the Member State in whose territory he has gone to work or has worked. If no seasonal employment contract is concluded in that Member State, the institution of the country of employment shall, where appropriate, issue, in the case of a claim for benefits, a certificate attesting that, on the basis of information supplied by the person concerned, the work which he is doing or has done is of a seasonal nature. ► □
Arrangement for payment of contributions
The employer who has no place of business in the Member State in whose territory the employed person is employed may agree with the latter that he shall assume the obligations of the employer with regard to the payment of contributions. ■ .
The employer shall notify the competent institution or, where necessary, the institution designated by the competent authority of the said Member State of any such arrangement.□
56. Article 113 shall be replaced by the following :
► Article 113
Recovery of benefits in kind provided but not due to persons employed in international transport
1. If the right to benefits in kind is not recognized by the competent institution, the benefits in kind which have been provided to a person employed in international transport by the institution of the place of stay by virtue of the presumption referred to in Article 20 (l) or 62 (l) of the Implementing Regulation, shall be refunded by the competent institution.
2, Expenses incurred by the institution of the place of stay in respect of any person employed in international transport who has not previously applied to the institution of the pla.ce of stay and is not entitled to benefits in kind but has nevertheless received benefits in kind upon presentation of the certified statement referred to in Article 20 (l) or 62 (l) of the Implementing Regulation, shall be refunded by the institution shown as competent in the said certified statement or by any other institution designated for that purpose by the competent authority of the Member State concerned.
31 2 The competent institution or, in. the case referred to in paragraph 2,
th' institution shown e-.cs oompot©nt or the inetltutlon designated for that purpose shall debit the recipient of benefits with the value of the benefits in kind which were provided but were not due to him. The said institutions shall notify these debits to the Audit Board referred to in Article' 101 (3) of the Implementing Regulation which shall draw up a statement thereof.►
57. In Article 114, 2to a worker2 shall be deleted.
58. Article 119 shall be replaced by the following s
: Article 119
4. In the 'bilateral relations 'between the Member States concerned,
the procedure for implementing the present Article shall be determined by those Member States or their competent authorities.-* □
Annexes 2,3; 9 an: as follows :
of Regulation (E^C) w° 379/72 shall to aflior.de'?.
Neither Regulation (EEC) N° 1390/81 of the Council nor this Regulation shall affect rights acquired, prior to their entry into force, under Regulation (EEC) N° 1408/71 and Regulation (EEC) N° 574/72.
Transitional provisions relating to pensions
1. Where the date on which the contingency arises precedes the date on which this Regulation enters into force, and where the claim for pension has not yet been awarded before the latter date, such claim shall give rise to a double award, inasmuch as benefits must be granted, pursuant to such contingency, for a period prior to the last-mentioned date :
(a) for the period prior to the entry into force of this Regulation, in accordance with the provisions of Regulation (EEC) N° 1408/71 or of agreements in force between the Member States concerned;
(b) for the period commencing from the date on which this Regulation enters into force, in accordance with the provisions of Regulation (EEC)
N° 1408/71 as amended by Regulation (EEC) N° 1390/81.
If, however, the amount calculated in pursuance of the provisions referred to in (a) above ' is greater than that calculated in pursuance
of _ (b) above, the person concerned shall continue
to be entitled to the amount calculated in pursuance of the provisions referred to in the preceding subparagraph.
2. A claim for invalidity, old age and survivors’ benefits submitted
to the institution of a Member State, as from the date on which this Regulation enters into force, shall automatically necessitate the reassessment of the benefits that have already been awarded for the same contingency prior to that date by the institution; .or institutions of one or more of the other Member States, in accordance with the provisions of Regulation (EEC) N°1408/71 as amended by Regulation (EEC) N° 1390/81, without prejudice to the provisions of Article '}.
This Regulation shall enter into force on the first day of the seventh month following its publication in the Official Journal of the European Communities.
This Regulation shall be binding in its entirety and directly applicable in all Member States. '
1
1. The rights referred to in Article 9^ (9) of the Regulation shall
be those enjoyed by employed persons in respect of members of their families giving entitlement to family benefits, a.t the rate and within the limits applicable on the day preceding that of the entry in force of the Regulation, pursuant either to Article 4-1 or Annex D to Regulation N° 3? or to .Article 20 or Annex 1 to Council Regulation N° 36/63/EEG of 2 April 19631, on social security for frontier workers. ID
paragraph 1 is higher than the amount of the family allowances which would be due under Article 73 (2) of the Regulations it shall be the respcnsi bility
of the French competent institution to ensure payment thereof to the employed
2
> ‘ „
: person, or directly to the members of his family at their plane of residence,
in respect of the children giving entitlement to such benefits.
the Regulation, the institution of the place of residence of the members of the family shall ensure payment of family allowances in accordance with the provisions of the legislation which it administers,, reimbursement to be made by the French competent institution.