Phases in Temporary Incapacity Management

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Management of the IT in FREMAP has a threefold approach

An initial diagnosis of the company's situation

To study the causes of absences for health reasons, companies are offered reports and indicators regarding temporary disability due to occupational and common contingencies, including graphic and numeric information about the monthly and annual evolution of these rates, comparing the company to others in the same sector.

These reports provide the companies an analysis on their temporary disability, based on:

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  • The following statistical variables: age, gender, type of contract, seasonal nature of leaves, percentage of the most common problems at the company per medical specialisation.
  • Most common temporary disability rates: Temporary disability rate, incidence rate, frequency rate, leave pending percentage rate.
  • Comparisons with the industry and geographic area of companies: Taking into account the statistical sample of FREMAP (3,800,000 protected workers), it allows comparisons of great importance for companies.
  • Reports on the cost of temporary disability: Companies will be able to quantify the direct and indirect costs of sick leaves for professional and common contingencies.

Reports and Management Indicators:

The following reports are available for companies:

In Occupational Accidents or Diseases
Accident rate reports
  • Monthly evolution of the Incidence rate and comparison with previous years and with the business sector.
  • Percentage of evolution of workers awaiting to return to work within the selected period.
  • Statistical distribution according to the following variables: gender, age, seniority, location of the accident, time of the working day, day of the week, how it occurred, anatomical area, material agent, contract type, seniority in the position, occupation code, time of the day, usual work, type of place and type of work.
  • The details of files registered with accidents involving or not involving medical leave and work-related illness that include the detailed information added to the their statement forms (Delt@ and CEPROSS).
  • Obtaining the report and direct access to all the data on accident rates, through the "FREMAP ONLINE " service.
Reports on temporary disability due to a work-related accident or illness

These reports show the monthly and annual evolution of absenteeism due to occupational contingency (work-related accidents and occupational illnesses), comparing the current year and/or the previous two with that of the sector the company is part.

In Common Contingency:
Reports on temporary disability due to a non-work-related accident or illness
  • Monthly and annual evolution of the temporary disability rate due to common contingency, comparing the current year and/or the previous two with that of the sector the company is part.
  • Percentage of evolution of workers awaiting to return to work within the selected period.
  • Statistical distribution according to the following variables: age, gender, type of contract, seasonal nature of the leave (month and day of the week) and medical specialisation.

All these reports can be obtained via the application"FREMAP ONLINE This link will open in a pop-up window

Internal reports and indicators

FREMAP internally monitors the TD management rates of each member company (appointments, medical consultations, days of delay of assistance, number of surgical procedures, rehabilitation treatments completed, discharge proposals carried out and favourable) with the purpose of establishing the suitable corrective measures according to their evolution. This is carried out with the aim of improving the workers' health. These reports are made available to the companies.

Proposed solutions

The following actions are taken in the management of temporary disability:

Management

FREMAP conducts Temporary Disability management for companies in the following coverage:

Work-related injuries

In the general regime, all bodily injury suffered by the worker due to or resulting from work conducted as an employee (Royal Legislative Decree 8/2015 of 30 October - article 156 - in PDFThis link will open in a pop-up window)

When a worker has a work-related accident

They visit one of the more than 200 centres that FREMAP has nationwide, where they will receive medical attention. If the pain prevents him/her from performing his/her job and he/she needs medical treatment, FREMAP's Medical Services will issue a medical leave slip and, the company will be immediately requested to send the required Work-related Injury Report within the statutory limit of five business days via the system Delt@ of the MEYSS.

Link: Go to website Delt@ System This link will open in a pop-up window

If a worker goes on sick leave

FREMAP takes care of all medical and/or surgical procedures, diagnostic testing, rehabilitative treatment and consultations with specialists, including issuing medical leave certificates and medical clearance certificates so the employee may return to work. Each worker will have their own Attending Physician, who will coordinate the entire treatment when several specialists are involved.

If, after receiving treatment, the employee is unable to perform their normal job

FREMAP will submit a disability recommendation to the Regional Directorate of the National Social Security Institute. In addition, workers are offered an individualised vocational guidance and training programme, in order to promote their employment integration, called professional readaptation.This link will open in a pop-up window

Occupational Diseases

In the General Regime, an Occupational Disease is a disease contracted as a result of work performed as an employee in the activities specified in the table (R.D. 1299/2006, of 10 November in PDFThis link will open in a pop-up window) approved by the applicable provisions of application and the General Law on Social Security (Royal Legislative Decree 8/2015, of 30 October – CONSOLIDATED TEXT OF THE GENERAL LAW ON SOCIAL SECURITY in PDFThis link will open in a pop-up windowand which is caused by the action of the elements or substances indicated in the said chart for each occupational disease.

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The entity covering the occupational risk will be responsible for communicating the diagnosis of the work-related illness using the electronic work-related illness report and submitting it via the CEPROSS application (Royal Decree. 1299/2006, of 10 November in PDFThis link will open in a pop-up window).

The Directorate-General of Organisation of the Social Security Institute is in charge of the CEPROSS system.

FREMAP handles the medical and surgical treatment and rehabilitation from the time of sick leave until the issue of medical discharge.

Non-Work Related Injuries and Non-Work Related Illnesses:

Situations determining temporary disability due to non work-related injury or disease are those situations caused by a non-occupational disease or a non work-related injury while the worker receives healthcare and is unable to work.

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Within the regulatory framework of the Royal Legislative Decree 8/2015, of 30 October, which approves the amended text of the Social Security Act in PDFThis link will open in a pop-up window which, among other aspects, governs the management by mutual insurance providers that collaborate with the Social Security Department of financial assistance for temporary disability caused by a non-work-related accident or illness. Once the Public Health Services issue the medical leave certificate, FREMAP focuses on medical follow-up and rapid diagnosis by performing tests and/or additional scans, or by speeding up these processes in the event the worker is on a waiting list in order to treat their condition immediately so the individual is fully fit to return to their job quickly. In order to do this, the following actions are required:

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  • The Single contact person will record the medical leave immediately upon reception from ITRED.
  • The Single contact person will acknowledge the right to the Temporary Disability benefit; it can also deny, terminate and/or suspend the benefit on the basis of the guarantees control.
  • A member of the FREMAP nursing staff will contact the worker by phone when the medical leave has been received. FREMAP has implemented a Protocol of Action for the Nursing Service, which is the same at a national level and has been adapted to the Spanish Personal Data Protection Act.
  • If, after contacting a patient, the member of nursing staff considers that he/she does not need an appointment, See more:
    they will request a medical report from the worker to confirm why they missed work. Subsequently, FREMAP's Medical Service will carry out a regular follow-up by phone so, depending on the patient's state and evolution, he can receive the type of help required. If the member of nursing staff, after contacting the patient, considers that he/she can attend FREMAP, an appointment will be arranged at the healthcare centre closest to the patient's address. If the worker cannot be reached by telephone or cannot be located, he will be informed on the appointment via ordinary post or burofax (certified fax).
  • FREMAP Medical Services Appointment: Once the healthcare staff contacts the worker, if the pathology allow so, he will be given an appointment with FREMAP's Medical Services.
  • Each patient is assigned a doctor See more:
    who organises all their treatment and ongoing healthcare. The FREMAP's medical service will evaluate whether to carry out diagnostic tests, therapeutic and rehabilitation treatment or any surgical procedures. They will be performed upon authorisation of the Public Health Service Practitioner and the patient's informed consent. The practitioner may evaluate carrying out any other consultations with specialists. The results will be made available to the Public Health Service doctor that attends to the worker.
  • Medical Discharge and/or Disability proposals: See more:
    The regulations empower the medical services of Mutual Insurance Providers to submit return to work and/or permanent disability recommendations to the Medical Inspectorate that are simultaneously sent to both the worker and to the National Social Security Institute. If the Public Health Service determines that the patient still requires temporary disability leave, FREMAP may submit a return to work recommendation to the INSS if it considers that the patient is fit for work.
  • Termination due to non-appearance to medical check-up: See more:
    If it is produced unjustifiably. A preventive suspension of the benefit will be implemented, and a period of 10 business days from the date of non-appearance will be given to justify it. If the patient justifies and proves the reasons behinds the non-appearance, the preventive suspension will be lifted and the medical follow-up resumed. If the patient does not justify sufficiently his non-appearance, the right to the benefit will be extinguished.