APPROVED

APPROVED

International Process Guidelines

Sickness

S_BUC_14a – Information Related to Cash Benefits in Respect of Incapacity for Work – given by Competent Institution

Date: 11/09/2018

Version of guidelines document: v4.1.0

Based on: S_BUC_14a version 4.1.0

Common Data Model version: 4.1.0

TABLE OF CONTENTS

S_BUC_14a –Information Related to Cash Benefits in Respect of Incapacity for Work – given by Competent Institution 4

How to start this BUC? 5

What is my role in the social security exchange of information I have to

complete? 5

CO.1 Who do I need to transmit information to? 5

CO.2 How do I identify the correct institution to exchange information with? 5

CO.3 How do I proceed after having identified the Counterparty? 5

CP.1 What should I do if I receive ‘Information on Payment or Not of Cash Benefits' SED S046? 6

BPMN diagram for S_BUC_14a 7

Structured Electronic Documents (SEDs) used in the process 7

Administrative sub-processes 7

Horizontal sub-processes 7

Document history:

Revision

Date

Created by

Short Description of Changes

V0.1

23/5/2017

Secretariat

First draft of the document submitted for review to the Sickness Ad Hoc group

V0.2

02/08/2017

Secretariat

New version of the document, after review from AHG. Version submitted for AC review.

V0.99

05/10/2017

Secretariat

Implemented changes and updates following the AC review. Version submitted for AC approval.

V1.0

11/12/2017

Secretariat

AC approved version.

V4.1.0

11/09/2018

Secretariat

Performed patch changes to reference the new CDM version 4.1.0

S_BUC_14a –Information Related to Cash Benefits in Respect of Incapacity for Work – given by Competent Institution

Description: An insured person residing or staying in a Member State other than the Competent Member State may be entitled to cash benefits provided by the competent institution in accordance with the legislation it applies.

This particular case deals with the situation where the Competent Member State provides the institution in the Member State of Residence/Stay with information related to cash benefits in respect of incapacity for work of the insured person concerned.

At least two scenarios are covered by this case:

1. The most common case is an assumed need of information about the

last day for which the person concerned receives cash benefits in respect of incapacity for work. This information is to be sent by the competent institution;

2. If the competent institution is in possession of other crucial

information related to cash benefits in respect of incapacity for work of the person concerned, it may send it to an institution in another Member State.

Legal Base: The Business Use Case document's legal base is described in the following Regulations

Basic Regulation (EC) No 883/2004

Implementing Regulation (EC) No 987/2009.

The following matrix specifies the SEDs that are used in this Business Use Case and documents the articles that provide the legal basis for each SED.

Basic Regulation (883/2004)

Implementing Regulation (987/2009)

SED

21

2(2)

S047 -Information Related to Cash Benefits in respect of Incapacity for Work or other crucial information – given by competent institution

Glossary of relevant terms used in S_BUC_14a:

Term used

Description

Case Owner

In this BUC, the Case Owner is the institution of the Competent Member State which sends to the institution of the Member State of Residence/ Stay information related to cash benefits in respect of incapacity for work.

Counterparty

In this BUC, the Counterparty is the institution of the Member State of Residence/Stay which receives information on cash benefits in respect of incapacity for work from the institution of the Competent Member State.

How to start this BUC?

In order to help you understand S_BUC_14a we have created a set of questions that will guide you through the main scenario of the process as well as possible sub-scenarios or options available at each step along the way. Ask yourself each question and click on one of the hyperlinks that will guide you to the answer. You will notice that in some of the steps, where it is allowed to use the additional horizontal and administrative sub-processes, they will be listed under the step description.

What is my role in the social security

exchange of information I have to complete?

If you want to send to the Member State of Residence/Stay of a person information related to cash Benefits in respect of Incapacity of Work, or crucial/additional information, your role will be defined as the Case Owner.

I am the Case Owner. (step CO.1)

If you are the Competent Institution of a Member State of Residence or Stay of a person where the person(s) in question has/have acquired the rights for the health benefits and if you are contacted by an institution from another Member State (Case Owner) to receive information related to the Cash benefits or any crucial/additional information, your role will be defined as the Counterparty.

I am the Counterparty. (step CP.1)

CO.1 Who do I need to transmit information to?

As the Case Owner, your first step in any new exchange of information will be to identify the responsible Member State where the person is insured. The second step is to identify the relevant institution in this Member State that you need to exchange information with. This activity will define the Counterparty you will be working with. There can be only one Counterparty.

I need to identify the Counterparty. (step CO.2)

I have identified the Counterparty I need to contact. (step CO.3)

CO.2 How do I identify the correct

institution to exchange information with?

In order to determine the relevant Competent Institution from another Member State you will need to consult the Institution Repository (IR). The IR provides an electronic record of all current and previous Competent Institutions and Liaison Bodies that have been responsible for the cross-border coordination of social security information for each of the relevant Member States.

Please note that the Liaison Body should be chosen only if it is impossible to identify the correct Competent Institution in the respective Member State or if the case is handled by the Liaison Body.

To access the IR please use the following link.

I have now identified the Competent Institution from the Member State I need to contact. (step CO.3)

CO.3 How do I proceed after having identified the Counterparty?

You should fill in an 'Information Related to Cash Benefits in respect of Incapacity for Work or other crucial information – given by competent institution' SED S047, by entering:

- the last day for which the person concerned receives cash benefits in respect of incapacity for work, i.e. the date of the last day of incapacity of work;

- and/or any other valuable information related to cash benefits in respect of incapacity for work of the person concerned.

Both sections can be filled in. After filling it in, you can send it to the Counterparty. The Business Use Case

ends here.

Sub-process steps available to the Case Owner at this stage:

I want to request ad-hoc information from the Counterparty (H_BUC_01).

I want to forward the case to another Competent Institution in my Member State (AD_BUC_05).

I want to invalidate the sent SED (AD_BUC_06).

I want to remind the Case Owner of a SED or information that it needs to send to me (AD_BUC_07).

I want to Reject a received SED (AD_BUC_09)

CP.1 What should I do if I receive ‘Information on Payment or Not of Cash Benefits' SED S046?

If you have received an 'Information Related to Cash Benefits in respect of Incapacity for Work or other crucial information – given by competent institution' SED S047 from the Case Owner you don't need to reply anything to the Case Owner.

If you cannot identify the petitioner in your database or there is no insurance record of that person in your country, you can reject SED S047 by using the Administrative process Reject (AD_BUC_09).

If you do not receive any other information from the Case Owner, then the Business Use Case ends here.

Sub-process steps available to the Counterparty at this stage:

I want to forward the case to another Competent Institution in my Member State (AD_BUC_05).

I want to exchange additional information not foreseen in the case- specific SED (H_BUC_01).

I want to invalidate the sent SED (AD_BUC_06).

I want to remind the Case Owner of a SED or information that it needs to send to me (AD_BUC_07).

I want to Reject a received SED (AD_BUC_09)

BPMN diagram for S_BUC_14a

Click here to open the BPMN diagram(s) for S_BUC_14a.

Structured Electronic Documents (SEDs) used in the process

The following SEDs are used in S_BUC_14a:

SED S047 – Information Related to Cash Benefits in respect of Incapacity of Work - Given by the Competent Authority;

Administrative sub-processes

The following administrative sub-processes are used in S_BUC_14a:

AD_BUC_05_Subprocess – Forward Case

AD_BUC_06_Subprocess.docx - Invalidate SED

AD_BUC_07_Subprocess – Reminder

AD_BUC_09_Subprocess – Reject SED

The following sub-processes are used for the handling of exceptional business scenarios that arise due to the exchange of social security information in an electronic environment and can be used at any point in the process:

AD_BUC_11_Subprocess – Business Exception

AD_BUC_12_Subprocess – Change of Participant

Horizontal sub-processes

The following horizontal sub-process is used in S_BUC_14a:

H_BUC_01_Subprocess Ad hoc exchange of information