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Стари образци на удостоверения за изплащане на парични обезщетения за периоди преди 01.07.2019 г. ще се приемат до 14.07 включително. След 17.07.2019 г. ще се приемат само новите образци на Прил. № 9, 10 и 11 към НПОПДОО

SHORT-TERM BENEFITS

2019

What types of compensations and benefits are paid by state social insurance?

Temporary incapacity to work due to general illness, accident at work and occupational illness, sanatorium-resort treatment and in case of urgent medical examination or test, quarantine, removal from work by prescription of health authorities, looking after a sick person or a quarantined family member, urgent accompanying a sick family member for a medical examination,test or treatment, as well as looking after a healthy child returned from a childcare facility due to quarantine at the facility or the child;

  • Placement in a suitable job for temporary reduced working capacity due to a general illness, an accident at work or an occupational illness;
  • Placement in a suitable job due to pregnancy or breastfeeding or advanced stage of in vitro treatment;
  • Pregnancy and childbirth;
  • Raising a child up to 2 years of age;
  • Adoption of a child up to 5 years of age.

Cash benefits:

  • for disability due to a general illness where the insured person does not have the necessary insurance period for granting a disability pension due to a general illness;
  • in the case of death of the insured person.

Who is entitled to cash compensation for temporary incapacity to work and placement in a suitable job?
Insured persons for general sickness and maternity are entitled to cash benefit if they have at least 6 months of insurance for this risk. The 6-month insurance period does not apply to persons under the age of 18 and to acquire the right to cash benefit for temporary incapacity or work due to accidents at work and occupational disease.
The insurer pays the insured person for the first three working days of the temporary inability to work 70 per cent of the average daily gross remuneration for the month in which the temporary incapacity to work occurred but not less than 70 per cent of the average daily agreed remuneration.
The cash benefits for temporary incapacity to work shall be reimbursed by the persons for the period for which they have been granted an invalidity/disability pension for the same illness except in the case of the hospital sheet being issued with objective data on the exacerbation of the condition as well as with interventions related to treatment of chronic disease.

What documents and data are necessary for the payment of cash benefits for temporary incapacity to work and for placement in a suitable job?
Cash benefits for temporary incapacity to work and placement in a suitable job are paid on the basis of a hospital sheet/bill.
The data from the hospital lists, adopted under the Ordinance on the procedure for submission to the National Social Security Institute of the data from the issued hospital sheets and the decisions on their appeal, using also the data from the register of insurers and self-insured persons, the register of income from social security contributions for the state public insurance, "Labor contracts" register, "Pensions" register, "Accidents at work" register, "Occupational diseases" register, "Cash benefits for prevention and rehabilitation "and from the register "Cash compensations and benefits from the State Social Security".
Declaration in accordance with Appendix 1 to the Ordinance on Cash Benefits and Allowances from State Social Security presented by the insured person to the insurer, in which the first presentation of a hospital bill once claims data about the bank account for payment of the cash benefits.
Certificate from the insurer, the social security funds or the self-insured persons with data on the right to financial compensation to be presented to the National Social Security Institute for each hospital sheet - Annex 9 of the Ordinance on Cash Benefits and Allowances from State Social Security.

From what remuneration is the cash benefits for temporary incapacity to work determined?
The daily cash benefit for temporary incapacity for work due to a general illness is calculated at the rate of 80% and for temporary incapacity due to an accident at work or occupational disease – 90% of the average daily gross salary or average daily insurance income on which are paid or payable social security contributions and, for self-insured persons - paid social security contributions for general sickness and maternity for the period of 18 calendar months preceding the month of occurrence of incapacity to work.
The daily cash benefit for temporary incapacity for work due to a general illness may not exceed the average daily net remuneration for the period from which the benefit is calculated.
For the days included in the 18-month period preceding the month of occurrence of the incapacity for work, the average daily minimum salary for the country for the relevant period shall be taken into account if the person:

  • has not been insured for general illness and maternity;
  • has used unpaid leave, which is considered to be a length of service or work experience;
  • has used leave to raise a little child;
  • has been insured under the legislation of another State under the terms of an international treaty to which the Republic of Bulgaria is a party. 

For the days included in the 18-month period during which the person received financial compensation from the state social insurance for temporary incapacity to work, for pregnancy and childbirth or for adoption of a child up to the age of 5, account shall be taken of the income from which the cash benefit was determined.
The amount from which the cash benefits are calculated can not be higher than the maximum monthly amount of the insurance income determined by the State Social Security Budget Act for the period from which the cash benefits are determined. For 2019 it is BGN 3,000 BGN.

For what period is the benefit for temporary incapacity to work paid?
The cash benefit for temporary incapacity to work due to a general illness, an accident at work and an occupational disease shall be paid from the first day of the occurrence until the working capacity is restored or invalidity is established.
Where the temporary incapacity to work has occurred before termination of fixed-term labor and employment relations, military service contracts and management and control contracts of commercial companies, the cash benefit shall be paid no more than 30 calendar days after the termination of the legal relationship or the contract. If the temporary incapacity to work is due to an accident at work or an occupational disease, the cash benefit shall be paid until the working capacity is restored or invalidity is established.
Cash benefits for temporary incapacity to work due to an accident at work and occupational disease of the persons who have concluded a labor contract for short-term seasonal agricultural work for one day (under Article 114a, paragraph 1 of the Labor Code) are paid for the duration of the incapacity for work but for no more than 90 calendar days.

For what period are the benefits due to quarantine or removal from work paid?
Cash benefit for temporary incapacity for work due to quarantine or removal from work by prescription of health authorities is paid respectively for:

  • the time for which the insured is quarantined;
  • the time of removal from work if the insured can not be recruited to another suitable job during that time but for not more than 90 calendar days in one calendar year.

Are the persons entitled to benefits for sanatorium-resort treatment?
Compensation for disabled persons sent by health authorities to sanatorium treatment is paid for their entire stay, including up to three calendar days of travel, in the amounts determined for general sickness or for accidents at work and occupational disease respectively.

When and for what period can a benefit be paid for looking after a sick member of the family?
Cash benefit under the conditions and amount of the cash benefit for temporary incapacity due to a general illness is also paid for:

  1. taking care or urgent accompanying for a medicalcheck-up, examination or treatment in the country or abroad of a sick member of the family over the age of 18 - to every insured person up to 10 calendar days in one calendar year;
  2. taking care or urgent accompanying for a medicalcheck-up, examination or treatment in the country or abroad of a sick child up to 18 years of age - up to 60 calendar days in one calendar year in total for all insured family members; this period does not include the time for childcare under items 3 to 5;
  3. taking care of a child under quarantine up to 18 years of age, sick from a contagious disease - until the expiry of the quarantine period;
  4. taking care of a sick child up to the age of 3, placed in a hospital with the insured person - for the period during which the insured person has been in the hospital;
  5. taking care of a healthy child, brought back from kindergarten due to quarantine - for the period until the quarantine is over. 

The cash benefit referred to in items 2, 3, 4 and 5 above shall also be paid for the care of a child placed with relatives or foster family by the order of Art. 26 of the Child Protection Act.
For the same insurance case at the same time, a cash benefit for taking care of a sick member of the family can be paid only to one insured family member.
For taking care of a chronically ill family member, cash benefit is paid only when the disease is exacerbated.
The family members of the insured person are considered to be his ascending and descendant by straight line, husband and wife

In which cases no compensation is paid?
Cash benefit for temporary incapacity to work is not paid to insured persons who:

  1. deliberately harm their health in order to receive leave or benefit;
  2. violate the regime set by the health authorities - only for the days of the violation;
  3. have become incapacitated to work due to the use of alcohol, the intake of a strong narcotic medication without medical purpose or due to acts carried out under the influence of such means;
  4. have become incapacitated to work due to hooliganism and other antisocial acts established in the respective order;
  5. have become incapacitated to work due to failure to comply with the safety rules established by the appropriate procedure.

In the cases referred to in paragraphs 3 and 4 above, the period for which compensation is not payable may not exceed 15 calendar days, and in the case of item 5, not longer than 3 calendar days.
Cash benefit for temporary incapacity to work and for pregnancy and childbirth is not paid to persons exercising work which is the basis for general sickness and maternity insurance during the periods for which health authority acts have been issued.

In which cases, in what amount and in what period is the cash benefit for placement in a suitable job paid?
In the case of placement in a suitable job due to temporarily reduced working capacity as a result of a general illness, accident at work or occupational disease, the insured person pays a cash benefit if the new work reduces his/her remuneration.
The daily cash benefit is equal to the difference between the average daily gross salary received during the 18 calendar months preceding the month of employment, but not more than the average daily amount of the maximum monthly insured income and the average daily gross remuneration received after the labor adjustment. Where the insured person has worked for less than 18 months until the day of re-employment, the compensation is defined as the difference between the average daily wage determined under Art. 41 of the Social Insurance Code and the average daily gross remuneration received after the labor adjustment.
The cash benefit is paid for the duration of the re-employment, but for no more than 6 months.

Who, under what conditions and on the basis if what documents can receive disability allowance for general sickness and benefit in the case of death of insured person?
The right to disability allowance due to a general disease shall be granted to persons who have been refused a disability pension due to a general illness due to insufficient retirement age if they are insured for general illness and maternity, disability due to general disease, old age and death, occupational accidents and occupational disease and unemployment. The allowance is paid at the amount of the 60-day benefit for temporary incapacity to work, calculated as compensation for temporary incapacity for work due to a general illness.
It is paid on the basis of an application-declaration according to a model in accordance with Annex 16 to the Ordinance on Cash Benefits and Allowances from State Social Security on paper and an identity document for reference.
The spouse/wife, children, and parents have the right to a one-off benefit in the case of death of an insured person. The total amount of aid is distributed equally among the eligible persons and is determined annually in the State Social Security Budget Act. For 2019, the amount of the benefit is BGN 540. In the case of death of a self-insured person, the benefit is paid when the due insurance contributions have been paid for the last month for which the term for their payment has expired.
It is paid on the basis of an application-declaration according to a model in accordance with Annex 17 to the Ordinance on Cash Benefits and Allowances from State Social Security on paper and an identity document for reference.

What do we need to know about compensation for pregnancy or breastfeeding or advanced in-vitro treatment?
In case of re-employment of another job due to pregnancy or breastfeeding of a child or an advanced stage of in-vitro treatment of the insured woman, a cash benefit is paid if the new work reduces her labor remuneration.
The daily cash benefit is equal to the difference between the average daily gross salary received during the 24 calendar months preceding the month of the labor adjustment but not more than the average daily amount of the maximum monthly insured income and the average daily gross remuneration received after the labor adjustment. Where the insured person has worked less than 24 months until the day of the re-employment, the compensation is defined as the difference between the average daily wage determined under Art. 41 of the Social Insurance Code and the average daily gross remuneration received after the labor adjustment.
In the event that at the new job the re-employed woman receives the average daily gross remuneration, less than the minimum daily salary established for the country or the average daily salary determined under Art. 41 of the Social Insurance Code is less than the minimum wage established for the country, the daily allowance is equal to the difference between the received daily average gross salary before the re-employment and the minimum daily salary established for the country. From 1 January 2019, the minimum monthly salary is 560 BGN.

What is the condition for a right to compensation for pregnancy and childbirth?
The insured persons for general sickness and maternity are entitled to cash compensation for pregnancy and childbirth instead of remuneration if they have 12 months of insured service as insured for this risk.

What is the amount of compensation for pregnancy and childbirth?
The daily cash compensation for pregnancy and childbirth is set at 90 per cent of the average daily gross salary or the average daily insurable income on which contributions have been paid or payable, and for the self-insured persons - paid social security contributions for general sickness and maternity for the period from the 24 calendar months preceding the month of occurrence of temporary incapacity due to pregnancy and childbirth..
The daily cash benefit can not be higher than the average daily net remuneration for the period from which the compensation is calculated and less than the minimum daily salary established for the country and is determined by the order of art. 41, para. 2 to 5 of the Social Security Code.
When acquiring a right of cash benefit during pregnancy and childbirth during the period of payment of a cash benefit for pregnancy and childbirth or for raising a child, the benefit is in the above amount for the previous child if this is more favorable to the person.
Where the person is insured on more than one basis, the total daily benefit may not be less than the minimum daily salary established for the country.

For what period is the cash benefit paid during pregnancy and childbirth?
The mother insured for general illness and motherhood is entitled to cash compensation for pregnancy and childbirth for a period of 410 days, out of which 45 days before birth.
When the birth occurs before the expiration of 45 days from the beginning of the benefit, the remainder up to 45 days is used after childbirth.
When the child was born dead, died, it is placed under the procedure of Art. 26, para. 1 of the Child Protection Act (in a family of relatives as well as in a foster family) or is given in a state institution for full state support or for adoption, the mother is entitled to cash compensation until the expiration of 42 days from the birth . If the working capacity of the mother due to childbirth is not recovered after the 42nd day, the duration of the benefit is continued at the discretion of the health authorities until recovery of the working capacity. Until the expiry of the 410-day period, this benefit is payable as a pregnancy and childbirth allowance.
When the child is given for adoption, accommodated by the order of art. 26, para. 1 of the Child Protection Act in a state-run childcare facility or dies after the 42rd day of birth, as well as when raised by a person included in maternity support programs, the compensation for pregnancy and childbirth shall be terminated from the next day. In such cases, if the mother's working capacity following birth is not restored, the duration of the benefit is continued at the discretion of the health authorities until the working capacity is restored. Until the expiry of the 410-day period, this benefit is paid as compensation for pregnancy and childbirth.
The insured for general illness and motherhood person, where a child is placed under Art. 26, para. 1 of the Child Protection Act, shall be entitled to childbirth compensation amounting to the difference of the child's age on the day of the child's accommodation under the procedure of Art. 26, para. 1 of the Child Protection Act until the expiry of the maternity benefit.
The insured for general illness and maternity father is entitled to cash compensation for the birth of a child in the amount determined for pregnancy and childbirth for up to 15 days during the respective leave under the Labor Code (Article 163, paragraph 8) , if there is a 12-month insurance period as insured for that risk. The father is entitled to a 15-day childbirth leave from the date of delivery of the child from the hospital when married with the mother or living in one household.
The person insured for general sickness and maternity is entitled to cash compensation for the birth of a child in the amount determined for pregnancy and childbirth after the child has reached the age of 6 months for the remainder up to 410 days during the leave under Art. 163, para. 10 and 12 of the Labor Code, namely:

  • under the terms of Art. 163, para. 10, with the consent of the mother after the age of 6 months, the father may take leave for the remainder for 410 days instead. When the father is unknown, the leave can be used by one of the mother's parents. When the father died, the leave may be taken by one of the parents of the mother or the father.
  • according to Art. 163, para. 12, when the child is accommodated under Art. 26 of the Child Protection Act, in case of spouses with the consent of the worker or employee after reaching the age of 6 months, her spouse may take leave for the remainder till 410 days instead.

Who can receive compensation in the event of a serious illness or death of the mother or the adoptive parent of a child up to the age of 5?
In case of death or serious illness of the mother (the adoptive parent), which prevents her from looking after the child, the person who is receiving the leave under Art. 167 of the Labor Code, is paid the cash benefit for the birth of a child, for raising a child up to the age of 2 and adopting a child up to the age of 5 years. Compensation is also paid to self-insured persons who are insured for general sickness and maternity when they have 12 months of insurance for this risk.

Is the person entitled to a pregnancy and childbirth allowance and upon the adoption of a child up to the age of 5 on termination of the insurance?
Upon termination of sickness and maternity insurance at the time of receipt of a pregnancy and childbirth allowance or upon adoption of a child up to the age of 5, the insured person shall be paid a cash benefit until the end of the period of the pregnancy and childbirth under Art. 50 of the Social Security Code (410 days) or the adoption of a child under Art. 53c of the Social Security Code (365 days).

Is the person entitled to a benefit in the event of non-use of pregnancy and childbirth leave?
The mother who is insured for general sickness and maternity and who was entitled to a pregnancy and childbirth benefit shall receive a cash benefit of 50% of it if:

  • after expiry of the post-birth periods, which are authorized by acts of the health authorities, does not take leave for pregnancy and childbirth or the person taking such leave interrupts its use;
  • after the expiry of the post-birth periods, which are authorized by acts of the health authorities, the self-employed person starts to work for which is insured for general illness and maternity.

When the mother has died, she is deprived of parental rights, or the custody of the child is granted to the father, this benefit is paid to the father, and when he is deceased - to the guardian. Compensation is paid when the child caretaker has 12 months of insured service as insured for general illness and maternity.
This benefit is not paid upon death of the child when the child was given for adoption, is accommodated under the procedure of Art. 26, para. 1 of the Child Protection Act or in a state-run childcare facility as well as in the care of a person included in maternity support programs.

What is the condition for a right of benefit to child-raising up to the age of 2?
The insured persons for general illness and maternity are entitled to cash benefit for raising a child up to the age of 2 if they have 12 months of insured service as insured for this risk.

What is the amount of the benefit during the extra parental leave for raising a child up to the age of 2 and under what conditions it is obtained?
After the expiration of the period of pregnancy and childbirth compensation during the additional paid parental leave for raising a child up to the age of 2 years, a monthly cash benefit is paid to the mother at the amount, determined by the State Social Security Budget Act, which for 2019 is BGN 380. Compensation is also paid to the adoptive parent if, after expiration of the benefit for the adoption of a child, the child is not at the age of 2 years.
When the additional paid leave for raising the child, instead of the mother (adoptive parent), is used by the father (adopter) or the person who has taken up the care of the child, a monthly cash benefit is paid at the amount determined by the State Social Security Budget Act . This compensation shall be paid to the guardian when he is entitled to use the leave under Art. 167, para. 5 of the Labor Code.
Child-raising benefit is also paid to persons who take parental leave up to the age of 2 years, placed under the procedure of Art. 26, para. 1 of the Child Protection Act.
The cash benefit for raising a child up to the age of 2 shall not be paid upon death of the child, giving for adoption, upon termination of the adoption or upon accommodation of the child by the order of art. 26, para. (1) of the Child Protection Act or in a childcare facility, including nursery, as well as when grown by a person included in maternity support programs.
Self-insured persons who are insured for general illness and maternity are also entitled to a child-raising benefit when raising a child up to the age of 2 if they have 12 months of insured service as insured for that risk.

What is the amount of compensation for non-use of supplementary paid parental leave for raising a child up to the age of 2 and under what conditions is it obtained?
The mother (adoptive parent) who is insured for general illness and maternity and was entitled to child-raising allowance receives cash compensation of 50% of the child-raising allowance up to 2 years of age if:

  • does not use the additional paid parental leave for child raising or the person who takes such leave, discontinue its use;
  • the self-insured person entitled to child-raising allowance up to the age of 2 years starts to work for which he is insured for general illness and maternity.

If the mother (adoptive parent) has died, is deprived of parental rights, or the custody of the child is granted to the father (adopter), this benefit is paid to the father (adoptive parent) and, if he/she has died, to the guardian. Compensation is paid if the child carer is insured for general illness and maternity and has 12 months of insured service as insured for this risk.
Compensation in the amount of 50 percent of the child-raising allowance up to the age of 2 years shall not be paid upon death of the child, when the child was given for adoption, when the adoption was terminated or when accommodated under Article 26, para. 1 of the Child Protection Act in a state-run childcare facility as well as in the care of a person included in maternity support programs.

What is the condition for receiving a child benefit upon adoption of a child till the age of 5?
The insured for general illness and maternity a person, who has 12 months of insured service as insured for this risk during the leave upon adoption of a child up to the age of 5, is entitled to compensation amounting to the amount of compensation for pregnancy and childbirth for a period up to 365 days from the day the child is delivered for adoption but not later than the age of 5 years.
The person who is insured for general illness and motherhood adopter is paid cash compensation for the adoption of a child in the amount determined for pregnancy and childbirth for a period of up to 15 days during the leave under art. 164b, para. 8 of the Labor Code. The adopter is entitled to a 15-day leave on adoption of a child up to the age of 5 from the date of delivery of the child for adoption but no later than the age of 5 when the adoptive parent and the adopter are married.
The person insured for general sickness and maternity shall be paid cash compensation at the amount determined for pregnancy and childbirth after the expiration of 6 months from the day of delivery of the child for adoption for the remainder up to 365 days during the leave under art. 164b, para. 2, 3 or 5 of the Labor Code, namely:

  • When the child is adopted by spouses, the leave with the consent of the adoptive parent can be used instead by the adopter after the expiration of 6 months from the day of delivery of the child for adoption but not later than the age of 5 years, working under an employment relation (Article 164b (2) of the Labor Code). When the adopter has died, the leave may be used by one of the parents of the adoptive parent or the adopter when working under an employment relation;
  • According to Art. 164b, para. 3 of the Labor Code, with the consent of the worker or the employee who has adopted a child on her own, after 6 months from the date of giving the child for adoption, one of her parents may use the leave for her when working under an employment relation;
  • Pursuant to Art. 164b, para. 5 of the Labor Code, a right to leave under the conditions and at the amount of the adoption leave for a child up to the age of 5, i.e. up to 365 days has the employee in cases where he has adopted the child alone. With his consent six months after the date of the child's adoption, one of his parents may use the leave instead when working under an employment relation.

Self-insured persons who are insured for general sickness and maternity and have 12 months of insured service as insured for this risk are entitled to cash benefit upon adoption of a child up to the age of 5 within the terms of the above conditions.
The cash benefit for the adoption of a child up to the age of 5 is not payable on death of the child, on termination of adoption, on accommodation at a state-run childcare facility, and when the child attends a childcare facility, including nursery or school.

What benefit is paid in case of non-use of parental leave for adoption of a child up to the age of 5?
The adoptive parent of a child up to the age of 5 or the adopter who has alone adopted a child up to 5 years of age if he/she has 12 months of insured service as a general sickness and maternity insurance receives a cash benefit of 50 per cent of the benefit upon adoption of a child up to the age of 5 when, after the expiration of 90 days from the date of delivery of the child for adoption:

  • they are not using adoption leave or the person using such leave interrupts its use;
  • the self-insured person begins to engage in occupational activity which is provided for general illness and maternity.

When the adoptive parent has died, has been deprived of parental rights and / or the custody of the child has been granted to the adopter, the compensation is paid to the adopter and, when he / she has died, to the guardian. Compensation is also paid to the guardian if the adoptive parent who has adopted a child has died or is deprived of parental rights. Compensation is paid when the child caretaker has 12 months of insured service as insured for general illness and maternity.
Compensation is not payable on death of the child, on termination of adoption, on full-time child support in a childcare facility and on raising by a person included in maternity support programs.

What documents and data are required to provide compensation for pregnancy and childbirth, raising a child up to the age of 2 and adopting a child up to 5 years of age?

  • Cash benefits for pregnancy and birth up to 135 days or re-employment due to pregnancy or breastfeeding or advanced in-vitro treatment are paid on the basis of a hospital sheet.
  • Data from hospital sheets for the period up to 135 days, adopted by the order of the Ordinance on the Procedure for Presentation at the National Social Security Institute of the data from the issued hospital sheets and the decisions on their appeals.
  • On the first presentation of a hospital bill, data on the bank account for payment of the cash benefits is declared once with a declaration according to a model form according to Annex 1 to the Ordinance on Cash Benefits and Allowances from State Social Security, presented by the insured person to the insurer. It shall also be submitted for the maternity hospital sheets after the 42nd day of birth and for the cases under Art. 167 of the Labor Code.
  • Certificate from the insurer, the social security funds or the self-insured persons with data on the right to financial compensation to be presented to the National Social Security Institute for each hospital sheet - Annex 9 to the Ordinance on Cash Benefits and Allowances from State Social Security.
  • Application-declaration for payment of cash benefits during pregnancy and childbirth on the grounds of Art. 50 para. 1 and 5 of the Social Insurance Code for the remainder up to 410 days in the form of Annex 2 to the Ordinance on Cash Benefits and Allowances from State Social Security from the insured person to the insurer.
  • Application-declaration for payment of cash benefits during pregnancy and childbirth in case of non-use of leave for pregnancy and childbirth (pursuant to Article 50a of the Social Insurance Code) for the remainder up to 410 days in the form of Annex 2a to the Ordinance on Cash Benefits and Allowances from State Social Security from the insured person to the insurer.
  • Application-declaration for payment of a cash benefit to the father for the birth of a child (Article 50, paragraph 6 of the Social Insurance Code) and the adoptive parent in the event of adoption of a child up to the age of 5 (Article 53c (2) of the Social Insurance Code) for the time of the 15-day leave according to a model form according to Annex 3 to the Ordinance on Cash Benefits and Allowances from State Social Security from the insured person to the insurer.
  • Application-declaration for payment of a cash benefit at the birth of a child on the grounds of Art. 50 para. 7 of Social Insurance Code after the child has reached the age of 6 months for the remainder of the father's 410 days or the person who has taken up the child’s raising during the leave under Art. 163, para. 10 or 12 of the Labor Code according to a model in accordance with Annex 4 to the Ordinance on Cash Benefits and Allowances from State Social Security from the insured person to the insurer.
  • Application-declaration for payment of a cash benefit for adoption of a child up to the age of 5 for 365 days on the grounds of Art. 53c, para. 1 of the Social Insurance Code according to a model according to Annex 5 to the Ordinance on Cash Benefits and Allowances from State Social Security from the insured person to the insurer.
  • Application-declaration for payment of a cash benefit on the grounds of Art. 53d of the Social Insurance Code for the remainder up to 365 days in case of non-use of the adoption leave of a child up to the age of 5 according to a model in accordance with Annex 5a to the Ordinance on Cash Benefits and Allowances from the insured person to the insurer.
  • Application-declaration for payment of a cash benefit upon adoption of a child up to the age of 5 on the grounds of Art. 53c, para. 3 of the Social Insurance Code after the expiration of 6 months from the date of delivery of the child for adoption for the remainder up to 365 days according to the model according to Annex 6 to the Ordinance on Cash Benefits and Allowances from the insured person to the insurer.
  • Application-declaration for payment of a cash benefit for child care up to the age of 2 on the grounds of Art. 54 of the Social Insurance Code according to Sample №7 of the Ordinance on Cash Benefits and Allowances from State Social Security from the insured person to the insurer.
  • Application-declaration for payment of a cash benefit in case of non-use of payd child care leave on the grounds of Art. 54 of the Social Insurance Code according to a Sample № 8 of the Ordinance on Cash Benefits and Allowances from State Social Security from the insured person to the insurer.
  • Model certificate, Annex 10 to the Ordinance on Cash Benefits and Allowances - for insured persons or Annex 11 to the Ordinance on Cash Benefits and Allowances - for self-insured persons, with information on the right to cash benefits.

How is data from hospital sheets presented to the NSSI?
The data contained in the issued hospital sheets are presented to the NSSI by:

  1. doctors/doctors in dental medicine - in person or through the medical establishments in which they operate;
  2. medical Advisory Committee (MAC) - through the medical establishments to which they are established.

The data contained in the decisions on the appeal of the hospital sheets are submitted to the NSSI by:

  1. Medical Advisory Committee (MAC) - through the medical establishments to which they are established;
  2. Territory Expert Medical Commission (TEMC) – through the Regional Card-index of Medical Expertise (RCME);
  3. The National Expert Medical Commission (NEMC).

The submission of the data contained in the issued medical sheets and in the decisions on their appeal, except for the data contained in the expert decisions of TEMC/NEMC, issued on the basis of appealed hospital sheets, is made electronically through web services, provided by NSSI. The entered data are sent to the NSSI and entered into the electronic register of the hospital sheets and the decisions on their appeals simultaneously with their issue or in the absence of a technical possibility within 7 days from their issuance.

How do the necessary documents and data for the payment of the cash benefits for temporary incapacity, re-employment, pregnancy and childbirth, the raising of a child up to the age of 2 and the adoption of a child up to the age of 5 are presented in the NSSI?
Certificates in accordance with Annex 9, Annex 10 and Annex 11 shall be submitted on paper, in hard copy or electronically, using a qualified electronic signature of the sender.

  • More than two certificates are submitted only in hard copy or electronically using a qualified electronic signature of the sender;
  • More than ten certificates are submitted only electronically using a qualified electronic signature of the sender;
  • Insurance funds provide the certificates only electronically by using a qualified electronic signature of the sender.

The documents on paper or in electronic form shall be submitted to the respective territorial unit of NSSI with a cover letter according to Annex 12, signed and stamped by the person obliged to submit them under the the Ordinance on Cash Benefits and Allowances from State Social Security or its representative and for the self-insured persons - signed by the person and stamped, if the self-insured person has a stamp.
When an electronic carrier is presented, a unique identification code (UIC) under BULSTAT is indicated on it. The cover letter is submitted on paper form in duplicate, one of which is left in the relevant territorial unit of NSSI and the other is delivered to the bearer.
The certificates according to Annex 9, Annex 10 and Annex 11 shall be submitted electronically via a web application accessible through the NSSI web site or by using a software product distributed free of charge by the NSSI or other software that satisfies the functional requirements, structure and format of the data, approved by an order of the NSSI Manager, with a qualified electronic signature of the sender.
After receipt of the certificates, the NSSI issues a rreference on the received and returned documents in accordance with Annex 14.
Upon receiving the documents electronically, to the e-mail address of the registered user who has submitted the documents is sent a message with access to the contents of the reference.
Upon receipt of the documents in paper or electronic form, the reference shall be issued, signed and stamped by the official in the relevant territorial division of the NSSI and handed over to the person submitting the documents.

What are the deadlines for submitting the certificates, Annexes No 9 - No 11 to the National Social Security Institute for payment of cash benefits?
The certificates, Annexes No 9 - No. 11 with data on the right to financial compensation are submitted to the NSSI within the following deadlines:

  • From the insurers, their branches and divisions and the social security funds - by the 10th day of the month following that during which the insured person has submitted the documents for payment of the benefit to the insurer (hospital sheet and / or declaration-declaration);
  • From the self-insured persons - by the 10th day of the month following the one in which the hospital sheet was issued and respectively by the 10th day of the month following the one from which payment of the benefit for pregnancy and childbirth is required, raising a child up to the age of 2 and upon adoption of a child up to 5 years of age.

How and in what terms are the cash benefits and allowances paid by NSSI?
The cash benefits and allowances are paid by the territorial division of the NSSI to the bentitled persons within 10 working days of entering in the NSSI the data from the issued hospital sheets and presentation of the certificates upon the model according to Annexes 9 - 11 to the Ordinance on Cash Benefits and Allowances from the State Social Security.
Cash benefits over a period of more than one calendar month are paid within 10 working days for the first month of the period, for the remaining calendar months - up to 5 business days after the end of the month to which they relate and for the last month - up to 5 business days after expiration of the period of the benefit.
The territorial division of the NSSI pays the entitled persons the cash benefits on the declared by them in the applications-declarations personal payment or saving indefinite bank accounts, as the transfers to the banks are done twice a week.
If the person does not have the right to benefit or allowance, the official who is entrusted with the payment of benefits and allowances or another official designated by the Head of the territorial unit of the NSSI issues a refusal order within 10 working days of receipt in the NSSI the data from the issued medical sheets and presentation of the certificates upon the model in accordance with Annexes 9 - 11 or of the declaration forms in accordance with Annexes 15 - 18. One copy of the refusal order is sent within 3 days of its being issued to the person who may appeal against it to the Head of the territorial unit of NSSI within 14 days of its receipt.
The order shall be revoked if, in the three-year limitation period under the Social Security Code, the person or the insurer presents new or additional evidence establishing entitlement to benefit or compensation. The receivables due from the State Social Security are extinguished with the expiration of a three-year statute of limitation as of 1 January of the year following the year to which they relate.
The official at the NSSI territorial unit issues an order for suspending the payment of the benefits for temporary incapacity to work, accidents at work and occupational disease, re-employmentn, pregnancy and childbirth when the acts of medical expertise are appealed or when evidence is presented which may may lead to the issuance of an order for refusal or termination of the payment of the benefit or when no data are provided on the issued medical sheets and the decisions on their appeal in the electronic register of hospital sheets and decisions on their appeal.

In what period does the territorial unit of the NSSI notify the persons who have submitted irregular or missing documents under the Ordinance on Cash Benefits and Allowances from State Social Security as well as to clarify the facts and circumstances related to the calculation and payment of the cash benefits and benefits?
Within 7 working days of documents submission, the territorial unit of the NSSI shall notify the persons obliged to submit documents under the Ordinance on Cash Benefits and Allowances from State Social Security or its authorized persons, giving them the necessary instructions for correcting the irregularities or for clarifying the facts and circumstances.
The notification shall be made through a licensed postal operator at a specified exact address or electronically to a specified electronic address or by telephone, signed by the official who has performed it.
Within 7 working days of the notification, the persons submit to the NSSI the corrected or missing documents.

What are the deadlines to submit to the NSSI the documents and data in case of a change in the circumstances leading to termination of payment of benefits and allowances?
Within 3 working days from the change of the circumstances related to the payment of the cash benefits, including the change of the bank account, the insured persons shall submit to the insurers a new declaration, Annex1 to the Ordinance on Cash Benefits and Allowances from State Social Security or a new application-declaration, Annexes 2 to 8 to the Ordinance on Cash Benefits and Allowances from State Social Security and the relevant evidence to it.
The insurers, their branches and divisions and the insurance funds shall submit to the NSSI, within 3 working days of receipt of the declaration or application-declaration, new certificates according to Annexes 9, 10 and 11 with data on changed circumstances.
Within 3 working days of the change of circumstances related to the payment of the cash benefit the self-insured persons, the companies through which the partners in the commercial companies are insured, the owners of the company and the natural persons - members of unincorporated companies, and the insurance funds present in the NSSI new certificates according to Annexes 9, 10 and 11 with data on change of circumstances.

What is the time period for the insurers to keep the documents for granting cash benefits for temporary incapacity to work, re-employment, pregnancy and childbirth, raising a child up to the age of 2 and adopting a child up to 5 years of age?
Documents for the payment of benefits and the relevant evidence to them shall be submitted by the insured persons to the insurer, who shall record them in a separate journal and keep them for a period of 5 years from 1 January of the year following the year of presentation.
The self-insured persons, the social security funds and the companies, through which the partners in the commercial companies, the owners of the company and the natural persons - members of unincorporated companies, keep the documents for a period of 5 years from 1 January of the year following the year in which the payment of the benefit was requested.

When and how are recalculated cash benefits for temporary incapacity to work, re-employment, pregnancy and childbirth and upon adoption of a child up to the age of 5?
Until 30 June of the current year, the cash benefits paid for the previous calendar year shall be recalculated, when after the payment, for the period from which the amount has been determined, the data under Art. 5, para. 4, item 1 of the Social Insurance Code were submitted and/or corrected and/or the final amount of the insurance income under Art. 6, para. 9 of the Social Insurance Code on which social security contributions have been paid, is different from the insurance income under Art. 6, para. 8 of the Social Insurance Code, on which advance payments were made.
When, after the date of recalculation, for the period from which the amount of the cash benefits paid has been determined, the data under Art. 5, para. 4, item 1 of the Social Insurance Code submitted and/or corrected and/or the final amount of the insurance income under Art. 6, para. 9 of the Social Insurance Code on which insurance contributions have been paid is different from the insurance income from which the benefit is calculated/ recalculated, cash benefits are recalculated ex officio until 30 June of the following calendar year.
When as a result of recalculation a difference is established between the amount paid and the due amount of the benefit:

  • the difference to the higher amount is paid to the person by 30 June of the year following the year to which they relate;
  • the amount paid in excess of the due amount shall be reimbursed by the person, except when it is the result of incorrectly submitted data for payment of the cash benefit and/or certifying of the insurance period and income from the insurer.

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For more information, use the appropriate sections in the website the National Social Security Institute (nssi.bg), or contact the relevant local office of the Institute.

 

Last update: 05.06.2019

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