Security Law

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Assistance with objections and appeals against decisions regarding your benefits

Your income situation can drastically change if you become unemployed, disabled, or retire. There are various laws and measures within Social Security Law that ensure you still receive an income. For example, there are benefits under the Sickness Benefits Act and the Unemployment Insurance Act (WW and WIA).

For instance, you are generally entitled to a Sickness Benefits Act allowance (ZW) when your employment contract ends while you are sick, or if you become sick shortly after the end of your employment contract. If you become unemployed because your employment contract is not extended, you are usually entitled to an Unemployment Insurance Act allowance (WW). If you have been disabled for more than two years during your employment, you may be entitled to a WIA benefit.

If you believe you are entitled to a benefit, you must apply for it from the benefits agency: the UWV, or the municipality where you reside. If you meet the requirements, the benefit will be granted.

However, sometimes the application process does not go smoothly. An employer may, for example, dispute that you are disabled, or the UWV may take the position that you are not entitled to a benefit. Once you have a benefit, problems can still arise. Your benefit may suddenly be stopped because, for example, you inadvertently failed to report something.

If you receive a decision that your benefit is being stopped or denied, you can take legal action against it. You can object to the decision of the benefits agency. You can go to court if you disagree with the decision on your objection. If you disagree with the court’s decision, you can appeal to the Administrative Jurisdiction Division of the Council of State.

It is important that you have an expert from the objection phase to support you in the procedures. The lawyers at Elfi are specialized in Social Security Law and are happy to assist you in this matter.

The Work and Income according to Labor Capacity Act (WIA) provides the option to apply for a benefit if you have been sick for more than 88 weeks and are still not (fully) able to work.

The WIA has two benefits: the Return to Work (Partially Disabled) Scheme (WGA) and the Income Provision for Fully Disabled Workers (IVA).

WGA You are entitled to a WGA benefit if you have been sick for two years or more and it is expected that you will be able to work again in the future. You must also earn 65% or less than your previous salary with that work. The WGA benefit partially compensates for income loss and provides you with an income during your illness.

IVA You are entitled to an IVA benefit if you can earn 20% or less of your previous salary and this will remain the case in the future. The amount of the IVA benefit depends on the salary you earned in the year before you became sick (daily wage). This is based on the salary on which you pay social premiums and taxes.

After applying for a WIA benefit, the UWV first looks at your reintegration process. It is assessed whether you (and your employer) have done everything to get you back to work. This is based on the period from your first day of sickness to the WIA application. If it is established that your employer has not made sufficient effort for your reintegration, they can be obliged to continue paying your salary for up to a year. After your employer meets the obligations, the WIA application is further processed.

If the UWV judges that the reintegration obligations have been met, your health is assessed by an insurance doctor from the UWV. This doctor examines your complaints and assesses whether they are temporary or permanent. If the insurance doctor believes that your complaints are temporary, you are invited for a consultation with an employment expert. If the complaints are permanent, this is not the case. The employment expert then investigates what kind of work you can do in the future. If it is established that you can earn 65% or less with this work, you will receive a WIA benefit.

The UWV decides on your WIA application within 8 weeks. If the UWV decides that you are not entitled to a WIA benefit and judges that you can work for more than 65%, you should discuss with your employer. If no solution can be found regarding your reintegration, your employer may dismiss you. You can then apply for an Unemployment Insurance Act benefit (WW). More information about the WW benefit can be found under the heading ‘Unemployment Insurance Act’.

If you disagree with the UWV’s decision on the WIA benefit, you can file an objection within six weeks. The UWV is then obliged to reassess your application and make a decision on the objection. If you disagree with the decision on the objection, you can appeal to the court. As a last resort, you can appeal to the Administrative Jurisdiction Division of the Council of State.

It is important to have an expert from the objection phase to support you in the procedures. The lawyers at Elfi are specialized in Social Security Law and are happy to assist you in this matter. If you want to know more about other topics in the field of social security law, see the “Social Security Law” section on the website of Elfi Advocaten.

[1]https://www.uwv.nl/particulieren/ziek/ziek-wia-uitkering/beoordeling-beslissingwia-aanvraag/detail/wia-beoordeling-of-ik-kan-werken/beoordeling-arbeidsdeskundige

The employer is obligated to continue paying your salary for two years during your illness. However, if you no longer have an employer, you may be eligible for protection under the Sickness Benefits Act. You receive a Sickness Benefits Act allowance if you have been reported sick and the employer no longer has an obligation to pay wages.

This can be the case if you no longer have an employer because your employment contract expires while you are sick. Also, if you become sick within four weeks after the end of your employment contract, you are eligible for the Sickness Benefits Act.

Furthermore, temporary workers also have the right to a Sickness Benefits Act allowance. If you meet the conditions of the Sickness Benefits Act, you are entitled to the Sickness Benefits Act allowance for 104 weeks. You can apply for this allowance at the UWV. The amount of the Sickness Benefits Act allowance is initially 70% of your daily wage. This is based on the salary on which you pay social premiums and taxes. In exceptional cases, you are entitled to 100% of your daily wage. This is the case if you become sick due to pregnancy or childbirth before your maternity leave. Also, if you are sick due to organ donation, you have the right to 100% of your daily wage. After two years, the Sickness Benefits Act allowance automatically stops, even if you are still sick. After this, you can apply for a WIA benefit at the UWV. More information about the WIA benefit can be found under the heading ‘WIA’.

The Sickness Benefits Act allowance can be terminated earlier if you are no longer sick and return to work. Also, if you reach the state pension age, your Sickness Benefits Act allowance is automatically stopped. In addition, the UWV can terminate the Sickness Benefits Act allowance if the UWV is of the opinion that you are less than 35% disabled at the end of the first year. You are then able to earn 65% of your old income.

If you disagree with the UWV’s decision on the Sickness Benefits Act allowance, you can file an objection within six weeks. For some Sickness Benefits Act decisions, the objection period is only two weeks! If you have filed an objection in time, the UWV is obliged to reassess your case and make a decision on the objection. If you disagree with the decision on the objection, you can appeal to the court. As a last resort, you can appeal to the Administrative Jurisdiction Division of the Council of State.

It is important to have an expert from the objection phase to support you in the procedures. The lawyers at Elfi are specialized in Social Security Law and are happy to assist you in this matter. If you want to know more about other topics in the field of social security law, see the “Social Security Law” section on the website of Elfi Personal Injury Lawyer.

[1] Art. 7:629 BW.
[2] https://www.uwv.nl/particulieren/overige-onderwerpen/wat-is-sv-loon/index.aspx

If you become unemployed and are unable to find new work, you may be eligible for an Unemployment Insurance Act (WW) benefit. Under the WW, ‘unemployed’ also includes partial loss of work hours. This means if your employer requires you to work at least 5 hours less, you may be eligible for a WW benefit.

You are entitled to a WW benefit if you have worked at least 26 weeks in the past 36 weeks. The number of hours you worked is not relevant. Additionally, you are not entitled to a WW benefit if you are receiving a Sickness Benefits Act or WIA benefit.

The amount of your WW benefit depends on your daily wage. For the first two months, the benefit is 75% and thereafter 70% of your daily wage. The duration of the benefit is at least 3 and at most 24 months, depending on your employment history. If you have worked less than 11 years, you are entitled to 1 month of WW benefit for each calendar year worked. A different calculation applies if you have worked 11 years or longer. For the first 10 years before January 2006, you also get 1 month of WW benefit per calendar year. After that, for each calendar year after January 2006, you get 0.5 months of WW benefit. However, you can never receive WW benefits for longer than 24 months.

After 24 months, you may be eligible for the Participation Act, also known as the ‘social assistance benefit.’ After receiving a WW benefit, you are still obligated to seek suitable employment. For example, you are required to actively apply for jobs. Every four weeks, you must have seriously applied for at least four jobs. You are also required to share all information about your situation with the UWV, such as your income and job applications. The UWV checks whether you comply with these obligations. If the UWV believes you are not fulfilling your obligations, your WW benefit can be terminated. Also, any undue payments can be reclaimed. Furthermore, the UWV can impose a fine or make a report.

If you find a new job, your WW benefit will be terminated by the UWV. This only applies if you find a job where you earn more than 87.5% of your monthly salary for two consecutive months. If you disagree with the UWV’s decision on the WW benefit, you can file an objection within six weeks. The UWV is then obliged to reassess your application and make a decision on the objection. If you disagree with the decision on the objection, you can appeal to the court. As a last resort, you can appeal to the Administrative Jurisdiction Division of the Council of State.

It is important to have an expert from the objection phase to support you in the procedures. The lawyers at Elfi are specialized in Social Security Law and are happy to assist you in this matter. If you want to know more about other topics in the field of social security law, see the “Social Security Law” section on the website of Elfi Advocaten.

The Personal Budget (PGB, “Persoonsgebonden budget” in Dutch) can be applied for if you have a disability and need care, support, or aids. This can include household help and nursing, as well as taxi transportation or a mobility scooter.

A PGB can be requested from the Municipality or health insurer. Applications for the Social Support Act (WMO, “Wet maatschappelijke ondersteuning”) or the Youth Act can be made to the municipality. For this, you must prepare a personal plan in which you substantiate your application. The municipality then processes your application and determines whether you are entitled to support. The municipality is required to decide within 6 weeks.

If the municipality approves your application, you will receive a PGB. The hourly rate for the provided care varies per municipality, as they determine this themselves. These hourly rates depend on the type of care you receive. You do not receive the amount yourself. The Social Insurance Bank (SVB, “Sociale Verzekeringsbank”) makes the payments on your behalf. In addition, if you are older than 18 years, you must pay a minimum monthly contribution of €19.

The application for the Health Insurance Act (ZVW, “Zorgverzekeringswet”) can be submitted to your health insurer. The PGB is available if you need nursing or care for more than one year. However, if you need care for the rest of your life, you should submit a PGB application at the Care Office (“Zorgloket”) according to the Long-Term Care Act (WLZ, “Wet langdurige zorg”). This is the case, for example, if you are chronically ill. With the application, you must prepare a budget plan and indicate what care you need and explain the costs. The Care Office should then discuss the application with you before making a decision.

If the Care Office approves your application, you will receive a PGB for the required care. The WLZ uses different hourly rates for informal and formal caregivers. There is also a minimum and maximum hourly wage. In addition, you must pay a personal contribution to the CAK, depending on your income, assets, living situation, age, and the type of care you receive. Here too, you do not receive the amount yourself. The Social Insurance Bank (SVB) makes the payments on your behalf.

However, if the Municipality or the Care Office decides to reject your PGB application, you have the option to object within 6 weeks. They are then obliged to reassess your application and make a decision on the objection. If you disagree with the decision on the objection, you can appeal to the court. As a last resort, you can appeal to the Administrative Jurisdiction Division of the Council of State.

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