Following a complaint, the NTA issued an audit order on the e-National Social Security Fund (e-EFKA), regarding the possibility of granting an absolute disability benefit or an extra-disability benefit to a pensioner with a 95% disability rate from 2014 and for life, on based on a Certificate issued by the Health Committee of the Disability Certification Centre (KEPA).
The extra-institutional allowance is now also granted to those suffering from diseases that result in a form of disability identical to the ailments mentioned in article 42 of Law 1140/1981, at the discretion of the competent Health Committee, while the granting of an absolute disability benefit to persons who retire for a cause other than disability is not provided for.
In accordance with the above provisions, the pensioner and complainant are not entitled to the total disability allowance. However, he is entitled to receive the extra-institutional benefit, subject to the assessment by the competent authority of Health Committee of Disability Certification Centres, as stipulated in Law 4554/2018.
The Directorate of the Metropolitan Centre of the e-National Social Security Fund (e-EFKA), following the NTA intervention, sent the Disability Certificate for re-evaluation to the Health Committee in the framework of the audit carried out.
Specifically: The audit team, considering the provisions in force according to which it is possible to request a review of the original Disability Certificate, recommended to the management of the e-EFKA, inter alia, to supervise, through its competent Directorates:
- for the immediate handling of the procedure for the re-examination of the extra-institutional benefit and its granting, if it is positively assessed by the Health Committee of Disability Certification Centres
- to examine any similar cases.
- The competent Health Committee, to proceed within two (2) months to re-evaluate the initial Disability Certificate, in order to decide whether the conditions mentioned in the Certificate fall under article 56 of Law 4554/2018, bringing the same form of disability as the diseases defined for the granting of the extra-institutional benefit.
Following the transmission of the audit report, the e-EKFA Services have taken steps to implement the NTA recommendations as follows:
α) The insured person, who has a disability rate of 95%, was granted the paraplegic benefit to which he was entitled, according to the aforementioned Law (article 56 - Law 4554/2018), by issuing the relevant Decisions of the competent Director of e- EFKA, based on the opinion of the Health Disability Certification Centre, retroactively, from 22/02/2022, the date of submission of his application, and for life.
b) The guidelines have been updated, based on the amendment of the relevant legislative framework and the introduction of new rules on the procedures for granting disability benefits, so that similar cases will not occur in the future.