COUNCIL OF EUROPE
FORM
FOR THE
BIENNIAL REPORT
ON THE
EUROPEAN CODE OF SOCIAL SECURITY
(ARTICLE 76 – PARTS NOT SPECIFIED
IN THE RATIFICATION OF THE CODE
OR IN A NOTIFICATION MADE SUBSEQUENTLY)
________
STRASBOURG
R E P O R T
for the period from July 1, 2018 to June 30, 2020 made by the Government of Estonia in accordance with Article 76 of the European Code on Social Security on the position of national law and practice in regard to the matters dealt with in Parts of the European Code of Social Security which have not been specified in the ratification of the Code or in a subsequent notification.
I. Please indicate whether any laws, regulations or contractual provisions (for example, in collective agreements) exist in your country with regard to each of the contingencies referred to in those of the Parts II to X of the Code which have not been accepted. (Please indicate in each case whether protection is provided under a compulsory or a voluntary scheme.)
II. If so, please list the laws and regulations in force at the date of the preparation of the report (with precise references to the official gazettes in which they appeared).
The Republic of Estonia has not ratified Part VI of the European Code of Social Security that concerns theemployment injury benefit.
Part VI of the Code is connected with the following legal acts:
Acts:
1) Occupational Health and Safety Act;
4) State Pension Insurance Act;
5) Work Ability Allowance Act.
Regulations of the Minister of Social Affairs:
1) Guidelines for Determining, Recalculating and Paying State Pension;
2) Composition of Documents and Data Required for Determining and Paying Benefits for Temporary Incapacity for Work and Procedure for Determining and Paying the Benefit;
3) The conditions of assessment of work ability and the list of states of health precluding work ability;
4) List of Occupational Diseases.
All the schemes are obligatory.
The legislation can be accessed in Estonian and English at www.riigiteataja.ee.
1. Scope
Please indicate, for each of the contingencies referred to in the non-accepted Parts of the Code, so far as possible on the basis of available statistics, the approximate number of persons protected, that is:
either (a) the number of employees protected and
(b) the total number of employees
or (a) the number of persons belonging to the economically active population protected (or to the prescribed classes of residents protected) and
(b) the total number of residents.
(If the protection covers all employees, the entire economically active population, or all residents, it will be sufficient to indicate this, without supplying any statistics.)
Pursuant to the Health Insurance Act, the State Pension Insurance Act and the Social Tax Act, all workers on behalf of whom employers are paying social tax are insured with health insurance and pension insurance on a compulsory basis.
a) there were 639 904 economically active insured persons as of December 31st 2019 (data of the Health Insurance Fund);
b) the total amount of workers was 671 300 at the end of 2019 according to data of the Statistics Estonia;
c) 95,3% of all workers were insured.
2. Conditions for Entitlement to Benefits
Please indicate, for each contingency referred to in the non-accepted Parts of the Code, the conditions for entitlement to benefits, particularly as regards the definition of the contingency, the qualifying period, the waiting period, the maximum duration of benefits, etc.
(See also, as regards Part VI, Articles 32, 37 and 38.)
§ 22 and § 23 of the Occupational Health and Safety Act provide the definitions of occupational accident and occupational disease.
An occupational accident is damage to the health of an employee or death of an employee which occurred in the performance of a duty assigned by an employer or in other work performed with the employer’s permission, during a break included in the working time, or during other activity in the interests of the employer.
An occupational disease is a disease which is brought about by a working environment hazard specified in the list of occupational diseases or by the nature of the work.
In the event of an occupational accident or an occupational disease:
- health services will be provided and sickness benefits will be paid pursuant to the Health Insurance Act;
- work ability allowance will be paid pursuant to the Work Ability Allowance Act;
- survivor’s pensions will be paid pursuant to the State Pension Insurance Act.
The sickness benefit is paid in case of occupational accident and occupational disease from the second day of sickness. The waiting period is one day. There is no requirement for length of service in order to receive health care and sickness benefits. The maximum duration of the benefit is 182 days.
Since 1st of July 2016 Estonia has implemented new work ability support system (work ability reform). In this new system work ability allowance is paid to the persons with partial or no ability for work instead of pension for incapacity for work. From 1st of January 2017 incapacity for work pensions are no longer granted. There is no requirement for length of service in order to receive work ability allowance. The work ability allowance is paid until the end of the term for which partial or no work ability has been established.
See the information presented in our 2018-2019 Article 74 report about the minimal extent of loss of capacity for work that grants the right to a work ability allowance.
See the information presented in our 2018-2019 Article 74 report and 2019-2020 Article 74 report for the widow’s right to a survivor’s pension.
In addition to health services, sickness benefits, work ability allowance and survivor`s pension, an employee has a right to receive benefits from the employer for health damages caused by the work in the extent provided in the Law of Obligations Act. The employer shall compensate the aggrieved person for expenses arising from damage or injury caused by work, including expenses arising from the increased needs of the aggrieved person, and damage arising from total or partial incapacity to work, including damage arising from a decrease in income or deterioration of the future economic potential of the aggrieved person. In the case of an obligation to compensate for the damage arising from the death of a person, employer shall compensate for the expenses arising from the death of the deceased person, in particular for reasonable funeral expenses, reasonable medical expenses relating to the health damage or bodily injury which caused the death of the person, and the damage arising from the aggrieved person's interim incapacity for work. The compensation takes place on the basis of an agreement between the employer and the aggrieved person. If damage is established but the exact amount of the damage cannot be established, including in the event of non-material damage or future damage, the amount of compensation shall be determined by the court.
According to the Occupational Health and Safety Act, if the employer has been liquidated without legal successor, the material damage suffered due to health loss caused by occupational accident or occupational disease or due to death is compensated from the state budget through the Estonian National Social Insurance Board.
3. Level of Benefits
(a) As regards periodical payments, please indicate the manner in which the respective benefits are calculated, relating this information to the criteria laid down in Articles 65, 66 and 67 of the Code.
The following Articles of part XI of the Code are referred to regarding the different cases specified in Article 36 (1):
- temporary incapacity for work – Article 65;
- total loss of ability to earn an income – Article 66;
- loss of provider – Article 66.
1) Temporary incapacity for work
The rate of sickness benefit in the case of temporary incapacity for work caused by occupational accident or disease is 100% of the insured person’s average income per calendar day based on data by the Tax and Customs Board. The average income is calculated on the basis of social tax calculated for or paid to the person. See the information presented under Article 16 regarding the calculation of an insured person’s average income. Also see the information presented under Article 16 regarding the upper limit of the income that is taken into consideration and taxation of sickness benefits.
2) Total loss of ability to earn income
See the information presented in our 2019-2020 Article 74 report regarding work ability allowance that is paid in the case of partial and no ability for work.
In addition to state benefits a person has the right to receive a benefit for the personal injury caused at work from the employer in the extent established by the Law of Obligations Act. Damage arising from partial or no ability for work, including damage arising from a decrease in income or deterioration in the further economic potential, i.e. first and foremost loss of profit, must be compensated for in the case of health damage or bodily injury pursuant to the Law of Obligations Act. Damage must be compensated for in periodic payments unless the nature of the damage makes it reasonable to compensate for the damage in a lump sum.
Upon the liquidation of the employer without a legal successor the state shall assume the payment of benefits (Estonian National Social Insurance Board).
3) Loss of provider
See the information presented in our 2019-2020 Article 74 report for survivor’s pension that is paid in the case of loss of provider.
The Law of Obligations Act provides additionally that if a person whose death has been caused has at the time of his or her death an obligation arising from law to maintain another person, the person obligated to compensate for the damage will pay the person reasonable monetary compensation corresponding to the maintenance payments which the deceased person would have paid to the person during the deceased person’s presumed lifetime. Compensation must also be paid to a person whose obligation to maintain would have arisen for the deceased person in the future during his or her presumed lifetime or who was conceived but not yet born at the time of death. Damage must be compensated for to the dependent person by periodic monetary payments.
(b) As regards benefits in kind (medical care), please indicate whether they cover the benefits mentioned in Articles 10, 34 and 49 of the Code.
In case of occupational accident or diseases health services are provided pursuant to the Health Insurance Act. The benefits are financed from the social tax.
The same rules and procedure (including participation of patients in covering the costs) are in force regarding the benefits provided for in the Health Insurance Act as those specified under Article 10 (see the information provided for Article 10 in our 2018-2019 Article 74 report).
(c) Please indicate whether there exist any provisions for the review of current periodical payments following substantial changes in the general level of earnings where these result from substantial changes in the cost of living.
According to the State Pension Insurance Act the survivor pensions are indexed annually. The value of the index depends to the extent of 20 per cent of the annual increase of the consumer price index and to the extent of 80 per cent of the annual increase in receipt of the pension insurance part of social tax. In 2019 the state pensions (including survivors’ pensions) were indexed with index 1,084 and in 2020 with index 1,080. In average state pensions increased 8,4 and 8,0% in 2019 and 2020. Additionally state pensions were increased in 2020 with extraordinary pension increase of 7 euros.
According to the Occupational Health and Safety Act, the periodical benefit paid by Social Insurance Board in case of the liquidation of the employer without a legal successor is indexed also with the pension index on the 1st of April every year. The benefit is not indexed if the index value is lower than 1,000.
4. Miscellaneous
(a) Please indicate whether claimants have a right of appeal in case of refusal of the benefit or complaint, and indicate the authority to which any such appeal lies.
Regarding the granting of limited work ability, complaints may be addressed to Unemployment Insurance Board or to the court.
(b) Please indicate the manner in which the cost of benefits is financed and the distribution of actual resources according to the sources from which they are derived.
The health services and sickness benefits are financed from the social tax. The work ability allowance is financed from the general taxes.
(c) Please specify which authority or authorities are entrusted with the supervision of the application of the laws and regulations and indicate the manner in which organisations of employers and workers may be called upon to co-operate in this application.
The Ministry of Social Affairs carries out supervision in its area of government. The main task of the Internal Audit Department is to provide an independent evaluation of the legitimacy, expediency, economy, efficiency and effectiveness of the activities of the Ministry and the institutions in its area of government.
The Health Board carries out supervision of its area of activity, including health care, surveillance of communicable diseases, environmental health, chemical safety and safety of medical equipment. Also, the Health Board solves statements and applications of persons in its area of activity, including the quality of treatment.
The Tax and Customs Board carries out state supervision regarding the correctness of calculation and payment of state taxes and application of tax exemptions, collection of tax arrears, postponement of payment of tax arrears, writing off and cancellation of tax arrears.
The Labour Inspectorate carries out state supervision over compliance with the requirements of legislation regulating occupational health and safety, including investigation of occupational accidents and deceases if necessary.
(d) Please attach copies of the laws and regulations referred to in the present report. If reports on the application of the legislation are submitted to a national authority, please supply a copy of the most recent report.
The legal acts referred to in the present report are available at the following addresses (in English):
1. Occupational Health and Safety Act: https://www.riigiteataja.ee/en/eli/ee/Riigikogu/act/510112015002/consolide
2. Law of Obligations Act: https://www.riigiteataja.ee/en/eli/ee/Riigikogu/act/528032016012/consolide
3. Health Insurance Act: https://www.riigiteataja.ee/en/eli/ee/Riigikogu/act/516052016001/consolide
4. State Pension Insurance Act:
https://www.riigiteataja.ee/en/eli/ee/501022016016/consolide
5. Work Ability Allowance Act
https://www.riigiteataja.ee/en/eli/522032019013/consolide
The regulations referred to in the present report are available at the following addresses (in Estonian):
1. Guidelines for Determining, Recalculating and Paying State Pension: https://www.riigiteataja.ee/akt/131032015010
2. Composition of Documents and Data Required for Determining and Paying Benefits for Temporary Incapacity for Work and Procedure for Determining and Paying the Benefit: https://www.riigiteataja.ee/akt/129122014040
3. The conditions of assessment of work ability and the list of states of health precluding work ability: https://www.riigiteataja.ee/akt/108092015004
4. List of Occupational Diseases: https://www.riigiteataja.ee/akt/897867
III. (a) Please indicate whether any modifications have been made in the national legislation or practice with a view to giving effect to all or some of the provisions of the Code.
There have been no changes made to the regulation since the last reporting period.
(b) Please state, where appropriate, any difficulties due to the Code, to the legislation, to the national practice or to any other reason which may prevent or delay the ratification of the Code.
Estonia did not ratify part VI of the Code in 2004 regarding work injury benefit because cost-sharing by the patient for benefits in kind (health care and medicinal products) was not fully precluded in the case of occupational accidents and occupational diseases.
(c) Please state also whether it is intended to adopt measures to give effect to those provisions of the Code not yet covered by the national legislation or practice.
At present, Estonia cannot ratify part VI, as self-participation of the aggrieved person regarding medical help provided in Article 34 cannot be excluded.