natgillin/translations-raw huggingface dataset:
začasnega prebivališča je pristojnemu nosilcu, ki to zahteva, dolžan zagotoviti potrebne podatke o teh stopnjah
with all necessary information about these rates
ali zneskih
or amounts
lahko pristojni nosilec
, the competent institution may reimburse the
v mejah in v skladu s stopenjami, ki jih določa njegova zakonodaja, in sicer
within the limits of and at the rates laid down in its legislation,
Povračilo, ki ga prejme zavarovana oseba, v nobenem primeru ne sme presegati zneska stroškov, ki jih je ta oseba dejansko imela.
The reimbursement to the insured person shall not, in any event, exceed the amount of costs actually incurred by him/her.
Družinski člani
Family Members
Načrtovano zdravljenje
Scheduled treatment
A) Postopek za izdajo dovoljenja
Authorisation procedure
za pristojnega nosilca
the competent institution
Če zavarovana
If an insured
, ki to nemudoma posreduje pristojnemu nosilcu
, which shall forward it to the competent institution without delay
V tem primeru nosilec v kraju stalnega prebivališča z izjavo potrdi, da so pogoji iz drugega stavka člena 20(2) osnovne uredbe v državi stalnega prebivališča izpolnjeni.
In that event, the institution of the place of residence shall certify whether the conditions set out in the second sentence of Article 20(2) of the basic Regulation are met in the Member State of residence.
Pristojni nosilec lahko dovoljenje zavrne le, če v skladu z oceno nosilca v kraju stalnega prebivališča pogoji iz drugega stavka člena 20(2) osnovne uredbe v državi članici stalnega prebivališča zavarovane osebe niso izpolnjeni ali če se lahko enako zdravljenje zagotovi v pristojni državi članici, in sicer v roku, ki je sprejemljiv z zdravniškega vidika, ob upoštevanju trenutnega zdravstvenega stanja in verjetnega poteka bolezni zadevne osebe.
The competent institution may refuse authorisation only if, in accordance with the assessment of the institution of the place of residence, the conditions set out in the second sentence of Article 20(2) of the basic Regulation are not met in the Member State of residence of the insured person, or if the same treatment can be provided in the competent Member State itself, within a time-limit which is medically justifiable, taking into account the current state of health and the prognosis of the person concerned.
Če odgovor ne prispe v petnajstih "koledarskih dneh" od datuma pošiljanja, se šteje, da je pristojni nosilec dovoljenje izdal.
In the absence of a reply within fifteen "calendar days" of the date on which the request was sent, the authorisation shall be considered to have been granted by the competent institution.
Če zavarovana oseba, ki nima stalnega prebivališča v pristojni državi članici, nujno potrebuje zdravljenje
If an insured person who does not reside in the competent Member State is in need of an urgent and
življenjskega pomena,
vitally necessary treatment
dovoljenja ni mogoče zavrniti v skladu z drugim stavkom člena 20(2) osnovne uredbe.
, the authorisation cannot be refused under the second sentence of Article 20(2) of the basic Regulation.
V takih okoliščinah
In such circumstances, the
dovoljenje ▌v imenu pristojnega nosilca
The competent institution shall be obliged to accept the findings
v kraju
and the treatment options
v primeru potrebe po
urgent and
začasnega prebivališča brez
institution of the place of stay shall
je z zdravstvenega vidika
appears medically
dodatno zdravljenje
to supplement the treatment
, ki ga zajema obstoječe dovoljenje
covered by the existing authorisation
B) Kritje stroškov zdravstvenih storitev
Meeting the cost of benefits in kind
Brez poseganja v odstavek 7 se smiselno uporablja člen 25(5) in (6) izvedbene uredbe.
Without prejudice to paragraph 7, Article 25(5) and (6) of the implementing Regulation shall apply mutatis mutandis.
Če je zavarovana oseba dejansko sama krila stroške ali del stroškov za dovoljene zdravstvene storitve in so stroški, ki jih je pristojni nosilec obvezan povrniti nosilcu v kraju začasnega prebivališča ali zavarovani osebi v skladu z odstavkom 6 (dejanski stroški), nižji od stroškov, ki bi jih moral prevzeti za enako zdravljenje v pristojni državi članici (teoretični stroški), pristojni nosilec na zahtevo zavarovani osebi povrne stroške zdravljenja, ki jih je ta imela, do višine, za katero teoretični stroški presegajo dejanske stroške.
If the insured person has actually borne all or part of the costs for the authorised medical treatment, and the costs which the competent institution is obliged to reimburse to the institution of the place of stay or to the insured person pursuant to paragraph 6 (actual cost) are lower than the costs which it would have had to assume for the same treatment in the competent Member State (notional cost), the competent institution shall reimburse, upon request, the cost of treatment incurred by the insured person up to the amount by which the notional cost exceeds the actual cost.
Vendar povrnjeni znesek ne sme presegati stroškov, ki jih je zavarovana oseba dejansko imela; lahko se upošteva znesek, ki bi ga zavarovana oseba morala plačati, če bi bila zdravstvena storitev opravljena v pristojni državi članici.
The reimbursed sum may not, however, exceed the costs actually incurred by the insured person and may take account of the amount which the insured person would have had to pay if the treatment had been delivered in the competent Member State
ki ga/jo spremlja
shall be
kadar je dano dovoljenje v primeru zdravljenja v drugi državi članici.
when an authorisation is granted in the case of treatment in another Member State.
D) Družinski člani
Family members
Določbe odstavkov 1-8 se smiselno uporabljajo za družinske člane zavarovane osebe.
The provisions of paragraphs 1-8 shall apply mutatis mutandis to the members of the family of the insured persons.
Denarne dajatve za nezmožnost za delo v primeru začasnega ali stalnega prebivališča v državi članici, ki ni pristojna država članica.
Cash benefits relating to incapacity for work in the event of
A) Postopek, predpisan za zavarovano osebo
Procedure to be followed by the insured person
zaprosi za potrditev njene nezmožnosti
and its probable duration
Zavarovana oseba pošlje
The insured person shall send the
pristojnemu nosilcu
to the competent institution
Če lečeči zdravniki v državi članici stalnega prebivališča ne izdajajo potrdil o nezmožnosti za delo in če so le-ta zahtevana v skladu z zakonodajo pristojne države članice, zadevna oseba vloži zahtevek neposredno pri nosilcu v kraju stalnega prebivališča.
Where doctors providing treatment in the Member State of residence do not issue certificates of incapacity for work, and where such certificates are required under the legislation of the competent Member State, the person concerned shall apply directly to the institution of the place of residence.
Ta nosilec nemudoma poskrbi, da se nezmožnost za delo zdravstveno oceni in da se sestavi potrdilo iz odstavka 1.
That institution shall immediately arrange for a medical assessment of the person's incapacity for work and for the certificate referred to in paragraph 1 to be drawn up.
Potrdilo se takoj posreduje pristojnemu nosilcu.
The certificate shall be forwarded to the competent institution forthwith.
zavarovane osebe ne odvezuje od izpolnjevanja obveznosti, določenih z veljavno zakonodajo, zlasti obveznosti do njenega delodajalca.
shall not exempt the insured person from fulfilling the obligations provided for by the applicable legislation, in particular with regard to his/her employer.
B) Postopek, predpisan za nosilca države članice stalnega prebivališča
Procedure to be followed by the institution of the Member State of residence
Na zahtevo pristojnega nosilca ali v primerih iz
At the request of the competent institution or in the cases referred to in
odstavka 3
paragraph 3,
C) Postopek, predpisan za pristojnega nosilca
Procedure to be followed by the competent institution
Pristojni nosilec ohrani možnost, da zavarovanca napoti na zdravniški pregled k zdravniku po svoji izbiri.
The competent institution shall retain the right to have the insured person examined by a doctor of its choice.
Brez poseganja v drugi stavek člena 21(1) osnovne uredbe
Without prejudice to the second sentence of Article 21(1) of the basic Regulation,
o tem obvesti nosilca
, where necessary,
Za uporabo člena 21(1)
For the purposes of the application of Article 21(1) of
so navedbe potrdila o nezmožnosti za delo zavarovane osebe, ki je bilo izdelano v drugi državi članici na podlagi zdravniških ugotovitev zdravnika
Regulation, the particulars of the certificate of incapacity for work of an insured person drawn up in another Member State on the basis of the medical findings of the
, ki je opravil pregled,
examining doctor must
o tej odločitvi obvesti zavarovano osebo
shall notify the insured person
D) Postopek v primeru začasnega bivanja v državi članici, ki ni pristojna država članica
Procedure in the event of a stay in a Member State other than the competent Member State.
Določbe odstavkov 1-
The provisions of paragraphs 1-
se smiselno uporabljajo, kadar zavarovana oseba začasno prebiva v državi članici, ki ni pristojna država članica.
shall apply mutatis mutandis when the insured person stays in a Member State other than the competent Member State.
Denarne dajatve za dolgotrajno oskrbo v primeru stalnega ali začasnega prebivanja v državi članici, ki ni pristojna država članica.
Long-term care benefits in cash in the event of a stay or residence in a Member State other than the competent Member State
Postopek, predpisan za zavarovano osebo
Procedure to be followed by the insured person
Postopek, predpisan za nosilca v kraju stalnega prebivališča
Procedure to be followed by the institution of the place of residence
Nosilec v kraju stalnega prebivališča na zahtevo pristojnega nosilca preuči zdravstveno stanje zavarovane osebe s stališča njene potrebe po dolgotrajni oskrbi.
At the request of the competent institution, the institution of the place of residence shall examine the condition of the insured person with respect to his/her need for long-term care.
Pristojni nosilec posreduje nosilcu v kraju stalnega prebivališča vse potrebne informacije za zadevno preučitev.
The competent institution shall provide the institution of the place of residence with all the information necessary for such an examination.
Postopek, predpisan za pristojnega nosilca
Procedure to be followed by the competent institution
Da bi opredelil stopnjo potrebe po dolgotrajni oskrbi, ima pristojni nosilec pravico, da zavarovano osebo napoti na zdravniški pregled k zdravniku ali drugemu strokovnjaku po svoji lastni izbiri.
In order to determine the degree of need for long-term care, the competent institution shall have the right to have the insured person examined by a doctor or any other expert of its choice.
Pri tem se smiselno uporablja člen 27(7) izvedbene uredbe.
Article 27(7) of the implementing Regulation shall apply mutatis mutandis.
Postopek v primeru začasnega bivanja v državi članici, ki ni pristojna država članica
Procedure in the event of a stay in a Member State other than the competent Member State
Odstavki 1 do 4 se smiselno uporabljajo, če zavarovana oseba začasno prebiva v državi članici, ki ni pristojna država članica.
Paragraphs 1-4 shall apply mutatis mutandis when the insured person stays in a Member State other than the competent Member State.
Odstavki 1 do 5 se smiselno uporabljajo za družinske člane zavarovane osebe.
Paragraphs 1-5 shall apply mutatis mutandis to the members of the family of the insured person.
Uporaba člena 28
Application of Article 28 of
Če država članica, v kateri je bil bivši obmejni delavec nazadnje zaposlen, ni več pristojna država članica in če bivši obmejni delavec ali njegov družinski član potuje v to državo, da bi prejel storitve v skladu s členom 28 osnovne uredbe, bivši obmejni delavec ali njegov družinski član nosilcu v kraju začasnega prebivališča predloži dokument, ki ga je izdal pristojni nosilec.
If the Member State where the former frontier worker last pursued his/her activity is no longer the competent Member State, and the former frontier worker or a member of his/her family travels there with the purpose of receiving benefits in kind by virtue of Article 28 of the basic Regulation, he/she shall submit to the institution of the place of stay a document issued by the competent institution.
Prispevki upokojencev
Contributions by pensioners
Če oseba pokojnino prejema od več kot ene države članice
If a person receives a pension from more than one Member State,
prispevkov, ki se odtegnejo od
be greater than the amount
Uporaba člena 34
Application of Article 34 of
določbi iz člena 34 osnovne uredbe glede preprečitve prekrivanja dajatev
provision contained in Article 34 of the basic Regulation regarding the prevention of overlapping of benefits.
takšnih pravil
at least the same
, ki je najmanj enak
to which
bi bila upravičena, če bi imela v tej državi stalno prebivališče.
resided in that Member State.
Pristojni nosilec o izplačilu denarnih dajatev za dolgotrajno oskrbo obvesti tudi nosilca v kraju stalnega ali začasnega prebivališča, če zakonodaja, ki jo uporablja slednji nosilec, predvideva storitve dolgotrajne oskrbe, ki so navedene na seznamu iz člena 34(2) osnovne uredbe.
The competent institution shall also inform the institution of the place of residence or stay of the payment of long-term care cash benefits where the legislation applied by the latter institution provides for long-term care benefits in kind included in the list referred to in Article 34(2) of the basic Regulation.
Postopek, predpisan za nosilca v kraju stalnega ali začasnega prebivališča
Procedure to be followed by the institution of the place of residence or stay
Po prejemu podatkov iz odstavka 2 nosilec v kraju stalnega ali začasnega prebivališča nemudoma obvesti pristojnega nosilca o storitvah dolgotrajne oskrbe, ki so predvidene za enak namen, za katerega jih odobri zadevni osebi v skladu s svojo zakonodajo, ter o stopnji povračila.
Having received the information provided for in paragraph 2, the institution of the place of residence or stay shall, without delay, inform the competent institution of any long-term care benefit in kind intended for the same purpose granted under its legislation to the person concerned and of the rate of reimbursement applicable thereto.
Posebni izvedbeni ukrepi
Special implementing measures
Za države članice iz Priloge II
For the Member States referred to in Annex II,
, ki se nanašajo na zdravstvene storitve, ▌veljajo za osebe, ki so do storitev upravičene izključno v skladu s posebnim sistemom, ki se uporablja za javne uslužbence
Regulation ▌relating to benefits in kind shall apply to persons entitled to benefits in kind solely on the basis of a special scheme for civil servants
, in sicer le v tam določenem obsegu
only to the extent specified therein
Prilogi II
the basic
, in pokojnino v skladu z zakonodajo druge države članice.
Regulation shall apply to persons who are entitled to both a pension under a civil servants" scheme in one of the Member States referred to in Annex 2 and a pension under the legislation of another Member State.
Ukrepe za praktično uporabo odstavkov 1 in 2 sprejme Upravna komisija.
Practical implementing measures for paragraphs 1 and 2 shall be taken by the Administrative Commission.
Dajatve za nezgode pri delu in poklicne bolezni
Benefits in respect of accidents at work and occupational diseases
Pravica do storitev in denarnih dajatev v primeru stalnega ali začasnega bivanja v državi članici, ki ni pristojna država članica
Right to benefits in kind and in cash in the event of residence or stay in a Member State other than the competent Member State
Za namen uporabe člena 36(1)
For the purposes of applying Article 36(1) of
se smiselno uporabljajo postopki, določeni v členih od 24 do 27
Regulation, the procedures laid down in Articles 24 to 27 of
Sodelovanje med nosilci v primeru nezgode pri delu ali poklicne bolezni, ki nastopi v državi članici, ki ni pristojna država članica
Cooperation between institutions in the event of an accident at work or occupational disease which occurs in a Member State other than the competent Member State
To obvestilo se pošlje pristojnemu nosilcu, kopija pa nosilcu kraja stalnega prebivališča ali nosilcu kraja začasnega prebivališča.
This declaration shall be addressed to the competent institution and a copy shall be sent to the institution in the place of residence or stay.
Nosilec države članice, na katere ozemlju je prišlo do nezgode pri delu ali je bila prvič zdravniško ugotovljena poklicna bolezen, pristojnemu nosilcu pošlje zdravniška potrdila, izdelana na tem ozemlju, in na njegovo zahtevo tudi vse ustrezne podatke.
The institution of the Member State in the territory of which the occupational accident occurred or in which the occupational disease was first diagnosed, shall notify the competent institution of medical certificates drawn up in the territory of that State and, at the request of that institution, shall provide any appropriate information.
Če v primeru nezgode med potovanjem po ozemlju države članice, ki ni pristojna država članica, obstajajo razlogi za izvedbo preiskave na ozemlju prve države članice, lahko pristojni nosilec v ta namen imenuje preiskovalca in o tem obvesti organe te države članice.
Where, as a result of a commuting accident which occurs in the territory of a Member State other than the competent Member State, an inquiry is necessary in the territory of the first Member State, an investigator may be appointed for this purpose by the competent institution, which shall inform the authorities of that Member State.
Ti organi preiskovalcu pomagajo zlasti tako, da imenujejo osebo, ki mu pomaga pri pregledu uradnih poročil in vseh drugih dokumentov, povezanih z nezgodo.
The authorities shall assist the investigator, in particular by appointing a person responsible for helping to consult the reports and any other documents relating to the accident.
Ob koncu zdravljenja se pristojnemu nosilcu pošlje podrobno poročilo, ki so mu priložena zdravniška potrdila o trajnih posledicah nezgode ali bolezni ter zlasti o trenutnem stanju in okrevanju ali stabilizaciji zdravstvenega stanja.
Following treatment, a detailed report accompanied by medical certificates relating to the permanent consequences of the accident or illness, in particular the victim's present state and the recovery or stabilisation of injuries, shall be sent to the competent institution.
Ustrezne honorarje po potrebi plača nosilec kraja stalnega prebivališča ali nosilec kraja začasnega prebivališča po stopnji, ki jo uporablja ta nosilec, vendar se zaračunajo pristojnemu nosilcu.
The relevant fees shall be paid by the institution in the place of residence or by the institution in the place of stay, where appropriate, at the rate applied by that institution to the charge of the competent institution.
Pristojni nosilec nosilca kraja stalnega prebivališča ali nosilca kraja začasnega prebivališča na njegovo zahtevo obvesti o odločitvi, ki določa datum okrevanja ali stabilizacije zdravstvenega stanja, in po potrebi o odločitvi v zvezi z dodelitvijo pokojnine.
At the request of the institution in the place of residence or the institution in the place of stay, where appropriate, the competent institution shall notify it of the decision setting the date for the recovery or stabilisation of injuries and, where appropriate, the decision concerning the granting of a pension.
Izpodbijanje poklicne narave nezgode ali bolezni
Contestation of the occupational nature of the accident or disease
Kadar pristojni nosilec izpodbija uporabo zakonodaje o nezgodah pri delu in poklicnih boleznih v okviru člena 36(2)
Where the competent institution contests application of the legislation relating to accidents at work or occupational diseases under Article 36(2) of
, o tem nemudoma obvesti nosilca kraja stalnega prebivališča ali nosilca kraja začasnega prebivališča, ki je zagotovil storitve, za katere se torej šteje, da spadajo v zdravstveno zavarovanje.
Regulation, it shall immediately inform the institution in the place of residence or stay which provided the benefits in kind, which will then be considered as sickness insurance benefits.
Kadar glede tega pride do dokončne odločitve, pristojni nosilec o tem nemudoma obvesti nosilca kraja stalnega prebivališča ali nosilca kraja začasnega prebivališča, ki je zagotovil storitve.
When a final decision has been taken on this subject, the competent institution shall immediately inform the institution in the place of residence or stay which provided the benefits in kind.
še naprej zagotavlja storitve iz naslova zdravstvenega zavarovanja, če je zaposleni ali samozaposleni delavec do tega upravičen in ko ne gre za nezgodo pri delu ali poklicno bolezen.
shall continue to pay benefits in kind as sickness insurance benefits if the employed or self-employed person is entitled to them and an occupational accident or disease is not involved.
Postopek v primeru izpostavljenosti tveganjem za nastanek poklicne bolezni v več državah članicah
Procedure in the event of exposure to the risk of an occupational disease in several Member States
V primeru iz člena 38
In the case referred to in Article 38 of
se obvestilo o poklicni bolezni pošlje bodisi pristojnemu nosilcu za poklicne bolezni v državi, v skladu z zakonodajo katere je oseba, ki trpi za boleznijo, zadnjič opravljala dejavnost, ki bi lahko povzročila zadevno bolezen, bodisi nosilcu v kraju stalnega prebivališča, ki to obvestilo pošlje ║ pristojnemu nosilcu.
Regulation, the declaration of the occupational disease shall be sent either to the competent institution for occupational diseases of the last Member State under the legislation of which the victim pursued an activity likely to cause the said disease, or to the institution in the place of residence, which shall forward the declaration to the ║competent institution.
O svoji odločitvi hkrati obvesti zavarovano osebo in pri tem navede zlasti razloge za zavrnitev dajatev, pravna sredstva in roke za pritožbo ter datum, ko je bila zadeva poslana nosilcu države članice, v skladu z zakonodajo katere je zavarovana oseba predhodno izvajala dejavnost, ki bi lahko povzročila zadevno poklicno bolezen.
It shall also inform the insured person of its decision, indicating in particular the reasons for refusing benefits, the remedies and periods allowed for appeals, as well as the date on which the dossier was sent to the institution of the Member State under the legislation of which the insured person previously pursued an activity likely to cause the occupational disease in question.
Izmenjava podatkov med nosilci in izplačilo predujmov v primeru pritožbe zoper odločitev o zavrnitvi zahtevka
Exchange of information between institutions and advance payments in the event of an appeal against rejection
V primeru pritožbe zoper odločitev o zavrnitvi zahtevka, ki jo sprejme nosilec ene od držav članic, v skladu z zakonodajo katerih je oseba, ki trpi za boleznijo, izvajala dejavnost, ki bi lahko povzročila zadevno poklicno bolezen, je ta nosilec dolžan o tem obvestiti nosilca, ki mu je bilo obvestilo poslano po postopku iz člena 36(2)
In the event of an appeal against a decision to refuse benefits taken by the institution of one of the Member States under the legislation of which the victim pursued an activity likely to cause the occupational disease in question, that institution shall inform the institution to which the declaration was sent, in accordance with the procedure provided for in Article 36(2)
, in ga naknadno obvestiti o dokončno sprejeti odločitvi.
, and shall subsequently inform it of the final decision.
Če je bila pravica do dajatev pridobljena po zakonodaji, ki jo uporablja nosilec, ki mu je bilo poslano zadevno obvestilo, ta nosilec izplača predujme v višini zneska, ki se po potrebi določi po posvetovanju z nosilcem, ki je izdal odločitev, zoper katero je bila vložena pritožba.
Where a person is entitled to benefits under the legislation applied by the institution to which the declaration was sent, that institution shall make the advance payments, the amount of which shall be determined, where appropriate, after consulting the institution which made the decision against which the appeal was lodged.