natgillin/translations-raw huggingface dataset:
• a family member of an insured person residing in Luxembourg (spouse, registered partner, minor child or child who is not a minor but is under the age of thirty and whose income is below a certain limit).
• družinski član zavarovanca, ki ima stalno prebivališče v Luksemburgu (zakonec, registriran partner, vzdrževani mladoletni otroci in polnoletni otroci do 30.leta starosti, katerih dohodek je nižji od določene meje).
Minor children and students who are not insured as members of the family are also covered.
Zavarovani so tudi mladoletni otroci in študenti, ki niso zavarovani kot družinski člani.
• Caisses de maladie de l’ARBED (sickness fund for manual and non-manual workers employed by the Arcelor group);
• Kmetijski sklad zdravstvenega zavarovanja (CMA).
There is no qualifying period for sickness benefits.
Družinski člani zavarovanca prejemajo dajatve iz sklada tega zavarovanca.
• Entraide médicale des chemins de fer luxembourgeois - EMCFL (sickness fund for railway employees in Luxembourg);
Sklad zdravstvenega zavarovanja za fizične delavce je pristojen za vse osebe, ki so zavarovane
• Caisse de maladie des professions indépendantes - CMPI (sickness fund for the independent professions);
Za upravičenost do dajatev v primeru bolezni ni potrebno nobeno obdobje zavarovanja.
When in hospital you have to pay a flat-rate daily contribution towards the cost of hospitalisation for a maximum of 30 days.
je, in sicer največ 30 dni.
This contribution is not required for the hospitalisation of a child under the age of 18.
Tega prispevka ni treba plačati v primeru hospitalizacije otroka, mlajšega od 18 let.
The union des caisses de maladie is responsible for all the more general cases, in particular relations with healthcare providers and international transfers.
v sistemu druge države članice in imajo začasno ali stalno prebivališče v Luksemburgu.
• reimbursement of healthcare costs paid in advance by insured persons;
Združenje skladov zdravstvenih skladov je pristojno za vse splošnejše zadeve, zlasti razmerja z izvajalci zdravstvenih storitev in mednarodne prenose.
• payment of the lumpsum confinement allowance;
Skladi zdravstvenega zavarovanja so pristojni za:
It should be noted that costs relating to care which is not regarded as necessary are not refunded.
Treba je upoštevati, da se stroški v zvezi s storitvami, ki se ne štejejo za nujne, ne povrnejo.
For example, fees for only two consultations or home visits per sevenday period can be refunded by the sickness funds, unless more are authorised by the fund.
Tako nosilci povrnejo stroške za dva pregleda ali dva obiska na domu za vsako obdobje sedmih dni, razen odobritve vašega nosilca; v primeru nadstandardnega zdravljenja v bolnišnici ali pregleda, na katerega ste naročeni, morate kriti dodatne stroške, ki iz tega izhajajo.
For first-class treatment in hospital and for consultations by appointment, you will have to pay the extra costs yourself.
• povračilo stroškov zdravstvenih storitev, ki jih predložijo zavarovanci;
• payment of the cash sickness and maternity benefit and funeral grants.
• izplačilo pavšalnega zneska poroda;
When seeking medical treatment, you are free to choose any healthcare provider (doctor, hospital etc.).
Za zdravstvene storitve lahko prosto izberete izvajalca (zdravnika, bolnišnico itd.).
You may claim the following benefits in kind:
2.1.1 Zdravstvene storitve
• medical and dental treatment;
Storitve, ki jih lahko dobite, so:
You should show your insurance identity card at all medical consultations and visits. This card is issued to you when you register for insurance.
V primeru pregleda ali obiska pri zdravniku morate pokazati svojo kartico zdravstvenega zavarovanja, ki ste jo dobili ob vključitvi v sistem zdravstvenega zavarovanja.
• paramedical treatment (nursing, physiotherapy, etc.);
• zdravstvena in zobozdravstvena oskrba;
• dental, orthopaedic and other prostheses;
• laboratorijske analize in preiskave;
For some services you must obtain prior authorisation from your sickness fund; this is often granted on the basis of a favourable opinion by the Contrôle médical de la sécurité sociale (Social Security Medical Inspectorate). Please contact your fund for further details.
Za nekatere zdravstvene storitve morate predhodno pridobiti dovoljenje vašega nosilca zdravstvenega zavarovanja, ki se pogosto odobri na podlagi pozitivnega mnenja zdravstvene komisije za socialno varstvo; za več informacij o tej zadevi se obrnite na svojo zavarovalnico.
• visual aids (spectacles, contact lenses etc.);
• zobozdravstvene, ortopedske in druge proteze;
Payment of benefits
Plačilo zdravstvenih storitev
• stay in hospital;
• vizualni pripomočki (očala, kontaktne leče);
• therapeutic and convalescent cures;
• obveze, dodatna sredstva in različne potrebščine;
As a general rule, you should pay all bills for treatment received and then apply to your sickness fund for a refund, from which the amount you have to pay yourself will be deducted.
Na splošno morate plačati za prejeto oskrbo in se obrniti na svojega nosilca zdravstvenega zavarovanja, ki vam bo po morebitnem odbitku povrnil znesek, ki ste ga sami plačali.
• general and occupational rehabilitation;
• terapevtsko in rekonvalescenčno zdravljenje;
• travel and transport expenses incurred in connection with such care.
• potne stroške, povezane z navedenimi storitvami.
However, the costs of hospitalisation, surgery, medicines and laboratory analyses and tests are settled directly between the sickness funds and the practitioners or establishments which provided the relevant services.
Vendar pa nosilci zdravstvenega zavarovanja lečečim zdravnikom, lekarnam ali negovalnim ustanovam neposredno poravnajo stroške hospitalizacije, kirurških posegov, zdravil ter laboratorijskih analiz in preiskav.
In these cases, you need to pay only the amount which is not met by the sickness fund.
Za te zdravstvene storitve morate samo plačati znesek, ki ga ne krije nosilec zdravstvenega zavarovanja.
These benefits and services are provided for an unlimited period from the onset of illness, for as long as you are insured.
Te storitve se odobrijo od začetka bolezni brez časovne omejitve trajanja, dokler ste zavarovani.
When your insurance ends, you are still entitled to benefits during the current month and the following three months (six months for illnesses which were already being treated).
Če prekinete zavarovanje, imate do storitev pravico še v tekočem mesecu in naslednje tri mesece (šest mesecev za bolezni, ki so že bile predmet zdravljenja).
Cash sickness benefit (indemnité pécuniaire de maladie) is awarded for up to 52 weeks, in a reference period of 104 weeks, from the first day of illness.
Denarna nadomestila za primer bolezni se odobrijo od prvega dne bolezni naprej, za največ 52 tednov, v referenčnem obdobju 104 tednov.
However, you must submit a medical report from the doctor treating you at the latest by the tenth week in which you are unfit to work; the benefit will continue to be paid subject to the favourable opinion of the contrôle médical de la sécurité sociale.
Vendar pa morate zdravniško potrdilo svojega lečečega zdravnika predložiti najpozneje za deseti teden nezmožnosti za delo, izplačevanje nadomestila pa se nadaljuje ob upoštevanju pozitivnega mnenja zdravstvene komisije socialnega varstva.
The benefit corresponds to the earnings you would have received if you had been able to continue working and is not paid as long as your employer continues to pay you your wage or salary.
Višina nadomestil je enaka plači, ki bi jo morali dobiti, če bi še naprej delali. Teh dajatev ne morete dobiti, dokler vam delodajalec še naprej izplačuje plačo.
As a rule, the benefits are reimbursed in full on the basis of a tariff agreed between the Union of Sickness Funds and the providers of care (doctors, nurses, hospitals, etc.).
Načeloma se stroški zdravstvenih storitev v celoti povrnejo na podlagi cene, določene v pogodbi med združenjem skladov zdravstvenega zavarovanja in izvajalci zdravstvenih storitev (zdravniki, medicinske sestre, bolnišnice itd.).
In some cases, however, the insured person has to contribute to the cost of treatment.
Kljub temu mora zavarovanec za nekatere zdravstvene storitve sam prispevati k stroškom.
Thus, you have to pay 20% of the fee for the first visit of a doctor to your home within each period of 28 days.
Tako morate za vsako 28-dnevno obdobje kriti 20% cene prvega obiska zdravnika na domu.
For subsequent home visits and for consultations you have to pay 10% of the tariff.
Za naslednje obiske na domu in zdravstvene posvete morate plačati 10% cene.
Payment of benefits equal to the invalidity pension, with the obligation to remain available for employment.
dne četrtega meseca, ki sledi mesecu, ko je bila nezmožnost za delo prijavljena.
As a rule, cash sickness benefit is paid monthly through your employer in the month when your illness occurs and the following three months, after which the benefits will be transferred directly by the sickness insurance fund.
Denarno nadomestilo za primer materinstva se dodeli zaposlenim in samozaposlenim ženskam za obdobje šestnajstih tednov, od tega osem pred porodom in osem po njem.
To obtain cash sickness benefit, you must submit a medical certificate drawn up by your doctor within three days of the beginning of your incapacity for work owing to illness.
Za pridobitev denarnih nadomestil za primer bolezni morate zdravniško potrdilo, ki ga napiše vaš zdravnik, predložiti v treh dneh po začetku nezmožnosti za delo zaradi bolezni.
If you are incapable of working for only one or two days, no medical certificate is required provided that you declare that you are unfit for work on the day itself.
Če je nezmožnost za delo omejena na en dan ali dva, zdravniško potrdilo ni potrebno, če se nezmožnost prijavi isti dan.
A cash maternity allowance is awarded to employed and self-employed women for 16 weeks, from eight weeks before to eight weeks after confinement.
To nadomestilo pripada tudi, če je bila nosečnica ali ženska, ki je rodila, oproščena dela zaradi dejstva, ker je delala na zdravju nevarnem delovnem mestu.
The amount of the allowance corresponds to the earnings she would have received if she had been able to continue working.
Znesek tega nadomestila je enak plači, ki bi jo zadevna oseba prejela, če bi bila sposobna delati.
The cash maternity allowance is not paid as long as her employer continues to pay her wage or salary.
Denarna nadomestila za primer materinstva se ne izplačajo tako dolgo, dokler delodajalec še plačuje plačo matere.
In order to obtain the lumpsum confinement allowance, the birth certificate of the new-born child must be submitted.
Za pridobitev povprečnega zneska za porod je treba predložiti potrdilo o rojstvu novorojenčka.
One section of the medical certificate must be submitted to the sickness fund and the other to your employer.
En del zdravniškega potrdila mora biti naslovljen na vašega nosilca zdravstvenega zavarovanja, drugi na vašega delodajalca.
If you submit the certificate late, you are awarded sickness benefit only from the day on which incapacity was notified.
Če potrdilo predložite pozneje, imate do denarnega nadomestila pravico šele od dneva prijave nezmožnosti za delo.
In order to obtain the cash maternity allowance during the eight weeks before confinement, you should submit to your sickness fund a medical certificate stating the expected date of confinement.
Za pridobitev denarnega nadomestila za primer materinstva v obdobju osmih mesecev pred porodom morate svojemu nosilcu zdravstvenega zavarovanja predložiti zdravniško potrdilo, v katerem je naveden predvideni datum poroda.
You are required to undergo the medical checks to which you will be invited by the sickness fund’s doctor.
Opraviti morate kontrolni zdravniški pregled, na katerega vas pokliče komisija za kontrolne zdravniške preglede vašega nosilca zdravstvenega zavarovanja.
If you do not present yourself for these examinations, payment of benefit will be stopped.
Če na pregled ne pridete, se vam nadomestila ne bodo več izplačevala.
Cash benefits are also payable for the adoption of a child and are paid to the mother or father who has been granted adoption leave.
Denarno nadomestilo pripada tudi v primeru posvojitve otroka in se dodeli materi ali očetu, ki izkoristi dopust za otroke v zgodnji starosti.
If you have a sick child under the age of fifteen you are entitled to two days’ leave for family reasons per child and per year.
Če zboli vaš otrok, mlajši od 15 let, imate pravico do dopusta zaradi družinskih razlogov v višini dveh dni na otroka in na leto.
You must notify your employer of your absence on the day itself and submit a medical certificate stating that the child is ill.
Delodajalca morate o odsotnosti obvestiti še isti dan in predložiti zdravniško potrdilo, ki potrjuje otrokovo bolezen.
During family leave you are entitled to the same benefit as if you were unfit for work yourself.
V času tega dopusta imate pravico do enakega nadomestila kot v primeru nezmožnosti za delo.
If you are a member of a Luxembourg sickness insurance fund, you automatically have nursing care insurance cover.
Če ste zavarovani pri luksemburškemu nosilcu zdravstvenega zavarovanja, ste uradno zavarovani za pomoč in postrežbo.
Vocational rehabilitation measures
Ukrepi za poklicno vključevanje
You are considered to be in need of nursing care if you regularly require assistance from a another person in order to carry out basic day-to-day tasks owing to illness or a physical, psychological or mental disability.
Šteje se, da potrebujete pomoč in postrežbo, če pri bistvenih življenjskih opravilih zaradi bolezni ali telesne, fizične ali duševne invalidnosti redno potrebujete pomoč tretje osebe.
• personal hygiene: washing, brushing your teeth, skin care, visits to the toilet;
• pri telesni higieni: umivanje, ščetkanje zob, nega kože, opravljanje potrebe;
• nutrition: preparing meals with a diet to suit your needs, eating, drinking;
• pri prehranjevanju: priprava prilagojene hrane, hranjenje, pitje;
• mobility: getting up, going to bed, changing position, getting dressed and undressed, moving around, going up and down stairs, going out and coming home.
• pri gibanju: vstajanje s postelje, leganje k počitku, spreminjanje položaja, oblačenje, slačenje, premikanje, stanje na nogah, vzpenjanje in spuščanje po stopnicah, odhod z doma in vrnitev domov.
If you are unfit for work for an extended period you will be required to undergo a medical examination by the Social Security Medical Inspectorate, which will decide whether your sick leave should be extended or whether you must return to work.
V primeru daljše nezmožnosti vas bo zdravstvena komisija socialne varnosti poklicala na kontrolni zdravniški pregled in odločila, ali se vam bolniški dopust podaljša oziroma ali se morate vrniti na delo.
If you are recognised as disabled you will be granted an invalidity pension (see Section 2.4), otherwise your file is sent to the medical officer who will decide whether you are unfit only for the job you had most recently.
Če se vam prizna invalidnost, se dodeli invalidska pokojnina (glej točko 2.4), drugače se kartoteka pošlje zdravniku za medicino dela, ki ugotovi, če ste za delo nezmožni samo na delovnem mestu, na katerem ste nazadnje delali.
If that is the case, the occupational rehabilitation procedure will begin, either within the company to find you another post in which you can use your remaining skills, or outside on the labour market by registering you as a job-seeker claiming unemployment benefit.
V takem primeru se začne postopek vaše ponovne poklicne razvrstitve, bodisi znotraj podjetja s premestitvijo na drugo delovno mesto, ustrezno vašim preostalim sposobnostim, bodisi zunaj podjetja na trgu dela z vpisom v register kot iskalec zaposlitve z nadomestilom za brezposelnost.
In either case you are entitled to a compensation allowance, subject to a ceiling, up to the difference between your previous remuneration and your new remuneration.
V obeh primerih imate pravico do nadomestila, katerega najvišji znesek je razlika med staro in novo plačo.
If at the end of the period in which unemployment benefit is paid you have still not been redeployed, you will receive a tideover allowance,
Če po izteku prejemanja nadomestila za brezposelnost še niste ponovno razvrščeni, ste upravičeni do nadomestila za čakanje, ki ustreza znesku invalidske pokojnine, dolžni pa ste ostati na voljo za trg dela.
You must, in theory, require assistance with basic day-to-day tasks for at least three and a half hours a week, and
Ta povprečni znesek zajema pomoč zdravnika in babice, bivanje v bolnišnici, zdravila in dietične izdelke za dojenčke.
Cash benefits the need for nursing care must be likely to last at least six months or be irreversible.
za pomoč in postrežbo na podlagi mnenja enote za ocenjevanje in usmerjanje.
You should therefore notify the Centre commun de la sécurité sociale that this person is caring for you.
V ta namen morate to osebo prijaviti skupnemu centru za socialno varnost.
You are not entitled to cash benefits if you live in an establishment providing care and assistance.
Če živite v negovalni in oskrbovalni ustanovi, niste upravičeni do denarnih dajatev.
The Cellule d’évaluation et d’orientation determines the degree of dependency and the care and assistance which you require.
Enota za ocenjevanje in usmerjanje ugotovi stanje odvisnosti in določi, kakšno pomoč in postrežbo potrebujete.
It is made up of a team with members from various professions: doctors, nurses, psychologists, occupational therapists, physiotherapists and social workers.
Sestavlja jo skupina, katere člani pripadajo različnim poklicem: zdravnikom, medicinskim sestram, psihologom, ergoterapevtom, fizioterapevtom, socialnim delavcem.
Other benefits
Druge dajatve
In order to receive nursing care insurance, you must complete an application form to which a blank medical report is attached which must be filled in by the doctor who is treating you.
Za upravičenost do zavarovanja za pomoč in postrežbo morate izpolniti obrazec vloge, kateremu je priloženo prazno zdravniško potrdilo, ki ga izpolni vaš lečeči zdravnik.
This form and the medical report should be sent to the Cellule d’évaluation et d’orientation (assessment and guidance unit).
Ta obrazec in zdravniško potrdilo morate poslati enoti za ocenjevanje in usmerjanje.
The following benefits are provided:
2.2 Dajatve za nesreče pri delu in poklicne bolezni
This assessment covers:
Zavarovanje predvideva:
• benefits in kind for an accident or occupational disease;
Če je vaša kartoteka popolna, vam bo enota za ocenjevanje sporočila datum, ko se bo vaše stanje odvisnosti ocenjevalo. To ocenjevanje zajema:
• cash benefits for incapacity for work (cash allowance and pension);
• zdravstvene storitve v primeru nezgode ali poklicne bolezni;
• a medical assessment by the doctor within the unit, and
• zdravniško oceno, ki jo opravi zdravnik enote;
• an evaluation, by another member of the unit, of the degree of dependency.
• oceno odvisnosti, ki jo opravi drug član enote.
• survivor’s benefits if the insured person died as a result of an accident or occupational disease (see also Section 2.3).
• denarne dajatve v primeru nezmožnosti za delo (denarno nadomestilo in renta);
The insurance covers accidents sustained while at work, accidents sustained while travelling to or from work, and occupational diseases.
• dajatve za preživele osebe, kadar je nezgoda ali poklicna bolezen povzročila smrt žrtve (glej tudi točko 2.3).
On the basis of this evaluation, the unit will set out your care needs on a standard form which is the basis for the nursing care provision plan for the use of professionals in a network chosen by you or the establishment providing care and assistance in which you live.
Na podlagi te ocene enota vpiše vaše potrebe po pomoči na tipski seznam, ki je podlaga za načrt prevzema stroškov, namenjen strokovnjakom iz mreže, ki jo izberete vi, ali iz ustanove za pomoč in postrežbo, kjer živite.
This plan and the standard form are sent in the form of an opinion to the Union des caisses de maladie, which will notify you of the decision taken.
Zavarovanje krije nezgodo v pravem pomenu besede, nezgodo na poti na delu in vrnitvi z njega ter poklicne bolezni.
An accident at work is an accident which arises out of or in the course of work. An accident while travelling is an accident which occurs on the usual way taken to or from the workplace.
Načrt prevzema stroškov in tipski seznam se v obliki mnenja pošljeta združenju skladov zdravstvenega zavarovanja, ki vam sporoči odločitev.
Payment of benefits
Plačilo dajatev
A person insured under Luxembourg legislation who is injured in an accident outside the country while travelling to or from work is treated as if the accident had occurred in Luxembourg.
Če se nezgoda na poti na delo, katere žrtev je zavarovanec, za katerega velja luksemburška zakonodaja, zgodi zunaj območja Luksemburga, se šteje, kot da se je zgodila na tem območju.
The cost of benefits in kind are assumed directly by the nursing care insurance institution.
Zdravstvene storitve se neposredno krijejo iz naslova zavarovanja za pomoč in postrežbo.
If you live in an establishment providing care and assistance, you only have to pay the accommodation costs.
Če živite v negovalni in oskrbovalni ustanovi, morate plačati samo stroške hrane in nočitve.
Cash benefits and the lump sum for care products will be transferred to your account.
Denarne dajatve in povprečni znesek za izdelke, ki so nujni za pomoči, se nakažejo na vaš račun.
There is an official list of occupational diseases, which can be consulted in the Social Insurance Code (code des assurances sociales) or on the social security website: http://www.secu.lu/legis/sommaires/sommlegacc2.html #maladies.
Poklicne bolezni so povzete na uradnem seznamu, ki ga lahko poiščete v kodeksu socialnih zavarovanj ali na spletni strani organov socialne varnosti: http://www.secu.lu/legis/sommaires/sommlegacc2.html #maladies.
Benefits in kind
Zdravstvene storitve
Compensation may also be paid for illnesses not on the list, however, if it can be proved that they were caused by your work.
Za bolezen, ki ni navedena na tem seznamu, se lahko kljub temu odobri nadomestilo, če se dokaže, da je nastala zaradi dela.
A professional from a care and assistance network comes to you at home to help you with basic day-to-day tasks and housework, and to provide support and advice.
Strokovnjak iz mreže za pomoč in oskrbo vas obišče na domu in vam pomaga pri opravljanju bistvenih življenjskih opravil, pomaga pri gospodinjskih opravilih, zagotavlja podporo in svetuje.
Persons covered
Denarne dajatve
All persons who are in gainful employment or selfemployed, as well as apprentices, are covered by insur-
Vse osebe, ki opravljajo poklicno dejavnost kot zaposlene ali samozaposlene osebe, in vajenci so zavarovani za primer nezgod pri delu in poklicnih bolezni.
You are also entitled to benefits in kind if you live in an establishment providing care and assistance (nursing home etc.).
Če še živite doma in če vam pomaga oseba iz vaše okolice, se lahko v določenem obsegu storitve (pomoč, ki jo zagotovi mreža) nadomestijo z denarnimi dajatvami.
If you were employed in agriculture, your pension will be calculated on the basis of a standard income laid down by law.
jen za vse zavarovance, razen osebe, ki opravljajo kmetijsko dejavnost in ki spadajo v kmetijsko in gozdarsko področje.
In the event of total incapacity, the pension amounts to 85.6% of your annual earnings (full pension).
Če prejemate rento, ki ustreza najmanj 50-odstotni nezmožnosti za delo, se vaša renta poveča za 10% za vsakega otroka, mlajšega od 18 let, ki ga vzdržujete.
For partial incapacity the pension is a fraction of the full pension, depending on the degree of incapacity.
To povišanje se odobri do 27. leta otroka, ki študira, in brez starostne omejitve za invalidnega otroka.
The competent institution is the Association d’assurance contre les accidents, which is divided up into two sections.
Vaši otroci, ki prebivajo v drugi državi članici, se upoštevajo pri dodelitvi tega povišanja.