Uruguay: Subsidio Por Enfermedad En El Uruguay Y Certificaciones Médicas Indebidas

Last Updated: 23 March 2016
Article by Karen Elorza Gutierrez

Recientemente se ha informado a través de los medios que el BPS había decidido profundizar los controles sobre las certificaciones médicas de los trabajadores, certificaciones que en caso de ser mayores a tres días implican el otorgamiento de un subsidio por enfermedad al trabajador impedido de estar en actividad por tal causa. A dichos efectos consideramos importante relevar cuál fue el motivante de que se planteara dicha necesidad, así como cuál es el procedimiento y funcionamiento de las certificaciones en el sistema del subsidio por enfermedad.

El subsidio por enfermedad se trata de una prestación económica a los trabajadores activos que por razones médicas se encuentran imposibilitados de trabajar, ya sea por enfermedad o por accidente de trabajo. La regulación de esta prestación se ha dado a través de las leyes 14.407, 17.786, 18.725 y 19.003.

Quienes pueden ser beneficiarios de dicha prestación son los trabajadores dependientes de la actividad privada, profesores del Instituto Elbio Fernández, los empleados de la Dirección de Arquitectura del Ministerio de Trabajo y Obras Públicas (vínculo funcional 53), los empleados con vínculo funcional 57 de la Presidencia de la República, los empleados con aportación civil y vínculo funcional 94, patrones unipersonales (de industria y comercio o rural con hasta 5 dependientes (según opción mutual), monotributista unipersonal con cónyuge colaborador y hasta 1 dependiente y monotributista unipersonal con hasta 3 dependientes en época de zafra).

En cuanto a las condiciones y requisitos necesarios para obtener el beneficio que otorga el Banco de Previsión Social,se debe estar a las diferentes situaciones que pueden darse:

  • Jornaleros o destajistas: requiere contar con setenta y cinco jornales efectivos
  • Mensuales: requiere tener tres meses de actividad efectiva en el año inmediato anterior a la enfermedad, en una o más empresas, ya sea consecutivos o interrumpidamente.
  • Embarazadas: podrían acceder al subsidio aun en el caso en que no lleguen a cotizar el mínimo de jornales.
  • Multiempleo: deberán estar certificados en todos sus empleos al mismo tiempo. Si una de sus actividades es del sector público, deberán presentar un comprobante emitido por el organismo donde cumplen funciones, que indique el período de certificación.

El plazo máximo de amparo al seguro es de dos años ya que aunque la ley señala como principio que la suspensión del contrato por enfermedad será de un año,  admite que se extienda a un año más por resolución fundada del órgano directivo del seguro  (arts. 14, 15 y 16 del D.L. 14.407). Si al fin de ese período el trabajador sigue estando incapacitado para el desempeño de tareas se establece un procedimiento para que obtenga una jubilación, dándose por extinguido el contrato de trabajo (art. 17 DL 14.407).

Por su parte y en cuanto ala relación entre  la existencia de una certificación médica y el cumplimiento de las tareas laborales, cabe resaltar que es un deber del trabajador certificado informar a la empresa sobre tal extremo, ya que de lo contrario de no presentarse en su trabajo ni  informar la ausencia,  podría cuestionarse la posibilidad de un abandono de trabajo, sin perjuicio de que para que se cumpla este último deben darse las intimaciones correspondientes por parte de la empresa. Adicionalmente y en cuanto a la finalización del plazo de la certificación,  la normativa establece que cuando el trabajador es dado de alta debe presentarse ante su empleador dentro de las 24 horas hábiles siguientes a su otorgamiento.

Como punto adicional, la normativa dispuso un plazo de estabilidad para aquel  trabajador enfermo que ha cumplido los requisitos de la ley de seguro de enfermedad y su reglamentación. En este sentido el trabajador en dichas condiciones no podría ser despedido ni suspendido durante la ausencia ni dentro de los 30 días siguientes a su reincorporación al trabajo. En caso de que sea despedido, la empresa deberá abonarla una indemnización especial del doble de la indemnización común, salvo que él empleador demuestre la notoria mala conducta del trabajador o que el despido no esté directa o indirectamente vinculado con la enfermedad o accidente de trabajo, lo cual es de extremada complejidad.

A causa de todo lo anterior, desde siempre han existido situaciones en la que algunos trabajadores han utilizado este sistema incorrectamente y en forma maliciosa, generando certificaciones para ausentarse de sus puestos laborales o bien en el caso de que dichas certificaciones fueran mayores a tres días provocando el cobro de un subsidio que no habría correspondido. Esto sin duda no solo perjudica a las empresas, sino también a los propios compañeros del trabajador que se certifica y al sistema todo, al corromperlo.

Pero lo que no es menor, y también es conocido por la sociedad, es que han existido casos de trabajadores que usan el sistema de certificaciones para mantenerse arraigados a un puesto de trabajo, sin que exista una dolencia real, o en todo caso asegurar un despido especial cuando sospechan una posible desvinculación.

Varias han sido las denuncias, respecto a situaciones de sospecha. Sin embargo  en el último tiempo y ante una denuncia de un medio de comunicación, se ha realizado una investigación que evidenció la existencia de un doctor que cobraba 300 pesos por una licencia médica, siendo varias de las otorgadas, totalmente inmotivadas.

Según han recogido los medios,  Heber Galli, presidente del directorio del BPS, habría expresado que a los efectos de la fiscalización que se pretende llevar adelante por parte de dicho organismo, se estaría nombrando un gerente de administración de salud y contratado personal de certificaciones y peritajes. La función de los médicos certificadores, es justamente asistir al domicilio del trabajador que se encuentra certificado para de esta forma comprobar que este se encuentre en su domicilio cumpliendo con el reposo indicado.

También se estaría evaluando la actualización o modificación del software utilizado por la institución, a los efectos de que se pueda detectar con cabalidad cuáles son los médicos que más certificaciones realizarían, lo cual puede ser un insumo a los efectos de investigar alguna posible irregularidad, como la enunciada más arriba.

En virtud de lo anterior, es claro que el sistema debe tener ajustes en pro de evitar los malos usos que se pueden generar y así mantener un sistema genuino en el que se de protección a quién verdaderamente lo merece. Que los ajustes pretendidos efectivamente solucionen de forma definitiva esta problemática, es poco probable, pero sin duda que serán bienvenidos, sin perjuicio de que el mayor cambio debe provenir de la sociedad.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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