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samenvatting welzijn en gezondheid 2e jaar
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samenvatting welzijn en gezondheid 2e jaar sociaal werk
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SOCIAAL-JURIDISCHE ADMINISTRATIE1
,Inhoudsopgave
1 werkloosheidsverzekering..................................................................................................................................................... 5
1.1 actoren........................................................................................................................................................................................5
1.1.1 rva.........................................................................................................................................................................................5
1.1.2 vlaamse dienst voor arbeidsbemiddeling en beroepsopleiding -> VDAB............................................................................5
1.1.3 uitbetalingsinstellingen........................................................................................................................................................5
1.2 doel van de werkloosheidsverzekering.......................................................................................................................................6
1.3 werkloosheidsuitkeringen voor voltijds werklozen.....................................................................................................................6
1.3.1 toelaatbaarheidsvoorwaarden.............................................................................................................................................6
1.3.1.1 voorwaarde 1................................................................................................................................................................6
1.3.1.2 voorwaarde 2................................................................................................................................................................7
1.3.1.3 voorwaarde 3................................................................................................................................................................7
1.3.2 toekenningsvoorwaarden (“vergoedbaarheidsvoorwaarden”............................................................................................7
1.3.2.1 zonder arbeid zijn..........................................................................................................................................................8
1.3.2.1.1 springplank naar zelfstandige................................................................................................................................8
1.3.2.2 zonder loon zijn.............................................................................................................................................................9
1.3.2.3 onvrijwillig werkloos zijn...............................................................................................................................................9
1.3.2.4 beschikbaar zijn voor de arbeidsmarkt.......................................................................................................................10
1.3.2.5 inschrijving VDAB........................................................................................................................................................10
1.3.2.6 arbeidsgeschikt zijn.....................................................................................................................................................10
1.3.2.7 voldoen aan de leeftijdsvoorwaarden........................................................................................................................10
1.3.2.8 voldoen aan de verblijfsvoorwaarden........................................................................................................................10
1.3.2.9 voldoen aan de controleverplichtingen......................................................................................................................11
1.3.2.10 ingaan op uitnodigingen of oproepingen van controleurs.......................................................................................11
1.3.2.11 voldoen aan de voorwaarden in het kader van het actief zoekgedrag naar werk...................................................11
1.3.3 mogelijkheid tot vrijstelling van bepaalde toekenningsvoorwaarden..............................................................................12
1.4 passende dienstbetrekking.......................................................................................................................................................12
1.4.1 Gevolgen van werkloosheid wegens omstandigheden afhankelijk van de wil.................................................................13
1.5 werkloosheidsuitkeringen voor voltijds werklozen...................................................................................................................13
1.5.1 bedrag................................................................................................................................................................................13
1.6 werkloosheidsuitkeringen bij een deeltijdse betrekking...........................................................................................................14
1.7 inschakelingsuitkering en overbruggingsuitkering...................................................................................................................15
1.8 beschermingsuitkering..............................................................................................................................................................15
1.9 ontslagcompensatievergoeding (ocv).......................................................................................................................................15
1.10 tijdelijke werkloosheid............................................................................................................................................................16
1.10.1 regeling.............................................................................................................................................................................16
1.10.2 soorten.............................................................................................................................................................................16
1.10.2.1 overmacht.................................................................................................................................................................16
1.10.2.2 sluiting van de onderneming wegens jaarlijkse vakantie.........................................................................................16
1.10.2.3 technische stoornis...................................................................................................................................................16
1.10.2.4 slecht weer................................................................................................................................................................17
1.10.2.5 economische oorzaken.............................................................................................................................................17
1.10.2.6 staking & lock-out.....................................................................................................................................................17
1.10.3 uitkeringen bij tijdelijke werkloosheid.............................................................................................................................17
1.10.4 tijdelijke werkloosheid naar aanleiding van covid-19......................................................................................................18
1.10.4.1 welke bedrijven/ werknemers?................................................................................................................................18
2
, 1.10.4.2 vereenvoudigde procedure.......................................................................................................................................18
1.10.5 sancties en uitsluitingen...................................................................................................................................................18
1.10.6 procedure.........................................................................................................................................................................19
2 ziekte en invaliditeitsverzekering – deel 1........................................................................................................................... 21
2.1 Gezondheidszorg.......................................................................................................................................................................21
2.1.1 Wie heeft recht op terugbetaling?.....................................................................................................................................21
2.1.2 Algemene toekeningsvoorwaarden...................................................................................................................................21
2.1.2.1 Aansluiten ziekenfonds...............................................................................................................................................21
2.1.2.2 Doorlopen van een wachttijd......................................................................................................................................22
2.1.3 Niet-terugbetaalbare prestaties........................................................................................................................................22
2.1.4 Bijzondere voorwaarden voor terugbetaling.....................................................................................................................22
2.1.4.1 Welke verstrekkingen?................................................................................................................................................23
2.1.4.2 Nomenclatuur.............................................................................................................................................................23
2.1.5 Mate van tenlasteneming van prestaties..........................................................................................................................24
2.1.5.1 Correcties....................................................................................................................................................................24
2.1.6 OVereenkomsten en akkoorden met de zorgverstrekkers................................................................................................24
2.1.7 Verhoogde tegemoetkoming (VT).....................................................................................................................................24
2.1.7.1 Voordelen:...................................................................................................................................................................25
2.1.7.2 3 mogelijke toegangspoorten.....................................................................................................................................25
2.1.8 Maximumfactuur (MAF).....................................................................................................................................................25
2.1.8.1 Inkomens-MAF............................................................................................................................................................25
2.1.8.2 Sociale MAF.................................................................................................................................................................26
2.1.8.3 MAf voor kinderen jonger dan 19 jaar........................................................................................................................26
2.1.8.4 MAf chronisch zieken..................................................................................................................................................26
2.1.9 Wijze van uitbetaling in gezondheidszorg.........................................................................................................................26
2.1.9.1 E-attest........................................................................................................................................................................26
2.1.9.2 Derdebetalersregeling.................................................................................................................................................26
2.1.9.3 Forfaitair systeem.......................................................................................................................................................27
2.1.9.3.1 Voordelen.............................................................................................................................................................27
2.1.10 Verjaring...........................................................................................................................................................................27
2.1.11 Geschillen.........................................................................................................................................................................27
2.2 bijzonder solidariteitsfonds.......................................................................................................................................................28
2.2.1 Komt tussen in volgende gevallen.....................................................................................................................................28
2.2.2 komt niet tussen in volgende gevallen:.............................................................................................................................28
2.2.3 Criteria waaraan de medische verstrekking moet voldoen:..............................................................................................28
2.2.4 Procedure...........................................................................................................................................................................29
3 Ziekte & invaliditeitsverzekering – deel 2............................................................................................................................ 30
3.1 Verzekering tegen arbeidsongeschiktheid................................................................................................................................30
3.1.1 Arbeidsongeschiktheid & (moederschaps) verzekeringen................................................................................................30
3.1.2 Gerechtigden op uitkeringen.............................................................................................................................................30
3.1.3 Toekenningsvoorwaarden:................................................................................................................................................30
3.1.3.1 Wachttijd.....................................................................................................................................................................30
3.1.3.2 Arbeidsongeschikt zijn................................................................................................................................................30
3.1.3.2.1 Evaluatie van arbeidsongeschiktheid...................................................................................................................31
3.1.3.2.2 Vermoedens van arbeidsongeschiktheid.............................................................................................................32
3.1.3.3 Stopzetten van alle werkzaamheden..........................................................................................................................32
3.1.3.3.1 Uitvoeren of hervatten van werkzaamheden zonder toelating van de adviserend geneesheer........................32
3.1.3.3.2 toegelaten werkhervatting...................................................................................................................................32
4 OCMW................................................................................................................................................................................ 34
3
, 4.1 situering sociale bijstand..........................................................................................................................................................34
4.2 basiswetteksten........................................................................................................................................................................34
4.3 Recht op maatschappelijke integratie......................................................................................................................................34
4.3.1 Toekeningsvoorwaarden van het recht op maatschappelijke integratie..........................................................................34
4.3.2 leefloon..............................................................................................................................................................................35
4.3.2.1 de categorieën van rechthebbenden..........................................................................................................................35
4.3.2.1.1 enkele specifieke situaties...................................................................................................................................35
4.3.2.2 bedrag (1/1/22)...........................................................................................................................................................36
4.3.3 berekening van de bestaansmiddelen...............................................................................................................................36
4.3.3.1 algemene principes.....................................................................................................................................................36
4.3.3.2 vrijgestelde bestaanmiddelen.....................................................................................................................................36
4.3.3.3 beroepsinkomsten......................................................................................................................................................37
4.3.3.4 Bestaansmiddelen in geval van samenwoning...........................................................................................................40
5 ocmw deel 2....................................................................................................................................................................... 41
5.1 de hulpverleninng vanwege het ocmw.....................................................................................................................................41
5.1.1 maatschappelijke dienstverlening.....................................................................................................................................41
5.1.2 hulp bij het beheer van het budget (schuldhulpverlening)...............................................................................................41
5.2 procedure..................................................................................................................................................................................42
5.2.1 indienen van de aanvraag..................................................................................................................................................42
5.2.2 het ontvangsbewijs............................................................................................................................................................42
5.2.3 sociaal onderzoek...............................................................................................................................................................42
5.2.4 beslissing van het ocmw....................................................................................................................................................42
5.2.5 beroep bij de arbeidsrechtbank.........................................................................................................................................43
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