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Samenvatting Lesnotities socialezekerheidsrecht '23-'24 (15/20 in eerste zit)

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Course
Socialezekerheidsrecht (B001425A)

Institution
Universiteit Gent (UGent)

Lesnotities van het vak Socialezekerheidsrecht gedoceerd in het tweede semester van derde bachelor rechten door prof. dr. Inger De Wilde in academiejaar '23-'24 (incl. voorbeeldexamenvragen)

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Uploaded on May 15, 2024
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Written in 2023/2024
Type Summary

lesnotities
socialezekerheidsrecht
samenvatting

Institution
Universiteit Gent (UGent)
Education
Bachelor in de Rechten
Course
Socialezekerheidsrecht (B001425A)

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SOCIALEZEKERHEIDSRECHT
Academiejaar: 2023-2024

,INHOUD

Module 1: inleiding, historiek en administratieve organisatie ............................................................ 7
Inleiding ..................................................................................................................................................... 7
Historiek Belgische sociale zekerheid ................................................................................................ 9
Administratieve organisatie ............................................................................................................... 15
Algemeen .......................................................................................................................................... 15
Instellingen: soorten, organisatie en werking............................................................................ 15
Overzicht instellingen per stelsel/sector ................................................................................... 17
Verhouding tussen de socialezekerheidsinstellingen ............................................................... 19
Verhouding met de sociaal verzekerde ...................................................................................... 20
Voorbeeldvragen module 1 ............................................................................................................... 21
Module 2: toepassingsgebied ................................................................................................................. 22
Toepassingsgebied sociale zekerheid werknemers ...................................................................... 23
Arbeidsrelatiewet ............................................................................................................................ 24
Territoriaal toepassingsgebied ..................................................................................................... 25
Uitbreiding ........................................................................................................................................ 26
Uitsluitingen ...................................................................................................................................... 27
Niet verwarren met flexi-jobs! .................................................................................................... 29
Toepassingsgebied sociale zekerheid zelfstandigen ...................................................................... 30
Mandatarissen commerciële ondernemingen (art. 3, §1, lid 4 KB nr. 38) .......................... 31
Personen met een publiek mandaat (art. 5bis KB nr. 38) ...................................................... 31
Helpers .............................................................................................................................................. 31
Meewerkende echtgenoot ............................................................................................................ 32
Deeleconomie .................................................................................................................................. 32
Toepassingsgebied sociale zekerheid ambtenaren ....................................................................... 33
Definitie ambtenaar ........................................................................................................................ 33
Sociale bescherming ambtenaren? ............................................................................................... 33
Personen met afgeleide rechten ....................................................................................................... 34
Sociale bijstand ..................................................................................................................................... 35
Globaal overzicht ................................................................................................................................. 35
Module 3: financiering ............................................................................................................................. 36
Algemeen ............................................................................................................................................... 36
Financiering sociale zekerheid werknemers .................................................................................. 38

1

, Berekeninsgrondslag: loonbegrip socialezekerheidsrecht ...................................................... 38
Bijdragen............................................................................................................................................ 46
Andere inkomsten sociale zekerheid.......................................................................................... 52
Financiering sociale zekerheid zelfstandigen .................................................................................. 53
Berekeningsgrondslag ..................................................................................................................... 53
Bijdragepercentages ........................................................................................................................ 54
Andere bijdragen ............................................................................................................................. 56
Formaliteiten .................................................................................................................................... 57
Financiering sociale zekerheid ambtenaren ................................................................................... 58
Berekeningsgrondslag ..................................................................................................................... 58
Bijdragepercentages ........................................................................................................................ 58
Ambtenarenpensioen ..................................................................................................................... 59
Crisisbijdragen ................................................................................................................................. 60
Eenzijdige beëindiging ..................................................................................................................... 60
Financiering sociale bijstand .............................................................................................................. 60
Module 4: gezondheidszorg ................................................................................................................... 62
Rechthebbenden .................................................................................................................................. 62
Gerechtigden.................................................................................................................................... 63
Personen ten laste .......................................................................................................................... 65
Voorwaarden ........................................................................................................................................ 66
Bewijs verzekerbaarheid ................................................................................................................ 67
Specifieke voorwaarden................................................................................................................. 67
Soorten verstrekkingen ...................................................................................................................... 68
Geneeskundige verstrekkingen .................................................................................................... 68
Geneesmiddelen .............................................................................................................................. 69
Bijzonder solidariteitsfonds........................................................................................................... 69
Uitgesloten kosten .............................................................................................................................. 69
Prestaties ............................................................................................................................................... 71
Accreditering.................................................................................................................................... 72
Verhoogde tegemoetkoming ........................................................................................................ 72
Globaal medisch dossier ................................................................................................................ 73
Echelonnering................................................................................................................................... 73
Maximumfactuur (MAF) ................................................................................................................. 74

2

, Betaling .............................................................................................................................................. 75
Terugbetalingstarieven ....................................................................................................................... 75
Vaststelling tarieven ............................................................................................................................ 78
Module 5:arbeidsongeschiktheid ........................................................................................................... 82
Inleiding .................................................................................................................................................. 82
Werknemers......................................................................................................................................... 82
Algemeen .......................................................................................................................................... 84
Rechthebbenden .............................................................................................................................. 84
Voorwaarden ................................................................................................................................... 84
Arbeidsongeschiktheid ................................................................................................................... 85
ZIV-uitkeringen ................................................................................................................................ 86
Re-integratie ..................................................................................................................................... 91
Moederschap .................................................................................................................................... 92
Zelfstandigen ......................................................................................................................................... 96
Rechthebbenden .............................................................................................................................. 96
Arbeidsongeschiktheid ................................................................................................................... 96
Formalteiten ..................................................................................................................................... 98
ZIV-uitkeringen ................................................................................................................................ 98
Terug Naar Werk-traject.............................................................................................................. 99
Moederschap .................................................................................................................................... 99
Andere gezinsverloven................................................................................................................. 100
Ambtenaren ........................................................................................................................................ 100
Arbeidsongeschiktheid ................................................................................................................. 100
Verminderde/deeltijdse prestaties ............................................................................................ 103
Disponibiliteit ................................................................................................................................. 103
Ziektepensioen .............................................................................................................................. 104
Zorgverloven.................................................................................................................................. 104
Tegemoetkomingen voor personen met een handicap ............................................................ 104
Module 6: Professioneel risico ............................................................................................................ 106
Inleiding ................................................................................................................................................ 106
Historiek ......................................................................................................................................... 106
Bestuurlijke organisatie ................................................................................................................ 107
Toepassingsgebied......................................................................................................................... 107

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