If you are looking for information on how to fill out the return 14-08 For pensioners with disabilities, here we show you how to do it.
What is the 14-08 form and what is it for?
It is a format that consists of two pages where you must fill out a series of personal data, data about your employer, medical information related to your disability, information from the administrative office that handles your case and later the result of the exposed disability.
If you are a social security pensioner, this form is used to make the request for residual disability that will be presented to the Evaluation Commission for partial disability or invalidity.
- Pay attention to patients in consultation who request the disability pension, to corroborate the assessment of the treating physician.
- Assist in consultation with patients who request reconsideration of their status.
- Calculation of the percentage of disability based on the scale.
- Make the reports on the Disability Assessment.
- Make a detailed report on the number of patients who have been evaluated for disability and their respective percentage to deliver it to the Rehabilitation department.
- Preserve all records of the disabled attended
Who can process the form?
The candidates will be the insured who, due to some type of accident, has decreased their ability to work between 25% and up to 66.66%.
How to obtain Return 14-08?
1. Only to be completed by the Employer or Applicant:
- Applicant Type: You must make your selection with «X» indicating the type of Employer, Employer or Natural person/physician applicant.
- Date of elaboration: Day month and year the form is issued.
- Patient First Name and Middle Initial and Last Name and Middle Initial
- Identity card: Indicate with «X» if you are Venezuelan or foreigner, and enter all the digits of your ID.
- Date of Birth of the patient.
- Age: Written in numbers.
- Sex: mark with “X” if it is female or male.
- Patient Address: It must be placed clearly and specifically.
- Patient Phone Number: Nlocal number
- Control number registration of applications issued by the Employer or Employer.
- Name of Employer or Company Name: Write the name of the Employer or Company Name, where the insured works.
- Employer Number of Employer or Employer assigned by the IVSS.
- Phone number: indicate the local telephone number of the Employer or Employer for which the insured works.
- Seniority in the Company or Institute: Place in number the years, months or days that the insured has working for the Company or Institution.
- Occupation: Position or function performed by the insured in their current job.
- If you are a Public Employee, Total Seniority Recognized as a Public Employee: Indicate in numbers the total number of years you have worked for the public administration.
- Type of Request or Other Observations: write specifically the type of request you wish to process or any observations regarding the request.
- Employer or Legal Representative: Write the name and surname, the identity card, signature and seal, of the person responsible for the company in charge of the procedures and applications before the Social Security.
- Applicant: Write the name and surname, the identity card and signature of the Applicant of the procedure.
2. Only to be filled out by the Treating Physician:
- Control number that the Assistance Center records.
- Date of elaboration.
- Issuing Assistance Center: indicate clearly and legibly the name, denomination or company name of the public or private assistance center where the request was issued.
- Phone number of the care center where the form was prepared.
- Name and Surname of the Treating Physician requesting Evaluation.
- Specialty of the treating physician.
- Medical: Mark with an X (X) the type of facility where the treating physician works.
- Current Rest Start Date: Indicate in numbers the day, month and year in which the current disability began.
- Date of admission: Indicate in numbers the day, month and year that the patient began to be treated for the pathology described in the form.
- Egress date: Indicate by means of two (2) digits the day, month and year of the same date of preparation of the Residual Disability Evaluation Request Form (F: 14-08).
- Cause of the Injury (Etiology, indicating whether it is illness or accident) in case of occupational origin, attach INPSASEL Certificate: Mark with an X (X) the cause of the lesion for which the patient is being evaluated.
- Diagnosis(s) (if more space is required, attach Medical Report): write the diagnosis or diagnoses that effectively lead to requesting the evaluation of the disability for work.
- Treatment (Summary) in case of immediate surgical indication, indicate the probable date of the intervention (if more space is required, attach a Medical Report): You must write a summary of the treatment to which the patient must undergo.
- Evolution (Summary) (if more space is required, attach Medical Report): Summary of the patient’s evolution.
- Description of Residual Disability (Current Status) summary (if more space is required, attach Medical Report): detail the functions you have lost and, according to the treating physician, that limit you from carrying out your work activities.
- Attending Physician: affix signature, MPSS code and stamp of the doctor in charge of the medical evaluation to the patient.
- Director or Chief Medical Officer of the Issuing Center (Public or Private): indicate name and surname, identity card number and signature of the Director of the Assistance Center or Chief Medical Officer (if necessary) and affix the seal of the Assistance Center.
3. Only to be filled out at the Administrative Office closest to the Patient’s residence:
- Control number from the records of the Administrative Office.
- Date of elaboration: of the Residual Disability Evaluation Request Form (F: 14-08), by the Administrative Office.
- Administrative office name that receives the request for disability evaluation.
- Phone number the administrative office where the form was made.
- The undersigned Head of the Administrative Office, requests a medical evaluation of the citizen who is identified below, for the application of the regulations in force in: Mark with an X (X) the type of contingency to which the applicant wishes to accept.
- Receiving Official: Enter the name, surname, identity card number, signature and seal of the public servant responsible for receiving and preparing the form.
- Head of the Administrative Office: indicate name and surname, resolution number, signature and seal of the Administrative Office.
- Control number with which the Evaluation Commission counts the number of forms issued by said center.
- Date of elaboration: Day, month and year in which the form is issued.
- Name of the Authorized IVSS Commission or Sub-Commission: which leads the evaluation of the cases.
- Phone number: Indicate the local telephone number where the Evaluation Commission or Sub-Commission resides.
- Diagnosis of residual disability: The specific evaluating committee or sub-committee for work disability in order of importance.
- Observations: write of concretely if there is any observation regarding the application.
- Percentage Loss of Ability to Work: indicate the percentage in numbers and letters at which the evaluation commission or sub-commission has concluded.
Next, indicate the percentage in numbers and letters of the disability by common origin and occupational origin.
- Occupational Origin or Aggravated by Work, according to the INPSASEL Certificate: write the DIRESAT certificate number and the date it was certified.
- Authorized Member of the Commission or Sub-Commission: Write name, surname, identity card number, MPPS registration number, signature and seal.
- President of the Commission or Sub-Commission: Write name, surname, identity card number, MPPS registration number, signature and seal.
If it is not carried out on the assigned date, the evaluation is deferred for: Indicate the day and time you attended and were not attended, along with the official’s signature and seal and the times you attended.
Delivery of the evaluation result: Enter the name and identity card number of the person receiving the evaluation and indicate the date and time of delivery and sign as received.
In the case of groups of files, Communication No. or delivery relationship: indicate the number of the communication or relationship where the evaluation is delivered.
- Residual Disability Assessment Request, Form 14-08 (issued by the treating specialist doctor corresponding to the diagnosis or diagnoses) in ORIGINAL and two (2) carbon copies.
- Copy of the Enlarged and Legible Identity Card.
- Original and two (2) carbon copies of Proof of Work for the IVSS Form 14-100 (issued by the Human Resources Department of the Institution of affiliation).
- Original and Copies of the Clinical and Paraclinical Report related to the Pathology (s).
- Official Letter of Request for Evaluation of the Affiliation Institution mentioning the Article 9 and/or 13 of the IVSS Law Or to Article 14 of the Law of the Statute on the Retirement and Pension Regime of Officials or Employees of the National Public Administration.
- Individual Account (through the Internet through the page www.ivss.gov.ve).
of partial disability
Article. twenty : «The insured (a) that is a cause of occupational disease or work accident with a disability greater than twenty-five percent (25%) and not greater than two thirds (66.66%), is entitled to a pension. He will also have the right to a cause of a common accident with a disability between the limits of each one, provided that on the day of the accident the worker is subject to the Social Security obligation ”.
Single indemnities: these are dynamic benefits granted to the insured as a result of an occupational disease or work accident that decreases their ability to work between 5% and 25%.
Article 21 : The pension for partial disability will be equal to the result of applying the percentage of disability attributed to the case to the pension that will correspond to the totally disabled insured.
Article 22 : The insured that is the cause of an occupational disease or work accident with a disability greater than five percent (5%) and not greater than twenty-five percent (25%), is entitled to a single compensation equal to the result of applying the percentage of disability attributed to the case, the value of three (3) annuities of the pension for total disability that would correspond to him.
You will also be entitled to this pension for common accidents as long as the aesthetic worker is subject to Social Security obligations.
Article 23 : The Board of Directors of the Venezuelan Institute of Social Security will issue the rules that apply to determine the degree of disability.
Article 24 : Pensions for partial disability will be paid while maintaining subsistence and from the insured.
Provisions common to invalidity and partial incapacity
Article 25 : The Venezuelan Institute of Social Security must prescribe tests, treatments and rehabilitation practices in order to prevent, reduce or lessen the state of disability or incapacity for work. Failure to comply with the recommended measures, by the applicants or the beneficiaries of the pension, will produce, respectively, the suspension of the processing of the right to the pension, while the insurance and the beneficiary do not comply with the prescribed measures.
Article 26 : During the first five (5) years of attribution to the pension, the Venezuelan Insurance Institute. Write the degree of disability. Think and suspend, continue or modify the payment of the respective pension. . After this term, the degree of incapacity will be considered final, as well as the invalid or incapacitated, has reached sixty (60) years of age.
- personal: Despite the fact that you have been diagnosed with a disability, it is possible that you remain working in the same company where you were before the diagnosis, holding another position, thus being able to supplement your income with that of the disability pension.
- State: They are those granted by the state such as socialist mission cards
- Transportation: In some public transport services considerations are taken with disabled people and they do not pay the ticket.
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