The insured of an accident at work, of a commuting accident, or of an occupational disease may apply to the Accident Insurance Association (Association d'assurance accident - AAA) for a partial pension in order to be compensated for lost wages if they have suffered irreversible consequences preventing them completely or partially from resuming a professional activity or only allowing them to resume it with reduced income.
Who is concerned
In case of a permanent reduction in working capacity following a work-related/commuting accident or occupational disease and resulting in partial loss of income, the following persons may request a partial pension:
- employees (private and public sector) insured in Luxembourg, be they residents or cross-border employees, whether or not they are nationals of the European Union;
- self-employed (non-salaried) workers;
- insured individuals registered as job seekers with the National Employment Administration (ADEM) or a foreign body;
- children, schoolchildren, secondary school students and university students, subject to certain conditions.
The partial pension can only be determined in the event of resumption of a professional activity. The insured will therefore not be able to benefit from a partial pension if they abandon any professional activity after the accident for personal reasons.
In order to be eligible for the permanent partial pension, insured persons must demonstrate that they are suffering from minimum 10 % permanent partial disability at the time of the application - i.e. after the consolidation of the effects.Insured persons must also prove that they have lost at least 10 % of their income after they return to work.
After this 3-year period has elapsed, the application is only admissible if the insured:
- proves that the consequences of the accident, in terms of the victim's working capacity, could only be ascertained later;
- was physically unable to make a request.
How to proceed
Application for and specific features of the partial pension
The victim sends his partial pension application to the AAA by letter. The latter verifies if the eligibility conditions are met and sends the insured a form, which must be duly completed, signed and returned to the AAA.
In addition, the loss of income must be related to the insured person's permanent partial disability.
The occupational physician or the Social Security Medical Board (Contrôle médical de la sécurité sociale - CMSS) must decide:
- that the insured is unable to perform his or her last job, or;
- to maintain their last work regime mainly because of the consequences of the accident or the occupational disease.
Calculation, payment and revision of pension
Calculation of the pension
The partial pension is calculated in different ways depending on the insured's status at the time of the accident.
If the insured is an employee, the partial pension corresponds to the difference between:
- their taxable income in the 12 months preceding the accident;
- the salary they receive as a result of the consolidation or professional retraining evaluated over a 12-month reference period.
If the insured is self-employed, the partial pension corresponds to the difference between:
- their average annual professional income earned in the 36 months preceding the accident;
- the professional income earned during the 12 months following consolidation or professional retraining.
If the insured is a child, schoolchild, pupil or student, the partial pension corresponds to the permanent disability rate observed multiplied by the minimum social wage increased by 20%.
Payment of partial pension
The pension is granted one year after the insured returns to work, at the earliest. In the meantime, the insured can apply, under certain conditions, for the payment of a compensatory indemnity to the National Employment Agency (Agence pour le développement de l'emploi - ADEM).
If the insured person is entitled to a partial pension, it is first paid as compensation to the Employment Fund (Fonds pour l'emploi) up to the amount of the compensatory indemnity unduly advanced.
The definitively fixed pension is paid in advance on a monthly basis.
When a pension takes effect after the first of the month, the monthly payment is paid proportionally as of that date.
The allowance is adjusted to the cost of living index value according to the terms applicable to civil servants' salaries and pensions.
The pension is subject to social security and tax contributions, but exempt from contributions for benefits, contributions for accident insurance and family allowances.
These pension payments stop when the beneficiary turns 65 or in the event that an early retirement pension is granted. In this case, the insured still receives the full monthly payment of the pension for the month in which it is cancelled.
Revision of the pension
The amount of the pension is automatically revisable if the insured suffers a significant loss of income within 3 years after the setting of the pension compared to their situation as analysed at the time of the award of the annuity.
It should be noted that beneficiaries may also introduce the revision request on their own initiative.
The insured can request the modification of the amount of the pension beyond the 3 year limit, provided that:
- the beneficiary's health has deteriorated;
- the new rate of incapacity for work is at least 10 % higher than previously;
- the new rate of incapacity for work leads to a greater loss of income.
Interested parties have several means of appeal at their disposal to assert their rights.