The Social Security (Iceland) (Liechtenstein) (Norway) Order (Northern Ireland) 2023

• (2) Any personal data received under this Convention shall be used solely for the purposes of this Convention and in accordance with the domestic law of the receiving State.

• (3) Where one of the States wishes to use or disclose such personal data for other purposes, it shall obtain, in conformity with the domestic law of the State which provided the personal data, the prior written consent of the competent authorities or competent institutions. Such use shall be subject to any restrictions laid down by that authority or institution.

• (4) Where this Convention provides for the transfer of personal data, such transfer shall take place in accordance with the transferring State’s rules on international transfers of personal data. Where needed, each State will make best efforts, while respecting the transferring State’s rules on international transfers of personal data, to establish safeguards necessary for the transfer of personal data.

ARTICLE 62 Confidentiality

• (1) Any information communicated pursuant to this Convention shall be covered by an obligation of professional secrecy and shall enjoy the protections available to similar information subject to those obligations under the domestic law of the receiving State, unless the State which provided the information gives, in conformity with its domestic law, its consent to the disclosure of such information.

• (2) Any information subject to an obligation of professional secrecy that is received under this Convention shall be used solely for the purposes of this Convention and in accordance with the domestic law of the receiving State.

• (3) Where one of the States wishes to use or disclose such information for other purposes, it shall obtain, in conformity with the domestic law of the State which provided the information, the prior written consent of the competent authorities or competent institutions. Such use shall be subject to any restrictions laid down by that authority or institution.

ARTICLE 63 Data processing

• (1) The States shall progressively use new technologies for the exchange, access and processing of the data required to apply this Convention.

• (2) Each State shall be responsible for managing its own part of any electronic exchange.

• (3) An electronic document sent or issued by a competent authority or institution in conformity with this Convention may not be rejected by a competent authority or institution of another State on the grounds that it was received by electronic means, once the receiving institution has declared that it can receive electronic documents. Reproduction and recording of such documents shall be presumed to be a correct and accurate reproduction of the original document or representation of the information it relates to, unless there is proof to the contrary.

• (4) An electronic document shall be considered valid if the computer system on which the document is recorded contains the safeguards necessary in order to prevent any alteration, disclosure, or unauthorised access to the recording. It shall at any time be possible to reproduce the recorded information in an immediately readable form.

ARTICLE 64 Exemptions

• (1) Any exemption from or reduction of taxes, stamp duty, notarial or registration fees provided for under the legislation of one State in respect of certificates or documents required to be produced in application of the legislation of that State shall be extended to similar certificates or documents required to be produced in application of the legislation of another State or of this Convention.

• (2) All statements, documents and certificates of any kind whatsoever required to be produced in application of this Convention shall be exempt from authentication by diplomatic or consular authorities.

ARTICLE 65 Claims, declarations or appeals

Any claim, declaration or appeal which should have been submitted, in application of the legislation of one State, within a specified period to an authority, institution or tribunal of that State shall be admissible if it is submitted within the same period to a corresponding authority, institution or tribunal of another State. In such a case, the authority, institution or tribunal receiving the claim, declaration or appeal shall forward it without delay to the competent authority, institution or tribunal of the former State either directly or through the competent authorities of the States concerned. The date on which such claims, declarations or appeals were submitted to the authority, institution or tribunal of the second State shall be considered as the date of their submission to the competent authority, institution or tribunal.

ARTICLE 66 Medical examinations

• (1) Medical examinations provided for by the legislation of one State may be carried out, at the request of the competent institution, in the territory of another State, by the institution of the place of stay or residence of the person entitled to benefits, under the conditions laid down in Annex 1 or agreed between the competent authorities of the States concerned.

• (2) Medical examinations carried out under the conditions laid down in paragraph(1) shall be considered as having been carried out in the territory of the competent State.

ARTICLE 67 Collection of contributions and recovery of benefits

• (1) Collection of contributions due to an institution of one State and recovery of benefits provided by the institution of one State but not due, may be effected in another State in accordance with the procedures and with the guarantees and privileges applicable to the collection of contributions due to the corresponding institution of the latter and the recovery of benefits provided by it but not due.

• (2) Enforceable decisions of the judicial and administrative authorities relating to the collection of contributions, interest, and any other charges or to the recovery of benefits provided but not due under the legislation of one State shall be recognised and enforced at the request of the competent institution in another State within the limits and in accordance with the procedures laid down by the legislation and any other procedures applicable to similar decisions of the latter. Such decisions shall be declared enforceable in that State insofar as the legislation and any other procedures of that State so require.

• (3) Claims of an institution of one State shall in enforcement, bankruptcy or settlement proceedings in another State enjoy the same privileges as the legislation that the latter accords to claims of the same kind.

• (4) The procedure for implementing this Article, including costs reimbursement, shall be governed by Annex 1 or, where necessary and as a complementary measure, by means of agreements between the States.

ARTICLE 68 Rights of institutions

• (1) If a person receives benefits under the legislation of a State in respect of an injury resulting from events occurring in another State, any rights of the institution responsible for providing benefits against a third party liable to provide compensation for the injury shall be governed by the following rules:

• (a) where the institution responsible for providing benefits is, under the legislation it applies, subrogated to the rights which the beneficiary has against the third party, such subrogation shall be recognised by each State;

• (b) where the institution responsible for providing benefits has a direct right against the third party, each State shall recognise such rights.

• (2) If a person receives benefits under the legislation of one State in respect of an injury resulting from events occurring in another State, the provisions of the said legislation which determine the cases in which the civil liability of employers or of their employees is to be excluded apply with regard to the said person or to the competent institution.

Paragraph(1) shall also apply to any rights of the institution responsible for providing benefits against employers or their employees in cases where their liability is not excluded.

• (3) Where, in accordance with Article36(3) or Article 42(2), two or more States or their competent authorities have concluded an agreement to waive reimbursement between institutions under their jurisdiction, or, where reimbursement does not depend on the amount of benefits actually provided, any rights arising against a liable third party shall be governed by the following rules:

• (a) where the institution of the State of residence or stay grants benefits to a person in respect of an injury sustained in its territory, that institution, in accordance with the provisions of the legislation it applies, shall exercise the right to subrogation or direct action against the third party liable to provide compensation for the injury;

• (b) for the application of sub-paragraph (a):

• (i) the person receiving benefits shall be deemed to be insured with the institution of the place of residence or stay, and

• (ii) that institution shall be deemed to be the institution responsible for providing benefits;

• (c) paragraphs(1) and(2) shall remain applicable in respect of any benefits not covered by the waiver agreement or a reimbursement which does not depend on the amount of benefits actually provided.

ARTICLE 69 Implementation of legislation

Special provisions for implementing the legislation of a certain State are referred to in Annex 7 to the Convention.

ARTICLE 70 Establishment and role of the Joint Administrative Committee

• (1) The competent authorities of the States shall establish a committee to be called the Joint Administrative Committee. The Joint Administrative Committee shall comprise representatives of each of the States.

• (2) The Joint Administrative Committee shall be co-chaired by the representatives of the competent authorities of:

• (a) the United Kingdom; and

• (b) one of the EEA EFTA States, on a rotating basis.

• (3) The Joint Administrative Committee may:

• (a) monitor and review the interpretation, implementation and application of this Convention and make recommendations in respect thereof;

• (b) agree administrative arrangements necessary for the application of this Convention;

• (c) provide a forum for the States to exchange information, and discuss best practices and technical issues;

• (d) prepare and maintain an updated list of cash benefits which the competent authorities confirm fall within scope of this Convention as set out in Article 6(2).

• (e) provide a forum to resolve disputes in accordance with Article 71(3) and (4);

• (f) adopt decisions in respect of all matters where this Convention so provides; and

• (g) set rules of procedure for the Joint Administrative Committee.

• (4) The Joint Administrative Committee may, when carrying out its functions, consider guidance issued in relation to other international social security agreements by which any of the States are bound.

• (5) The Joint Administrative Committee shall act by consensus.

• (6) The Joint Administrative Committee shall meet at the request of any State, and, in any event, at least once a year, unless the Joint Administrative Committee decides otherwise. The Joint Administrative Committee’s meeting schedule and agenda shall be set by consensus of the States.

ARTICLE 71 Dispute resolution

• (1) For the purposes of this Article “Concerned State” means one or more State or States to this Convention whose interests are directly affected by a dispute concerning this Convention.

• (2) Concerned States shall make all reasonable efforts to resolve between them all disputes concerning this Convention.

• (3) If a dispute cannot be resolved in accordance with paragraph (2) it shall be submitted by a Concerned State for discussion at the Joint Administrative Committee.

• (4) The Joint Administrative Committee shall provide a forum for States to seek to resolve disputes submitted to it. The Concerned States shall provide it with all information which might be of use in resolving a dispute submitted to it. The Joint Administrative Committee shall examine all possibilities to maintain the good functioning of the Convention.

• (5) If a dispute cannot be resolved following discussion at the Joint Administrative Committee in accordance with paragraphs (3) and (4), it shall be submitted, at the request of a Concerned State, to an arbitration tribunal which shall be constituted in the following manner:

• (a) a Concerned State shall send the request for arbitration to the other Concerned State, and shall notify the States who are not Concerned States;

• (b) the arbitration tribunal shall be composed of three arbitrators;

• (c) each Concerned State shall appoint an arbitrator within one month from receipt of the request for arbitration. The arbitrators shall appoint a third arbitrator, who shall not be a national of a Concerned State, within two months from the date on which the Concerned State which was the last to appoint its arbitrator has notified the other Concerned State of the appointment;

• (d) if within the prescribed period either Concerned State should fail to appoint an arbitrator, the other Concerned State may request the President of the International Court of Justice or, in the event of their having the nationality of one of the Concerned States, the Vice-President or next senior judge of that Court not having the nationality of a Concerned State, to make the appointment. A similar procedure shall be adopted at the request of a Concerned State if the arbitrators cannot agree on the appointment of the third arbitrator.

• (6) The arbitration tribunal shall determine its own rules of procedure, and its costs shall be agreed with the Concerned States and borne in equal shares by them. These rules may include provision for States other than the Concerned States to be provided with access to, or copies of, any evidence relied upon by any of the Concerned States before the tribunal and any documents sent by the tribunal or a Concerned State to the other.

• (7) The arbitration tribunal shall decide the matter by majority vote. The decision shall be binding on the Concerned States.

ARTICLE 72 Annexes

The Annexes (including any appendices) shall form integral parts of this Convention.

TITLE V FINAL PROVISIONS

ARTICLE 73 Authentic text and depositary

• (1) This Convention is drawn up in a single original in the English language.

• (2) The Government of Norway shall be the Depositary of this Convention.

ARTICLE 74 Entry into force

• (1) The States shall notify the Depositary in writing of completion of their respective internal requirements and procedures for entry into force of this Convention.

• (2) This Convention shall enter into force, in relation to those States which have notified the Depositary, on the first day of the month following the later of the dates on which the Depositary receives the notifications of at least one EEA EFTA State and the United Kingdom.

• (3) This Convention shall enter into force, in relation to an EEA EFTA State which notifies the Depositary after the date on which at least one EEA EFTA State and the United Kingdom have notified the Depositary, on the first day of the month following the date on which the Depositary receives the notification of that EEA EFTA State.

ARTICLE 75 Withdrawal and termination

• (1) Subject to Article 76, each State may withdraw from this Convention by means of a written notification to the Depositary. The withdrawal shall take effect 12 months after the date on which the notification is received by the Depositary unless the States agree otherwise.

• (2) If the United Kingdom withdraws, this Convention shall terminate when its withdrawal becomes effective.

ARTICLE 76 Post-termination and post-withdrawal arrangements

• (1) In the event that this Convention is terminated or a State withdraws from it in accordance with Article 75, to the extent that individuals are affected by the withdrawal or termination, rights to cash benefits acquired by a person in accordance with the provisions of this Convention shall be maintained, if:

• (a) at the date of withdrawal or termination, the person is in receipt of those cash benefits;

• (b) at or prior to the date of withdrawal or termination, they have lodged a claim for, and would be entitled to receive, those cash benefits; or

• (c) the only reason they are not entitled to receive those cash benefits is that they have not lodged a claim for them at or prior to the date of withdrawal or termination.

• (2) Prior to the expiry of the period referred to in Article 75, and without prejudice to the protections in paragraph (1), the States shall commence discussions on appropriate consequential and transitional arrangements for the protection of persons affected by a State’s withdrawal from or the termination of this Convention.

ARTICLE 77 Transitional Provision

• (1) No provision of this Convention shall confer any right to receive a benefit for any period before the date of entry into force of this Convention.

• (2) The following shall be taken into consideration in determining the right to benefits under this Convention:

• (a) any period of insurance, and, where appropriate, any period of employment, self-employment or residence completed under the legislation of the States before the entry into force of this Convention; and

• (b) insured events occurring before the entry into force of this Convention.

• (3) This Convention shall not apply to rights extinguished by the payment of a lump-sum payment.

• (4) In this Article at paragraphs (5) and (6), any reference to ‘a certificate’ or ‘that certificate’ is a reference to the certificate issued under the provisions of either the 1990 Convention or the 1983 Convention confirming the state where a person is liable to be insured.

• (5) If, as a result of this Convention, a person is subject to the legislation of a State other than the legislation identified as applying to that person in a certificate issued to them, that person shall continue to be subject to the legislation identified in that certificate for the period identified in that certificate, provided that person’s situation remains unchanged.

• (6) A person’s situation remains unchanged where the circumstances that justified the issue of a certificate to that person continue after the time this Convention enters into force.

• (7) A person to whom paragraph (5) applies may request that they be subject to the legislation applicable under Title II of this Convention. The request shall be in writing and should be submitted to the State whose legislation would be applicable to that person under Title II of this Convention within the three months following the date this Convention enters into force. The person shall be subject to the legislation of that State as of the date this Convention applies to that State. If the request is made after the expiry of the three-month period indicated, the changeover shall take place on the first day of the following month.

ARTICLE 78 Relationship with pre-existing Social Security Coordination Agreements

• (1) Subject to paragraphs (2) to (4), the following treaties between the United Kingdom and relevant individual EEA EFTA States shall, as from the date of entry into force of this Convention in relation to those EEA EFTA States in accordance with Article 74, cease to apply to England, Scotland, Wales and Northern Ireland:

• (a) The 1990 Convention;

• (b) The Protocol Concerning Medical Treatment of 19 June 1990, supplementary to the 1990 Convention, (“Norway Healthcare Protocol”);

• (c) The 1983 Convention;

• (d) The Agreement Between the Government of the United Kingdom of Great Britain and Northern Ireland and the Government of the Republic of Iceland on Health Services, signed in Reykjavik on 22 September 1982 (“Iceland Health Services Agreement”).

• (2) The provisions of the 1990 Convention, the Norway Healthcare Protocol, and the 1983 Convention shall continue to apply to the Isle of Man and Jersey.

• (3) The provisions of the Iceland Health Services Agreement shall continue to apply to the Bailiwick of Guernsey, the Isle of Man and Jersey.

• (4) The provisions of the 1990 Convention and the 1983 Convention shall continue to apply in relation to:

• (a) any award of a cash benefit, pension or allowance made prior to the date upon which this Convention comes into force;

• (b) any claim to a benefit, pension or allowance made but not determined at the date upon which this Convention comes into force;

• (c) any claim to a benefit, pension or allowance made after the date this Convention comes into force but only where that claim relates to entitlement to such benefit, pension or allowance for a period prior to the date upon which this Convention comes into force.

In witness whereof the undersigned, duly authorised by their respective Governments, have signed this Convention.

Done at London, this 30th day of June 2023, in one original in the English language, which shall be deposited with the Depositary, who shall transmit certified copies to all the States.

For Iceland: JOHANNA JONSDOTTI
For the Principality of Liechtenstein: ESTHER SCHINDLER
For the Kingdom of Norway: LARS-ERIK HAUGE
For the United Kingdom of Great Britain and Northern Ireland: LEO DOCHERTY

CONVENTION ON SOCIAL SECURITY COORDINATION BETWEEN ICELAND, THE PRINCIPALITY OF LIECHTENSTEIN, THE KINGDOM OF NORWAY AND THE UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND

ANNEXES

ANNEX 1 IMPLEMENTING PART

TITLE I GENERAL PROVISIONS

CHAPTER 1

ARTICLE 1 Definitions

For the purposes of this Annex, the following definitions, in addition to those set out in Article 1 of this Convention, apply.

• (a) “document” means a set of data, irrespective of the medium used, structured in such a way that it can be exchanged electronically and which must be communicated in order to enable the operation of this Convention and this Annex;

• (b) “fraud” means any deliberate act or deliberate omission to act, carried out with the intention to either:

• (i) receive social security benefits, or enable another person to receive social security benefits, when the conditions of entitlement to such benefits under the law of the State(s) concerned or this Convention are not met; or

• (ii) avoid paying social security contributions, or enable another person to avoid paying social security contributions, when such contributions are required under the law of the State(s) concerned or this Convention.

• (c) “liaison body” means any body designated by the competent authority of a State for one or more of the branches of social security referred to in Article 6 of this Convention to respond to requests for information and assistance for the purposes of the application of this Convention and of this Annex and which has to fulfil the tasks assigned to it under Title IV of this Annex;

• (d) “transmission by electronic means” means the transmission of data using electronic equipment for the processing (including digital compression) of data and employing wires, radio transmission, optical technologies or any other electromagnetic means.

CHAPTER 2 PROVISIONS CONCERNING COOPERATION AND EXCHANGES OF DATA

ARTICLE 2 Scope and rules for exchanges between authorities and institutions

• (1) For the purposes of this Annex, exchanges between the States’ authorities and institutions and persons covered by this Convention shall be based on the principles of public service, efficiency, active assistance, rapid delivery and accessibility, including e-accessibility, in particular for the disabled and the elderly.

• (2) The institutions shall without delay provide or exchange all data necessary for establishing and determining the rights and obligations of persons to whom this Convention applies. Such data shall be transferred between the States directly by the institutions themselves or indirectly via the liaison bodies.

• (3) Where a person has mistakenly submitted information, documents or claims to an institution in the territory of a State other than that in which the institution designated, in accordance with this Annex, is situated, the information, documents or claims shall be resubmitted without delay by the former institution to the institution designated in accordance with this Annex, indicating the date on which they were initially submitted. That date shall be binding on the latter institution. The institutions of the States shall not, however, be held liable, or be deemed to have taken a decision by virtue of their failure to act as a result of the late transmission of information, documents or claims by States’ institutions.

• (4) Where data are transferred indirectly via the liaison body of the State of destination, time limits for responding to claims shall start from the date when that liaison body received the claim, as if it had been received by the institution in that State.

ARTICLE 3 Scope and rules for exchanges between the persons concerned and institutions

• (1) The States shall ensure that the necessary information is made available to the persons concerned in order to inform them of the provisions introduced by this Convention and this Annex to enable them to assert their rights. They shall also provide for user-friendly services.

• (2) Persons to whom this Convention applies shall be required to forward to the relevant institution the information, documents or supporting evidence necessary to establish their situation or that of their families, to establish or maintain their rights and obligations and to determine the applicable legislation and their obligations under it.

• (3) To the extent necessary for the application of this Convention and this Annex, the relevant institutions shall forward the information and issue the documents to the persons concerned without delay and in all cases within any time limits specified under the legislation of the State in question.

• (4) The relevant institution shall notify the claimant residing or staying in another State of its decision directly or through the liaison body of the State of residence or stay. When refusing the benefits, it shall also indicate the reasons for refusal, the remedies and periods allowed for appeals. A copy of this decision shall be sent to other involved institutions.

ARTICLE 4 Forms, documents and methods of exchanging data

• (1) Subject to Article 73 and Appendix 1 of this Annex, the structure, content and format of forms and documents issued on behalf of the States for the purposes of implementing this Convention shall be agreed by the Joint Administrative Committee.

• (2) The transmission of data between the institutions or the liaison bodies may, subject to the approval of the States through the Joint Administrative Committee, be carried out by way of electronic exchange. To the extent the forms and documents referred to in paragraph (1) are transmitted by electronic exchange, they shall respect the rules applicable to that system.

• (3) Where the transmission of data between institutions or the liaison bodies is not carried out by way of electronic exchange, the relevant institutions and liaison bodies shall use the arrangements appropriate to each case, and favour the use of electronic means as far as possible.

• (4) In their communications with the persons concerned, the relevant institutions shall use the arrangements appropriate to each case, and favour the use of electronic means as far as possible.

ARTICLE 5 Legal value of documents and supporting evidence issued in another State

• (1) Documents issued by the institution of a State and showing the position of a person for the purposes of the application of this Convention and this Annex, and supporting evidence on the basis of which the documents have been issued, shall be accepted by the institutions of the other States for as long as they have not been withdrawn or declared to be invalid by the State in which they were issued.

• (2) Where there is doubt about the validity of a document or the accuracy of the facts on which the particulars contained therein are based, the institution of the State that receives the document shall ask the issuing institution for the necessary clarification and, where appropriate, the withdrawal of that document. The issuing institution shall reconsider the grounds for issuing the document and, if necessary, withdraw it.

• (3) Pursuant to paragraph (2), where there is doubt about the information provided by the persons concerned, the validity of a document or supporting evidence or the accuracy of the facts on which the particulars contained therein are based, the institution of the place of stay or residence shall, insofar as this is possible, at the request of the competent institution, proceed to the necessary verification of this information or document.

• (4) Where no agreement is reached between the institutions concerned, the matter may be referred to the Joint Administrative Committee by the competent authorities.

ARTICLE 6 Provisional application of legislation and provisional granting of benefits

• (1) Unless otherwise provided for in this Annex, where there is a difference of views between the institutions or authorities of two or more States concerning the determination of the applicable legislation, the person concerned shall be made provisionally subject to the legislation of one of those States, the order of priority being determined as follows:

• (a) the legislation of the State where the person actually pursues their employment or self-employment, if the employment or self-employment is pursued in only one State;

• (b) the legislation of the State of residence if the person concerned pursues employment or self-employment in two or more States and performs part of their activity or activities in the State of residence, or if the person concerned is neither employed nor self-employed;

• (c) in all other cases, the legislation of the State the application of which was first requested if the person pursues an activity, or activities, in two or more States.

• (2) Where there is a difference of views between the institutions or authorities of two or more States about which institution should provide the benefits in cash or in kind, the person concerned who could claim benefits if there was no dispute shall be entitled, on a provisional basis, to the benefits provided for by the legislation applied by the institution of that person’s place of residence or, if that person does not reside on the territory of one of the States concerned, to the benefits provided for by the legislation applied by the institution to which the request was first submitted.

• (3) Where no agreement is reached between the institutions or authorities concerned, the matter may be referred to the Joint Administrative Committee by the competent authorities.

• (4) Where it is established either that the applicable legislation is not that of the State of provisional membership, or the institution which granted the benefits on a provisional basis was not the competent institution, the institution identified as being competent shall be deemed retroactively to have been so, as if that difference of views had not existed, at the latest from either the date of provisional membership or of the first provisional granting of the benefits concerned.

• (5) If necessary, the institution identified as being competent and the institution which provisionally paid the cash benefits or provisionally received contributions shall settle the financial situation of the person concerned as regards contributions and cash benefits paid provisionally, where appropriate, in accordance with Chapter 2 of Title IV of this Annex.

• (6) Benefits in kind granted provisionally by an institution in accordance with paragraph (2) shall be reimbursed by the competent institution in accordance with Title IV of this Annex.

ARTICLE 7 Provisional calculation of benefits and contributions

• (1) Unless otherwise provided for in this Annex, where a person is eligible for a benefit, or is liable to pay a contribution in accordance with this Convention, and the competent institution does not have all the information concerning the situation in another State which is necessary to calculate definitively the amount of that benefit or contribution, that institution shall, on request of the person concerned, award this benefit or calculate this contribution on a provisional basis, if such a calculation is possible on the basis of the information at the disposal of that institution.

• (2) The benefit or the contribution concerned shall be recalculated once all the necessary supporting evidence or documents are provided to the institution concerned.

CHAPTER 3 OTHER GENERAL PROVISIONS FOR THE APPLICATION OF THIS CONVENTION

ARTICLE 8 Other procedures between authorities and institutions

• (1) The UK and one or more of the EEA EFTA States, or their competent authorities, may agree procedures other than those provided for by this Annex, provided that such procedures do not adversely affect the rights or obligations of the persons concerned.

• (2) Any agreements concluded to this end shall be agreed by the States in question through the Joint Administrative Committee.

ARTICLE 9 Prevention of overlapping of benefits

Notwithstanding other provisions in this Convention, when benefits due under the legislation of two or more States are mutually reduced, suspended or withdrawn, any amounts that would not be paid in the event of strict application of the rules concerning reduction, suspension or withdrawal laid down by the legislation of the State concerned shall be divided by the number of benefits subjected to reduction, suspension or withdrawal.

ARTICLE 10 Elements for determining residence

• (1) Where there is a difference of views between the institutions of two or more States about the determination of the residence of a person to whom this Convention applies, these institutions shall establish by common agreement the centre of interests of the person concerned, based on an overall assessment of all available information relating to relevant facts, which may include, as appropriate:

• (a) the duration and continuity of presence on the territory of the States concerned;

• (b) that person’s situation, including:

• (i) the nature and the specific characteristics of any activity pursued, in particular the place where such activity is habitually pursued, the stability of the activity, and the duration of any work contract;

• (ii) that person’s family status and family ties;

• (iii) the exercise of any non-remunerated activity;

• (iv) in the case of students, the source of that student’s income;

• (v) that person’s housing situation, in particular how permanent it is;

• (vi) the State in which that person is deemed to reside for taxation purposes.

• (2) Where the consideration of the various criteria based on relevant facts as set out in paragraph (1) does not lead to agreement between the institutions concerned, the person’s intention, as it appears from such facts and circumstances, especially the reasons that led the person to move, shall be considered to be decisive for establishing that person’s actual place of residence.

• (3) The centre of interests of a student who goes to another State to pursue a full-time course of study shall not be considered as being in the State of study for the entire duration of the course of study in that State, without prejudice to the possibility of rebutting this presumption.

• (4) Paragraph (3) applies mutatis mutandis to the family members of the student.

ARTICLE 11 Aggregation of periods

• (1) For the purposes of applying Article 10 of this Convention, the competent institution shall contact the institutions of the States to whose legislation the person concerned has also been subject in order to determine all the periods completed under their legislation.

• (2) The respective periods of insurance, employment, self-employment or residence completed under the legislation of a State shall be added to those completed under the legislation of any other State, insofar as necessary for the purposes of applying Article 10 of this Convention, provided that these periods do not overlap.

• (3) Where a period of insurance or residence which is completed in accordance with compulsory insurance under the legislation of a State coincides with a period of insurance completed on the basis of voluntary insurance or continued optional insurance under the legislation of another State, only the period completed on the basis of compulsory insurance shall be taken into account.

• (4) Where a period of insurance or residence other than an equivalent period completed under the legislation of a State coincides with an equivalent period on the basis of the legislation of another State, only the period other than an equivalent period shall be taken into account.

• (5) Any period regarded as equivalent under the legislation of two or more States shall be taken into account only by the institution of the State to whose legislation the person concerned was last compulsorily subject before that period. In the event that the person concerned was not compulsorily subject to the legislation of a State before that period, the latter shall be taken into account by the institution of the State to whose legislation the person concerned was compulsorily subject for the first time after that period.

• (6) In the event that the time in which certain periods of insurance or residence were completed under the legislation of a State cannot be determined precisely, it shall be presumed that these periods do not overlap with periods of insurance or residence completed under the legislation of another State, and account shall be taken thereof, where advantageous to the person concerned, insofar as they can reasonably be taken into consideration.

ARTICLE 12 Rules for conversion of periods

• (1) Where periods completed under the legislation of a State are expressed in units different from those provided for by the legislation of another State, the conversion needed for the purpose of aggregation under Article 10 of this Convention shall be carried out under the following rules:

• (a) the period to be used as the basis for the conversion shall be that communicated by the institution of the State under whose legislation the period was completed;

• (b) in the case of schemes where the periods are expressed in days the conversion from days to other units, and vice versa, as well as between different schemes based on days shall be calculated according to the following table:

Scheme based on	1 day corresponds to	1 week corresponds to	1 month corresponds to	1 quarter corresponds To	Maximum of days in one calendar year
5 days	9 hours	5 days	22 days	66 days	264 days
6 days	8 hours	6 days	26 days	78 days	312 days
7 days	6 hours	7 days	30 days	90 days	360 days

• (c) in the case of schemes where the periods are expressed in units other than days,

• (i) three months or 13 weeks shall be equivalent to one quarter, and vice versa;

• (ii) one year shall be equivalent to four quarters, 12 months or 52 weeks, and vice versa;

• (iii) for the conversion of weeks into months, and vice versa, weeks and months shall be converted into days in accordance with the conversion rules for the schemes based on six days in the table in sub-paragraph (b);

• (d) in the case of periods expressed in fractions, those figures shall be converted into the next smaller integer unit applying the rules laid down in sub-paragraphs (b) and (c). Fractions of years shall be converted into months unless the scheme involved is based on quarters;

• (e) if the conversion under this paragraph results in a fraction of a unit, the next higher integer unit shall be taken as the result of the conversion under this paragraph.

• (2) The application of paragraph (1) shall not have the effect of producing, for the total sum of the periods completed during one calendar year, a total exceeding the number of days indicated in the last column in the table in paragraph (1)(b), 52 weeks, 12 months or four quarters.

If the periods to be converted correspond to the maximum annual amount of periods under the legislation of the State in which they have been completed, the application of paragraph (1) shall not result within one calendar year in periods that are shorter than the possible maximum annual amount of periods provided under the legislation concerned.

• (3) The conversion shall be carried out either in one single operation covering all those periods which were communicated as an aggregate, or for each year, if the periods were communicated on a year-by-year basis.

• (4) Where an institution communicates periods expressed in days, it shall at the same time indicate whether the scheme it administers is based on five days, six days or seven days.

TITLE II DETERMINATION OF THE LEGISLATION APPLICABLE

ARTICLE 13 Details relating to Articles 14 and 15 of this Convention

• (1) For the purposes of the application of Article 14(1) of this Convention, a “person who pursues an activity as an employed person in the territory of a State for an employer which normally carries out its activities there and who is sent by that employer to the territory of another State” shall:

• (a) include a person who is recruited with a view to being sent to a State, other than the State where the employer normally carries out its activities, provided that, immediately before the start of that person’s employment, the person concerned is already subject to the legislation of the State in which their employer is established;

• (b) have been subject to the legislation of the State in which their employer is established for a prior minimum period of time. The prior minimum period shall be agreed by the Joint Administrative Committee;

• (c) continue to have a direct relationship with their employer during the period of their detachment; and

• (d) be paid by or on behalf of their employer, in accordance with the legislation of the State whose legislation is applicable pursuant to Title II of this Convention, during the period of their detachment.

• (2) For the purposes of the application of Article 14(1) of this Convention, the words “which normally carries out its activities there” shall refer to an employer that ordinarily performs substantial activities, other than purely internal management activities, in the territory of the State in which it is established, taking account of all criteria characterising the activities carried out by the undertaking in question. The relevant criteria must be suited to the specific characteristics of each employer and the real nature of the activities carried out.

• (3) For the purposes of the application of Article 14(2) of this Convention, the words “who normally pursues an activity as a self-employed person” shall refer to a person who habitually carries out substantial activities in the territory of the State in which that person is established. In particular, that person must have already pursued their activity for a minimum period of time before the date when they wish to take advantage of the provisions of that Article and, during any period of temporary activity in the other State, must continue to fulfil, in the State where they are established, the requirements for the pursuit of their activity in order to be able to pursue it on their return. The minimum period of time that person must have already pursued their activity shall be agreed by the Joint Administrative Committee.

• (4) For the purposes of the application of Article 14(2) of this Convention, the criterion for determining whether the activity that a self-employed person goes to pursue in another State is “similar” to the self-employed activity normally pursued shall be that of the actual nature of the activity, rather than of the designation of employed or self-employed activity that may be given to this activity by the other State where the activity occurs.

• (5) For the purposes of the application of Article 15(1) and (5) of this Convention, a person who “normally pursues an activity as an employed person in one or more EEA EFTA States as well as in the United Kingdom”, or in “two or more EEA EFTA States (and not in the United Kingdom)”, shall refer to a person who simultaneously, or in alternation, for the same undertaking or employer or for various undertakings or employers, exercises one or more separate activities in such States.

• (6) For the purposes of Article 15 (1) and (5) of this Convention, an employed flight crew or cabin crew member normally pursuing air passenger or freight services in two or more States shall be subject to the legislation of the State where the home base, as defined in Article 1 of this Convention, is located.

• (7) Marginal activities shall be disregarded for the purposes of determining the applicable legislation under Article 15 of this Convention.

• (8) Article 15 of this Annex shall apply to all cases under this Article.

• (9) For the purposes of the application of Article 15(2) and (6) of this Convention, a person who “normally pursues an activity as a self-employed person” in “one or more EEA EFTA States as well as in the United Kingdom”, or in “two or more EEA EFTA States (and not in the United Kingdom)” respectively, shall refer, in particular, to a person who simultaneously or in alternation pursues one or more separate self-employed activities, irrespective of the nature of those activities, in such States.

• (10) For the purposes of distinguishing the activities under paragraphs (5) and (9) of this Article from the situations described in Article 14(1) of this Convention, the duration of the activity in one or more States (whether it is permanent or of an ad hoc or temporary nature) shall be decisive. For these purposes, an overall assessment shall be made of all the relevant facts including, in particular, in the case of an employed person, the place of work as defined in the employment contract.

• (11) For the purposes of the application of Article 15(1), (2), (5) and (6) of this Convention, a “substantial part of employed or self-employed activity” pursued in a State shall mean a quantitatively substantial part of all the activities of the employed or self-employed person pursued there, without this necessarily being the major part of those activities.

• (12) To determine whether a substantial part of the activities is pursued in a State, the following indicative criteria shall be taken into account:

• (a) in the case of an employed activity, the working time or the remuneration; and

• (b) in the case of a self-employed activity, the turnover, working time, number of services rendered or income.

In the framework of an overall assessment, a share of less than 25% in respect of the criteria mentioned above shall be an indicator that a substantial part of the activities is not being pursued in the relevant State.

• (13) For the purposes of the application of Article 15(2)(b) of this Convention, the “centre of interest” of the activities of a self-employed person shall be determined by taking account of all the aspects of that person’s occupational activities, notably the place where the person’s fixed and permanent place of business is located, the habitual nature or the duration of the activities pursued, the number of services rendered, and the intention of the person concerned as revealed by all the circumstances.

• (14) For the determination of the applicable legislation under paragraphs (11), (12) and (13), the institutions concerned shall take into account the situation projected for the following 12 calendar months.

• (15) If a person pursues their activity as an employed person in two or more States on behalf of an employer established outside the territory of the States, and if this person resides in a State without pursuing substantial activity there, they shall be subject to the legislation of the State of residence.

ARTICLE 14 Procedures for the application of Article 13(3)(b), Article 13(3)(c), Article 13(4) and Article 14 of this Convention (on the provision of information to the institutions concerned)

• (1) Unless otherwise provided for by Article 15 of this Annex, where a person pursues their activity outside the competent State, the employer or, in the case of a person who does not pursue an activity as an employed person, the person concerned shall inform the competent institution of the State whose legislation is applicable thereof, whenever possible in advance. That institution shall issue the attestation referred to in Article 17(2) of this Annex to the person concerned and shall without delay make information concerning the legislation applicable to that person, pursuant to Article 13(3)(b) or Article 14 of this Convention, available to the institution designated by the competent authority of the State in which the activity is pursued.

• (2) Paragraph (1) shall apply mutatis mutandis to persons covered by Article 13(3)(c) of this Convention.

• (3) An employer within the meaning of Article 13(4) of this Convention who has an employee on board a vessel flying the flag of another State shall inform the competent institution of the State whose legislation is applicable thereof whenever possible in advance. That institution shall, without delay, make information concerning the legislation applicable to the person concerned, pursuant to Article 13(4) of this Convention, available to the institution designated by the competent authority of the State whose flag, the vessel on which the employee is to perform the activity, is flying.

ARTICLE 15 Procedure for the application of Article 15 of this Convention

• (1) A person who pursues activities in two or more States, or where Article 15(5) or (6) of this Convention applies, shall inform the institution designated by the competent authority of the State of residence thereof.

• (2) The designated institution of the place of residence shall without delay determine the legislation applicable to the person concerned, having regard to Article 15 of this Convention and Article 13 of this Annex. That initial determination shall be provisional. The institution shall inform the designated institutions of each State in which an activity is pursued of its provisional determination.

• (3) The provisional determination of the applicable legislation, as provided for in paragraph (2), shall become definitive within two months of the institutions designated by the competent authorities of the State(s) concerned being informed of it, in accordance with paragraph (2), unless the legislation has already been definitively determined on the basis of paragraph (4), or at least one of the institutions concerned informs the institution designated by the competent authority of the State of residence by the end of this two-month period that it cannot yet accept the determination or that it takes a different view on this.

• (4) Where uncertainty about the determination of the applicable legislation requires contacts between the institutions or authorities of two or more States, at the request of one or more of the institutions designated by the competent authorities of the State(s) concerned, or of the competent authorities themselves, the legislation applicable to the person concerned shall be determined by common agreement, having regard to Article 15 of this Convention and Article 13 of this Annex.

Where there is a difference of views between the institutions or competent authorities concerned, those bodies shall seek agreement in accordance with the conditions set out above and Article 6 of this Annex shall apply.

• (5) The competent institution of the State whose legislation is determined to be applicable either provisionally or definitively shall without delay inform the person concerned.

• (6) If the person concerned fails to provide the information referred to in paragraph (1), this Article shall be applied at the initiative of the institution designated by the competent authority of the State of residence as soon as it is appraised of that person’s situation, possibly via another institution concerned.

ARTICLE 16 Procedure for the application of Article 18 of this Convention

A request by the employer or the person concerned for exceptions to Articles 13 to 17 of this Convention shall be submitted, whenever possible in advance, to the competent authority or the body designated by the authority of the State, whose legislation the employee or person concerned requests be applied.

ARTICLE 17 Provision of information to persons concerned and employers

• (1) The competent institution of the State whose legislation becomes applicable pursuant to Title II of this Convention shall inform the person concerned and, where appropriate, their employer(s) of the obligations laid down in that legislation. It shall provide them with the necessary assistance to complete the formalities required by that legislation.

• (2) At the request of the person concerned or of the employer, the competent institution of the State whose legislation is applicable pursuant to Title II of this Convention shall provide an attestation that such legislation is applicable and shall indicate, where appropriate, until what date and under what conditions.

ARTICLE 18 Cooperation between institutions

• (1) The relevant institutions shall communicate to the competent institution of the State whose legislation is applicable to a person pursuant to Title II of this Convention the necessary information required to establish the date on which that legislation becomes applicable and the contributions which that person and their employer(s) are liable to pay under that legislation.

• (2) The competent institution of the State whose legislation becomes applicable to a person pursuant to Title II of this Convention shall make the information indicating the date on which the application of that legislation takes effect available to the institution designated by the competent authority of the State to whose legislation that person was last subject.

ARTICLE 19 Cooperation in case of doubts about the validity of issued documents concerning the applicable legislation

• (1) Where there is doubt about the validity of a document showing the position of the person for the purposes of the applicable legislation or the accuracy of the facts on which the document is based, the institution of the State that receives the document shall ask the issuing institution for the necessary clarification and, where appropriate, the withdrawal or rectification of that document. The requesting institution shall substantiate its request and provide the relevant supporting documentation that gave rise to the request.

• (2) When receiving such a request, the issuing institution shall reconsider the grounds for issuing the document and, where an error is detected, withdraw it or rectify it within 30 working days from the receipt of the request. The withdrawal or rectification shall have retroactive effect. However, in cases where there is a risk of disproportionate outcome, and in particular, of the loss of status as an insured person for the whole or part of the relevant period in the State(s) concerned, the States shall consider a more proportionate arrangement in such case. When the available evidence permits the issuing institution to find that the applicant of the document has committed fraud, it shall withdraw or rectify the document without delay and with retroactive effect.

TITLE III SPECIAL PROVISIONS CONCERNING THE VARIOUS CATEGORIES OF BENEFITS

CHAPTER 1 SICKNESS, MATERNITY AND EQUIVALENT PATERNITY BENEFITS

ARTICLE 20 General implementing provisions

• (1) The competent authorities or institutions shall ensure that any necessary information is made available to insured persons regarding the procedures and conditions for the granting of benefits in kind where such benefits are received in the territory of a State other than that of the competent institution.

• (2) Notwithstanding Article 9(a) of this Convention, a State may become responsible for the cost of benefits in accordance with Article 26 of this Convention only if, either the insured person has made a claim for a pension under the legislation of that State, or in accordance with Articles 27 to 33 of this Convention, they receive a pension under the legislation of that State.

ARTICLE 21 Residence in a State other than the competent State

Procedure and scope of right

• (1) For the purposes of the application of Article 21 of this Convention, the insured person or members of that person’s family shall be obliged to register promptly with the institution of the place of residence. Their right to benefits in kind in the State of residence shall be certified by a document issued by the competent institution upon request of the insured person or upon request of the institution of the place of residence.

• (2) The document referred to in paragraph (1) shall remain valid until the competent institution informs the institution of the place of residence of its cancellation. The institution of the place of residence shall inform the competent institution of any registration under paragraph (1) and of any change or cancellation of that registration.

• (3) This Article applies mutatis mutandis to the persons referred to in Articles 26, 28, 29 and 30 of this Convention.

Health fee reimbursement

• (4) Where a person or the members of that person’s family:

• (a) have been issued with the document referred to in paragraph (1);

• (b) have registered that document with the institution of the place of residence in accordance with paragraph (1); and

• (c) a health fee has been paid by or on behalf of the person or members of their family to the State of residence as part of an application for a permit to enter, stay, work or reside in that State,

that person or members of that person’s family may apply to the institution of the State of residence for reimbursement (in whole or part, as the case may be) of the health fee paid.

• (5) Where a claim is made in accordance with paragraph (1), the institution of the State of residence shall determine that claim within three calendar months, starting on the day the claim was received, and shall make any reimbursement of a health fee paid in accordance with the conditions in this Article.

• (6) Where the period of validity of the document referred to in paragraph (1) is less than the period of time in respect of which the health fee has been paid, the amount reimbursed shall not exceed that portion of the health fee which corresponds to the period for which the document had been issued.

• (7) Where the health fee was paid by another person on behalf of a person to whom this Article applies, reimbursement may be made to that other person.

ARTICLE 22 Stay in a State other than the competent State

Procedure and scope of right

• (1) For the purposes of the application of Article 23 of this Convention, the insured person shall present to the health care provider in the State of stay an entitlement document issued by the competent institution indicating their entitlement to benefits in kind. If the insured person does not have such a document, the institution of the place of stay, upon request or if otherwise necessary, shall contact the competent institution in order to obtain one.

• (2) That document shall indicate that the insured person is entitled to benefits in kind under the conditions laid down in Article 23 of this Convention on the same terms as those applicable to persons insured under the legislation of the State of stay, and shall satisfy the requirements in Appendix 1 of this Annex.

• (3) The benefits in kind referred to in Article 23(1) of this Convention shall refer to the benefits in kind which are provided in the State of stay, in accordance with its legislation, and which become necessary on medical grounds with a view to preventing an insured person from being forced to return, before the end of the planned duration of stay, to the competent State to obtain the necessary treatment.

Procedure and arrangements for meeting the costs and providing reimbursement of benefits in kind

• (4) If the insured person has actually borne the costs of all or part of the benefits in kind provided within the framework of Article 23 of this Convention and if the legislation applied by the institution of the place of stay enables reimbursement of those costs to an insured person, they may send an application for reimbursement to the institution of the place of stay. In that case, that institution shall reimburse directly to that person the amount of the costs corresponding to those benefits within the limits of and under the conditions of the reimbursement rates laid down in its legislation.

• (5) If the reimbursement of such costs has not been requested directly from the institution of the place of stay, the costs incurred shall be reimbursed to the person concerned by the competent institution in accordance with the reimbursement rates administered by the institution of the place of stay or the amounts which would have been subject to reimbursement to the institution of the place of stay, if Article 46 of this Annex had applied in the case concerned.

The institution of the place of stay shall provide the competent institution, upon request, with all necessary information about these rates or amounts.

• (6) By way of derogation from paragraph (5), the competent institution may undertake the reimbursement of the costs incurred within the limits of and under the conditions of the reimbursement rates laid down in its legislation, provided that the insured person has agreed to this provision being applied to them.

• (7) If the legislation of the State of stay does not provide for reimbursement pursuant to paragraphs (4) and (5) in the case concerned, the competent institution may reimburse the costs within the limits of and under the conditions of the reimbursement rates laid down in its legislation, without the agreement of the insured person.

• (8) The reimbursement to the insured person shall not, in any event, exceed the amount of costs actually incurred by them.

• (9) In the case of substantial expenditure, the competent institution may pay the insured person an appropriate advance as soon as that person submits the application for reimbursement to it.

Family Members

• (10) Paragraphs (1) to (9) apply mutatis mutandis to the members of the family of the insured person.

Health fee reimbursement for students

• (11) Where a person:

• (a) holds a valid entitlement document referred to in Appendix 1 of this Annex issued by the competent institution;

• (b) has been accepted by a higher education institution in a State other than the competent State (“State of study”) to pursue a full-time course of study leading to a higher education qualification recognised by that State, including diplomas, certificates or doctoral degrees at a higher education institution, which may cover a preparatory course prior to such education, in accordance with national law, or compulsory training;

• (c) does not exercise, or has not exercised, an activity as an employed or self-employed person in the State of study during the period to which the health fee relates; and

• (d) a health fee has been paid by or on behalf of that person to the State of study as part of an application for a permit to enter, stay or reside for the purposes of pursuing a full-time course of study in that State;

that person may apply to the institution of the State of study for reimbursement (in whole or part, as the case may be) of the health fee paid.

• (12) Where a claim is made in accordance with paragraph (11), the institution of the State of study shall process and settle that claim within a reasonable period but not later than three calendar months starting on the day the claim was received and make any reimbursement of a health fee paid in accordance with the conditions in this Article.

• (13) Where the period of validity of the entitlement document referred to in paragraph (11)(a) is less than the period of time in respect of which the health fee has been paid, the amount of the health fee reimbursed shall be the amount paid which corresponds to the period of validity of that document.

• (14) Where the health fee was paid by another person on behalf of a person to whom this Article applies, reimbursement may be made to that other person.

• (15) Paragraphs (11) to (14) apply mutatis mutandis to the members of the family of that person.

• (16) By way of derogation from Article 8(1) of this Convention, charges may be imposed by the State of study in accordance with its national law in respect of benefits in kind that do not fulfil the criteria set out in Article 23(1)(a) of this Convention and which are provided to a person in respect of whom reimbursement has been made during that person’s stay for the period to which that reimbursement relates.

ARTICLE 23 Scheduled treatment

Authorisation procedure

• (1) For the purposes of the application of Article 24(1) of this Convention, the insured person shall present a document issued by the competent institution to the institution of the place of stay. For the purposes of this Article, the competent institution shall mean the institution which bears the cost of the scheduled treatment; in the cases referred to in Article 24(4) and Article 31(5) of this Convention, in which the benefits in kind provided in the State of residence are reimbursed on the basis of fixed amounts, the competent institution shall mean the institution of the place of residence.

• (2) If an insured person does not reside in the competent State, they shall request authorisation from the institution of the place of residence, which shall forward it to the competent institution without delay.

In that event, the institution of the place of residence shall certify in a statement whether the conditions set out in the second sentence of Article 24(2) of this Convention are met in the State of residence.

The competent institution may refuse to grant the requested authorisation only if, in accordance with the assessment of the institution of the place of residence, the conditions set out in the second sentence of Article 24(2) of this Convention are not met in the State of residence of the insured person, or if the same treatment can be provided in the competent State itself, within a time-limit which is medically justifiable, taking into account the current state of health and the probable course of illness of the person concerned.

The competent institution shall inform the institution of the place of residence of its decision.

In the absence of a reply within the deadlines set by its national legislation, the authorisation shall be considered to have been granted by the competent institution.

• (3) If an insured person who does not reside in the competent State is in need of urgent vitally necessary treatment, and the authorisation cannot be refused in accordance with the second sentence of Article 24(2) of this Convention, the authorisation shall be granted by the institution of the place of residence on behalf of the competent institution, which shall be immediately informed by the institution of the place of residence.

The competent institution shall accept the findings and the treatment options of the doctors approved by the institution of the place of residence that issues the authorisation, concerning the need for urgent vitally necessary treatment.

• (4) At any time during the procedure granting the authorisation, the competent institution shall retain the right to have the insured person examined by a doctor of its own choice in the State of stay or residence.

• (5) The institution of the place of stay shall, without prejudice to any decision regarding authorisation, inform the competent institution if it appears medically appropriate to supplement the treatment covered by the existing authorisation.

Meeting the cost of benefits in kind incurred by the insured person

• (6) Without prejudice to paragraph (7), Article 22(4) and (5) of this Annex apply mutatis mutandis.

• (7) If the insured person has actually borne all or part of the costs for the authorised medical treatment themselves and the costs which the competent institution is obliged to reimburse to the institution of the place of stay or to the insured person according to paragraph (6) (actual cost) are lower than the costs which it would have had to assume for the same treatment in the competent State (notional cost), the competent institution shall reimburse, upon request, the cost of treatment incurred by the insured person up to the amount by which the notional cost exceeds the actual cost. The reimbursed sum may not, however, exceed the costs actually incurred by the insured person and may take account of the amount which the insured person would have had to pay if the treatment had been delivered in the competent State.

Meeting the cost of travel and stay as part of scheduled treatment

• (8) Where the national legislation of the competent institution provides for the reimbursement of the costs of travel and stay which are inseparable from the treatment of the insured person, such costs for the person concerned and, if necessary, for a person who must accompany them, shall be assumed by this institution when an authorisation is granted in the case of treatment in another State.

Family Members

• (9) Paragraphs (1) to (8) apply mutatis mutandis to the members of the family of the insured person.

ARTICLE 24 Cash benefits relating to incapacity for work in the event of stay or residence in a State other than the competent State

Procedure to be followed by the insured person

• (1) If the legislation of the competent State requires that the insured person presents a certificate in order to be entitled to cash benefits relating to incapacity for work pursuant to Article 25(1) of this Convention, the insured person shall ask the doctor of the State of residence who established that person’s state of health to certify their incapacity for work and its probable duration.

• (2) The insured person shall send the certificate to the competent institution within the time limit laid down by the legislation of the competent State.

• (3) Where the doctors providing treatment in the State of residence do not issue certificates of incapacity for work, and where such certificates are required under the legislation of the competent State, the person concerned shall apply directly to the institution of the place of residence. That institution shall immediately arrange for a medical assessment of the person’s incapacity for work and for the certificate referred to in paragraph (1) to be drawn up. The certificate shall be forwarded to the competent institution forthwith.

• (4) The forwarding of the document referred to in paragraphs (1), (2) and (3) shall not exempt the insured person from fulfilling the obligations provided for by the applicable legislation, in particular with regard to that person’s employer. Where appropriate, the employer or the competent institution may call upon the employee to participate in activities designed to promote and assist their return to employment.

Procedure to be followed by the institution of the State of residence

• (5) At the request of the competent institution, the institution of the place of residence shall carry out any necessary administrative checks or medical examinations of the person concerned in accordance with the legislation applied by this latter institution. The report of the examining doctor concerning, in particular, the probable duration of the incapacity for work, shall be forwarded without delay by the institution of the place of residence to the competent institution.

Procedure to be followed by the competent institution

• (6) The competent institution shall reserve the right to have the insured person examined by a doctor of its choice.

• (7) Without prejudice to the second sentence of Article 25(1) of this Convention, the competent institution shall pay the cash benefits directly to the person concerned and shall, where necessary, inform the institution of the place of residence thereof.

• (8) For the purposes of the application of Article 25(1) of this Convention, the particulars of the certificate of incapacity for work of an insured person drawn up in another State on the basis of the medical findings of the examining doctor or institution shall have the same legal value as a certificate drawn up in the competent State.

• (9) If the competent institution refuses the cash benefits, it shall notify its decision to the insured person and at the same time to the institution of the place of residence.

Procedure in the event of a stay in a State other than the competent State

• (10) Paragraphs (1) to (9) apply mutatis mutandis when the insured person stays in a State other than the competent State.

ARTICLE 25 Contributions by pensioners

If a person receives a pension from more than one State, the amount of contributions deducted from all the pensions paid shall, under no circumstances, be greater than the amount deducted in respect of a person who receives the same amount of pension from the competent State.

CHAPTER 2 BENEFITS IN RESPECT OF ACCIDENTS AT WORK AND OCCUPATIONAL DISEASES

ARTICLE 26 Right to benefits in kind and in cash in the event of residence or stay in a State other than the competent State

• (1) For the purposes of the application of Article 37 of this Convention, the procedures laid down in Articles 21 to 24 of this Annex apply mutatis mutandis.

• (2) When providing special benefits in kind in connection with accidents at work and occupational diseases under the national legislation of the State of stay or residence, the institution of that State shall without delay inform the competent institution.

ARTICLE 27 Procedure in the event of an accident at work or occupational disease which occurs in a State other than the competent State

• (1) If an accident at work occurs or an occupational disease is diagnosed for the first time in a State other than the competent State, the declaration or notification of the accident at work or the occupational disease, where the declaration or notification exists under national legislation, shall be carried out in accordance with the legislation of the competent State, without prejudice, where appropriate, to any other applicable legal provisions in force in the State in which the accident at work occurred or in which the first medical diagnosis of the occupational disease was made, which remain applicable in such cases. The declaration or notification shall be addressed to the competent institution.

• (2) The institution of the State in the territory of which the accident at work occurred or in which the occupational disease was first diagnosed, shall notify the competent institution of medical certificates drawn up in the territory of that State.

• (3) Where, as a result of an accident while travelling to or from work which occurs in the territory of a State other than the competent State, an inquiry is necessary in the territory of the first State in order to determine any entitlement to relevant benefits, a person may be appointed for that purpose by the competent institution, which shall inform the authorities of that State. The institutions shall cooperate with each other in order to assess all relevant information and to consult the reports and any other documents relating to the accident.

• (4) Following treatment, a detailed report accompanied by medical certificates relating to the permanent consequences of the accident or disease, in particular the injured person’s present state and the recovery or stabilisation of injuries, shall be sent upon request of the competent institution. The relevant fees shall be paid by the institution of the place of residence or of stay, where appropriate, at the rate applied by that institution to the charge of the competent institution.

• (5) At the request of the institution of the place of residence or stay, where appropriate, the competent institution shall notify it of the decision setting the date for the recovery or stabilisation of injuries and, where appropriate, the decision concerning the granting of a pension.

ARTICLE 28 Disputes concerning the occupational nature of the accident or disease

• (1) Where the competent institution disputes the application of the legislation relating to accidents at work or occupational diseases under Article 37(2) of this Convention, it shall without delay inform the institution of the place of residence or stay which provided the benefits in kind, which will then be considered as sickness insurance benefits.

• (2) When a final decision has been taken on that subject, the competent institution shall, without delay, inform the institution of the place of residence or stay which provided the benefits in kind.

Where an accident at work or occupational disease is not established, benefits in kind shall continue to be provided as sickness benefits if the person concerned is entitled to them.

Where an accident at work or occupational disease is established, sickness benefits in kind provided to the person concerned shall be considered as accident at work or occupational disease benefits from the date on which the accident at work occurred or the occupational disease was first medically diagnosed.

• (3) Article 6(6) of this Annex applies mutatis mutandis.

ARTICLE 29 Procedure in the event of exposure to the risk of an occupational disease in two or more States

• (1) In the case referred to in Article 39 of this Convention, the declaration or notification of the occupational disease shall be sent to the competent institution for occupational diseases of the last State under the legislation of which the person concerned pursued an activity likely to cause that disease.

When the institution to which the declaration or notification was sent establishes that an activity likely to cause the occupational disease in question was last pursued under the legislation of another State, it shall send the declaration or notification and all accompanying certificates to the equivalent institution in that State.

• (2) Where the institution of the last State under the legislation of which the person concerned pursued an activity likely to cause the occupational disease in question establishes that the person concerned or their survivors do not meet the requirements of that legislation, inter alia, because the person concerned had never pursued in that State an activity which caused the occupational disease or because that State does not recognise the occupational nature of the disease, that institution shall forward without delay the declaration or notification and all accompanying certificates, including the findings and reports of medical examinations performed by the first institution to the institution of the previous State under the legislation of which the person concerned pursued an activity likely to cause the occupational disease in question.

• (3) Where appropriate, the institutions shall reiterate the procedure set out in paragraph (2) going back as far as the equivalent institution in the State under whose legislation the person concerned first pursued an activity likely to cause the occupational disease in question.

ARTICLE 30 Exchange of information between institutions and advance payments in the event of an appeal against rejection

• (1) In the event of an appeal against a decision to refuse benefits taken by the institution of a State under the legislation of which the person concerned pursued an activity likely to cause the occupational disease in question, that institution shall inform the institution to which the declaration or notification was sent, in accordance with the procedure provided for in Article 29(2) of this Annex, and shall subsequently inform it when a final decision is reached.

• (2) Where a person is entitled to benefits under the legislation applied by the institution to which the declaration or notification was sent, that institution shall make the advance payments, the amount of which shall be determined, where appropriate, after consulting the institution which made the decision against which the appeal was lodged, and in such a way that overpayments are avoided. The latter institution shall reimburse the advance payments made if, as a result of the appeal, it is obliged to provide those benefits. That amount will then be deducted from the benefits due to the person concerned, in accordance with the procedure provided for in Articles 55 and 56 of this Annex.

• (3) Article 6(6) of this Annex applies mutatis mutandis.

ARTICLE 31 Aggravation of an occupational disease

In the cases covered by Article 40 of this Convention, the claimant must provide the institution in the State from which they are claiming entitlement to benefits with details concerning benefits previously granted for the occupational disease in question. That institution may contact any other previously competent institution in order to obtain the information it considers necessary.

ARTICLE 32 Assessment of the degree of incapacity in the event of occupational accidents or diseases which occurred previously or subsequently

Where a previous or subsequent incapacity for work was caused by an accident which occurred when the person concerned was subject to the legislation of a State which makes no distinction according to the origin of the incapacity to work, the competent institution or the body designated by the competent authority of the State in question shall:

• (a) upon request by the competent institution of another State, provide information concerning the degree of the previous or subsequent incapacity for work, and where possible, information making it possible to determine whether the incapacity is the result of an accident at work within the meaning of the legislation applied by the institution in another State;

• (b) take into account the degree of incapacity caused by these previous or subsequent cases when determining the right to benefits and the amount, in accordance with the applicable legislation.

ARTICLE 33 Submission and investigation of claims for pensions or supplementary allowances

In order to receive a pension or supplementary allowance under the legislation of a State, the person concerned or their survivors residing in the territory of another State shall submit, where appropriate, a claim either to the competent institution or to the institution of the place of residence, which shall send it to the competent institution.

The claim shall contain the information required under the legislation applied by the competent institution.

CHAPTER 3 DEATH GRANTS

ARTICLE 34 Claim for death grants

For the purposes of Articles 43 and 44 of this Convention, the claim for death grants shall be sent either to the competent institution or to the institution of the claimant’s place of residence, which shall send it to the competent institution.

The claim shall contain the information required under the legislation applied by the competent institution.

CHAPTER 4 INVALIDITY BENEFITS AND OLD-AGE AND SURVIVORS’ PENSIONS

ARTICLE 35 Additional provisions for the calculation of the benefit

• (1) For the purposes of calculating the theoretical amount and the actual amount of the benefit in accordance with Article 51(1)(b) of this Convention, the rules provided for in Article 11(3) to (6) of this Annex apply.

• (2) Where periods of voluntary or optional continued insurance have not been taken into account under Article 11(3) of this Annex, the institution of the State under whose legislation those periods were completed shall calculate the amount corresponding to those periods under the legislation it applies. The actual amount of the benefit, calculated in accordance with Article 51(1)(b) of this Convention, shall be increased by the amount corresponding to periods of voluntary or optional continued insurance.

• (3) The institution of each State shall calculate, under the legislation it applies, the amount due corresponding to periods of voluntary or optional continued insurance which, under Article 52(3)(c) of this Convention, shall not be subject to another State’s rules relating to withdrawal, reduction or suspension.

Where the legislation applied by the competent institution does not allow it to determine this amount directly, on the grounds that that legislation allocates different values to insurance periods, a notional amount may be established. The Joint Administrative Committee shall lay down the detailed arrangements for the determination of that notional amount.

ARTICLE 36 Claim for benefits

Submission of claims for old-age and survivors’ pensions

• (1) The claimant shall submit a claim to the institution of their place of residence or to the institution of the last State whose legislation was applicable. If the person concerned was not, at any time, subject to the legislation applied by the institution of the place of residence, that institution shall forward the claim to the institution of the last State whose legislation was applicable.

• (2) The date of submission of the claim shall apply in all the institutions concerned.