Diabetes sufferers can count on some benefits which, in part, lift the burden of a disease that is not always easy to live with. These are aids of an economic,  healthcare and employment nature.

LAW 104/92 (HANDICAP) AND DISABILITY, LET’S NOT MAKE CONFUSION

Law 104/92 (Handicap) and disability are two different benefits.

INVALIDITY

Citizens suffering from physical, mental or sensorial impairments, who have suffered a permanent reduction in working capacity of no less than one third (33%) or, if minors, are considered civil invalids , who have persistent difficulties in carrying out the tasks and functions specific to their age. People over sixty-five who have persistent difficulties in carrying out the tasks and functions specific to their age are also considered disabled. Civil invalids do not include: war invalids, work invalids, service invalids, the blind and the deaf and dumb. Different laws apply to these categories.

Only the recognition of disability gives rise to economic benefits (allowance, accompanying allowance, attendance allowance).

The evaluation of civil disability is based on the reduction of working capacity, with the consequent attribution of a percentage (on page 44 the endocrine system and diabetes mellitus)

The requirements include an age between 18 and 65 years. Before the age of 18 and after the age of 65, civil disability is recognized if the individual is unable to carry out tasks and functions typical of his age. Civil disability for minors, especially at a young age, is not calculated in as many percentage points as the reductions in generic working capacity following a certain pathology, since young people, in themselves, do not have working capacity. The recognition of the civil disability of minors is subject to the condition that they have persistent difficulties in carrying out the tasks and functions of their age (which instead, without that disability, they could perform). Exclusively for minors over the age of fifteen, the percentage of civil disability is also indicated, for the sole purpose of registration on the special employment lists pursuant to Law no. 68/99.

INPS disability guidelines

THE LAW 104/92 (DISABILITY)

Law 104/92, however, is the legislative reference “for assistance, social integration and the rights of disabled people”.
The main recipients of Law 104 are therefore disabled people, but there is also no shortage of references to those who live with them. The assumption is in fact that autonomy and social integration are achieved by guaranteeing adequate support to the disabled person and the family. recognition of the state of handicap, however, the difficulty of social inclusion due to the pathology or impairment found is taken into consideration. The concept of handicap – always as defined by Law no. 104/92 – expresses the condition of social disadvantage that a person presents compared to other people considered normal and differs from the impairment (physical, mental or sensorial) that is the cause of that condition. In other words, the state of handicap for its evaluation takes into account the difficulty of social inclusion of the disabled person, a difficulty which is due to the pathology or impairment that this person is suffering from. The recognition of the handicap situation does not give rise to economic benefits but is the indispensable condition for being able to take advantage of various benefits, including work permits, granted to disabled workers and family members who assist them, and two years’ paid leave, only for family members who assist recognized disabled people in serious situations.

The verification of one is not necessarily linked to the verification of the other.

This means that you can obtain handicap status (art 3 paragraph 3/paragraph 1) even in the absence of recognition of a civil disability.

A common question: “Where to start for the recognition of disability (monthly allowance for attendance or accompaniment) and of Law 104/92 (work permits, granted to disabled workers and their family members who assist them)?”

WHO CAN APPLY

Italian citizens who have residenceon the national territory can submit an application for recognition of disability. < /strong>

You can also apply:

  • foreign EU citizens legally residing in the territory of the State registered in the registry office of the Municipality of residence;
  • foreign non-EU citizens legally residing in the territory of the State and holding the requirement of a residence permit of at least one year as per art. 41 TU immigration, even if they do not have a long-term EC residence permit.

THE MEDICAL CERTIFICATE

To start the process of ascertaining the state of civil disability, the interested party must first go to a certifying doctor (even the general practitioner) and request the release of the introductory medical certificate
The certificate must indicate (in addition to personal data, tax code and health card) the exact nature of the disabling pathologies and the related diagnosis.

The certificate is drawn up in digital form by the doctor, who then forwards it electronically to INPS using the appropriate function on the website;< /p>

After transmission of the certificate, the procedure allows the printing of a receipt containing the identification code of the activated procedure. The receipt is given by the doctor to the interested party together with a copy of the original medical certificate that the citizen must show at the time of the medical examination.

The introductory medical certificate is valid for 90 days for the purposes of submitting the civil disability application

Check which disability has been checked (Handicap, disability or both)

THE QUESTION

Once the medical certificate has been obtained, the interested party can submit the application by also indicating the identification code of the medical certificate. The application must be submitted exclusively electronically:

  • through the Patronato or a trade association of disabled people (ANMIC, ENS, UIC, ANFASS);
  • directly from the interested party, using the device PIN code issued by the Institute via SPID

If the interested party is a minor, the PIN code issued to the minor must be used and not that of the parent or guardian.

From 4 July 2009 (with the exception of applications for aggravation referred to in law 80/2006) it is not possible to submit a new application for the same benefit until the process of the one in progress has been completed or, in the case of a judicial appeal, until a sentence passed in n judged.

As soon as the complete application is received, the INPS will transmit it, again electronically, to the relevant local health authority.

NB: Disability and handicap (L104) require two distinct questions.

THE MEDICAL EXAMINATION AND THE EXAMINATION REPORT

Once the application has been submitted, the citizen will receive communication of the date of the medical examination, according to the ASL appointment calendar corresponding to the ZIP code of residence of the interested party (or alternative domicile, if declared).

If the disabled person suffers from an oncological pathology, the visit is scheduled within 15 days of the submission of the application.

In case of non-transportability of the interested party, the doctor must complete and send electronically the medical certificate requesting a home visit, which must arrive at least < strong>5 days beforethe date already set for the outpatient visit.

The President of the Medical Commission makes his decision within five days of receiving the request. If accepted, the citizen will be informed of the date and time established for the home visit, otherwise a new date of invitation to the outpatient visit will be indicated.

The interested party, in case of impediment, can indicate a different date among those indicated by the system. If the interested party does not show up for the visit, he or she is summoned a second time. In case of further absence he is considered to have resigned and his application becomes ineffective.
The interested party can be assisted during the visit by a doctor he trusts.
The health assessment is the responsibility of the Local Health Authority, which carries it out through a Medical Commission integrated however by a doctor from the INPS and called, precisely, the Integrated Medical Commission (CMI).

Once the checks have been completed, the commission draws up the visit report, signed by at least 3 doctors (including the category representative, if present).

The ASL report is then validated by the INPS Legal Medical Center (CML), which can order new investigations, including through a direct visit.

The final report is sent in duplicate to the interested party: one with all the health data, including sensitive ones, and the other with only the final judgement.

A random monitoring is then carried out on the reports defined by the Medical Commissions (or based on a report from the INPS Medical Centres) by the Superior Medical Commission (CMS). The checks ordered by the CMS – even after the report has been sent to the citizen – may consist of a review of the health documentation on file or a direct visit

If you believe the commission’s decisions are incorrect, respecting the legal deadlines, you can appeal within the legal deadlines.

NB For further information: www.inps.it

DIABETES AND MINORS

  • INPS may recognize an attendance or accompaniment allowance, paid upon request, for the educational and social inclusion of minors with disabilities until they reach the age of majority.
  • Evaluation for the purposes of civil invalidity and handicap of minors suffering from diabetes mellitus 1 INPS GUIDELINES
  • The Family Nuclear Allowance (ANF) is a economic benefit provided by the INPS to the family units of certain categories of workers. The recognition and determination of the amount of the allowance take into account the type of family unit, the number of members and the overall income of the unit itself. The benefit is provided in decreasing amounts for increasing income brackets and ceases at different exclusion thresholds depending on the family type.
    • Increases in the case of children with disabilities: For the purposes of recognizing the increase, subjects receiving the attendance allowance can also be taken into consideration. In order to benefit from the ANF with increased amounts, however, the opinion of the INPS medical examiners is necessary because situations of varying severity are included. In fact, with message n.3604 of 4 October 2019, INPS modifies the requirements for access to the ANF increase in the presence of disabled minor children: only access to the attendance allowance will no longer be sufficient, but it will be INPS legal doctors to verify the right to access the benefit: “(…)for the purposes of recognizing the increased amount of the ANF, subjects benefiting from the attendance allowance can also be taken into consideration, but as the impairment complex of the minor entitled to the attendance allowance deployed in a wide range of underlying situations, it is necessary to request an endoprocedural opinion from the Headquarters Legal Medical Office for an examination of the case“. For this reason, the INPS must express its opinion on the presence or absence of a medium-severe/severe disability and only in the affirmative case will it be possible to proceed with further obligations.
  • Diabetes and school (For further information see the “diabetes and school” section of the site)
    • Lombardy Region. The circular number 30 DGS of 2005, always current, currently in force in Lombardy, was drawn up to manage the reception of children within the school and to allow the school itself to guarantee their stay in the structure safely. Guide on juvenile diabetes to encourage the inclusion of diabetic children in schools Circular no. 30 /SAN of 12/07/2005

MISCELLANEOUS