Occupational medicine

In order to comply with current legal regulations, Comfenalco Valle EPS determines the origin of health events and establishes whether these events may be related to the work performed by the user.

The foregoing, in order to allow the worker access to the rights they have within the General Social Security System.

Occupational medicine is responsible for:

  • Receive the work accidents of its members, reported by the companies.
  • Guide the worker and the company on the procedures and standards established for the report of work accidents.
  • Issue opinions to qualify the origin of occupational diseases and guide both companies and users on the process of qualifying the origin of health events.
  • Carry out the necessary procedures for the referral of cases with temporary disability of more than 180 days to the Pension Funds, so that said Funds continue with the payment of economic benefits to workers who have diseases of common origin.
  • Transcribe the disabilities derived from work accidents and professional diseases (procedure that the company can access through the PAI).

Which are the requirements:

Origin qualification

  • Photocopy of medical history
  • Photocopy of examinations for clinicians that support the diagnosis such as: laboratories, x-rays, electromyography, resonances, etc.
  • Unique Work Accident Report Format.
  • Certification of the sporting event issued by the company (applies only when the work accident indicates that it occurs during the development of a sporting activity).

***Note: the filing of these documents must be done at the nearest PAI (Comprehensive Care Point).

  • Photocopy of medical history
  • Photocopy of exams for clinicians
    that support the diagnosis such as: laboratories, x-rays, electromyography, resonances, etc.
  • Certificate of positions and detailed description of functions performed,
  • Entrance and periodic exams
  • Job study
  • Unique Occupational Illness Report Format, duly filled out with the information of the company and the affiliate.

***Note: the filing of these documents must be done at the nearest PAI (Comprehensive Care Point).

  • Photocopy of medical history that specifies: diagnosis, treatment, clinical evolution and prognosis of the disease.
  • Photocopy of examinations for clinicians that support the diagnosis such as: laboratories, x-rays, electromyography, resonances, etc.
  • Photocopy of citizenship card.
  • Photocopy of the form of affiliation to the Pension Fund.
  • Photocopy of the last proof of contributions to the pension fund.
  • Photocopy of all continuous disabilities generated by the same diagnosis.
  • Comprehensive rehabilitation certificate issued by the treating physician that indicates the prognosis of the disease.

***Note: the filing of these documents must be done at the nearest PAI (Comprehensive Care Point).

  • Original format of the disability issued.
  • Medical History that supports the issuance of the disability.
  • Work Accident Report Form (if the disability is generated by this concept).
  • Qualification opinion from the EPS and / or letter from the ARL confirming the origin of the qualification of the health event (if the disability is caused by a diagnosis of professional origin).

In compliance with regulations and for the benefit of your workers, it is important to remember that:

The General Health System establishes a Benefit Plan that is limited to the Mandatory Health Plan (POS).

Contrary to what happens with accidents at work and occupational diseases that are covered by the General System of Occupational Risks, whose Benefit Plan is much broader in both assistance and economic benefits.

Therefore, it is important to determine the origin of the different health events, in this way, if it is an event of professional origin, the workers will obtain the benefits that this system grants them, such as:

  • Medical treatment without the requirement of minimum membership periods, or the cost of moderating fees.
  • Supply of Medications that are relevant but that are not within the Benefit Plan.
  • Rehabilitation programs and elements such as splints, wheelchairs, crutches, etc.

Disabilities that are recognized on the 100% of the security for which the quotation is being made.

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