Obtainment The practical modalities of the allowance for the severely disabled (RPGH)

Anyone residing in Luxembourg who has a disability that prevents them from undertaking gainful employment

Filing an application

Applicants must contact the secretariat of the Medical Commission (Commission médicale) of the National Employment Agency (Agence pour le développement de l'emploi – ADEM) to:

• receive an application form; and
  
• acquaint themselves with the formalities for receiving the severely disabled allowance.

The application form must be duly completed, dated and signed and, together with the required supporting documents, sent by email to the secretariat of the Medical Commission at:  commissionmedicale@adem.etat.lu.

Supporting documents

Applicants must include the following with their application:

• a birth certificate (or equivalent document) establishing that the applicant is at least 18 years of age at the time of the application;
• a recent detailed medical report, issued by the relevant attending physician(s), indicating:

• a certificate of nationality or equivalent (for example: a copy of their ID card or passport);
• documents attesting to the capacity of their legal representative (if the applicant needs representation in their legal actions);
• a residence certificate dated within the last 3 months, issued by the commune of residence, stating that the applicant is domiciled there and actually lives there;
• proof of the right to reside in Luxembourg for more than 3 months (if the applicant is a national of an EU Member State, a state that is a signatory to the European Economic Area (EEA) Agreement, or the Swiss Confederation);
• proof that they have been residing in Luxembourg for at least 5 years in the last 20 years (if the applicant is a national of a State other than those listed above).
  Note: this residency requirement does not apply to the family members of Luxembourg nationals or nationals of other EU or EEA Member States or the Swiss Confederation, regardless of their nationality.

The application must be accompanied by a recent and detailed medical report, drawn up by ADEM's occupational health practitioner, specifying the percentage reduction in work capacity and certifying that the applicant's state of health is such that any effort is contraindicated (in the case of an application submitted by a job seeker).

Procedure and decision

The Medical Commission will:

• determine the applicant's reduced work capacity; and
• rule on the applicant's residual capacity and state of health.

To obtain the RPGH, the applicant state of health must, in principle, be medically stable. If the applicant's state of health is not sufficiently stabilised, the Medical Commission will postpone its decision.

The applicant will be informed of the Medical Commission's decision by registered letter within 2 months of submitting the complete application.

When its final decision has been established, the Medical Commission will forward it, together with the application and all supporting documents, to the National Solidarity Fund (Fonds national de solidarité – FNS).

The FNS will send the applicant a questionnaire to provide the information it requires to process the application.

The age, residency and income criteria will be checked by the FNS, which will inform the applicant of its decision, by registered letter, within one month of receiving the Medical Commission's decision.

The FNS will then inform the Medical Commission of its decision.

If the RPGH is granted, it is due to the beneficiary from the date of the application. The allowance is paid by the FNS.

Duration of validity

The RPGH is paid to the beneficiary as long as the conditions for entitlement are met.

Any change in circumstances that may affect entitlement to the RPGH must be reported to the FNS immediately.

Anyone with a recognised disability who has residual abilities allowing them to engage in a professional activity but who, for reasons beyond their control, do not have access to paid employment.

Filing an application

After being granted disabled worker status, applicants must contact the secretariat of the Medical Commission (Commission médicale) of the National Employment Agency (Agence pour le développement de l'emploi – ADEM) to:

• receive an application form; and
  
• acquaint themselves with the formalities for receiving the disabled workers allowance.

The application form must be duly completed, dated and signed and, together with the required supporting documents, sent by email to the secretariat of the Medical Commission at: commissionmedicale@adem.etat.lu.

Supporting documents

Applicants must include the following with their application:

• their birth certificate or a copy of a valid identity document;
• a copy of the Medical Commission's decision granting them the status of disabled worker;
• a copy of the decision by the Occupational Counselling and Redeployment Panel (Commission d’orientation et de reclassement professionnel) regarding their placement on the mainstream labour market or in a sheltered workshop;
• recent documents on the status of their financial resources;
• documents attesting to the status of legal representative, if the applicant needs representation in their legal actions;
• a residence certificate dated within the last 3 months, issued by the commune of residence, stating that the applicant is domiciled there and actually lives there;
• proof of the right to reside in Luxembourg for more than 3 months (if the applicant is a national of an EU Member State, a state that is a signatory to the European Economic Area (EEA) Agreement, or the Swiss Confederation);
• proof that they have been residing in Luxembourg for at least 5 years in the last 20 years (if the applicant is a national of a State other than those listed above).
  Note: this residency requirement does not apply to the family members of Luxembourg nationals or nationals of other EU or EEA Member States or the Swiss Confederation, regardless of their nationality.

Applications must be accompanied by:

• a declaration stating that the applicant does not have access to paid employment for reasons beyond their control (issued by ADEM's department in charge of employment and training); and
• a certificate of registration as a jobseeker issued by ADEM.

Procedure and decision

Once the application is complete and has been checked by the secretariat of the Medical Commission, ADEM will forward it to the National Solidarity Fund (Fonds national de solidarité – FNS).

The FNS will send the applicant a questionnaire to provide the information it requires to process the application and will check whether the applicant meets the age, residency and income criteria.

The FNS will then notify the applicant of its decision by registered letter within one month of the Medical Commission's announcement of its decision.

The FNS is responsible for the administration and payment of the disabled workers allowance.

If the disabled workers allowance is granted, applicants are entitled to receive it from the first day of the month in which ADEM forwarded their application to the FNS (as evidenced by the date on which the secretariat of the FNS acknowledged receipt of the application).

Duration of validity

Applicants will continue to receive the disabled workers allowance as long as they:

• are registered with ADEM; and
• are unable to find a job due to reasons beyond their control.

Review and repayment of the RPGH

The FNS will regularly check whether the conditions of entitlement are still met.

In the event of changes in the beneficiary's circumstances, the RPGH may be increased, reduced or withdrawn with retroactive effect.

The FNS may seek to recover sums that have been paid to the beneficiary if:

• the beneficiary received more than they were entitled to;
• the allowance was granted following a material error.

Repayment is mandatory if the beneficiary:

• provided false information to receive the allowance; or
• concealed important facts; or
• neglected to report major events after the benefit was granted.

Means of appeal and application for review

Decisions on reduced work capacity taken by the Medical Commission and decisions by the FNS to refuse to grant the RPGH may be appealed before the Social Security Arbitration Tribunal (Conseil arbitral de la Sécurité sociale).

This appeal must be lodged, on pain of ineligibility, within 40 days of notification of the contested decision.

Decisions handed down by the Social Security Arbitration Tribunal can be appealed, in which case the appeal must be lodged with the High Council of Social Security (Conseil supérieur de la sécurité sociale) within 40 days of notification of the contested decision.

If there is a fundamental change in the facts and circumstances relating to the claimant's work capacity, the initial decision (relating to the reduction in the claimant's work capacity and their state of health) may be the subject of an application for review.

The application for review must be lodged by the applicant or their guardian with the Medical Commission. It must be accompanied by the same supporting documents as for initial applications.

The Medical Commission will process the application for review under the same conditions and procedures as those defined for initial applications.

It is not possible to submit an application for review while proceedings before the social courts are in progress, or before 6 months have elapsed since the notification of a first decision that has become final.