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

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

Occupational medicine is responsible for:

  • Receive the work accidents of its affiliates, reported by the companies.
  • Guide the worker and the company on the procedures and standards established for reporting accidents at work.
  • 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 steps 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 present diseases of common origin.

Which are the requirements:

source qualification
  • Photocopy of the medical history
  • Photocopy of tests 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 accident at work 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 the medical history
  • Photocopy of tests 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

***Note: The filing of these documents must be done at the nearest PAI (Comprehensive Care Point).
  • Photocopy of clinical history that specifies: diagnosis, treatment, clinical evolution and prognosis of the disease.
  • Photocopy of tests for clinicians that support the diagnosis such as: laboratories, x-rays, electromyography, resonances, etc.
  • Photocopy of citizenship card.
  • Photocopy of the affiliation form 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 indicating the prognosis of the disease.

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

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 Professional Risks, whose Benefit Plan is much broader both in terms of 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 provided by said system, such as:

  • Medical treatment without the requirement of minimum affiliation periods, nor cost of moderator fees.
  • Supply of Medications that are pertinent 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 value for which the contribution is being made.

Comfenalco Valle Delagente
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