Socialezekerheidsrecht – H1 Inleiding
Socialezekerheidsrecht
Socialezekerheidsrecht 2024 – 2025
UA_1300PSWSZR_2425
Kim Van den Langenbergh
Samenvatting van H1 – H10 op basis van de slides en eigen lesnotities, maar ook
aanvullingen met het handboek
Persoonlijk examenpunt: 10/20 op ZIT1
1
, Socialezekerheidsrecht – H1 Inleiding
1 Inleiding + historiek
Inhoudsopgave
1 Inleiding + historiek..................................................................................................................................... 2
1.1 Inleiding..........................................................................................................................................................6
1.1.1 Wat is sociale zekerheid?........................................................................................................................6
1.1.2 Waarom socialezekerheidsrecht?...........................................................................................................6
1.1.3 Socialezekerheidsrecht: wat/hoe?..........................................................................................................7
1.2 Historiek Belgische sociale zekerheid...........................................................................................................10
2 Toepassingsgebied.................................................................................................................................... 19
2.1 Werknemers.................................................................................................................................................23
2.1.1 Definitie.................................................................................................................................................23
2.1.2 Territoriaal toepassingsgebied..............................................................................................................26
2.1.3 Uitbreidingscategorieën.......................................................................................................................28
2.1.4 Uitgesloten werknemers.......................................................................................................................28
2.1.5 Beperking tot bepaalde sectoren.........................................................................................................29
2.2 Zelfstandigen................................................................................................................................................30
2.2.1 Definitie.................................................................................................................................................30
2.2.2 Beroepsbezigheid..................................................................................................................................31
2.2.3 Helper...................................................................................................................................................31
2.2.4 Deeleconomie.......................................................................................................................................32
2.3 Ambtenaren / overheidspersoneel...............................................................................................................32
2.4 Personen met afgeleide rechten...................................................................................................................33
2.5 Gerechtigden op sociale bijstand.................................................................................................................33
2.6 Overzicht.......................................................................................................................................................34
3 Financiering.............................................................................................................................................. 35
3.1 Algemeen.....................................................................................................................................................39
3.2 Werknemers.................................................................................................................................................39
3.2.1 Berekeningsgrondslag...........................................................................................................................39
3.2.2 Werkgevers- en werknemersbijdragen.................................................................................................46
3.2.3 Crisisbijdragen......................................................................................................................................49
3.2.4 Responsabiliseringsbijdragen...............................................................................................................50
3.2.5 Solidariteitsbijdragen...........................................................................................................................51
3.2.6 Bijdrageverminderingen.......................................................................................................................52
3.2.7 Bijdragen op sociale uitkeringen..........................................................................................................53
3.2.8 Alternatieve financiering van de sociale zekerheid.............................................................................53
3.2.9 Formaliteiten........................................................................................................................................54
3.3 Zelfstandigen................................................................................................................................................55
3.3.1 Berekeningsgrondslag...........................................................................................................................55
3.3.2 Bijdragepercentages.............................................................................................................................57
3.3.3 Andere bijdragen..................................................................................................................................60
3.3.4 Formaliteiten........................................................................................................................................61
3.4 Overheidspersoneel / ambtenaren...............................................................................................................62
3.4.1 Gewone bijdragen.................................................................................................................................62
3.4.2 Financiering van de ambtenarenpensioenen.......................................................................................63
2
, Socialezekerheidsrecht – H1 Inleiding
3.4.3 Overheidssteun.....................................................................................................................................64
3.4.4 Subsidiaire financieringsbronnen.........................................................................................................64
3.5 Sociale bijstand.............................................................................................................................................64
4 Administratieve organisatie....................................................................................................................... 65
4.1 Algemeen.....................................................................................................................................................69
4.2 Werknemers.................................................................................................................................................70
4.2.1 Inning door de RSZ................................................................................................................................71
4.2.2 Uitvoering in de verschillende sectoren...............................................................................................71
4.3 Zelfstandigen................................................................................................................................................73
4.3.1 Inning van bijdragen.............................................................................................................................73
4.3.2 Uitvoering van prestaties......................................................................................................................73
4.4 Overheidspersoneel......................................................................................................................................74
4.4.1 Inning van bijdragen.............................................................................................................................74
4.4.2 Uitvoering.............................................................................................................................................74
4.5 Sociale bijstand.............................................................................................................................................74
5 Gezondheidszorg....................................................................................................................................... 75
5.1 Algemeen.....................................................................................................................................................79
5.2 Rechthebbenden...........................................................................................................................................80
5.2.1 Algemeen..............................................................................................................................................80
5.2.2 Gerechtigden........................................................................................................................................80
5.2.3 Voortgezette verzekering......................................................................................................................82
5.2.4 Personen ten laste voor de gezondheidszorg.......................................................................................82
5.3 Voorwaarden................................................................................................................................................83
5.3.1 Algemene voorwaarden.......................................................................................................................83
5.3.2 Soorten verstrekkingen.........................................................................................................................84
5.3.3 Specifieke voorwaarden voor terugbetaling (ziv).................................................................................85
5.3.4 Uitgesloten kosten................................................................................................................................86
5.4 Prestaties......................................................................................................................................................87
5.4.1 Algemene principes.............................................................................................................................87
5.4.2 Terugbetalingstarieven.........................................................................................................................90
5.4.3 Vaststelling van de tarieven..................................................................................................................93
5.4.4 TARIEVEN – gevolgen VERBONDEN zorgverstrekkers...........................................................................95
6 Gezinsbijslagen......................................................................................................................................... 97
6.1 Algemeen...................................................................................................................................................101
6.1.1 Sleuteljaar 2014..................................................................................................................................101
6.1.2 Defederalisering..................................................................................................................................101
6.2 Groeipakket in vlaanderen.........................................................................................................................102
6.2.1 Andere accenten.................................................................................................................................102
6.2.2 Actoren...............................................................................................................................................103
6.2.3 Prestaties............................................................................................................................................105
6.2.4 Rechtshandhaving...............................................................................................................................110
7 Professionele risico’s............................................................................................................................... 111
7.1 Arbeidsongevallen......................................................................................................................................115
7.1.1 Historische context.............................................................................................................................115
7.1.2 Toepassingsgebied – Ratione personae..............................................................................................115
7.1.3 Toepassingsgebied – Ratione materiae..............................................................................................116
7.1.4 Schadeloosstelling..............................................................................................................................122
3
, Socialezekerheidsrecht – H1 Inleiding
7.1.5 Burgerlijke aansprakelijkheid..............................................................................................................126
7.1.6 Procedure............................................................................................................................................128
7.1.7 Verzekering.........................................................................................................................................129
7.2 Beroepsziekten...........................................................................................................................................129
7.2.1 Gelijkenis en verschil met de arbeidsongevallen................................................................................129
7.2.2 Begrip en bewijs..................................................................................................................................130
8 Arbeidsongeschiktheid............................................................................................................................ 131
8.1 Algemeen...................................................................................................................................................135
8.2 Werknemers...............................................................................................................................................136
8.2.1 Rechthebbenden.................................................................................................................................137
8.2.2 Arbeidsongeschiktheid.......................................................................................................................137
8.2.3 Prestaties............................................................................................................................................140
8.2.4 Re-integratie.......................................................................................................................................143
8.2.5 Moederschapsverzekering..................................................................................................................144
8.2.6 Gezinsverloven....................................................................................................................................145
8.3 Zelfstandingen............................................................................................................................................146
8.3.1 Rechthebbenden.................................................................................................................................146
8.3.2 Arbeidsongeschiktheid.......................................................................................................................147
8.3.3 Prestaties............................................................................................................................................148
8.3.4 Moederschapsverzekering..................................................................................................................149
8.3.5 Gezinsverloven....................................................................................................................................149
8.4 Overheidspersoneel – ambtenaren............................................................................................................150
8.4.1 Algemeen............................................................................................................................................150
8.4.2 Rechtspositieregelingen......................................................................................................................150
8.5 Tegemoetkoming aan personen met een handicap...................................................................................153
9 Werkloosheid.......................................................................................................................................... 154
9.1 Algemeen...................................................................................................................................................158
9.2 Toelaatbaarheidsvereisten.........................................................................................................................159
9.2.1 Afbakening..........................................................................................................................................159
9.2.2 Arbeidsverleden..................................................................................................................................159
9.2.3 Behoud van de hoedanigheid van gerechtigde..................................................................................160
9.3 Toekenningsvoorwaarden..........................................................................................................................161
9.3.1 Algemeen............................................................................................................................................161
9.3.2 Geen arbeid verrichten.......................................................................................................................161
9.3.3 Onvrijwillig werkloos zijn....................................................................................................................163
9.3.4 Geen loon of vervaningsinkomen ontvangen.....................................................................................164
9.3.5 Als werkzoekende inschrijven.............................................................................................................165
9.3.6 Elke passende dienstbetrekking aanvaarden.....................................................................................165
9.3.7 Beschikbaar zijn voor de arbeidsmarkt..............................................................................................167
9.3.8 Arbeidsgeschikt zijn............................................................................................................................167
9.4 Prestaties, uitkeringen................................................................................................................................168
9.4.1 Algemeen............................................................................................................................................168
9.4.2 Familiale situatie.................................................................................................................................169
9.4.3 Duur van werkloosheid en beroepsverleden......................................................................................171
9.4.4 Bijzondere uitkeringen........................................................................................................................173
9.5 Deeltijds werken.........................................................................................................................................174
9.6 Overbruggingsrecht voor zelfstandigen.....................................................................................................174
9.7 FEDERAAL REGEERAKKOORD.....................................................................................................................176
4
Socialezekerheidsrecht
Socialezekerheidsrecht 2024 – 2025
UA_1300PSWSZR_2425
Kim Van den Langenbergh
Samenvatting van H1 – H10 op basis van de slides en eigen lesnotities, maar ook
aanvullingen met het handboek
Persoonlijk examenpunt: 10/20 op ZIT1
1
, Socialezekerheidsrecht – H1 Inleiding
1 Inleiding + historiek
Inhoudsopgave
1 Inleiding + historiek..................................................................................................................................... 2
1.1 Inleiding..........................................................................................................................................................6
1.1.1 Wat is sociale zekerheid?........................................................................................................................6
1.1.2 Waarom socialezekerheidsrecht?...........................................................................................................6
1.1.3 Socialezekerheidsrecht: wat/hoe?..........................................................................................................7
1.2 Historiek Belgische sociale zekerheid...........................................................................................................10
2 Toepassingsgebied.................................................................................................................................... 19
2.1 Werknemers.................................................................................................................................................23
2.1.1 Definitie.................................................................................................................................................23
2.1.2 Territoriaal toepassingsgebied..............................................................................................................26
2.1.3 Uitbreidingscategorieën.......................................................................................................................28
2.1.4 Uitgesloten werknemers.......................................................................................................................28
2.1.5 Beperking tot bepaalde sectoren.........................................................................................................29
2.2 Zelfstandigen................................................................................................................................................30
2.2.1 Definitie.................................................................................................................................................30
2.2.2 Beroepsbezigheid..................................................................................................................................31
2.2.3 Helper...................................................................................................................................................31
2.2.4 Deeleconomie.......................................................................................................................................32
2.3 Ambtenaren / overheidspersoneel...............................................................................................................32
2.4 Personen met afgeleide rechten...................................................................................................................33
2.5 Gerechtigden op sociale bijstand.................................................................................................................33
2.6 Overzicht.......................................................................................................................................................34
3 Financiering.............................................................................................................................................. 35
3.1 Algemeen.....................................................................................................................................................39
3.2 Werknemers.................................................................................................................................................39
3.2.1 Berekeningsgrondslag...........................................................................................................................39
3.2.2 Werkgevers- en werknemersbijdragen.................................................................................................46
3.2.3 Crisisbijdragen......................................................................................................................................49
3.2.4 Responsabiliseringsbijdragen...............................................................................................................50
3.2.5 Solidariteitsbijdragen...........................................................................................................................51
3.2.6 Bijdrageverminderingen.......................................................................................................................52
3.2.7 Bijdragen op sociale uitkeringen..........................................................................................................53
3.2.8 Alternatieve financiering van de sociale zekerheid.............................................................................53
3.2.9 Formaliteiten........................................................................................................................................54
3.3 Zelfstandigen................................................................................................................................................55
3.3.1 Berekeningsgrondslag...........................................................................................................................55
3.3.2 Bijdragepercentages.............................................................................................................................57
3.3.3 Andere bijdragen..................................................................................................................................60
3.3.4 Formaliteiten........................................................................................................................................61
3.4 Overheidspersoneel / ambtenaren...............................................................................................................62
3.4.1 Gewone bijdragen.................................................................................................................................62
3.4.2 Financiering van de ambtenarenpensioenen.......................................................................................63
2
, Socialezekerheidsrecht – H1 Inleiding
3.4.3 Overheidssteun.....................................................................................................................................64
3.4.4 Subsidiaire financieringsbronnen.........................................................................................................64
3.5 Sociale bijstand.............................................................................................................................................64
4 Administratieve organisatie....................................................................................................................... 65
4.1 Algemeen.....................................................................................................................................................69
4.2 Werknemers.................................................................................................................................................70
4.2.1 Inning door de RSZ................................................................................................................................71
4.2.2 Uitvoering in de verschillende sectoren...............................................................................................71
4.3 Zelfstandigen................................................................................................................................................73
4.3.1 Inning van bijdragen.............................................................................................................................73
4.3.2 Uitvoering van prestaties......................................................................................................................73
4.4 Overheidspersoneel......................................................................................................................................74
4.4.1 Inning van bijdragen.............................................................................................................................74
4.4.2 Uitvoering.............................................................................................................................................74
4.5 Sociale bijstand.............................................................................................................................................74
5 Gezondheidszorg....................................................................................................................................... 75
5.1 Algemeen.....................................................................................................................................................79
5.2 Rechthebbenden...........................................................................................................................................80
5.2.1 Algemeen..............................................................................................................................................80
5.2.2 Gerechtigden........................................................................................................................................80
5.2.3 Voortgezette verzekering......................................................................................................................82
5.2.4 Personen ten laste voor de gezondheidszorg.......................................................................................82
5.3 Voorwaarden................................................................................................................................................83
5.3.1 Algemene voorwaarden.......................................................................................................................83
5.3.2 Soorten verstrekkingen.........................................................................................................................84
5.3.3 Specifieke voorwaarden voor terugbetaling (ziv).................................................................................85
5.3.4 Uitgesloten kosten................................................................................................................................86
5.4 Prestaties......................................................................................................................................................87
5.4.1 Algemene principes.............................................................................................................................87
5.4.2 Terugbetalingstarieven.........................................................................................................................90
5.4.3 Vaststelling van de tarieven..................................................................................................................93
5.4.4 TARIEVEN – gevolgen VERBONDEN zorgverstrekkers...........................................................................95
6 Gezinsbijslagen......................................................................................................................................... 97
6.1 Algemeen...................................................................................................................................................101
6.1.1 Sleuteljaar 2014..................................................................................................................................101
6.1.2 Defederalisering..................................................................................................................................101
6.2 Groeipakket in vlaanderen.........................................................................................................................102
6.2.1 Andere accenten.................................................................................................................................102
6.2.2 Actoren...............................................................................................................................................103
6.2.3 Prestaties............................................................................................................................................105
6.2.4 Rechtshandhaving...............................................................................................................................110
7 Professionele risico’s............................................................................................................................... 111
7.1 Arbeidsongevallen......................................................................................................................................115
7.1.1 Historische context.............................................................................................................................115
7.1.2 Toepassingsgebied – Ratione personae..............................................................................................115
7.1.3 Toepassingsgebied – Ratione materiae..............................................................................................116
7.1.4 Schadeloosstelling..............................................................................................................................122
3
, Socialezekerheidsrecht – H1 Inleiding
7.1.5 Burgerlijke aansprakelijkheid..............................................................................................................126
7.1.6 Procedure............................................................................................................................................128
7.1.7 Verzekering.........................................................................................................................................129
7.2 Beroepsziekten...........................................................................................................................................129
7.2.1 Gelijkenis en verschil met de arbeidsongevallen................................................................................129
7.2.2 Begrip en bewijs..................................................................................................................................130
8 Arbeidsongeschiktheid............................................................................................................................ 131
8.1 Algemeen...................................................................................................................................................135
8.2 Werknemers...............................................................................................................................................136
8.2.1 Rechthebbenden.................................................................................................................................137
8.2.2 Arbeidsongeschiktheid.......................................................................................................................137
8.2.3 Prestaties............................................................................................................................................140
8.2.4 Re-integratie.......................................................................................................................................143
8.2.5 Moederschapsverzekering..................................................................................................................144
8.2.6 Gezinsverloven....................................................................................................................................145
8.3 Zelfstandingen............................................................................................................................................146
8.3.1 Rechthebbenden.................................................................................................................................146
8.3.2 Arbeidsongeschiktheid.......................................................................................................................147
8.3.3 Prestaties............................................................................................................................................148
8.3.4 Moederschapsverzekering..................................................................................................................149
8.3.5 Gezinsverloven....................................................................................................................................149
8.4 Overheidspersoneel – ambtenaren............................................................................................................150
8.4.1 Algemeen............................................................................................................................................150
8.4.2 Rechtspositieregelingen......................................................................................................................150
8.5 Tegemoetkoming aan personen met een handicap...................................................................................153
9 Werkloosheid.......................................................................................................................................... 154
9.1 Algemeen...................................................................................................................................................158
9.2 Toelaatbaarheidsvereisten.........................................................................................................................159
9.2.1 Afbakening..........................................................................................................................................159
9.2.2 Arbeidsverleden..................................................................................................................................159
9.2.3 Behoud van de hoedanigheid van gerechtigde..................................................................................160
9.3 Toekenningsvoorwaarden..........................................................................................................................161
9.3.1 Algemeen............................................................................................................................................161
9.3.2 Geen arbeid verrichten.......................................................................................................................161
9.3.3 Onvrijwillig werkloos zijn....................................................................................................................163
9.3.4 Geen loon of vervaningsinkomen ontvangen.....................................................................................164
9.3.5 Als werkzoekende inschrijven.............................................................................................................165
9.3.6 Elke passende dienstbetrekking aanvaarden.....................................................................................165
9.3.7 Beschikbaar zijn voor de arbeidsmarkt..............................................................................................167
9.3.8 Arbeidsgeschikt zijn............................................................................................................................167
9.4 Prestaties, uitkeringen................................................................................................................................168
9.4.1 Algemeen............................................................................................................................................168
9.4.2 Familiale situatie.................................................................................................................................169
9.4.3 Duur van werkloosheid en beroepsverleden......................................................................................171
9.4.4 Bijzondere uitkeringen........................................................................................................................173
9.5 Deeltijds werken.........................................................................................................................................174
9.6 Overbruggingsrecht voor zelfstandigen.....................................................................................................174
9.7 FEDERAAL REGEERAKKOORD.....................................................................................................................176
4
