SII (KELA) and employment pension institutions knowingly neglect deadlines
Referral of appeals to bodies that handle them takes longer than the law permits
14.5.2008
Parliamentary Ombudsman Riitta-Leena Paunio has repeatedly drawn attention to the fact that it often takes the Social Insurance Institution (KELA) and employment pension institutions longer to refer appeals to the bodies that handle them than the statutory deadlines allow.
In her view, however, the legislation concerning the referral of appeals is clear and the deadlines are absolute rather than merely recommendations. The intention is to safeguard appellants' right to have their appeals handled without delay.
The Ombudsman points out that KELA and the employment pension institutions must in all circumstances comply with the statutory deadlines for referring appeals. In order to ensure that the deadlines are not exceeded, they must develop their information systems and appeal-handling processes. Compliance with deadlines must also be directed, monitored and overseen.
Statutory deadlines
If the Social Insurance Institution or the employment pension institutions do not approve an appeal in its entirety, the law requires that within 30 days of the end of the appeal period they must forward the appeal to the appeal instance to be dealt with there. The deadline may be deviated from if additional reports are required in order for the appeal to be dealt with. The appellant must be informed that an additional report is being obtained. However, an appeal must always be forwarded to the appeal instance within 60 days of the end of the appeal period.
Problems concerning compliance with deadlines have featured in complaints for a long time
Failure to comply with the statutory deadlines has featured often in complaints to the Ombudsman in recent years. As long ago as 2005 she drew the attention of the Ministry of Social Affairs and Health to the fact that the absolute 60-day deadline appeared to be exceeded often. However, the Ministry took the view that the deadlines were being exceeded only in individual cases and reported that it had emphasised the importance of complying with them to the institutions. In addition, the Ministry reported that the institutions had been developing their information systems to facilitate monitoring of compliance with deadlines.
Nevertheless, deadlines have continued to be exceeded. Nor, according to the Ombudsman's observations, has the attitude to them changed. For example, the obligation to inform an appellant that an additional report is being obtained is being neglected. Staff being on holidays and backlog peaks have likewise been cited as excuses for deadlines being exceeded. In addition, there are indications that also the 60-day deadline has been exceeded in some instances. That is why the Ombudsman took the matter again under investigation in 2007.
That deadlines were being exceeded was known
It emerged in the course of the Ombudsman's investigation that the SII and the employment pension institutions had in some cases knowingly failed to comply with the deadlines. They have invoked flexibility in handling appeals and expediency considerations in justification of deadlines having been exceeded. According to the institutions, a request by the appellant that handling of the appeal be postponed because of an expected additional report is sometimes the background cause when a deadline is exceeded.
The Ombudsman stresses that current legislation does not justify an absolute deadline being exceeded in any circumstances. Such matters as a work backlog or staff being absent do not justify neglect of statutory deadlines, nor does a request on the part of an appellant.
Ombudsman's decision: Information systems and appeal-handling processes must be developed
The Ombudsman does not believe that the solution to the existing problems would lie in amending legislation so as to make deadlines more flexible or to lessen the degree to which they are binding. That would lead to the existing clear legislation becoming more complicated and cause problems of interpretation. It would also weaken the legal remedies available to appellants.
The Ombudsman considers it important that appellants can trust that the SII and the employment pension institutions comply with the statutory deadlines. She points out that also appellants are under a strict obligation to comply with the deadlines for submitting appeals.
In order to ensure that the deadlines for forwarding appeals are not exceeded, the SII and the employment pension institutions must develop their information systems and appeal-handling processes. The Ombudsman has asked the SII and the Ministry of Social Affairs and Health to inform her, by the end of January 2009, what measures they have taken to make compliance with the deadlines and monitoring of compliance more effective.
Additional information will be provided by Legal Adviser Juha Niemelä, tel.+ 358 (0)9 432 3356.