A worker who suffered a heart attack was initially refused permanent disability and retirement, continued to receive sick leave benefits due to an administrative error and ended up with a demand for a refund of €13,201.72 from Social Security, but the Court corrected the charge and limited the reimbursement.
According to the Spanish portal Noticias Trabajo, the case took place in Spain and was decided by the Superior Court of Justice of Galicia (TSXG). According to the description of the process published by the portal, Spanish Social Security considered the payment that accumulated during the transition period between discharge (temporary incapacity) and retirement to be undue, in a context marked by contradictory decisions and internal failures over time.
The “limbo” between discharge and retirement that ended up in a Social Security bill
According to the report, it all started in April 2018: the worker went on sick leave after an acute myocardial infarction and, as he approached the maximum limit of temporary incapacity, he was referred for assessment of permanent incapacity. This route ended up not moving forward and the process led to the request for reform, which, initially, was also not recognized.
Still according to the same source, the turning point arrived in October 2020, when Social Security itself notified the beneficiary that it had made a mistake and recognized the reform with retroactive effect since April 2019. The problem is that, afterwards, the Administration began to consider that part of what had been paid as temporary incapacity had become undue and proceeded with a charge of €13,201.72.
The Social Security argument: refund even when the State is responsible for the error
On the Spanish Social Security side, the basis invoked was article 55 of the General Social Security Law, which provides for the obligation to reinstate unduly received benefits and a four-year limitation period, even when the origin of the undue payment is attributable to the managing entity itself.
Good faith and proportionality: what influenced the TSXG’s decision
The worker contested the charge and the case reached the Superior Court of Justice of Galicia. According to Noticias Trabajo, the court did not validate the full refund under the terms required by the Administration and chose to limit the refund, valuing the good faith of the beneficiary and the need to avoid a disproportionate burden.
The decision framed this analysis within the logic of protecting legitimate expectations and European jurisprudence that discusses the impact of returns required years later due to the exclusive error of the State, namely through the case of Čakarević v. Croatia, frequently cited when the risk of an “excessive individual burden” on those who received benefits plausibly believing that they were due is at stake.
In practical terms, and according to the , the essence is simple: the court does not “erase” the rule for returning undue amounts, but can limit the refund when the Administration creates the problem and the beneficiary acts in good faith, always based on the specific facts of the case.
What if this case were in Portugal?
In Portugal, if Social Security understands that there were undue payments (for example, due to incompatibility between benefits), it may demand a refund of the amounts paid.
In the specific case of sickness benefit, the Social Security Institute’s Practical Guide indicates that, as a rule, it cannot be combined with an old-age pension or disability pension, among other benefits.
Regarding the replacement of undue payments, the framework is set out in Decree-Law no. 133/88, which regulates the obligation to reimburse and allows mechanisms such as compensation with future benefits (with legal limits). The prescription rule, in this context, is usually treated as occurring 5 years after the request for restitution, in accordance with the understanding expressed in court decisions.
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