いまさら聞けない年金入門|障害年金の仕組み

障害年金は、万が一労働が出来なくなったり、あるいは労働に支障が出た場合にあって、生活の補填に使える公的制度の一つです。

名称に障害とありますが、障害者手帳を有していなくても、条件を満たせば、受給は可能になっています。

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老齢年金以外の制度を知ること

公的年金制度には、65歳以上が受給可能な老齢年金以外にも、障害年金制度と遺族年金制度という3つから成り立っています。

このうち障害年金については、非常に煩雑であり、しかも名称に障害とあることから、障害者以外は受給出来ないと思われがちです。

しかしながら、その仕組みを知っておいて、正しく請求を行うことが出来れば、万が一の備えとして有用と言える公的制度となります。

この制度の利用には、様々な条件をクリアしなければならず、その条件もハードルが高いために、厳しい場合があり得ます。

場合によっては、年金請求のプロフェッショナルである、社会保険労務士に代行申請を依頼することなども、視野に入れて行動を起こすことが望ましいものです。

自ら請求を行うにせよ、代行を依頼するにせよ、請求出来る条件の概要は、抑えておくことが大事です。

症状からは該当になると思われるのに、それ以外の条件をクリアしていないがために、請求そのものが認められないということが起こりえます。

いざというときのために、正しい知識を得ておくことと、行動をしておくことが必要です。

障害年金の制度は複雑です

障害年金の仕組みとして、重要なキーワードがいくつか存在します。まずは、年金保険料の未納状況です。免除などで未納では無い状態は、問題ないとみられます。

また、初診日も重要です。障害年金の初診日の考え方は独特で、従前に誤診などで別の病気と間違えられた場合などであっても、関連があるとみられるときには、その誤診等をした医療機関の受診日が初診日になり得ます。

この点は、医療機関側でも非常に分かりにくいため、説明が必要なことがあり得るものです。

健康診断等で異常が見つかったときなどを、初診日と見なす場合もあるなど、複雑怪奇ととらえられることも多く、こうしたことから、請求をためらってしまうことがあるわけです。

もし不安がある場合には、障害年金の請求などについて、知識や経験を有する社会保険労務士に依頼をすることも、視野に入れておくことが望ましいと言われています。

初診日以外にも重要な点として、初診日から1年6ヶ月後の状態に関する診断、また、それ以降の現在の病状と労働が可能かどうかなどについて、診断が必要になってきます。

初診日時点に加入している制度

初診日時点で加入をしている年金制度、たとえば厚生年金であるとか、旧共済年金制度であるとか、色々な事情が個人ごとで異なっています。

このときに加入をしている年金制度によって、受給出来る金額が変わりますので、注意が必要というわけです。

特に、厚生年金と旧共済年金、厚生共済年金制度は3級から1級までと、障害基礎年金の1級または2級しかない制度と比較しても、手厚いです。

したがって、会社員や公務員の人などは、その健康管理をしっかりと行うと共に、異常があった場合には速やかに医療機関を受診して置くことも、必要になります。

無論、病気などを治療するのが一番ですし、健康であれば問題はありません。あくまで万が一に備えて受診をすることと、制度を知っておくことが大切というわけです。

初診日時点で厚生年金等に加入をしていれば、その診断をおこなった医療機関から、後日初診日証明などを取得しなければならないこともありますので、念頭に置いておくことが大切です。

なお、初診日から同じ医療機関を受診し続けている場合には、この初診日証明が省略出来ることがあります。

初診日から1年6ヶ月後というキーワード

医療機関等において、病気が発見されたからといってすぐに障害年金の請求、及び受給ができるわけではありません。この初診日から、1年6ヶ月経ってからでないと請求そのものが出来ないようになっています。

したがって、初診日の特定が非常に重要というわけです。

誤診や関連する治療で受診をしている場合、そのときが初診になるという特徴がある制度ですが、このことを医療機関側は知らない場合が多いため、説明をしっかりとする必要がある場合も想定されてきます。

なお、初診から1年6ヶ月後の状態が、障害年金の該当になる病状の場合に請求が出来ること、また、それ以降で病状が障害年金請求可能な状態であることなどが重要です。

この病状が、障害年金の該当にならない場合もあり得ます。

これらの、障害年金の書類の提出先にも注意が必要で、共済年金は加入していた共済年金事務局、多くは勤務先の共済組合所管課、国民年金や厚生年金の障害年金請求先は、年金事務所を通じてとなります。

この窓口も、チェックを要します。最初に書類等を取得する先や、提出先も異なるので確認が必要です。

最後に

障害年金は、制度自体が非常に複雑ですが、万が一労働に支障が出るような病気やけがなどの時には、生活を支える重要な収入になり得ます。

正しい知識と行動、保険料の未納がないようにすることなどを心掛け、こうした公的制度があるということ、制度の仕組みと請求について知っておいて損はありません。

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