Following the intervention of the Human Rights Ombudsman of the Republic of Slovenia (Ombudsman), the second-instance decision of the Pension and Disability Insurance Institute of Slovenia (ZPIZ) was “roughly” issued within the four-month statutory term, while the four-month statutory term for the issuing of a decision was exceeded in the decision-making process at first instance. Despite the new warning about the importance of appropriate explanation of decisions, the ZPIZ second-instance decision was again not appropriately explained, but solely invoked the opinion of the expert commission of level II, which is not a component part of the decision. The Ombudsman has warned the ZPIZ about the urgency of appropriate explanation of a decision several times; however, an appropriate change in practice cannot yet be detected.

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In her complaint to the Ombudsman a complainant warned about the lengthiness and non-transparency of procedures of exercising rights from disability insurance with the ZPIZ. She stated that she suffers from several illnesses, including fibromyalgia, and that the University Rehabilitation Institute of the Republic of Slovenia (URI Soča) had determined that she is no longer fit to work. She claimed that with a practically unchanged health condition, the ZPIZ is deciding on her rights for the second time, while not even taking a position on all the documentation provided. At the time the complaint was filed, the first procedure had already been legally finally concluded, and in the second procedure, which was started in February 2022, the appeal procedure against the first-instance decision from October 2022 was ongoing. The appeal was filed in November 2022.

The Ombudsman studied the available documentation, from which it was evident that the ZPIZ had not taken a position on the content of the proposal of a personal physician to start a procedure for the exercise of rights from disability insurance, nor had they done so on the basis of several documents issued by URI Soča. It took them six months to decide on the proposal on the first instance.

Therefore, the Ombudsman turned to the ZPIZ and expressed his expectation that the appeal body would issue a decision within the statutory term, while also thoroughly examining the statements of the complainant from the appeal and answering them with arguments in the decision on the appeal in accordance with the existing regulations. At the same time, the Ombudsman once again pointed out to the ZPIZ the importance of adequate explaining of decisions. The explanation is not only a component part of every decision according to the General Administrative Procedure Act (ZUP), but is also a part of the right to fair treatment and procedure in accordance with Article 6 of the European Convention on Human Rights and Fundamental Freedoms (ECHR) and to good administration according to Article 41 of the Charter of Fundamental Rights of the European Union (EU Charter). The explanation enables a party to enforce a legal remedy. The Ombudsman warned that in this specific case the appeal decision may still be subject to judicial review of its legality and regularity. He emphasised that the explanation of the decision is not only a mandatory component of formal legality. Every decision is primarily aimed at the client, who has the right to be informed of the decision and its reasons. The explanation shows the impartiality and objectivity of decision-making, and at the same time, the explanation obliges the authority to delve deeper into establishing the factual situation, the presentation of evidence, and the conditions of the substantive law (in this case the Pension and Disability Insurance Act, ZPIZ-2). The Ombudsman suggested that the ZPIZ take the above into consideration and send us a courtesy copy of the issued second-level decision.

The ZPIZ informed the Ombudsman of the decision of the Central Office in Ljubljana from March 2023, by which the appeal was granted and by which the complainant was classified in category I of disability due to the consequences of the disease with the right to a disability pension.

The Ombudsman concluded the consideration of the complaint as well-founded. On the basis of all the documentation received, the Ombudsman concluded that the second-instance decision of the ZPIZ was "roughly" issued within the four-month statutory term (the Ombudsman's intervention probably also helped), but the fact is that the four-month deadline for issuing the decision was exceeded in the first instance. The Ombudsman also concluded that even the second-instance decision of the ZPIZ is not adequately explained, but merely refers to the opinion of the expert commission of level II, which is not an integral part of the decision. The Ombudsman has warned the ZPIZ several times about the necessity of providing adequate explanation for decisions, but unfortunately no suitable change in practice has yet been detected. 9.2-27/2022