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We will conduct a new investigation of your work capacity no later than and contact you once it has been completed. Želimo Vas obavestiti da je ispitivanje Vaše radne sposobnosti završeno te da je isto pokazalo da Vaša radna sposobnost nije izmenjena. Chapter 33, Section 17 of the Social Insurance Code contains provisions concerning a new investigation. Odredbe o ponovljenom ispitivanju sadržane su u glavi 33 § 17 Zakonika o socijalnom osiguranju. Yours sincerely, Srdačan pozdrav! Försäkringskassan Försäkringskassan Jessica Selander Jessica Selander More information is available at forsakringskassan.se. Više informacija možete naći na www.forsakringskassan.se. You can also order brochures from our self-service line by dialling +4620-524 524. Možete također naručiti brošure na naš uslužni telefon: +4620-524 524. 1 (1) 1 (1) Datum Datum Jessica Selander, 010-116 66 07 Jessica Selander, 010-116 66 07 2016-12-13 2016-12-13 Postal address Postal address Customer service Customer service Telefax number Telefax number Bankgiro Bankgiro Försäkringskassans inläsningscentral SE-839 88 Östersund Försäkringskassans inläsningscentral SE-839 88 Östersund +46771-524 524 +46771-524 524 738-8036 738-8036 Internet Internet Customer service for partners Customer service for partners Org.ID Org.ID www.forsakringskassan.se www.forsakringskassan.se +46771-17 90 00 +46771-17 90 00 202100-5521 202100-5521 For this reason, Försäkringskassan (Swedish Social Insurance Agency) would like to know whether you have or have had any of the following benefits: S obzirom na to Försäkringskassan (Zavod švedskog socijalnog osiguranja) želi znati dali ste ili ste bili korisnik neke od sledećih povlastica: Sickness benefit Naknada za vreme bolovanja period______________________ u vremenu______________________ Unemployment benefit Naknada za nezaposlenost period______________________ u vremenu______________________ Social assistance Socijalna pomoć period______________________ u vremenu______________________ Other benefit, state which Druga naknada, navedite koja period______________________ u vremenu______________________ If you have returned to work, please notify Försäkringskassan of the date from which you have been working and how many hours per week you work. Ako ste se vratili na posao, Zavod švedskog socijalnog osiguranja Vas moli da navedete od kojeg datuma radite i koliko sati radite nedeljno. Försäkringskassan must have received your reply with date and signature at the latest by . Vaš odgovor sa datumom i potpisom mora prispeti Zavodu švedskog socijalnog osiguranja najkasnije . Otherwise, a decision will be made on your case on the basis of the existing documentation. U drugom slučaju Vaš predmet će biti rešen na osnovu podataka koje imamo. Yours sincerely, Srdacno Vas pozdravljamo Försäkringskassan Försäkringskassan Jessica Selander Jessica Selander Datum Datum Signature Potpis 1. 1. State your most recent employment in your country of residence Navedite zadnji radni odnos u Vašoj zemlji boravka a. a. Occupation/employment: Zanimanje/posao: b. b. Working hours per week: Radno vreme nedeljno: c. c. Wage per month: Mesečni prihod: d. d. Last working day: Zadnji radni dan: 2. 2. Do you have or have you had any of the following benefits? Dobijate li ili dali ste dobijali neku od sledećih naknada? Sickness benefit Naknada za vreme bolovanja time period: u vremenu od: Unemployment benefit Naknadu za nezaposlene time period: u vremenu od: Social assistance Socijalnu pomoć time period: u vremenu od: Other benefit, state which Drugu naknadu, navedite koju time period: u vremenu od: Datum Datum Signature Potpis Please send your reply to Försäkringskassan signed and dated at the latest by . Pošaljite Vaš odgovor Blagajni socijalnog osiguranja Švedske sa navedenim datumom i Vašim potpisom najkasnije . Otherwise, Försäkringskassan will make a decision on the basis of the documentation available to us today. U drugom slučaju Blagajna socijalnog osiguranja Švedske doneće odluku na osnovu podataka kojima danas poseduje. Do you have any questions? Da li imate pitanja? You are welcome to call our customer centre at +46 771-524 524 if you have any questions about your case. Vi ste dobrodošli da nazovete našu sluzbu na telefon +46 771-524 524 ako imate pitanja oko vašeg predmeta. Yours sincerely Srdacno Vas pozdravljamo Försäkringskassan Försäkringskassan Jessica Selander Jessica Selander Since you receive sickness compensation from Sweden, Försäkringskassan is asking you to answer the following questions: S obzirom na to da dobijate naknadu za bolovanje iz Švedske Zavod švedskog socijalnog osiguranja želi da odgovorite na sledeća pitanja: 1. 1. Give as detailed a description as possible of your present state of health. Opišite Vaše sadašnje zdravstveno stanje čim detaljnije moguće. 2. 2. Describe your present impediments to work and complaints. Opišite Vaše sadašnje smetnje pri radu i Vaše tegobe. 3. 3. How often are you in contact with your doctor? Koliko često posećujete lekara? 4. 4. Which doctor do you go to? Kod kog lekara idete? 5. 5. Describe the medication and treatment that you have undergone during the year/years. Navedite lekove i terapiju koju ste primali tokom . 6. 6. What kind of work do you do? Koju vrstu posla radite? 7. 7. When did you return to work? Kada ste se vratili na posao? 8. 8. How much do you work? U kojem stepenu radite? (no. of hours/month) (broj sati mesečno) 9. 9. How much income do you earn from paid employment? Koliki je Vaš prihod od rada? 10. 10. Have you had any of the following benefits from any other country apart from Sweden during the years – : Jeste li tokom godina – imali neku od sledećih naknada iz neke druge zemlje sem Švedske: ☐ Sickness benefit ☐ Naknada za vreme bolovanja period______________________ u vremenu______________________ ☐ Unemployment benefit ☐ Naknada za nezaposlenost period______________________ u vremenu______________________ ☐ Social assistance ☐ Socijalna pomoć period______________________ u vremenu______________________ ☐ Other benefit, state which ☐ Druga naknada, navedite koja period______________________ u vremenu______________________ 11. 11. Other relevant information which you wish to provide: Ostale informacije koje želite dati: Date Datum Signature Potpis Försäkringskassan also requests you to send copies of your income tax returns for the year /years . Zavod švedskog socijalnog osiguranja želi takođe da dostavite kopije Vaših poreskih prijava za god. Please send Försäkringskassan a current medical statement which gives a clear picture of your current state of health and which takes a position on your work capacity in all kinds of work. Zavod švedskog socijalnog osiguranja želi takođe da dostavite aktuelni nalaz lekara specijaliste sa jasnom slikom Vašeg sadašnjeg zdravstvenog stanja i ocenom Vaše radne sposobnosti za sve vrste poslova. Försäkringskassan also wishes to inform you that we have requested information from the pension authority and the tax agency in the country where you live. Zavod švedskog socijalnog osiguranja želi Vam skrenuti pažnju da smo zatražili podatke od penzijskih i poreskih vlasti iz mesta Vašeg stalnog boravka. Försäkringskassan also wishes to draw to your attention that we have requested the pension authority in the country where you live to have you undergo a medical examination. Zavod švedskog socijalnog osiguranja želi Vam takođe skrenuti pažnju da smo zatražili od penzijskog organa u zemlji u kojoj živite da Vas pošalju na lekarski pregled. Please send your reply to Försäkringskassan with date and signature. Pošaljite odgovor Zavodu švedskog socijalnog osiguranja sa datumom i potpisom. If the Social Insurance Agency has not received the requested information at the latest by , your sickness compensation may be terminated. Ako zatraženi podaci ne stignu Zavodu švedskog socijalnog osiguranja najkasnije do , Vaša naknada za bolovanje može biti ukinuta. Yours sincerely Srdacno Vas pozdravljamo Försäkringskassan Försäkringskassan Jessica Selander Jessica Selander