Saturday 19 December 2009

Getting the Social Security to step in By Kate

In Spain, if you've made social security payments for a minimum of six months, you're entitled to maternity money from the national system. You get four months fully-paid maternity leave and after that it's up to you and your employer to negotiate the remainder (I'm a bit hazy about that part because maternity leave would take me to the end of my contract with the language academy where I've been working anyway).

However, the widely practised way of enhancing one's maternity allowance is to request a baja del medico from your doctor. Basically, you quit work and ask the doctor to officially sign you off on sick leave. 99.9 per cent of doctors are happy to do this for any embarazada complaining of tiredness or a sore back - the usual health complaints that accompany the third trimester. You then lumber back to your health centre once a week and your doctor renews the sick note, usually without any further conversation required. The good part about this is that you start receiving sick pay (70 per cent of your salary) and it continues until the day you give birth, at which point maternity leave officially kicks in and instead of losing part of it pre-partum, you get the whole paid four months once the baby is born.

However, my boss wants me to go one better than this. I had indicated that health-allowing, I would be willing to work until at least the end of January (mainly because I would like to contribute another month's-worth of salary to the domestic piggy bank before earning a living becomes a secondary priority after baby care). He accepts this, but from his point of view, it makes more sense for me to finish my classes at the end of the Christmas term and my replacement to take over at the beginning of the Spring term. Not wanting to cheat me out of my full January salary (and possibly because he would also receive a little financial support from the government) he's been advised by his lawyer that I should request a baja for an embarazada del riesgo.

What this amounts to is that I claim my work is not just becoming difficult for me to perform because of my condition, but that my work is actually putting my pregnancy at risk. A baja obtained for this reason would basically mean I was treated as if I had had an industrial accident. I would receive 100 per cent of my salary from the Social Security until the day of the birth and I wouldn't have to keep heaving myself to the health centre to get it renewed.

When I first consulted my GP about being signed off, I hadn't appreciated the difference between the two bajas. Dr Paniagua indicated that she would be willing to give me the ordinary baja, but I would need to return once I'd actually stopped going to work. Once my boss realised my Spanish wasn't up to the intricacies of discussing the finer points of the other baja, he bade me to make another appointment and lent me his Spanish wife as chief negotiator and translator.

Marina and I arrived at the appointed time in the waiting room, only to observe Dr Paniagua choose that moment to leave her consulting room, lock the door behind her and depart the vicinity. We both treated her disappearance philosophically, as did the other patients in the queue, and settled down to chat until such a time as she should choose to reappear. This she did some twenty minutes later, carrying a shopping bag and with renewed post-coffee break vigour. She then glanced perfunctorily at her appointment list and called my name ("Katt-ee Sal-eess-boorr-ee?"). Marina and I promptly took up positions in front of her desk.

Luckily, I only had to say one sentence in my halting Spanish before Marina took over and laid out the facts of my risky pregnancy to Dr P. The whole time Marina was making her impassioned plea on my behalf, Dr P seemed more interested in trying to disentangle the cord holding her ID, then re-attaching what looked like a small pair of surgical scissors to it - no easy task as far as I could judge. Half way through Marina's brilliant and articulate outlining of my case, another medic unceremoniously walked in and interrupted her flow with some query or other for Dr P, which then became a peripheral discussion. When she thought the other medic had finished, Marina started again, only to be interrupted a second time with another question, which completely ignored the fact that Dr P was in the middle of seeing a patient. Marina and I waited patiently for Dr P's attention to come back to us, such as it was.

When Marina resumed, it seemed clear that Dr P was not buying the risky pregnancy scenario. "So what if she gets tired and has to work late in the evenings, so do I," seemed to be the central tenet of her argument. Eventually - once I'd pointed out that I was awaiting the results of a test for gestational diabetes - Dr P grudgingly gave us a form indicating a suspected risky pregnancy, but told us we would need to get the opinion of an obstetrician before she was prepared to give me the baja.

Both Marina and my boss were taken aback by the doctor's attitude. Apparently, signing people off work for whatever reason is usually a straightforward process in Spain and the medics don't generally fuss too much about establishing the veracity of each case as it's not their problem. Just our luck to get one of the few who was a tougher nut to crack on that score.

Of course the irony of all this is that my pregnancy is unlikely to be risky, given its progress so far (touch wood). Yes, I do get a bit tired (especially when climbing the steps of the Metro) and I have a little backache, but these are relatively minor discomforts. Overall, I feel pretty healthy and have had a very easy pregnancy so far. The only risk element is my age - 39 - but that's hardly unusual nowadays, half my friends have had their babies at around the age of 40 with no serious problems to speak of. As for the diabetes, well I was being honest about waiting to hear the results of my second glucose curve test, but given that I haven't been recalled (beyond a routine 32-week appointment with my obstetrician in January) with any urgency, I rather suspect the result was normal.

Anyway, Marina will come with me to see my obstetrician and have another crack at getting the baja. Only this time she will be armed with a risk assessment my boss commissioned for the academy in terms of hazards for a pregnant woman. Rather to our surprise, they are many - three full pages of them. It seems my work-place is a potential death-trap for people in my condition, with danger lurking in every computer, photocopier and classroom (not to mention the biological hazard of coming into contact with so many germ-infested students). Whether this will convince the Madrid medical profession of my imminent peril - well, we shall see.

No comments:

Post a Comment