Article 27Certification of Needed Long-Term Care

①An Insured Person that intends to obtain a Certification of Needed Long-Term Care, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, must submit to a Municipality a written application with the Certificate of Insured Person attached. In this case, said Insured Person, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, may have a Designated In-Home Long-Term Care Support Provider prescribed in Article 46, paragraph (1), a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care or a Facility Covered by Long-Term Care Insurance, as determined by Order of the Ministry of Health, Labour and Welfare, or a community general support center prescribed in Article 115-46, paragraph (1) implement the procedures pertaining to said application on behalf of said Insured Person.

③A Municipality, when the application as prescribed in paragraph (1) is submitted, request an attending physician of the Insured Person pertaining to said application for opinions regarding the status of illness or injury that is the cause of the physical or mental problems of said Insured Person, however, provided that the Municipality may, when there is no attending physician of the Insured Person pertaining to said application, or it is difficult to request for said opinion, etc., order said Insured Person to obtain the diagnosis of a designated physician or from the Municipality's personnel who is a physician.

④A Municipalityis to notify the relevant Certification Committee of the result of the investigation as set forth in paragraph (2) (in a case of entrustment pursuant to the provisions of Article 24-2, paragraph (1), item (ii), including an investigation pertaining to said entrustment) of the opinion of the attending physician as prescribed in the preceding paragraph, the result of a diagnosis by the designated physician or its personnel who is a physician, and other matters as specified by Order of the Ministry of Health, Labour, and Welfare, and request an examination and judgment pertaining to matters as prescribed in each said item according to the Category of the Insured Person as listed in the following items with regard to the Insured Person pertaining to an application as prescribed in paragraph (1):

⑤A Certification Committee, when being requested to conduct an examination and provide judgment pursuant to the provisions of the preceding paragraph, act in compliance with standards as determined by the Minister of Health, Labour, and Welfare, examine and judge matters as prescribed in each item of the same paragraph of the Insured Person pertaining to said examination and judgment, and notify said result to the Municipality. In this case, a Certification Committee may, when it determines it necessary, state opinions to the Municipality regarding the matters listed as follows:

⑥A Certification Committee may, when it determines it necessary in an examination or judgment referred to in the first sentence of the preceding paragraph, hear opinions of the Insured Person pertaining to said examination and judgment, said Person's family members, the attending physician as set forth in paragraph (3), and other relevant persons.

⑦A Municipality, when providing a Certification of Needed Long-Term Care based on the results of an examination and judgment of a Certification Committee as notified pursuant to the provisions of the first sentence of paragraph (5), must notify the Insured Person pertaining to said Certification of Needed Long-Term Care of said result. In this case, the Municipality shall enter the following items on the Certificate of Insured Person of said Insured Person and return the Certificate of Insured Person to the Insured Person:

⑧A Certification of Needed Long-Term Care becomes effective retroactively on the date that said application was submitted.

⑨A Municipality, when it determined the Insured Person pertaining to the application as set forth in paragraph (1) fails to be qualified as a Person Requiring Long-Term Care based on the results of an examination and judgment of a Certification Committee as notified pursuant to the provisions of the first sentence of paragraph (5), is to notify said Insured Person of that effect, indicating the reason(s), and return the Certificate of Insured Person of said Insured Person.

⑩A Municipality may dismiss an application submitted pursuant to paragraph (1) when the Insured Person pertaining to the application as set forth in paragraph (1) fails to respond to an investigation pursuant to the provisions of paragraph (2) (in a case of entrustment pursuant to the provisions of Article 24-2, paragraph (1), item (ii), an investigation pertaining to said entrustment) without a justifiable reason or when said Insured Person fails to comply with an order for a diagnosis pursuant to the provisions of the proviso of paragraph (3).

⑪Action for an application as set forth in paragraph (1) must be performed within thirty (30) days from the date of submission of said application, however, provided that in a case that there are special reasons that an investigation of the mental or physical conditions of the Insured Person pertaining to said application may require additional hours or days, etc., said action for the matter may be postponed after notifying said Insured Person of the additional period necessary for the action for said application (herein referred to as the "Prospective Processing Period" in the following paragraph) and said reasons within thirty (30) days from the date of submission of said application.

⑫In a case when the action for an application as set forth in paragraph (1) has not been executed within thirty (30) days from the date of submission of said application or the notification as set forth in the proviso of the preceding paragraph has not been issued, or when the action for said application has not been executed by the date that the Prospective Processing Period expires, the Insured Person pertaining to said application may deem that the Municipality has dismissed said application.