Apply for sick pay

In statutory health insurance, certain members (e.B employees, recipients of unemployment benefit I) and in the farmers' health insurance scheme are entitled to sickness benefit if the illness renders them incapacitated or are treated in a hospital, preventive or rehabilitation facility at the expense of health insurance funds. Sickness benefit amounts to 70 % of the regular salary earned, insofar as this is subject to the calculation of contributions (regular remuneration). However, it may not exceed 90% of net earnings. Contributions to pension and unemployment insurance are payable from the sickness benefit. For assisting family members of an agricultural entrepreneur who are not subject to pension insurance, the sickness benefit for the calendar day is one-eighth (possibly up to a quarter) of the contribution ceiling of the statutory health insurance scheme.

Certificate of incapacity for work Declaration on the payment of sickness benefit If necessary, further documentation is required.


Preconditions
You have statutory health insurance with entitlement to sickness benefit The deadline for continued payment of remuneration has expired (6 weeks). You must report the incapacity to work to the health insurance company without delay. Recipients of unemployment benefit, maintenance allowance or short-time working allowance are also entitled to sickness benefit. Mainly self-employed workers can cover loss of income due to illness (from the seventh week of incapacity for work) if their health insurance fund provides for statutory provisions for a sickness benefit choice tariff. By concluding this electoral tariff, the insured person is bound to his health insurance fund for three years. Do not be entitled to sickness benefit Insured persons covered by family insurance Recipients of unemployment benefit II dutifully insured students or interns.

Hints
The entitlement is suspended to the extent and as long as the insured person receives a salary or income subject to contributions during the illness or receives sickness benefit, injury allowance, transitional allowance, maintenance allowance or short-time working allowance. Likewise, the payment is suspended as long as the insured person takes parental leave in accordance with the Federal Parental Benefit and Parental Leave Act, the insured receives maternity benefit or unemployment benefit I or the entitlement to benefits under the Employment Promotion Act is suspended due to a blocking period. This also applies if the sickness benefit is higher than one of these benefits.
While you are ill and the employer continues to pay your salary, you must send a copy of the incapacity certificate to your health insurance company. At the end of six weeks, your treating doctor will also confirm that you are incapacitated with an incapacity certificate for work, which you must send to your health insurance companies immediately. If you are still ill for a longer period of time and are therefore unable to work, you must regularly submit the further certificates of incapacity for work to the health insurance company. In addition, you must complete an "declaration on the payment of sickness benefit" at most health insurance funds. The sickness benefit will be transferred to the account you have specified in the application form for the past period of incapacity for work. The sickness benefit is calculated per calendar day. If you are entitled to sickness benefit for a whole calendar month, it is set at 30 days. If you are only partially entitled to sickness benefit in one month, payment will be made for the days actually incurred. Sickness benefit is reduced by contributions for the insured's share of pension, unemployment and long-term care insurance if there is an obligation to provide insurance. Important: The incapacity for work must be fully proven. It is sufficient for complete proof of the existence of incapacity for work to be medically established on the working day following the last day of incapacity for work following the previous certified day of incapacity for work and, accordingly, a follow-up certificate of incapacity for work is issued on the day after the date of the end of the incapacity for work. If this day does not fall on a working day (Saturday is not considered to be a working day in this respect), it is sufficient if the further incapacity for work due to the same illness is determined by a doctor at the working day following the previous confirmed end of incapacity for work.