Unable to work, and how are things going now financially?
Those who have been ill for a longer period of time may receive sick pay.
Employees should know their rights and obligations.
Anyone who is absent from work for a longer period is entitled to sickness benefit *.
It is not uncommon for problems to arise with the employer due to missed application deadlines, incorrect information or doubts.
It is all the more important that employees know their rights and obligations.
Who gets sick pay anyway?
As a rule, employees and trainees who have statutory health insurance and who have been ill for a longer period of time.
“Even unemployed people with statutory health insurance who receive unemployment benefit I are basically entitled to it,” says Reinhard Schwanke from the AOK Federal Association in Berlin.
In which cases am I entitled to sick pay?
Employers are obliged to pay sick employees the full gross salary for up to six weeks.
This is called continued
payment
.
For this, the employment relationship must have existed for at least four weeks, says Yvonne Vollmer from the Hamburg consumer center.
Employees must present their employer with a medical certificate of incapacity for work.
After the six weeks, the statutory health insurance pays sickness benefits.
Read more about sick pay here,
How much is the sick pay?
"For employees, the amount of sick pay is
70 percent of regular gross wages
, but it must not exceed 90 percent of net earnings," said Schwanke.
The statutory maximum amount of sick pay is € 112.88 per day for 2021.
Contributions to pension, unemployment and long-term care insurance are deducted from this amount if there is compulsory insurance in these social insurances.
While receiving sickness benefits, compulsorily insured members are insured free of charge.
Recipients of unemployment benefit (ALG I) receive sickness benefit in the amount of the benefits they last received.
Also read:
Sick leave: Does the weekend actually count towards the three-day period?
+
A certificate of incapacity for work or the “yellow slip” is essential when it comes to applying for sick pay.
© Alexander Heinl / dpa-tmn
How does it look for the self-employed?
The self-employed are not legally entitled to sick pay.
However, you can protect yourself by submitting an election declaration to your statutory health insurance company.
You will then receive sick pay from the 43rd day of your sick leave.
To do this, the self-employed have to take out a corresponding optional tariff and thus pay a higher contribution.
And what applies to those with private health insurance?
In contrast to statutory health insurance, private health insurance does not automatically pay sick pay.
Those who are privately insured have to take out extra cover with the tariff module
“
daily
sickness
allowance
”
.
What should be considered when applying for sickness benefit?
The certificate of incapacity for work must reach the health insurance company in good time.
Timely means: You have a week's deadline.
"The employee, self-employed or insured person has to take care of the submission," says Vollmer.
She advises either handing in the certificate of incapacity for work personally and having it correspondingly acknowledged, or sending it by registered mail with a reply.
Also read:
Sick notification: what happens if I do not send the AU to the health insurance company?
What can the health insurance company ask for and what not?
Those with statutory health insurance who receive sick pay often receive a so
-
called
self
-
disclosure form with questions
from the health insurance company
.
Some health insurance companies have now also started calling insured persons and requesting information.
"However, nobody has to provide information on the phone," says Vollmer.
The health insurance company is
entitled to ask, for example, how long someone is likely to be sick
.
But that can also be done in writing.
If the health insurance company continues its calls even though the insured person has forbidden telephone contact, the insured person can lodge a complaint with the competent supervisory authority.
Many questions about the cause of the inability to work are not allowed to be asked by the health insurance fund, but by the Medical Service (MD).
Provided that the questions relate to the specific individual case.
"Explicit questions from the health insurance company about the personal environment of the insured person, such as whether one lives alone or not, are not permitted," says Schwanke.
What are the obligations associated with receiving sick pay?
Recipients of sick pay have an obligation to
cooperate
.
The legislature expects the insured person to actively participate in restoring his or her workforce.
"For example, they have to apply for rehabilitation within the deadline set by the health insurance company," says Schwanke.
Insured persons must also answer truthfully and completely the questions about the declaration of receipt of sickness benefit.
Also interesting: would
you have thought that?
You can do this despite being on sick leave
How long do you get sick pay?
A maximum of
78 weeks for the same illness
within three years.
If the employer has paid for the continued payment for six weeks, the maximum period is reduced accordingly.
As a rule, employees receive sick pay for 72 weeks.
(dpa / ans) * Merkur.de is an offer from IPPEN.MEDIA
.
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List of rubric lists: © Alexander Heinl / dpa-tmn