It is certain that all employees, at least once in their lives, have been sick and unable to go to work. Many of them, however, are only vaguely familiar with all the rules on this subject, especially those relating to the economic aspect. In this article we will try to answer the most frequently asked questions.
Who pays the sick pay?
If an employee falls ill, the employer continues to pay his salary for the first 6 weeks (provided that the employee has been working in the company for at least one month). If the illness exceeds 6 weeks, the health insurance will continue to pay sickness benefits (Krankengeld).
What are the conditions for receiving Krankengeld?
In order to receive the Krankengeld first of all you must be regularly registered with one of the public health insurance companies (e.g. AOK, Barmer, etc.). If you feel unwell, you will need to go to your doctor to get a certificate of illness in triple copy, one of which must be sent to your health insurance within 7 days (many insurance agencies now offer the possibility of uploading the certificate of illness directly online, using a special application).
In case of prolonged illness?
An additional medical certificate that serves to prolong the illness must be submitted, at the latest, by the working day following the last day indicated on the previous certificate. Saturdays do not count as working days, so, for example, if you are on sick leave until Friday, you must submit a new medical certificate by the following Monday. Do not forget to send a copy of the certificate not only to your employer, but also to your health insurance, otherwise the insurance will stop paying compensation for the illness.
When do you start to perceive Krankengeld?
Employees are entitled to sick pay from the day the doctor determines that they are unable to work. Those who need treatment in hospital or in a prevention or rehabilitation facility receive the Krankengeld from the beginning of their stay at the facility.
Is there a maximum time limit for Krankengeld?
Krankengeld are paid for a maximum of 78 weeks for the same type of illness over a period of 3 years. If the employer continues to pay the salary during the first 6 weeks of illness, the health insurance will cover the cost of the other 72 weeks.
How much are the Krankengeld?
The sum is equal to 70% of the gross salary, but not more than 90% of the net salary. The share increases, for example, if you have received holidays or Christmas bonuses in the last twelve months before the start of your impossibility to work. Social security contributions for unemployment, nursing care and pension insurance are deducted from the Krankengeld, but not health care contributions. In order to calculate the exact amount to be paid for compensation, the health insurance company contacts the employer to obtain information on the monthly salary of its employee.
Is it the worker himself who has to apply for Krankengeld?
You are not required to apply to your health insurance company for sick pay; however, if you already know or suspect that the illness will last longer than 6 weeks, it is best to notify your health insurance company in good time. This is because Krankenkasse often needs time to obtain information from the employer in order to calculate the amount of the benefits.
Who is not entitled to sick pay?
Family insurance members, pensioners, ALGII beneficiaries and trainees are not entitled.
What happens after 78 weeks?
At the end of the 78 weeks, people who are not yet able to work should register as unemployed if they are entitled to a disability pension (Erwerbsminderungsrente). The employee should apply if, due to illness, it is no longer possible to do the job. (The advice is always to inquire with the health insurance in good time, even before the compensation ends). As long as a person is waiting for the outcome of his or her pension claim for the reduction of earning capacity, he or she is entitled to unemployment benefit (Arbeitslosgeld). Those who are not entitled to a pension for reduced earning capacity must apply for basic insurance.
basically, the membership of the health insurance ends when the entitlement to sickness benefit ceases, those who receive help from the Job Center or Agentur fürArbeit can remain regularly registered with their public insurance. All those who receive or have applied for a pension with the public institution can be insured with the health insurance for pensioners (KVdR).