Benefit for temporary incapacity for work
Benefit for temporary incapacity for work is a financial compensation paid by the Health Insurance Fund or the employer on the basis of a incapacity for work certificate to an insured person (an employee, a civil servant, a person receiving remuneration or service fees on the basis of a contract under the law of obligations, a member of the management or controlling body of a legal person, a self-employed person, a spouse participating in the activities of a self-employed person) who does not receive income due to a temporary release from their work duties. Benefit for temporary incapacity for work is paid to persons for whom social security tax has been paid.
There are more than ten types of temporary incapacity for work benefits and they depend on the reason for the leave, for example, illness, maternity leave, taking care of a sick child, etc.
For EHIF to be able to pay the incapacity for work benefit, the employer must submit the data of the beneficiary to EHIF within seven calendar days after the closure of the incapacity for work certificate. EHIF will pay the incapacity for work benefit within 30 days of the date when the employer submitted the information. Normally, the Health Insurance Fund transfers the benefit money to the employee's current account within a few working days after the employer has submitted the data.
Estonia uses an electronic incapacity for work certificate system (E-TVL), which enables the physician and the employer submit the data to the EHIF database electronically. To use the E-TVL service, the employer has to join the service on the state portal eesti.ee. Read more about the transfer of incapacity for work data here.
From July 1, 2023, the pre-corona sickness benefit payment procedure will be restored
The government decided to restore the pre-corona order for the payment of sick leaves from July 1, 2023. This means that the sickness benefit is paid to the employee from the fourth day instead of the second day.
From July 1, when issuing a primary sick leave, the first three days are the employee's deductible, the employer pays from the fourth to the eighth day, and from the ninth day of illness, the Health Fund pays compensation.
In the case of a primary sick leave issued up to and including June 30, the first day of illness is the employee's own responsibility, the employer pays from the second to the fifth day, and the Health Insurance Fund pays compensation from the sixth day of illness.
The employer's obligation to pay sickness benefits is regulated by § 122 subsections 1 and 3 of the Occupational Health and Safety Act.
Calculation of benefit for incapacity for work
|Employer calculates the sickness benefit:||The EHIF calculates the benefit for incapacity to work:|
on the basis of the employee's average salary for the last six months.
on the basis of the data on social security tax calculated or paid for the employee for the previous calendar year, as received from the Tax and Customs Board. See the information on the state portal www.eesti.ee under the service "My incapacity for work certificates".
In the event of an illness or injury, an insured person has the right to receive sickness benefit until the date on which their capacity for work is restored as specified in the certificate for sick leave, but not for more than 240 consecutive calendar days in the event of tuberculosis or 182 consecutive calendar days in the event of any other illness.
If necessary, a doctor may issue a certificate for sick leave for a longer time than the reimbursable period. This limitation applies only to the period for which the benefit is paid, and not to the duration of the sick leave certificate.