Sickness benefit and incapacity for work
To ensure that you remain financially secure even in the event of a longer period of sickness, you receive sickness benefit from SBK
When do you start receiving sickness benefit from SBK?
If the doctor treating you declares you unfit for work, you can start receiving sickness benefit from your health insurance provider. If you are employed, your employer will usually pay your salary up to the sixth week of sickness – this is known as continued remuneration. At the end of this period, SBK will send them an earnings certificate form. This is then returned to SBK electronically, complete with all the information required to calculate your sickness benefit.
If you are receiving unemployment benefits (ALG I), the Federal Employment Agency informs SBK when the continued payment will end and how much unemployment benefit you were receiving. You can start to receive sickness benefit from SBK from this point onwards.
Certificate of incapacity for work
Since 2016, the process for payment of your sickness benefit has been simplified: your doctor now completes a form to certify that you are unfit for work. The form combines the previous SBK payment certificate for sickness benefit and the certificate of incapacity for work. Now, your doctor only uses the certificate of incapacity for work to certify your sickness for the entire period in question.
You will be given your own copy of the certificate of incapacity for work on each occasion to ensure you have all the details. This means you will always know on which day the certificate of incapacity for work issued by your doctor will expire and when a new certificate will need to be issued. If you are ill for an extended period, it is important for your doctor to issue a new certificate of incapacity for work at the very latest on the day after the previous certificate expires, in order to ensure that there are no gaps in evidence for the overall period of sickness.
The sickness benefit equals 70% of your previous gross salary, from which contributions have been paid, but a maximum of 90% of the net salary. One-off payments such as holiday pay and Christmas bonuses can further increase the sickness benefit to 100%. Deferred compensation can reduce the level of sickness benefit. The maximum sickness benefit possible is €109.38 per calendar day for the year 2020 (€105.88 in 2019). If unemployment, nursing care or pension insurance cover is obligatory, sickness benefit is reduced by the proportion of contributions to be paid by the insured person towards unemployment, nursing care and pension insurance. SBK deducts these contributions prior to paying out the sickness benefits and transfers them to the relevant insurance provider along with the amounts to be paid by SBK.
In order to receive sickness benefit, you need to have selected the option for statutory sickness benefit from the 43rd day of incapacity for work. If you are self-employed, the level of sickness benefit is in line with your previous income before you fell ill; this will, however, be limited to a maximum of the income from which contributions have been paid.
Your sickness benefit equals 70% of the average daily income to a maximum of €109.38 per calender day (2019: €105.88).
Self-employed people can also secure an even higher level of sickness benefit with the premium tariff. You can get more information on the premium tariff from your personal consultant.
If unemployment, nursing care or pension insurance cover is obligatory, sickness benefit is reduced by the proportion of contributions to be paid by the insured person towards unemployment, nursing care and pension insurance. SBK deducts these contributions prior to paying out the sickness benefits and transfers them to the relevant insurance provider along with the amounts to be paid by SBK.
Your sickness benefit will be exactly the same as the unemployment benefit (ALG I) you last received.
The contributions to be paid from thesickness benefit towards health, nursing care and unemployment insurance are paid in full by SBK. Individuals without children are only required to pay the nursing care insurance premium of 0.25% themselves.
How long can you receive sickness benefit for?
You can receive sickness benefit for a maximum of 78 weeks for the same illness. Times in which sickness benefit is suspended are counted towards this maximum entitlement. Examples of this include times during which you are receiving continued remuneration from your employer or you are claiming a transitional allowance from the pension insurance provider during rehabilitation.
Good to know:
You and any family members covered by the insurance will not be required to make contributions to SBK while receiving sickness benefit. During this time, SBK will also continue to pay your contributions for unemployment, nursing care and pension insurance. This means your retirement is safeguarded even in the event of a longer illness.
Sickness benefit – your SBK benefits:
- If we do not already know your level of income, we will ask your employer directly. You do not need to do anything.
- SBK notifies the pension insurance provider directly of the times during which sickness benefit was being received so that there are no gaps in your pension account.
- For longer illnesses, we will support you in returning to work through progressive reintegration.
- For serious illnesses, we will help you apply for rehabilitation benefits to ensure you return to good health.
How to get your sickness benefit from SBK
In order for us to pay out sickness benefit, your doctor will give you a certificate of incapacity for work indicating that this is a sickness benefit case (‘from the 7th week of incapacity for work or other sickness benefit case’ or ‘final certificate’). Payment is always made up until the day on which your doctor issued the certificate of incapacity for work. Submitting the certificate of incapacity for work to SBK therefore allows you to control when you want to receive your sickness benefit yourself. If you continue to be unfit for work, your doctor will issue you another certificate of incapacity for work.
Important: please ensure that there are no gaps in the certification of incapacity for work for all such times. Certificates for continued incapacity for work must be obtained at the very latest on the day after the current certified period of incapacity for work to avoid any loss of sickness benefit.
Please always send the certificate of incapacity for work to SBK, 80227 Munich, Germany, so that we can transfer the sickness benefit to you without delay and within a few days.