Sickness Benefit

A person who is socially insured according to the Law on State Social Insurance and is:

  • a worker (including an employee of a micro-enterprise),
  • a self-employed person and actually making social insurance contributions,
  • a spouse of the self-employed person, who has voluntarily joined social insurance

has the right to receive the sickness benefit,

if he/she does not arrive at work and thus losses the income from paid job or if a self-employed person losses income due to the following reasons:

  • disablement related to the illness or injury,
  • care of a child under the age of 14 years at home or in a hospital,
  • a need to receive therapeutical or prophylactic medical help,
  • necessary isolation because of the quarantine,
  • treatment in a medical institution after the illness or injury, if such treatment is necessary to recover the ability to work,
  • prosthetics or orthotics in a hospital.

The persons for whom mandatory contributions for sickness insurance have been made or had to be made in the Republic of Latvia:

  • for at least 3 months within the period of the last 6 months before the month when the insurance case occurred (the first day of disablement) or
  • for at least 6 months within the period of the last 24 months

and who during the disablement period hold the status of a worker or a self-employed person, are entitled to the sickness benefit.

Example:

The first day of illness is on 03.01.2019.

Since the person did not manage to recover during the first 10 days of illness, the doctor has issued a sick-leave certificate B from the 11th day of the illness for the period from 13.01.2019 till 25.02.2019.

The person will be entitled to the sickness benefit if:

  • during the period of 6 months from July 2018 till December 2018 contributions to sickness insurance were made for at least 3 months, or
  • during the period of 24 months from January 2017 till December 2018 contributions to sickness insurance were made for at least 6 months.

The provision regarding the necessary term of insurance for granting the sickness benefit refers only to the cases when the insured person himself/herself was ill.

It means that, if the sickness benefit is granted for the care of an ill child, it does not make the term of insurance. Also it should be noted that this provision does not refer to insurance cases when disablement occurs due to the “accident at work” or “occupational disease”.

Application for the benefit

Only an application for the benefit should be submitted.

The most convenient way is to fulfil an e-application on the portal of unified national and local services www.latvija.lv.

The application addressed to the division of the State Social Insurance Agency (SSIA) in a standard form or free form can be submitted also:

  • in person;
  • by mail;
  • electronically by signing the application with a safe electronic signature containing a time stamp;
  • to the national and local united client service centres that have concluded a contract with the SSIA.

With his/her signature the applicant certifies that the information provided in the application is true.

If documents attesting the disablement that have been issued abroad are submitted, they have to be processed according to validation rules. If the document has been issued in a foreign language, a translation of the document may be necessary.

The benefit’s payment duration

If you are sick:

  • Continuously, the benefit will be paid for a maximum of 26 weeks. Based on a conclusion issued by VDEĀK (the State Medical Commission for the Assessment of Health Condition and Working Ability), the benefit payment period may be extended, but no more than for 52 weeks;
  • Intermittently, the benefit will be paid for a maximum of 52 weeks in a three year period.

If the disablement is caused by the fact that the person suffers from tuberculous, the sickness benefit is granted and paid from the 11th day of the disablement until the recovery of the ability to work or by the day when disability is established. It means that in such cases the sickness benefit is paid also for the period exceeding 26 weeks (without the opinion of the State Medical Commission for the Assessment of Health Condition and Working Ability (SMC)) or 52 weeks, but not more than by the day when the doctor closes the sick-leave certificate or when disability is established.

If during the illness period employment relationship with the person is terminated or the person has lost the status of the unemployed person, but the period of work disability continues, the sickness benefit will be paid for the 30 calendar days following the day when the employment relationship is terminated or the day when the person lost the status of the unemployed person. If the person has not managed to recover, for the rest of the period the sickness benefit is not granted.

This provision refers to the cases when the socially insured person himself/herself has been affected by the illness. The provision is not applied to illness cases when the cause of work disability is “an accident at work” or “an occupational disease”.

Example:

The first day of illness is on 10.01.2019.

During the period when the sickness benefit is received the employment contract for a limited period of time is terminated and on 31.01.2019 the employment relationship is terminated. However the person has not managed to recover and the doctor has issued a sick-leave certificate B for the period from 20.01.2019 until 31.03.2019.

In this case the benefit will be paid until 01.03.2019 (including), namely, 30 calendar days after 31.01.2019.

Benefit for a child in your care under the age of 14 shall be granted and paid:

  • From the 1st  to the 14th day of the child’s sickness;
  • From the 15th to the 21st day, if for a period time the child is cared for in a hospital.

The rates of the benefits

For the first 10 days of the sickness, the employer shall pay sick pay in the following amount:

  • For the second and third day of the sickness – not less than 75% of your average earnings;
  • From the fourth to the tenth day of the sickness – not less than 80% of your average earnings.

From the 11th day of sickness, the State Social Insurance Agency (VSAA) shall grant a sickness benefit in the amount of 80% of your average contributions salary.

The average contributions salary of an employee is calculated in accordance with the payments made during the last 12 months, ending one quarter (3 months) before the quarter, in which the temporary disability began.

Time for claiming

The benefit must be requested within 6 months from the first day of the temporary disability.

Time for decision

The decision on granting the benefit will be taken within ten days after the VSAA office has received all documents that are necessary for granting the benefit.

Receipt of the benefit

The benefit shall be transferred to the account in a credit institution or postal payment system (PNS) indicated in your application.

Good to know

If the person is entitled to receive the sickness benefit and the unemployment benefit at the same time, during this period only the sickness benefit is paid.

Published date: [28.12.2018]