Calculation of benefit for incapacity for work

Calculation of the temporary incapacity for work benefit at the EHIF

Basic formula:
  • The amount of calculated or paid social security tax is divided by 0.33 to obtain annual income;
  • For calendar day average wage calculation the annual wages is divided by 365:
  • For the amount of the benefit, the daily wage is multiplied by the corresponding benefit rate and multiplied by the number of days to be reimbursed;
  • Sickness benefit is subject to income tax of 20%.

 

A person working under an employment contract or in the public serviceMember of the management body of a legal person who receives remuneration or services on the basis of a contract under the law of obligationsSelf-employed person
Calculation of average per-calendar day wage
Income calculated on the basis of social security tax calculated for the insured person in the calendar year preceding the beginning of the certificate of incapacity for work divided by 365Income calculated for the insured person in the calendar year preceding the beginning of the certificate of incapacity for work or on the basis of social security tax paid by them or for them divided by 365Income calculated for the insured person in the calendar year preceding the beginning of the certificate of incapacity for work or on the basis of social security tax paid by them or for them divided by 365
Calculation of the average wage per calendar day if there was no income in the previous calendar year or was less than the minimum monthly wage

daily wage = basic wage / 30, but not more than the minimum monthly wage divided by 30

 

If the basic wage is equal to or higher than the minimum monthly wage, then daily wage = minimum monthly wage / 30

Daily wage = the monthly rate established in the Social Tax Act / 30

If there is no obligation to pay advance payments of social security tax, the EHIF does not pay the benefit.

 

If the FIE has no obligation to pay advance payments of social tax, no compensation is paid

Calculation of the average income of a calendar day, if the average income of the previous calendar year is less than the minimum wageCalculation of the average income of a calendar day, if the average income of the previous calendar year is less than the monthly rate of social taxCalculation of the average income of a calendar day, if the average income of the previous calendar year is less than the monthly rate of social tax

If the basic salary is higher than the minimum salary, the minimum salary is divided by 30 to get the income for the calendar day

If both the basic salary and the average income of the previous calendar year are lower than the minimum wage, the income of the calendar day is calculated at a more favorable rate for the person

Income calculated on the basis of paid social tax is divided by 365Income calculated on the basis of paid social tax is divided by 365

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.