Sickness Benefit

What is it?

Sickness Benefit is payable to insured persons who lose income due to illness, over a period of up to twenty-six weeks.

Who Qualifies?

An employee or self-employed person:

Who is between the ages of 16 and pensionable age
Who has paid at least 26 weekly contributions
Who has paid or has been credited with at least 8 contributions in the 13 week period before the illness

NB: Age pensioners and invalidity pensioners cannot receive sickness benefit.

How and When Should You Claim?

A claim for Sickness Benefit must be supported by a medical certificate given by a medical doctor. The medical certificate must be submitted to the employer.

The claim form must be completed by the claimant and a medical doctor
The claim form must be submitted to NIS within 15 days of visiting the medical doctor
All sickness claims should be submitted to the NIS, even if granted for three days or less, in the event that there is a subsequent claim that is linked with the first one.

While an insured person is receiving Sickness Benefit, no NIS contributions are due to the NIS. The insured will receive benefit credits, which will entitle the insured person for further benefits relating to sickness, maternity, age pension, invalidity and survivors’ benefit.

What is the Amount?

An insured person will be paid sixty-five percent (65%) of his/her average weekly wages for up to 26 weeks. Other things affecting payment:

Sickness benefit is paid for public holidays
Sickness Benefit is not paid for Sundays
Sickness Benefit is not paid for the first three days
The payment would only be paid to the claimant if he/she is not receiving a full salary from his/her employer for the period of illness. If the claimant receives a full salary, then the benefit will be paid to the employer.

How is it calculated?

Average weekly earnings = ^{Total Insurable Earnings}⁄₁₃
Rate of benefit: 65% of average weekly insured earnings
Benefit payable: Daily rate x amount of benefit allowed

e.g. Claimant earns $560 per week and claims Sickness Benefit for 6 days

Contributions used prior to claim = 13 weeks

Average weekly Insurable Earnings = ^{Total Insurable Earnings}/₁₃ = ^{($560 x 13 weeks)}/₁₃ = ^($7280)/₁₃ = $560.00

Daily rate = ($560.00 x 65%)/6 = $60.70
Benefit payable: $60.70 x 3 days = $182.00 (3 waiting days have been deducted)

For subsequent claims within an eight week period, the waiting days are not deducted

How Can You be Disqualified?

Sickness Benefit is not available to persons who are in receipt of an Age Pension, or who have received an Age Grant and returned to work.
If the person becomes incapable of work because of his/her own misconduct
If the person is engaged in paid employment during the period of sick leave
If the person does anything to retard his/her recovery
If the person leaves the State without informing the NIS
If the person does not meet the qualifying conditions