Benefits for incapacity for work

Benefits for incapacity for work are paid by the employer and the EHIF.

A doctor can issue a certificate of incapacity for work to a person who is insured through their employer. A doctor decides whether or not to issue a certificate of incapacity for work on the basis of a person's state of health. 

On the basis of this certificate, the employer and the EHIF pay the person a sickness benefit, the purpose of which is to partially compensate the employee for the loss of earnings during illness.

The calculation of incapacity for work benefit does not take account of the social security tax paid on doctoral student benefits, parental benefit or other benefits paid by the rural municipality, city or creative associations.

You can access the information regarding your certificate of incapacity for work on the state portal www.eesti.ee under the service “My certificates of incapacity for work".

The EHIF usually pays the benefit within a few working days of the receipt of the information from the employer. The processing time is extended if, for example, a bailiff has filed an attachment order, the employer is late with the insurance details, etc.

Procedure for reimbursement of sick days as of 01.01.2021.

To reduce the risk associated with people going to work when they are ill, as well as to reduce the employees’ deductibles, and thereby limit the spread of COVID-19, the procedure for reimbursing sick leaves was temporarily changed as of 01.01.2021. The employee’s deductible applies to the first day of illness, the employer pays the benefit from the second to the fifth day of illness and the EHIF pays the benefit from the sixth day of illness. This compensation procedure will continue in 2022.

If enforcement proceedings have been instituted against you and the bailiff has submitted one or more  attachment orders to the EHIF, the EHIF is obliged to withhold the amount to be seized from your temporary incapacity for work benefit and transfer the amount to the professional account of the bailiff who sent the attachment order.

If you find that your income and dependents have not been taken into account in the attachment order, please contact the bailiff conducting the enforcement proceedings. The bailiff is authorized to change the seizure order. Contact details of bailiffs can be found on the website of the Chamber of Bailiffs and Trustees in Bankruptcy

You can access the information about enforcement proceedings initiated against you on the state portal under the service "Enforcement files initiated against me".

1. I have COVID-19, am I entitled to a sickness certificate?

If you have been diagnosed with COVID-19, your doctor will issue you a sick leave certificate by indicating the reason as “illness”. The sick leave certificate is issued only to those who are insured through their employer.

2. I am a close contact of a COVID-19 patient, am I entitled to a sick leave certificate?

A close contact is a person who lives with, is permanently in the same place of residence or otherwise has been in close contact with a person infected with COVID-19.

If you are in close contact, you will be issued a sick leave certificate, if necessary.

If you are in close contact with a COVID-19 patient and have been issued a sick leave certificate during the period of self-isolation and you fall ill, then your sick leave certificate will be renewed.

3. If I return from a country that is included in the risk area and I have to self-isolate after arrival, am I entitled to a sick leave certificate?

You are not issued a sick leave certificate during post-travel isolation. You need to discuss with your employer on your working arrangements.

4. If my child under the age of 12 is a COVID close contact and I need to stay home with the child, will I be entitled to care leave?

Yes, your doctor will issue you a care leave certificate, if needed.

5. If a child becomes ill during the follow-up period, will I be issued a new care leave certificate for 14 days?

Yes, if your child becomes ill, your doctor will issue you a new care leave certificate for 14 days.

6. If I become a COVID close contact during my child's follow-up period, will I be issued a sick leave certificate?

If you find that you have had close contact with Covid-19 during the care leave, your doctor will need to close the care leave certificate sheet and issue you a sick leave certificate.

7. If I already have one sick leave certificate opened and during that time information about a new close contact is added, will I be issued a new sick leave certificate?

If a sick leave certificate has been issued for you during self-isolation and during that time it turns out that you have been in close contact with the next Covid-19 patient, the sick leave certificate will be extended until the end of the last self-isolation. If you become ill during self-isolation, you will be issued a follow-up certificate.

8. In addition to the EHIF, can an employer pay additional benefits to an employee from the 6th day of illness?

The employer is obliged to pay compensation to the employee from the second to fifth calendar days of illness or injury. In turn, a person is not entitled to receive sickness benefit from the EHIF for the period of incapacity for work during which the person receives income subject to social security tax from the employer (§ 60 (1) 5) of the Health Insurance Act).

9. Is the employer obliged to reimburse the sick leave certificate issued due to quarantine?

A quarantine certificate is one of the types of sick leave certificates on the basis of which sickness benefit is paid. The employer reimburses the 2nd - 5th day of the sick leave.

10. Where can a person turn in case of a dispute with an employer (e.g., approval of an incapacity for work certificate, payment of sickness benefit, registration of employment)?

To resolve labour disputes, contact the Labour Inspectorate at https://www.ti.ee/en/node/9646. You can also turn to a court.

11. If a healthy child under the age of 12 (who is not a close contact) has to stay at home due to the physician issue me a care leave certificate so I can look after the child?

For a healthy child who stays home no care leave certificate is issued. The care leave certificate is only issued for the care of a sick or close contact child.

Read more:

Comparison of benefits for incapacity for work 01.01.2021–31.12.2022

Reason for release from workNumber of the reasonType of certificateReimbursement procedureDuration of payment for one insured event
Illness (including domestic injury from 30.06.2022)1Sick leave certificateThe employer pays the benefit from day 2 to day 5 of the illness. EHIF pays from day 6, the benefit rate is 70%.Up to 182 days (up to 240 days in case of tuberculosis)
Domestic injury (invalid from 30.06.2022)3Sick leave certificateThe employer pays the benefit from day 2 to day 5 of the illness. EHIF pays from day 6, the benefit rate is 70%.Up to 182 days

Traffic injury

Complication/illness as a result of a traffic injury

4

18

Sick leave certificateThe employer pays the benefit from day 2 to day 5 of the illness. EHIF pays from day 6, the benefit rate is 70%.Up to 182 days
Quarantine10Sick leave certificateThe employer pays the benefit from day 2 to day 5. The EHIF pays the benefit from day 6, the benfit rate is 70%.Until the end of quarantine
Occupational diseases2Sick leave certificateThe EHIF pays the benefit from day 2, the benefit rate is 100%.Up to 182 days

Occupational injury

Occupational injury in traffic

Complication/illness as a result of an occupational injury

Injury received while preventing a criminal offence, protecting national or public interests

5

6

 

7

 

8

Sick leave certificate

 

 

 

Sick leave certificate

The EHIF pays the benefit from day 2, the benefit rate is 100%.

 

 

The EHIF pays the benefit from day 2, the benefit rate is 100%.

Up to 182 days

 

 

 

Up to 182 days

Transfer to easier work17Sick leave certificate

The EHIF compensates for the difference in wages caused by the transfer to an easier work, if the person's salary at the time of the transfer to an easier work is lower than his or her average income for the previous calendar year.

If a person is released from work due to lack of easier work, the benefit is paid from day 2 at the rate of 70%.
Until the mother’s parental benefit is granted or up to 182 days
Illness or injury during pregnancy19Sick leave certificateThe EHIF pays the benefit from day 2, the benefit rate is 70%.Up to 182 days
Nursing a child under the age of 12 or a disabled insured person under the age of 19.14Care leave certificate

EHIF pays the benefit from the first day of release, the benefit rate is 80%.

Please note! An insured person is entitled to a care benefit on the basis of a certificate for care leave for nursing a child under the age of 12 for up to 60 calendar days, if the illness is caused by a malignant tumour and the child's treatment begins in a hospital.
Up to 14 days
Nursing a sick family member who is ill at home12Care leave certificateEHIF pays the benefit from the first day of release, the benefit rate is 80%.Up to 7 days
Caring for a child of under 3 years of age or for a disabled child of under 16 years of age when the child’s mother is ill or is receiving obstetrical care13Care leave certificateEHIF pays the benefit from the first day of release, the benefit rate is 80%.Up to 10 days
Maternity leave15Maternity leave certificateThe EHIF pays the benefit from the first day of release from work, the benefit rate is 100%.140 days
Adoptive parents leave for a child under 10 years of age16Adoption leave certificateThe EHIF pays the benefit from the first day of release from work, the benefit rate is 100%.70 days
Organ or haematopoietic stem cell donation20Sick leave certificateThe EHIF pays from day 1, the benefit rate is 100%.Up to 182 days

 

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.

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.

 

Frequently Asked Questions - FAQ

Töövabastuse perioodi kohta vormistab arst Sulle elektroonilise töövõimetuslehe ja edastab selle haigekassa andmekogusse. Kui  arst töövõimetuslehe lõpetab, siis palun teavita sellest oma tööandjat!

Selleks, et haigekassa määraks ja maksaks töövõimetuslehe alusel hüvitist, peab tööandja arsti poolt lõpetatud töövõimetuslehe andmed haigekassale esitama elektroonselt riigiportaalis www.eesti.ee. Pärast seda, kui tööandja on andmed haigekassale edastanud ja töövõimetuslehe andmed ei vaja täpsustamist, kantakse hüvitis Su arvelduskontole paari tööpäeva jooksul.

Infot oma töövõimetuslehtede kohta näed riigiportaalis www.eesti.ee teenuses “Minu töövõimetuslehed". 

Ravikindlustatud inimesel on õigus haiguse või vigastuse korral hüvitist saada kuni haiguslehel märgitud töövõime taastumise päevani, kuid mitte rohkem kui 240 järjestikust kalendripäeva tuberkuloosi või 182 järjestikust kalendripäeva mõne muu haiguse korral. Haiguslehe kestusel piirangut pole., Arst saab vajadusel haiguslehe väljastada ka pikemaks ajaks kui hüvitise maksmise periood.

 

Kalendriaastas kindlustatule kokku makstavate päevade piirangut ei ole, st ühe haigusjuhtumi korral makstakse haigushüvitist järjest kuni 182 päeva. Kui inimene haigestub uuesti, saab ta taas kuni 182 päeva järjest hüvitist.

FIE-le maksab haigekassa haigushüvitist alates kuuendast töövabastuse päevast. Viie esimese töövabastuse päeva eest FIE-dele haigushüvitist ei maksta.

Töölepingu seaduse kohaselt on töötajal õigus puhkus katkestada, edasi lükata või enneaegselt lõpetada töötajast tulenevatel olulistel põhjustel.

Töötajal on õigus nõuda kasutamata jäänud puhkuseosa vahetult pärast puhkuse kasutamist takistava asjaolu äralangemist või poolte kokkuleppel muul ajal. Töötaja on kohustatud tööandjale teatama puhkuse kasutamist takistavast asjaolust esimesel võimalusel.

Kui töötaja puhkust ei katkesta, ei ole tal õigust töövõimetushüvitist saada.

Töövõimetusleht väljastatakse töötajale haiguse või vigastuse korral kalendripäevade alusel ning hüvitise maksmist ei saa siduda töötaja tööajakavaga.

Tagasiulatuvalt (ka algusega puhkepäeval või riigipühal) võib töövõimetuslehe avada, kui kindlustatud isik haigestub või hoolduse või põetuse vajadus tekib nädalavahetusel, rahvuspühal või riigipühal ja isik teavitab sellest tervishoiutöötajat sidevahendite teel või vastuvõtule tulles vahetult järgneval tööpäeval ja kui kindlustatud isiku haigestumise kohta on tehtud kanne tervise infosüsteemi.

Ajutise töövõimetuse hüvitist arvutatakse sotsiaalmaksuga maksustatud tulult. Makstav hüvitis arvutatakse eelneva kalendriaasta sotsiaalmaksu alusel, mille andmed saab haigekassa maksu- ja tolliametist.

Vastavalt ravikindlustuse seadusele (§55 lg 1) ei võeta töövõimetushüvitise arvestamisel arvesse doktoranditoetusi, vanemahüvitist ja teisi valla, linna või loomeliidu poolt makstavaid toetusi ning nendelt makstud sotsiaalmaksu.

Hüvitise summa saamiseks arvutatakse töötaja kalendripäeva keskmisest tulust hüvitise määr ning see korrutatakse hüvitamisele kuuluvate päevade arvuga. Hüvitiselt peetakse kinni tulumaks.

Ajutise töövõimetuse hüvitise maksmise kord sõltub töövõimetuslehe liigist ja põhjusest. Täpsemalt saab hüvitise määramise ja maksmise korrast lugeda hüvitiste lehelt.

 

Kui eelmisel kalendriaastal sotsiaalmaksuga maksustatav tulu puudus, lähtutakse hüvitise arvutamisel inimesega kokkulepitud töötasust ja alampalgast. Lisainfot selle kohta saab haigekassa kodulehelt.

Haigekassa maksab ajutise töövõimetuse hüvitise välja 30 kalendripäeva jooksul alates päevast, kui kindlustatud inimese tööandja on teinud nõuetekohased kanded elektroonilisele töövõimetuslehele või kui paberil lisadokumendid on laekunud haigekassasse.

Tööandja peab maksma haigushüvitise välja palgapäeval, kuid mitte hiljem kui 30 kalendripäeva jooksul pärast seda, kui arst on riigiportaalis eesti.ee nõuetekohaselt vormistatud haiguslehe lõpetanud.

Jah, saab küll. Hüvitise saaja nime ja arvelduskonto andmeid on võimalik muuta:

  • Riigiportaali eesti.ee teenuses „Arvelduskonto ja andmed haigekassas“;
  • saates digiallkirjaga avalduse aadressile info [at] haigekassa.ee.

Töösuhte ajal alanud töövõimetuslehe ning järglehed maksab haigekassa välja, olenemata sellest, et vahepeal töösuhe lõpeb.

Välisriigi arstilt saadud paberil tõend esita oma tööandjale, kes edastab selle koos vajalike lisadokumentidega haigekassasse. Kui vajad töövabastust pikemaks perioodiks kui välismaa arsti tõendil märgitud töövabastuse lõpu kuupäev, pöördu viie päeva jooksul pärast tõendil märgitud töövabastuse lõpu kuupäeva oma perearsti poole. Perearst saab Sulle väljastada järglehe pärast seda, kui välismaa arsti poolt väljastatud tõend on haigekassa poolt esmase haiguslehena haigekassa andmekogusse sisestatud.

Euroopa Liidu liikmesriigi kindlustusasutuselt Eestis ravi saanud inimesele haigushüvitise maksmiseks peab arst täitma  „Arstliku läbivaatuse vastuse“.

Arstil tuleb dokument välja printida, allkirjastada ning anda inimese kätte. Inimene pöördub antud dokumendiga oma tööandja või oma kindlustajariigi hüvitist maksva asutuse poole.

On ka lubatud, et inimene edastab vastava originaaldokumendi koos avaldusega („Avaldus töövõimetushüvitise taotlemiseks EL liikmesriigis“ lingil https://www.haigekassa.ee/partnerile/avaldused-partnerile) haigekassale ning haigekassa edastab selle ise välisriigi kindlustusasutusele.

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