Tiếng Việt
中文 (中国)
日本語
한국어Currently, as the country is developing, people in society have tended to pay more attention to social insurance and accompanying policies and regimes. And one of the insurance policies that most people are interested in, is sickness regime. Through today’s article, let’s learn more specifically about the conditions and procedures to enjoy the sick regime of social insurance.
1. Eligibility
According to the provisions of Article 25 of the Law on Social Insurance 2014, conditions for enjoying sick benefits include:
First, being sick or having an accident that is not a labor accident must leave work and be certified by a competent medical examination and treatment establishment according to regulations of the Ministry of Health;
In case of illness or accident due to self-destruction of health, drunkenness or use of narcotics or drug precursors according to the list prescribed by the Government, they shall not be entitled to sick benefits;
Second, they must take time off work to take care of their sick children under 07 years old and certified by competent medical examination and treatment establishments.
Cases in which employees are not entitled to sick benefits
(1) The employee is sick or has an accident and must quit work due to self-destruction of health, drunkenness or use of narcotics or drug precursors.
(2) The employee leaves work for the first time due to a labor accident or occupational disease.
(3) The employee suffers an illness or accident that is not a labor accident while on annual leave, personal leave or unpaid leave as prescribed by labor law;
(4) The employee takes maternity leave in accordance with the law on social insurance.
(5) The employee must take leave from work to take care of a sick child but not in the case of taking care of a sick child under 07 years old certified by a competent medical examination and treatment establishment.
2. Duration of sick leave
For yourself
According to Article 26 of the Law on Social Insurance 2014, employees are entitled to leave for the regime with a number of days depending on working conditions:
Work under normal conditions:
– 30 days/year if you have paid social insurance premiums for less than 15 years;
– 40 days/year if paid from full 15 years to less than 30 years;
– 60 days/year if paid for 30 years or more;
Doing heavy, hazardous, dangerous or especially heavy, noxious or dangerous occupations or jobs:
– 40 days if you have paid social insurance premiums for less than 15 years;
– 50 days if paid from full 15 years to less than 30 years;
– 70 days if paid for 30 years or more;
The above-mentioned vacation time is calculated according to working days, excluding public holidays, Tet holidays, weekly holidays.
In case of long-term illness:
– Up to 180 days;
– After 180 days of continuing treatment, the maximum benefit period is equal to the time paid social insurance.
This break includes public holidays, Tet holidays, weekly holidays.
For sick children
According to Article 27 of the Law on Social Insurance 2014, according to working days, when the child is sick, the employee is entitled to leave;
– Maximum 20 working days/year if the child is under 03 years old;
– Maximum 15 working days/year if your child is from full 03 years old to under 07 years old.
3. Sickness benefits
According to Article 28 of the Law on Social Insurance 2014, in order to ensure income for employees and partially support treatment costs, sick employees are entitled to the following benefits:
Monthly benefit = 75% x Social insurance contribution salary of the month preceding the leave (salary divided 24 x 75% x number of vacation days)
* For long-term sick people who have taken 180 days off and still continue treatment, the benefit will be lower:
- Equal to 65% of the salary paid for social insurance in the month preceding the leave if you have paid social insurance premiums for full 30 years or more;
- Equal to 55% of the salary paid for social insurance in the month preceding the leave if the social insurance has been paid from full 15 years to less than 30 years;
- Equal to 50% of the salary paid for social insurance in the month preceding the leave if you have paid social insurance for less than 15 years.
Particularly, officers, military personnel, officers, police non-commissioned officers, and people doing basic work are entitled to 100% of the salary paid for social insurance in the month preceding the leave.
4. Composition of application for sickness benefits
According to Article 100 of the Law on Social Insurance 2014, in order to enjoy the regime, an employee must prepare a dossier of sickness benefits, including the following documents:
Discharge certificate for the employee or his/her child if receiving inpatient treatment;
Certificate of leave from work entitled to social insurance if outpatient treatment;
Certificate of medical examination and treatment translated in Vietnamese if medical examination and treatment is abroad.
5. Procedures and time limit for settlement
For employees:
Within 45 days from the date of returning to work, the employee submits the above application to the employer.
For employers:
Within 10 days from the date of receipt of a complete dossier from the employee, the employer is responsible for making a dossier (including the employee’s dossier and the List of employees who quit their jobs to enjoy the regime) and submit it to the social insurance agency.
For social insurance agencies:
Within 10 days from the date of receipt of complete documents from the employer, the social insurance agency shall settle and pay sick pay to the employee.
6. Convalescence and rehabilitation after illness
According to Article 29 of the Law on Social Insurance 2014, employees who have taken full leave to enjoy the regime in one year but in the first 30 days of returning to work have not yet recovered, are entitled to health convalescence and rehabilitation from 05 to 10 days, including public holidays, Tet, Weekly break:
– Up to 10 days for people with diseases requiring long-term treatment;
– Maximum 07 days for people undergoing surgery;
– Equal to 05 days for other cases.
Benefit from health care and rehabilitation after illness: During this period, employees are supported every day equal to 30% of the base salary.
Above is our sharing about the procedure for enjoying the pain regime of social insurance. Please contact Bi Law Firm for more detailed advice.
