Sickness benefit: What requirements do I have to meet in order to be eligible for it?
May 16, 2024 | 40,00 EUR | answered by Albrecht Dietrich
Dear Social Law Attorney,
My name is Anneliese Heuser and I am reaching out to you with a question regarding sickness benefit. Currently, I am on sick leave and receiving sickness benefit from my health insurance. However, I am concerned about whether I still have a right to it and what requirements I need to fulfill in order to continue receiving sickness benefit.
Regarding the current situation: I have been on sick leave for three months and my doctor has certified that I am still unable to work. So far, the health insurance has been paying out my sickness benefit without any issues, but I have heard that there are certain requirements I need to meet in order to continue to be eligible for it.
My concerns are that my health insurance may stop the payments or that I may no longer be classified as unfit for work, therefore losing my entitlement to sickness benefit. I rely on sickness benefit to support myself, as I am unable to work due to my illness.
Therefore, my question to you is: What specific requirements do I need to fulfill to continue to be eligible for sickness benefit? Are there any deadlines I need to adhere to or any additional documents I need to submit to secure my entitlement?
Thank you in advance for your support and advice on this matter.
Sincerely,
Anneliese Heuser
Dear Mrs. Heuser,
Thank you for your question regarding sickness benefits and your trust in my expertise in the field of social law. It is understandable that you are worried and want to ensure that you continue to be entitled to sickness benefits to secure your livelihood.
In general, insured persons are entitled to sickness benefits if they are unable to work and have a medical certificate to confirm this. In your case, you have been on sick leave for three months and your doctor has confirmed that you are still unable to work. This is the basic requirement for receiving sickness benefits.
To continue to be eligible for sickness benefits, you must regularly submit medical certificates of your inability to work to your health insurance company. Typically, a new certificate is required every three weeks to maintain your entitlement to sickness benefits. It is important that these certificates are submitted to the health insurance company in a timely and complete manner to avoid interruptions in payments.
Furthermore, the health insurance company may conduct a review of your inability to work as part of an examination. In this case, it may be necessary for you to see a medical expert or the medical service of the health insurance company to confirm your inability to work. It is important that you cooperate and provide all requested documents and information to secure your entitlement to sickness benefits.
If the health insurance company still doubts your inability to work and wants to stop payments, you have the option to appeal and potentially take legal action against it. In such cases, it is advisable to seek advice from an experienced lawyer specializing in social law to represent your interests.
In summary, you can secure your entitlement to sickness benefits by regularly submitting medical certificates, cooperating with the health insurance company, and seeking legal assistance in case of problems.
I hope that this detailed response has been helpful to you. If you have any further questions or need legal assistance, I am at your disposal.
Yours sincerely,
Albrecht Dietrich
Social Law Attorney
