ČESKÁ SPRÁVA SOCIÁLNÍHO ZABEZPEČENÍ

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Benefits


In Sickness

Sickness benefits

The purpose of sickness benefits is to provide financial security for economically active persons (more precisely insured persons) in a period when they cannot perform work due to illness and temporarily lose their earnings. In the event of illness, the sickness benefit (benefit paid by the State) is awarded to an insured person who has been declared temporarily incapable of work (or quarantined), and whose temporary incapacity for work (or quarantine) lasts more than 14 calendar days. For the first 14 days of temporary incapacity for work, the employee receives wage compensation from his or her employer.

Conditions for entitlement to sickness benefits:

  • employees: a citizen is insured for sickness (i.e. participates in sickness insurance), regardless of the length of insurance. As a rule, participation in sickness insurance for all employees arises from the law and is mandatory. Sickness insurance is paid for them by the employer.

  • Self-employed persons: may pay for sickness insurance voluntarily. In order for a self-employed person to be entitled to sickness benefits, participation in the sickness insurance of self-employed persons must last for at least three months immediately preceding the day of the onset of temporary incapacity for work (quarantine).

Sickness benefits also belong to a person after the end of the insurance, if the temporary incapacity for work occurred after the end of the insured employment within the protection period. The protection period lasts for 7 calendar days from the date of termination of the sickness insurance, if the insurance lasted for at least this long. However, if the insurance lasted for a shorter period, the protection period is only as long as the number of calendar days of insurance.

Temporary incapacity for work

The attending physician decides on the occurrence of temporary incapacity for work by issuing a Decision on temporary incapacity for work (i.e. eSick Leave).

eSick Leave has 3 parts:

  • Parts I. and III. are sent by the doctor electronically upon the occurrence or termination of temporary incapacity for work to the competent District Social Security Administration (DSSA)

  • Part II. is handed over to the insured person by the physician in paper form –Certificate of an insured person temporarily incapable to work

    eSick Leave contains personal data on the insured person, including the sickness insurance number; diagnosis – this information is not provided to the employer and can only be found on parts I. and III.; date of occurrence and termination of temporary incapacity for work; medical check-ups; permission to go out; place of residence during incapacity for work; health service provider identification data; also the expected length of incapacity for work in the version for foreign insured persons

    The employee is obliged to immediately inform his or her employer about his or her incapacity for work.

    Employees / self-employed persons insured in the Czech sickness insurance system:

    From 1 January 2020, the attending physician gives the sick insured person only a printed “Certificate of an insured person temporarily incapable for work“.

    The certificate is used for records of further examinations at the physician’s office and remains with the insured person after the termination of incapacity for work. A sick insured person also uses the certificate to proves his or her identity in the case of inspection of adherence to the treatment regime.

    Other documents relating to incapacity for work are sent digitally directly to the District Social Security Administration (DSSA), including the certificate of the duration of the temporary incapacity for work.

  • The employee is obliged to inform the employer without delay (by e-mail, SMS, phone) that he or she has fallen ill and to observe the regime prescribed by the physician.

The employee does not have to hand over any other documents to the employer during his or her illness. Sickness benefits (after 14 days of incapacity to work) will be paid in the same way the employer pays the employee his or her usual wages or salary. All communication takes place between the physician, the DSSA and the employer.

  • The self-employed person is paid the sickness benefits in the same way this person pays sickness insurance premiums.

Newly, self-employed persons must fill in the form “Report of employer / a person voluntarily insured for sickness at the end of incapacity for work” immediately after termination of temporary incapacity for work by a physician. (The form may also be picked up, filled in and submitted in person at a DSSA branch.) Without this report, the last sickness benefit cannot be paid. A self-employed person does not have to submit any other documents during their illness.

Employees / Self-employed persons insured abroad and residing in the Czech Republic shall receive from the Czech physician:

  • Certificate an insured person temporarily incapable for work; and
  • Certificate of the duration of temporary incapacity for work: this certificate is used to claim the benefit abroad and it must be handed over as soon as possible (the doctor will indicate in it the date of occurrence of incapacity for work and its probable duration).

The employer can obtain information about the temporary incapacity to work of its employees in several ways, one of which is the possibility to ask the CSSA to send a notification of the occurrence of temporary incapacity for work.

The attending physician no longer issues a paper-based decision on temporary incapacity for work for the employer; the information is available electronically.

The employer is informed about the occurrence of incapacity for work in two ways:

  1. The employee must immediately inform his or her employer about the prevention from work (by phone, e-mail, SMS)
  2. Notification sent to the employer – only upon the employer’s request through the CSSA ePortal and after the employer has previously logged in to the CSSA ePortal. In this case, employers will receive automatic notifications whenever a physician decides on the occurrence, duration and termination of temporary incapacity for work

The employer is obliged to send to the District Social Security Administration (DSSA) in an electronic form to the designated electronic address without delay after the first 14 days of temporary incapacity to work the following:

data for the calculation of sickness benefits and information on the method of payment of wage, salary or remuneration (in accordance with Section 97(2) of Act No 187/2006 Coll., on sickness insurance, as amended). The employer shall send these data via a form called Attachment to the application for benefit.

Information about the termination of temporary incapacity for work and data necessary for the payment of the last benefit shall be provided by the employer via a form called Report of employer / a person voluntarily insured for sickness at the end of incapacity for work.

Calculation and amount of the benefit

  • until the 30th day of the temporary incapacity for work or ordered quarantine, 60% of the reduced daily assessment basis;
  • from the 31st day to the 60th day of the temporary incapacity for work or ordered quarantine, 66% of the reduced daily assessment basis; and
  • from the 61st day of the temporary incapacity for work or ordered quarantine, 72% of the reduced daily assessment basis.

Note: The amount of sickness benefit per calendar day is reduced by 50% in cases where the insured person has caused the temporary incapacity for work himself or herself, for example by participating in a fight or by intoxication.

Payments of the benefit

In the first two weeks of temporary incapacity for work, the employer pays wage compensation for working days. From the 15th day of incapacity for work, the district social security administration pays sickness benefits for calendar days (i.e. including weekends and holidays).

The law does not set a specific date for the payment of sickness benefits. According to the Act on Sickness Insurance, sickness benefits are paid retrospectively usually no later than one month following the day on which all necessary and correctly completed documents for entitlement to the payment of the benefit were delivered to the DSSA.

Sickness benefits are usually provided for a maximum of 380 calendar days (i.e. the support period) from the date of occurrence of the temporary incapacity for work or quarantine order. In justified cases, it is possible to extend the payment of sickness benefits, but only at the request of the insured and with the consent of the sickness insurance authority (DSSA).

 

Obligations

Temporarily incapacitated persons are obliged to follow the treatment regime of a temporarily incapacitated insured person and to follow the instructions of the competent physician. In principle, the patient should stay at a valid address that he or she has provided to the attending physician and which is recorded in the eSick Leave. If the attending physician allows the patient to go out (at the longest for a total of 6 hours a day, between 7 a.m. and 7 p.m.), the insured person is obliged to observe the specific period set by the physician.

Every temporarily incapacitated insured person should know that he or she can be inspected at any time during the period of incapacity.

The rule of “providing the necessary cooperation” applies for inspection purposes. This means, in particular, that the temporarily incapacitated insured person must visibly mark his or her place of residence at the time of illness (with his or her name) and provide a functional doorbell or free access to the door so that the inspection can contact the incapacitated person.

Attendance allowance

Attendance allowance belongs to an employee who is unable to work because he or she is caring for a sick household member or caring for his or her child under the age of 10 (e.g. due to the closure of a school or children’s facility). A self-employed person who voluntarily participates in sickness insurance is not entitled to attendance allowance.

Entitlement to the benefit shall be claimed using the form called Decision on the need for attendance (care), which is issued by the attending physician. The employee shall immediately hand it over to his or her employer, who shall then hand over the documents for the payment of the benefit to the competent DSSA.

Calculation and amount of the benefit

It is 60% of the reduced daily assessment basis for a calendar day from the first calendar day.

Payments of the benefit

The attendance allowance may be drawn for a maximum of 9 days (a maximum of 16 day in the case of a single parent, if he or she is caring for a child under the age of 16 who has not yet completed compulsory education). The benefit is paid by the DSSA (territorially competent branch based on the registered office of the employer or its accounting department), no later than 1 month following the day on which the duly completed documents were delivered to the DSSA.

More about payments of benefits:

Long-term attendance allowance

Long-term attendance allowance belongs to an insured person who cares for a close person (spouse, partner, companion, relative in a direct line) who requires long-term care in the home environment.

The basic condition for entitlement to long-term attendance allowance is the existence of a decision of the attending physician on the need for long-term care for at least 30 days following discharge from hospital (at least 4 days of hospitalisation of the treated person) and the participation in sickness insurance for a specified length.

The support period (i.e. the period for which benefit is provided) is a maximum of 90 calendar days and begins on the first day of the need for long-term care.

Calculation and amount of the benefit

The amount of the long-term attendance allowance is 60% of the reduced daily assessment basis per calendar day.

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In Maternity

Maternity benefits

Maternity benefits are awarded in connection with the birth and care of a newborn child to the mother, or the child’s father (mother’s husband) on the basis of an agreement with the child’s mother or for serious reasons when the mother cannot care for the child or has died, to an insured person (man or woman), who took the child into care replacing the care of the parents on the basis of a decision of the competent authority.

An applicant for maternity benefits must be a sickness insurance participant at the time of taking up the benefit, or he or she must be covered by the protection period after an expired sickness insurance. The protection period for the entitlement to maternity benefits in cash is 180 calendar days from the date of termination of the insurance for women who were pregnant on the date of termination of employment. If the insurance lasted for a shorter period, the protection period will be only as long as the insurance lasted (for example, if the insurance lasted 3 months, the protection period is 3 months). In other cases, the protection period is only 7 calendar days.

Self-employed persons are entitled to maternity benefits in cash only if they pay sickness insurance voluntarily and for a certain period of time. A self-employed person must meet the condition of participation in sickness insurance for self-employed persons for at least 180 days in the period of one year preceding the day of taking up maternity benefits in cash. At the same time, participation in sickness insurance (from employment or business) must last at least 270 calendar days in the last two years preceding the date of taking up the benefit.

The father of the child or the husband of the woman who gave birth to the child is entitled to the benefit, except for the first 6 weeks after the birth, when maternity benefits belong exclusively to the mother.

Submission of application

The employee submits an application to the employer before taking up the benefit (the employer hands it over to the competent DSSA); a self-employed person does so himself or herself at the competent DSSA.

The mother submits an application for the benefit on the prescribed form called Application for maternity benefits, which is issued to her by the attending physician – gynaecologist.

The father of the child / mother’s husband applies for the benefit via the form called Application for maternity benefits when taking a child into care. If he is taking over the child on the basis of an agreement, he must also enclose the agreement concluded with the child’s mother. If the insured person takes over the child on the basis of a decision of the competent authority, he must also submit this decision.

Calculation and amount of the benefit

The amount of maternity benefits in cash is 70% of the reduced daily assessment basis per calendar day.

Payments of the benefit

The benefit is provided for 28 weeks (or 37 weeks if the woman gives birth to twins or more children). A woman take up maternity benefits in cash 8–6 weeks before the expected day of childbirth; she determines the date of taking up the benefits herself. If the parents take turns taking care of the child (note, by agreement – see above), the exhausted part of the support period is counted for each other’s time spent caring. It is important to know that the mother / father must then apply for a follow-up state social support benefit, the parental allowance. This is paid out and processed solely by the Labour Office of the Czech Republic.

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Paternity benefits

Paternity benefits are awarded for 7 days in connection with the care of a newborn child to the father of the child or the insured person (male or female) who took the child into care replacing the care of the parents on the basis of a decision of the competent authority.

The basic condition for entitlement to paternity benefits is participation in sickness insurance. In the case of self-employed persons, the condition of voluntary participation in sickness insurance for self-employed persons must be met for the entitlement to paternity benefits for at least 3 months immediately preceding the day of taking up paternity benefits.

The child’s father must be registered in the child’s birth certificate. The parents do not have to be married.

Paternity benefits belong to a person only if they have been taken up within a period of six weeks from the date of the child’s birth or his or her taking into care. The day of taking up the benefits is determined by each person as needed.

The application for the benefit shall be submitted as follows:

  • by an employee before taking up the benefit to his or her employer (who will hand it over to the competent DSSA), at the same time it is necessary to apply to the employer for parental leave (on the basis of the Labour Code);
  • by a self-employed person at the competent DSSA, with which he or she is registered, after the end of seven days of care (more precisely, after the end of the support period).

The application for the benefit shall be submitted on the prescribed form called “Application for paternity benefit (paternity benefits)”, which is also available at any DSSA.

If the child was born abroad, it is necessary to submit a document proving paternity (e.g. the child’s birth certificate) along with the application.

Calculation and amount of the benefit

The amount of paternity benefits is 70% of the reduced daily assessment basis for a calendar day from the first calendar day.

Payments of the benefit

The benefits are provided for a maximum of 1 week, i.e. 7 calendar days from the date of taking up the benefits. The payments of the benefit cannot be interrupted, it cannot be drawn for individual days. Paternity benefits are awarded only once, even in cases where the parent takes care of twins or multiples.

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Compensatory benefit in pregnancy and maternity

Compensatory benefit in pregnancy and maternity is a benefit provided to women who have been transferred to another job due to pregnancy or maternity (within the 9th month after childbirth) and had a decrease in their eligible income in connection with this transfer.

The basic condition for entitlement to this benefit is the temporary transfer of a pregnant worker to another job on the grounds that the work which she has previously performed is prohibited for pregnant women or, according to the attending physician, such work endangers her pregnancy. It also protects women who are transferred to another job by the end of the ninth month after giving birth and female workers who are breastfeeding and are therefore transferred to another job.

Another condition is the employee’s participation in sickness insurance.

To be entitled to this benefit, the Application for Compensatory benefit in pregnancy and maternity is required. This will be given to the woman by her attending physician or gynaecologist. The employee shall fill in the form and, after transferring to another activity, hand it over to her employer, who hands the form over to the competent DSSA.

A self-employed person who voluntarily participates in sickness insurance is not entitled to a compensatory benefit in pregnancy and maternity.

Calculation and amount of the benefit

The amount of the compensatory benefit in pregnancy and maternity is the difference between the reduced daily assessment basis for the purposes of the Act on Sickness Insurance determined on the date of the transfer and the average of their eligible income per calendar day after the transfer.

Payments of the benefit

The compensatory benefit in pregnancy and maternity is awarded for the calendar days on which the transfer to another job took place, no later than at the beginning of the 6th week before the expected date of birth. After giving birth, the compensatory benefit is paid to the woman until the end of the 9th month.

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Last update: 11. 5. 2023