Proof of incapacity to work and application for sickness benefit

A Czech insured person who falls ill in the territory of another Member State and wishes to claim sickness benefit from the Czech system shall proceed as follows:

He or she shall visit a local attending physician and present the European Health Insurance Card (EHIC), which will simplify the use of health care abroad (more information on health care in other Member States and the EHIC can be obtained at KZP, and he or she shall have a national certificate of temporary incapacity to work issued for the expected duration. He or she will then send the certificate issued by the attending physician directly to his or her employer (for self-employed person to the relevant DSSA). If the incapacity to work lasts longer than 14 calendar days and the insured person therefore applies for sickness benefits, he or she shall also send the form “Application for sickness benefits in the event of incapacity to work in another EU Member State” to his or her employer (self-employed person to the relevant DSSA). If a certificate of long-term incapacity to work is not issued by the attending physicians in the insured person’s country of residence, the insured person shall apply for it to an institution at the place of stay (i.e. an institution providing the relevant benefits at the place where the insured person lives or resides) in that Member State, and that institution will ensure a physician’s evaluation and issuance of such certificate. The calculation and payment of the benefit is carried out in accordance with Czech legislation.

If for some reason the above procedure cannot be used, it is possible for the attending physician of the person concerned in the Czech Republic to issue a decision on temporary incapacity to work on the basis of a medical report from abroad. Retrospective recognition of incapacity to work requires the . After this consent is granted, the attending physician will issue a decision on temporary incapacity to work.

Application for sickness benefit during quarantine

According to Czech regulations, persons who are sickness insured and who have been quarantined are entitled to sickness benefit if the ordered quarantine lasts longer than 14 calendar days (until then the insured person receives the wage compensation paid by the employer).

If a Czech insured person resides in an EU country and has been quarantined there, a national certificate must be issued about the fact (either by the attending physician in that Member State or by the authority empowered to declare the quarantine measure in that State).

The insured person shall send the quarantine certificate directly to his or her employer (self-employed person to the relevant DSSA). If the quarantine is ordered for more than 14 calendar days and the insured person therefore applies for sickness benefits, he or she shall also send the form “Application for sickness benefits in the event of incapacity to work in another EU Member State” to his or her employer (self-employed person to the relevant DSSA).

Maternity benefit

An insured person shall claim her maternity benefit from sickness insurance in the Czech Republic during her stay in the territory of another EU Member State using the form “Application for maternity benefit during residence / stay abroad”. She shall also submit a medical report (confirmation) on the probable date of birth and the child’s birth certificate (after the birth), or a decision of the competent authority to entrust the child to care replacing maternity care. Maternity benefit shall be claimed by the insured person who lives or resides abroad directly at the employer (self-employed person at the relevant DSSA).

Attendance allowance

This benefit is claimed via the form “Application for attendance allowance when a need for attendance (care) arises in another EU Member State”. The form shall be completed by the applicant and the need for attendance to a child under 10 year of age or another household member shall be evidenced by a foreign certificate from the attending physician confirming the need to attend to a sick household member, by a quarantine certificate (issued either by the attending physician in that Member State or by an authority in that State authorised to declare quarantine measures), or by a certificate of closure of a children’s educational facility abroad, etc. The applicant shall present the form together with the documents (or sends it if he or she is staying in another Member State for a long time) via his or her employer to the DSSA, who assesses based on the submitted documents whether the need for attendance (care) is sufficiently documented.

Paternity benefit

This benefit shall is claimed via the form “Application for the Fathers Post-Natal Care (paternity) benefit”. If the born child, for which the parent applies for paternity benefits, is not a Czech citizen (i.e. no Czech birth certificate is issued), a copy of the child’s birth certificate must be attached to the application (if the birth certificate is issued in the language of an EU state or a contracting state, there is no need to supplement the copy of the birth certificate with a translation).

Long-term attendance allowance

Insured persons who provide home care to their relatives or persons living in the same household are entitled to long-term attendance allowance. The allowance is claimed via the form “Application for long-term attendance allowance”. The treated person must give his or her written consent using this form. If the need for long-term care has arisen for a treated person in the territory of another Member State, a medical report concerning the treated person must be provided. This medical report should include information on the length of stay of the treated person in an inpatient medical facility (minimum length is 4 calendar days) and the scope of care of the treated person after the end of hospitalisation (it should be at least 30 calendar days). The report should be issued on the day the patient is released from hospitalisation.

On the employer’s procedure

Sickness insurance benefits claimed via the above forms are submitted by the employer together with all documents (e.g. certificate of incapacity to work, probable date of birth) and with the completed form “Annex to the application for benefit” to the relevant DSSA.

Certificates of incapacity to work issued by attending physicians in other EU Member States are a sufficient basis for employers to pay wage compensation during the first 14 calendar days of incapacity to work. If these certificates relate to incapacity to work that did not exceed 14 calendar days, they are not submitted to the DSSA and the employer retains them. If the incapacity to work exceeds 14 calendar days and the insured person applies for sickness benefits, foreign certificates of incapacity to work (originals) must be sent to the relevant DSSA (including certificates covering the first 14 calendar days of incapacity to work). The employer shall keep copies of these certificates for its own use.

Sickness benefits in cash

A person insured in another Member State who becomes incapacitated to work during his or her stay in the Czech Republic and who wishes to claim benefits shall proceed as follows:

The Czech attending physician shall issue to the person a Czech form “Decision on temporary incapacity to work” (hereinafter the “DTIW”), in electronic form, the eSick Leave. The physician shall first issue Part I of the DTIW, in which he or she states that this is a case with a foreign insurance institution and sends it to the relevant DSSA. Subsequently, the physician shall print to the patient the Certificate of an insured person temporarily incapable to work – Part II of the DTIW and for the purposes of claiming benefits abroad also a Certificate of temporary incapacity to work (ticking the EU box on the form), in which the physician indicates the beginning of incapacity to work and its probable duration. The confirmation of the duration may be printed in several copies by the physician so that the patient has one for the employer and once for the competent institution (e.g. the German sickness fund). Thereafter, the physician shall at least once a month issue a “Confirmation of the duration of the temporary incapacity to work”. Upon termination of the incapacity to work, the physician shall electronically issue Part III of the DTIW, which he sends the competent DSSA. The physician shall also record the data on the termination of the incapacity to work in the Certificate of an insured person temporarily incapable to work – Part II of the DTIW, which will remain with the insured person for the purposes of administration of his or her incapacity to work abroad.

Data on the foreign employer (and sometimes also on the insured person, if it is a foreigner who does not have a Czech personal identification number assigned) must be entered into the eSick Leave based the information provided by the insured person. The CSSA does not have information on foreign insurance relationships in its applications (on the contrary, these data are kept abroad), and therefore these data cannot be automatically fetches into the eSick Leave.

Entitlement to sickness insurance benefits and their amount are assessed according to the legislation applicable to the insured person at the time he or she claims the benefits. In the event that the insured person is insured in accordance with Czech legislation, the conditions for entitlement to the benefit and its amount are governed by Act No 187/2006, on sickness insurance, as amended.