Sickness allowance

The film below explains in Dutch what the rules are if you live in the Netherlands and work in Germany and become ill.

Continued payment of wages in case of illness and sickness allowance

If you work in Germany and become ill, you are initially entitled to a maximum of 6 weeks’ continued payment of wages. If you are still ill after 6 weeks, you will receive a sickness allowance from your health insurance fund. You can find all the information about this sickness allowance below.

Who is entitled to sickness allowance?

If you are compulsorily or voluntarily insured with a health insurance fund and you fall ill, you are entitled to a sickness allowance.

When am I entitled to a sickness allowance?

A sickness allowance is paid in the event of incapacity for work as a result of illness and if you are admitted to a hospital, in preventive health care or rehabilitation. Entitlement to a sickness allowance starts on the day when the doctor/UTC establishes incapacity for work.

In case of incapacity for work, workers generally receive continued payment of wages from their employer for the first 6 weeks. During this time, the entitlement to the sickness allowance is suspended.

The first 4 weeks of a new employment relationship are considered a waiting period and do not include any entitlement to continued payment of wages. In this case, a sickness allowance is paid until the 28th day of the employment relationship. If the incapacity for work continues after this time, the employer pays the wage for 6 weeks.

What if my employer does not continue to pay my wages during my illness?

In addition to the entitlement to continued payment of wages due to incapacity for work, there is also an entitlement to a sickness allowance. The entitlement to a sickness allowance is suspended as long as the employer continues to pay the salary. If the employer refuses to continue paying, the health insurance fund pays the sickness allowance.

How much is my sickness allowance?

For employees, the amount of the sickness allowance depends on their salary paid before the onset of the incapacity for work.The payment is 70 per cent of the gross wage, but not more than 90 per cent of the net wage. The calculation also takes into account one-off payments made in the last 12 months before the incapacity for work.Social security contributions for pension, unemployment and long-term care insurance are deducted from the gross sick pay.No tax is payable on a sickness allowance in Germany, but it counts towards progression if you have other income in Germany. This can put you in a higher tax bracket.

If the sickness allowance, possibly with other benefits from Germany, is less than € 15,000 gross per year, you have to take into account that you have to pay tax on your net sickness allowance in the Netherlands. From 1 January 2022, this will most likely change and you will no longer have to pay tax on a sickness allowance in the Netherlands.

What do I have to do when reporting sick to the health insurance fund?

If you are still sick after 6 weeks of continued payment of wages by your employer, you must make sure that the periods during which you are registered sick with the UWV are uninterrupted. If the period is interrupted, the sickness allowance may be refused. Make sure that you contact the UWV for a new expiry date before the period expires. Saturdays do not count as working days. Any gap in the period of incapacity for work has financial consequences.

Reporting incapacity for work is an obligation of the sick worker. The consequences of a failure to report or a delay in reporting are therefore borne by the person concerned.

Can I go on holiday while receiving a sickness allowance?

A sickness allowance can continue to be paid during your leave if you have received approval from your health insurance fund. It is useful to have the UWV confirm that the leave will not put your recovery process in danger or delay it from a medical point of view and that you are still not able to work while on leave. Make sure that you submit the application to the health insurance fund in time (at least 3 weeks in advance).

What do I have to look out for in a rehabilitation measure?

If, according to medical advice, your earning potential is seriously threatened, the health insurance fund may ask you to apply for rehabilitation (called rehab or cure) within 10 weeks. If the application is not made within this period, the entitlement to a sickness allowance will be suspended.

By applying for rehabilitation, it is possible that this application for rehabilitation will be considered as an application for a Erbwerbsminderungsrente [reduced earning capacity pension].

What if you are no longer entitled to a sickness allowance?

A sickness allowance is paid for the same illness for a maximum of 78 weeks in a three-year period. The entitlement to sickness allowance is suspended during the period when wages are continued to be paid. This period is included in the 78-week period for the same illness. A new, different cause of illness does not extend the entitlement to a sickness allowance. After 78 weeks of sickness, one speaks of “Aussteuerung†[removal].

What happens when my entitlement to sickness allowance ends?

You can receive a sickness allowance for a maximum of 78 weeks. After that, it is called “Aussteuerungâ€. You may then be entitled to an Erbwerbsminderungsrente [reduced earning capacity pension] from the Deutsche Rentenversicherung [German pension insurance]. The disadvantage is that an reduced earning capacity pension is lower than a sickness allowance. If you also have a Dutch employment history, you must also apply for a WIA benefit. The waiting period for WIA is not two years for cross-border workers, but is the same as the waiting period in Germany. For more information, see Erwerbsminderungsrente [reduced earnings capacity pension].

If you are not incapacitated for work in Germany or the Netherlands after expiry of the sickness allowance, you are unemployed. If your employment contract is terminated, you are entitled to unemployment benefits from the UWV in the Netherlands. If the employment contract still exists, you are entitled to unemployment benefits from the employment agency if you are available for light work for at least 15 hours a week. You must also meet the other conditions for receiving unemployment benefits.

For more information, please contact an adviser at GrensInfoPunt.

Thanks to the Saarland Chamber of Labour