Sickness benefits

Sickness benefits – conditions

To acquire the right to sickness benefits, the employer needs to have paid premiums to the fund for at least the last three months before the accident/sickness occurs.

Premium amount depends on the employer

The agreed premium amount depends on the employer. In the private labour market, employers pay a premium which is equivalent to 1% of the employee’s wages. Public institutions and companies, i.e. the state, municipal authorities and private, non-profit institutions such as nursing and residential care homes, as well as privately operated preschools, pay a lower premium to the fund. Employees of public institutions and companies are entitled to a shorter period of payments from the fund, but their sickness leave rights within the workplace are considerably more than in the private labour market.

Sickness benefits are paid to members who are without wages due to sickness or accidents, and who have made full use of their sickness rights with the employer. 

Sickness benefits are income based If premiums have been paid to the fund for the past 6 consecutive months, sickness benefits can amount to up to 80% of wages. However, the total benefit amount from Efling and the Icelandic Health Insurance combined cannot exceed ISK 561,532 per month.

If premiums have been paid for a shorter period

Full rights are based on 6 months premiums to the fund. When calculating average wages, it is always done by dividing by 6 months, even if premiums have been paid for a shorter period.

Transfer of rights between unions

The transfer of rights from a different trade union within the Icelandic Confederation of Labour (ASÍ) is possible if premiums have been paid to Efling on behalf of the member for at least 1 month, and to another trade union within ASÍ for at least the 6 months prior to that.
In those cases, the divisor number is the number of months with premiums paid to the Efling Sickness Benefits Fund. Sickness benefits are calculated based on premiums to the fund, which are proportional to wages.

100% income-based

If consecutive membership has lasted for 4 years or longer, sickness benefits can amount to up to 100% of wages. However, the total benefit amount from Efling and the Icelandic Health Insurance combined cannot exceed ISK 637.839 per month.

When are sickness benefits not paid?

Sickness benefits are a temporary assistance. The fund does not pay if a member is entitled to payments from the Social Insurance Administration (Tryggingastofnun) or a pension fund, such as disability benefits, rehabilitation pension or old-age pension/retirement
benefits. The fund does not pay in the case of accidents covered by insurance, such as traffic or work accidents. In such cases, the insurance company should reimburse the member for temporary work loss. The right to sickness benefits expires if it is not sought within 12 months from when the right was created.

Sickness benefits renewal

The right to sickness benefits is renewed proportionately in 12 months while working and paying to the union.

Duration of Sickness Benefits and conditions - Employees in the private labour market

Duration of Sickness Benefits

Employees in the private labour market
– After 6 months of premiums to the sickness benefits fund, the fund pays up to 180 days.
– After 5 months of premiums to the sickness benefits fund, the fund pays up to 150 days.
– After 4 months of premiums to the sickness benefits fund, the fund pays up to 120 days.
– After 3 months of premiums to the sickness benefits fund, the fund pays up to 90 days.

– For a child’s illness, the fund pays up to 180 days.
– For a spouse’s illness, the fund pays up to 90 days.
– For alcohol or drug treatment, the fund pays up to 42 days.

Extended payments 
Under special circumstances it is possible to receive extended payments for up to 180 days, if a member does not have right to payments from pension fund or Tryggingarstofnun.  An application has to be presented before the funds Board in cooperation with Efling VIRK representative or the funds consulting physician. Extended payments cannot exceed minimum pay for full time work according to collective agreements.

Duration of Sickness Benefits and conditions - Employees in the public sector/private non-profit institutions

Employees in the public sector/private non-profit institutions (The employer pays less than 1% premium to the fund)

The fund pays up to 90 days, unless the member’s sickness rights with the employer reach a whole year (360 days), in which case the fund pays 30 days.

– For a child’s illness, the fund pays up to 180 days.
– For a spouse’s illness, the fund pays up to 90 days.
– For alcohol or drug treatment, the fund pays up to 42 days.

Extended payments 
Under special circumstances it is possible to receive extended payments for up to 90 days, if a member does not have right to payments from pension fund or the Social Insurance Administration (Tryggingarstofnun).  An application has to be presented before the funds Board in cooperation with Efling VIRK representative or the funds consulting physician. Extended payments cannot exceed minimum pay for full time work according to collective agreements.

The following documents must accompany an application for sickness benefits

– A copy of a medical certificate for sickness benefits (sjúkradagpeningavottorð)
– An employment certificate signed by the employer
– A copy of the last pay slip
– Information about whether the member would like to use his/her electronic personal tax credit with the fund

I case of long term illness doctors certificates need to bee renewed every two months.

Sickness benefits from the Icelandic Health Insurance (Sjúkratryggingar Íslands)

In addition to sickness benefits from Efling, you may be entitled to sickness or accident benefits from the Icelandic Health Insurance. We recommend that you look into what your rights are there.

Reporting Requirements

A member receiving Sickness Benefits is required to inform the fund if he is able to resume work or if he starts to receive payments from other institutions.

Retrospective payments

Sickness benefits can be paid retrospectively for a maximum of three months.

The right to sickness benefits can expire

The right to sickness benefits expires if it is not sought within 12 months from when the right was created.

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