When a medical condition affects your ability to work – how to find support
Falling ill or being diagnosed with a medical condition can raise all kinds of questions. How long will my employer pay my salary? Do I have to apply for sickness allowance myself? Could I work part time? What do I do if I need sick leave for a very long time?
When you fall ill or are diagnosed with a medical condition, you do not have to know in advance how long your incapacity for work will last or what kind of support you will need later. Your situation and your alternatives for returning to work can be worked out later during your sick leave.
You, your employer and your occupational healthcare provider or another healthcare provider will work together to see if you can continue to work or go back to work. Kela and your authorised pension provider (työeläkelaitos) can also take part if your situation requires it.
This article explains what usually happens at different stages of sick leave, what you should do yourself, and where you can get help.
This article is intended for employees. If you are self-employed, unemployed or a student, the process involved in getting sickness allowance (sairauspäiväraha) and support for your ability to work is different.
Employers have different practices for reporting sick leave and different requirements concerning medical certificates. If you need a medical certificate or a medical statement, a doctor will assess your health and ability to work.
Do as follows
- Notify your employer of your sick leave.
- Find out what kind of medical certificate your employer needs and when you must submit it.
- If necessary, go to your occupational healthcare provider or another healthcare provider.
- Give or send the certificate to your employer.
Important information: Check your employer’s instructions even if you have been away from work due to an illness or a medical condition before.
Sickness allowance may compensate for your loss of income if you cannot work. Sickness allowance is paid after a waiting period (omavastuuaika). The waiting period is usually the first day of illness and the following 9 working days. This includes Saturdays.
After the waiting period, sickness allowance can usually be paid for a maximum of 300 working days (about a year).
If your employer pays you sick pay
If your employer pays you sick pay (sairausajan palkka), your employer will usually apply for sickness allowance for the same period of time. Kela then pays the daily sickness allowance to the employer. You usually do not have to submit an application of your own for the same period of time when you receive sick pay.
Do as follows
- Ask your employer how long they will pay you sick pay.
- Check OmaKela to see if your employer has applied for sickness allowance and for what period they have stated that they will pay you a wage or salary.
- If you no longer get sick pay and your incapacity for work continues, check OmaKela to see if you need to submit an application or other information in order to get sickness allowance.
- Check that Kela has received the required medical certificate or statement.
- Reply to any requests for further information from Kela.
As a rule, Kela pays sickness allowance for a maximum of 60 days if you have a medical statement A issued by a doctor. After that, you will usually need a medical statement BC.
Sick leave does not always just mean that you stay home from work and wait to get better. During your sick leave, your illness or medical condition can be examined and treated. This can include looking for ways to support your ability to work and help you go back to work.
Depending on your situation, you may have different options, such as:
- going back to full-time work
- adapting your duties or your working hours
- changing to part-time work while receiving partial sickness allowance (osasairauspäiväraha)
- work try-out
- rehabilitation
- a new job, or going into education or training.
Your return to work can be made easier by, for example, changing your work duties or working hours or arranging remote work. You must agree any changes like this with your employer. Kela does not pay a separate benefit if your work is simply adapted, but on certain conditions you may get partial sickness allowance while you work part time. If your previous job is no longer suitable for you because of your illness, you can talk to your employer about other work you could do instead.
The aim is to find a solution that suits your health and circumstances. There is no simple solution that suits everyone. Your situation must always be assessed separately.
At certain points during your sick leave, you will be asked about support you might need to continue to work or to return to work.
You do not necessarily have to go straight back to working full time. You could start by going back to part-time work and partial sickness allowance if you can do some of your work without risk to your health or recovery.
Partial sickness allowance is intended to help you remain employed and eventually return to full-time work. It is a voluntary arrangement. Part-time work is agreed between the employee and the employer on the basis of an evaluation by a doctor.
Partial sickness allowance could be available if
- you are incapacitated for full-time work
- your health allows you to work part time
- part-time work will not put your health or recovery at risk
- your employer can arrange part-time work for you
- your working hours are 40–60 per cent of your previous full-time hours.
The part-time work must be agreed to last for a continuous period of at least 12 working days. Partial sickness allowance can be paid for a maximum of 150 working days.
Do as follows
- Discuss the possibility of part-time work with your occupational health doctor or some other doctor familiar with your circumstances at work.
- Ask your employer if your working hours or duties can be changed.
- Agree on part-time work with your employer.
- Apply for partial sickness allowance in OmaKela.
Part-time work is not suitable for everyone or all situations. The possibility of part-time work must always be assessed on a case-by-case basis.
Read more about partial sickness allowance
Work try-out could be an alternative
In some situations, you can try returning to work through a work try-out arranged by your occupational healthcare provider. In a work try-out, the employee returns to their work for a fixed period of time and their duties are adapted to suit their health.
A work try-out arranged by an occupational healthcare provider may last up to 45 working days. Kela can pay rehabilitation allowance (kuntoutusraha) for its duration. If your employer pays you a wage or salary during the work try-out, Kela can pay the rehabilitation allowance to your employer.
If your sick leave is prolonged, your ability to work and your alternatives for going back to work will be examined several times while you are on sick leave. You can talk to your occupational healthcare provider about any worries that you have about your work ability whenever such worries arise. That way, you can get the support or rehabilitation that you need as early as possible.
After 30 days of sick leave
When your sick leave has lasted for a total of 30 days, your employer will notify the occupational healthcare provider of your sick leave. Your occupational healthcare provider may ask you to come and discuss your ability to work and your potential for returning to work.
Do as follows: Attend the discussion and explain how your illness affects your ability to work. Your healthcare provider will help you consider alternatives such as adjusting your duties or working hours.
After 60 days of sickness allowance
Kela will assess your need for rehabilitation at the latest once you have been paid sickness allowance for 60 working days. At that point, you will get a letter from Kela about rehabilitation options and rehabilitation providers.
If your incapacity for work continues, you will usually have to submit a medical statement BC so that Kela can pay you sickness allowance.
Do as follows: Make sure that you get the right medical statement and that it is submitted to Kela.
After 90 days of sickness allowance
When you have been paid sickness allowance for 90 days, Kela needs a statement from your occupational healthcare provider concerning your ability to continue working.
For the statement, your occupational healthcare provider will talk to you and your employer about the following questions:
- can you return to your job?
- can your work or working hours be adapted?
- what kind of support do you need to return to work?
- could you benefit from rehabilitation?
Do as follows: Contact your occupational healthcare provider well before the 90 days are up and make sure that the medical statement is submitted to Kela. Note that Kela may suspend the payment of sickness allowance if it does not get the medical statement in time.
After 150 and 230 days of sickness allowance
If you are still incapacitated for work, Kela will reassess your need for rehabilitation when you have been paid sickness allowance for a period of 150 days, and then again after 230 days, if necessary. Your occupational healthcare provider can assess your ability to go back to work and issue a new statement if needed.
When you have been paid sickness allowance for a period of 150 working days, you will get a letter from Kela about rehabilitation options and about how to apply for rehabilitation subsidy (kuntoutustuki) or disability pension (työkyvyttömyyseläke).
Do as follows: Talk to your occupational healthcare provider about rehabilitation and other alternatives that support your return to work. If your occupational health doctor prepares a new statement, make sure that it is submitted to Kela.
Rehabilitation could help if your illness, medical condition or disability makes it difficult for you to continue working or to go back to work. You should find out more about rehabilitation alternatives already while you are on sick leave.
For example, rehabilitation can help you to
- improve your work ability and functional capacity
- return to your own job
- continue to work despite your illness or medical condition
- identify tasks that you can do
- find a new direction if you need it, either a different job description or training in a different field.
Vocational rehabilitation services are offered by authorised pension providers and Kela. Finding the right rehabilitation and service provider will depend on factors such as your work history and educational background, your age and you situation.
If you have already worked for a longer period of time, an authorised pension provider will usually be responsible for your vocational rehabilitation. The rehabilitation offered by the authorised pension provider can include, for example, a work try-out, job coaching or training for a new occupation.
If rehabilitation is not provided by an authorised pension provider, you can find out if you can get vocational rehabilitation from Kela.
Kela’s Kiila rehabilitation is intended for people who are employed but have problems with their work ability due to an illness or medical condition, when the measures on offer from their employer and occupational healthcare provider are not enough.
Depending on your situation, Kela can also offer rehabilitation services other than vocational rehabilitation. If a mental health disorder makes everyday life, work or studying difficult, support is available in the form of such rehabilitation as the Oras rehabilitation course or Silmu rehabilitation. Kela can also provide reimbursement for rehabilitative psychotherapy which aims to support the ability to study and work. On the other hand, if your work ability and functional capacity is reduced due to a musculoskeletal disorder, you might benefit from Tules rehabilitation. Kela also offers other rehabilitation services for various illnesses, medical conditions and situations.
You can get rehabilitation allowance for the period of rehabilitation if certain conditions are met. If your employer pays you a wage or salary during rehabilitation, Kela can pay the rehabilitation allowance to your employer.
Do as follows
Tell your occupational health doctor or another doctor treating you how your illness or medical condition makes it more difficult for you to cope with work and ask if rehabilitation could help you to continue to work or return to work.
If you already have a long work history, check if your authorised pension provider can provide vocational rehabilitation for you.
Ask Kela or your authorised pension provider for advice if you do not know what kind of rehabilitation or which service provider would be right for your situation.
Learn more about rehabilitation organised by Kela
Sometimes the right solution is not found immediately. You may not be able to go back to your job, but you do not know what to do next, either. The uncertainty can make your situation even more stressful, on top of your illness.
It is helpful at this stage to address your situation one step at a time. Your alternatives may include, for example
- to continue your medical treatment and stay on sick leave
- to have your duties adapted
- part-time work
- work try-out
- vocational or other rehabilitation
- a new job, education or training
- rehabilitation subsidy, meaning a fixed-term disability pension
- disability pension, if the criteria are met.
If you can continue to work part time but your ability to work is impaired in the long term, you can contact your authorised pension provider to ask if you have the right to partial disability pension or partial rehabilitation subsidy. These benefits are not paid by Kela.
You cannot automatically switch from sickness allowance to disability pension
Sickness allowance is usually payable for a maximum of 300 working days (about a year). You can apply for rehabilitation subsidy or disability pension if your work ability is impaired in the long term due to an illness, medical condition or disability. However, you can only get the benefit if you meet the criteria for granting it.
Rehabilitation subsidy is a fixed-term disability pension. You may be eligible for it if it is estimated that your incapacity for work will continue for an extended period of time but that treatment or rehabilitation can help you regain your ability to work. A disability pension can be granted for the time being if your work ability is reduced in the long term and it is not expected to be restored by treatment or rehabilitation.
Kela assesses your work ability differently for a disability pension than for sickness allowance. This is why a disability pension may not be granted even if you cannot go back to your job.
If you have almost reached the maximum period for which you can get sickness allowance and you still do not have a decision on your next source of income, contact Kela, your authorised pension provider and, if relevant, the employment services as soon as possible to find out what to do next.
If your application for disability pension is still being processed, you may get unemployment benefit under certain conditions. If this is the case, you must register as a jobseeker with the employment services on the day after the end of your sickness allowance at the latest. If you are a member of an unemployment fund (työttömyyskassa), apply for earnings-related unemployment allowance (ansiopäiväraha) from your fund.
Do as follows
- Talk to your occupational healthcare provider about your ability to work, possible rehabilitation and other alternatives well before your sickness allowance payments end.
- Ask Kela and your authorised pension provider what benefits you can get after the sickness allowance ends.
- Submit the necessary applications in time.
- If you do not yet have a decision on your next source of income, find out if you have the right to unemployment benefits and register as a jobseeker if necessary.
- You do not have to know in advance which alternative is the right one for you. The most important thing is to talk about your concerns about your ability to work and to start looking at the various alternatives early on.
Read more about rehabilitation subsidy and disability pension
Checklist for when you are on sick leave
- Talk to your occupational healthcare provider about any worries you have about your ability to work immediately when such worries arise.
- Ask your employer if your working hours or duties can be changed.
- Take care of matters related to sickness allowance in time. Check OmaKela to make sure that Kela has received the necessary medical certificates and statements.
- Find out about possible rehabilitation options early on. Rehabilitation can help you to continue to work, return to work or find work that suits your health better.
- If you have almost reached the maximum time limit for receiving sickness allowance, find out your next source of income before your daily sickness allowance ends.
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