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The sickness allowance is paid as compensation for loss of income due to incapacity for work lasting less than a full year.
You need a medical certificate to qualify for sickness allowance. Sickness allowance is usually available for up to 60 working days if based on a medical certificate A. Following the 60 days, payment can continue only if the recipient can present a medical certificate B or other statement about the incapacity for work. Recipients may be asked to provide further documentation even before the 60-day period is over.
Sickness allowance is available after completing a specified waiting period. The waiting period usually consists of the first day of illness and the following nine working days.
Sickness allowance is payable for a maximum of 300 working days (about a year). It can be paid until the end of the month preceding the month in which you would reach the 300-day limit. Generally, all days during the past two years on which you were entitled to sickness allowance from Kela count towards the total time for which you can receive sickness allowance. Included are also days in which you are unfit for work but for which you have not been paid sickness allowance for example because of low annual income.
Maximum entitlement reached - how soon can you get sickness allowance again?
If you reach the maximum entitlement limit, you must be fit for work for at least a year before you can again receive sickness allowance for the same illness. However, if you return to work after receiving sickness allowance for the maximum period and work for an uninterrupted period of at least 30 days, you can get sickness allowance for an additional 50 days.
After reaching the maximum entitlement limit, you can be paid sickness allowance if you are diagnosed with some other illness that was not a cause of incapacity for work during your previous sickness allowance period.
Based on the medical certificate, Kela evaluates whether you could benefit from rehabilitation.
Once you have been paid sickness allowance for 60 days, you get a letter from Kela informing you about various rehabilitation options and providers.
If you are employed, your occupational health care provider must evaluate your remaining capacity for work at the latest once you have been paid sickness allowance for 90 working days.
If needed, the occupational health care provider can also assess your ability to continue working once you have received sickness allowance for 150 and 230 days. Submit the occupational health care provider’s statement to Kela. Unlike with the 90-day rule, payment of the allowance can continue even if this statement has not been submitted.
Once you have been paid sickness allowance for 150 days, you get a letter from Kela telling you not only about rehabilitation options but also about how to claim a disability pension.
You can apply to rehabilitation even if Kela has not suggested it to you. If you think that you need rehabilitation, first see your occupational health doctor or personal doctor. If your doctor gives you a statement recommending rehabilitation, you can apply to Kela for rehabilitation.
If you are unfit for work because of an illness for longer than a year, you can claim a disability pension.
Illness and fitness for work
Being ill and being unfit for work are two different things. In order to receive sickness allowance, you must be unfit for work. Your fitness for work is evaluated in the context of your own job. When determining your eligibility for sickness allowance, Kela may consult a specialist in insurance medicine. Based on a statement from your doctor, the specialist evaluates your fitness for work and functional status in order to find out if you are unfit for work within the meaning of the law.