Guide for Patients: Sick Leave Issued in Poland for German Health Insurance Funds
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General Principles Regarding Sick Leave.
German health insurance funds (Krankenkassen) accept sick leave issued in Poland, provided it complies with international regulations (including EU Regulation 883/2004).
The sick leave must be issued on the appropriate form in Polish and, if required, translated into German.
It is crucial that the sick leave includes the ICD-10 disease code. The absence of this code may lead to the rejection of the sick leave by the health insurance fund. -
Regularity and Submission of Sick Leave.
Sick leave must be delivered to the German health insurance fund within 7 days from the issue date. Delays may result in the lack of payment for the days delayed.
If the sick leave covers a period before the issue date, such as due to the weekend or a holiday, the doctor must clearly specify the start date of the incapacity to work.
In the case of extending sick leave, a new document must be issued before the current sick leave expires. A break in documentation may cause a gap in the payment of benefits. -
Who Pays and When?
For the first 6 weeks of incapacity to work: The employer pays the sick leave wage (Entgeltfortzahlung).
From the 7th week of illness: The health insurance funds take over and pay sick pay (Krankengeld).
Krankengeld is usually 70% of the average gross wage but not more than 90% of the net wage. -
Documentation Required by the Health Insurance Fund.
Sick Leave (Krankschreibung): Provide a copy of the original.
Medical Reports (optional): In the case of long-term illness, the health insurance fund may require additional documents, such as test results or a specialist's opinion.
It is recommended that all documents be translated into German. -
How to Submit the Sick Leave.
Sick leave can be submitted to the health insurance fund by mail, fax, or electronically (if the health insurance fund offers an online portal or mobile app).
It is recommended to send the documents via registered mail to have proof of delivery. -
Important Issues Regarding Sick Benefits in Germany.
The sick leave should be thoroughly justified, especially in the case of a long-term illness.
The health insurance fund has the right to request a check of the sick leave by their own doctors. This may include a consultation request in Germany or an analysis of submitted documents.
If you are on sick leave in Poland for a longer period, inform your health insurance fund about your address in Poland and contact details. -
Breaks in Sick Leave and Loss of Benefits.
Any gap between consecutive sick leaves (even 1 day) may result in the loss of continuity in benefit payments. In such cases, the process of calculating sick pay eligibility may need to start over.
It is important to ensure that consecutive sick leaves are issued directly after one another.
If the sick leave falls on a non-working day, such as a weekend or holiday, those days are included in the incapacity period. Therefore, if your sick leave includes a non-working day, there is no need to issue a new certificate for that day.
If your treating doctor is unavailable, for example, due to illness, another doctor, including a family doctor, can issue the sick leave. In such cases, it is important that the new sick leave is consistent with previous recommendations and covers the continuity of the incapacity to work. -
Krankengeld Payment Period.
The maximum period for receiving sick pay is 78 weeks (1.5 years) within 3 years for the same illness. After this period, the patient may be referred for disability pension or other benefits. -
Other Tips.
If the sick leave lasts for several weeks, it is advisable to regularly contact the health insurance fund to ensure that all documents are in order.
Remember to inform your employer about your absence, preferably on the day the sick leave begins.
Summary
In the case of sick leave issued in Poland for German health insurance funds, it is crucial to maintain timeliness, complete documentation, and ongoing communication with the health insurance fund and employer. Properly issued and submitted sick leave will help avoid issues with benefit payments and ensure financial security during illness.
If you have any questions regarding procedures or concerns related to the documentation, we are at your disposal. We also offer professional assistance in translating medical documentation into German. This type of translation can be crucial, especially in the case of extended procedures or long-term benefits.
Remember, keeping deadlines and accuracy in formal matters will help avoid problems with the German health insurance fund and ensure peace of mind during treatment and recovery.
CONTACT
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Email: kontakt@medicaladvisor.pl
