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Illness and disability are unpleasant things that can happen to anyone. Minor colds and injuries have no effect on the entitlement to daily allowance. However, situations requiring hospital care and disability also affect the income security side.
Illness
A short illness or minor injury does not affect your right to an earnings-related daily allowance. If necessary, see a doctor and get well.
If you are ill for 10 days or less, select ‘Sick’ in the daily data section of your daily allowance application for the days that you have been ill. If you have been working part-time, indicate any sick pay in your application.
If you are ill for more than 10 days, please tick ‘Sick’ in the daily data section of the claim for daily allowance. Apply for sick pay from Kela.
Sickness allowance waiting period
The waiting period for sickness allowance is the day on which the incapacity for work begins and the nine working days closest to it. Working days include Saturdays, but not public holidays.
We can pay earnings-related daily allowance for such a waiting period for sickness allowance if you have received earnings-related daily allowance immediately before the waiting period for sickness allowance begins.
If your illness or injury is serious enough to require hospital or other institutional care, please also mention this in your application. When you are in institutional care, you are legally unavailable for work. During this period, you are not entitled to earnings-related daily allowance.
Incapacity for work
We cannot pay you earnings-related daily allowance if you are unable to work.
You are incapacitated if you get
sickness allowance
partial sickness allowance
disability pension
rehabilitation allowance
benefit paid on the basis of full incapacity for work
Your incapacity for work is therefore decided on the basis of whether you have been found to be incapacitated in accordance with the Health Insurance Act or the National Pensions Act. In practice, this means that we do not assess disability on the basis of a medical certificate. According to a medical certificate, you may be incapacitated, but if there is no decision from Kela or a pension company, we cannot find you incapacitated or healthy.
You are also incapacitated if you have been found to be incapacitated in accordance with the Health Insurance Act, the Occupational Pensions Act or the National Pensions Act, even if you have not been paid the benefit on the basis of these laws. Thus, we cannot pay earnings-related daily allowance if you have been found to be incapacitated, but the benefit has not been paid due to low income or when the benefit is not paid until the disability has lasted continuously for at least 55 days.
Exceptions
The main rule is that you are not entitled to an earnings-related daily allowance if you are unable to work. However, there are three exceptions to this rule.
The disability pension does not prevent us from paying you earnings-related daily allowance if you receive that pension under the legislation of another country. However, we will have to deduct such pension from the amount of your earnings-related daily allowance.
A disability pension does not prevent us from paying you earnings-related daily allowance if the disability pension has been granted to you because you are permanently blind, permanently disabled or permanently so helpless that you cannot get along without the help of another person.
Disability does not prevent us from paying you an earnings-related daily allowance if you have received sickness benefit for the maximum period, you are still unable to work for health reasons and your claim for disability pension is pending. If your employment contract is still valid, we require that the employer does not have a job available that matches your capacity to work. Your entitlement to benefits under this derogation will cease if your claim for disability pension is rejected because you have been assessed as fit for work and the decision is final.
Exceptions to the main rule only mean that in these situations the disability does not deprive you of the right to earnings-related daily allowance. In order to be able to pay earnings-related daily allowance, you must meet all the conditions and there must be no other restrictions on payment. Similarly, job-seeking must also be valid.
