Since the beginning of the health crisis, a number of measures have been taken to adapt the conditions for the payment of temporary disability benefits (hereinafter referred to as IJ - indemnités journalières).
Given the uncertainty surrounding the development of the epidemic, the Social Security Financing Bill for 2022 provides for the extension of these measures until the date set by the decree, but no later than December 31, 2022.
An insured person on sick leave receives, under certain conditions, IJ paid by the National Employees' Health Insurance Fund to compensate for lost wages.
Conditions
Given the exceptional circumstances associated with the Covid-19 epidemic, a number of temporary measures have been taken to adapt the terms of IJ payment.
The IJ calculation is determined based on the last salary before the date of termination of employment and subject to:
- during the first 6 months of sick leave:
- if you worked at least 150 hours in the last 3 months or 90 days preceding the work stoppage, or received a salary of at least 1015 times the hourly SMIC during the 6 calendar months preceding the work stoppage (SMIC 2021 - 10.25 € , that is 10,404 € for 6 months),
- and to receive daily maternity benefits, be registered as a contributor for at least 10 months before the expected date of birth of the child.
- when sick leave extends beyond the first 6 months:
- be registered as a payer of social contributions in the health insurance system for 12 months,
- and have worked at least 600 hours in the last 12 calendar months or 365 days preceding the date of termination of employment, or received wages at least equal to 2030 times the hourly SMIC during the 12 calendar months preceding the termination of employment (SMIC 2021 - 10.25 €, that is 20,808 € for 12 months).
All wages or similar remuneration is taken into account by the regime to which the insured is attached to cover his health expenses, subject to the common law cap of 1.8 SMIC.
Benefit amount
Decisions rendered since July 1, 2020
Compensation is paid from the 4th day of sick leave (the waiting period of 3 days is canceled in case of relapse of a long-term illness) and for a maximum period of 3 years.
IJ is equal to the share of income from previous activities, taking into account contributions on the date of the interruption of work, is held within the ceiling and is reduced to a daily payment. In accordance with the resolution of April 12, 2021, income from previous activities used to calculate the daily allowance is determined as follows:
- 1/91.25 of the amount of the last 3 payments for the calendar months preceding the date of termination of work, with monthly payment of wages or income from previous activities;
- 1/84 of the amount of the last 6 or 12 payments for the calendar months preceding the date of interruption in work, depending on whether the previous income from the activity is paid every 2 weeks or every week;
- 1/365 of the amount of income from previous activities for the 12 calendar months before the date of termination of work, when the work is seasonal or not continuous.
IJ is equal to half of the previous income thus determined.
The maximum IJ is equal to 1/730 of the annual ceiling of 1.8 annual SMIC and is therefore €47.03 from 1 October 2021. The minimum IJ size is 11€.
Decisions made before July 1, 2020
IJ is paid from the 4th day of sick leave (the waiting period of 3 days is waived in the event of a recurrence of a long-term illness). They are paid for a maximum of 3 years.
IJ is half the basic daily wage.
To calculate this daily salary, divide the gross salary for the last 3 months by 91.25.
For work breaks ordered between 1 January 2020 and 20 June 2020, the maximum daily allowance amount is equal to 1/730 of the annual ceiling of 1.8 annual SMIC, i.e.: €47.03.
As an exception, for persons with at least 3 dependent children and starting from the 31st day after sick leave, this amount increases to €61.33: 1/547.5 x 1.8 annual SMIC. This increase has been canceled for sick leave assigned from July 1, 2020.
IJ and pensions
From 1 January 2021, people receiving a pension who are also working (if they are entitled to receive both a salary and a pension) can receive IJ paid by health insurance in case of sick leave for 60 days for the entire period, during which they receive a pension starting at age 62.
In addition, if the pension is granted due to disability, it can be combined with IJ, which will cease from the 7th month of sick leave. This combination is no longer valid if sick leave was issued from January 1, 2021.
If you are interested in what benefit for temporary disability, disability you can count on, as well as survivor benefits and the forecast of your future pension. It is interesting to know what solutions are available that will allow you to provide financial protection for you and your loved ones. Sign up for a consultation.
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