Health Insurance Fund adopts the changes: sick leave will not be cut to five days

The board of the Health Insurance Fund today unanimously adopted amendments to the regulation governing temporary incapacity for work, as 4NEWS reports. The Fund clarifies that sick leave is not being shortened to five days and its duration is not limited where medically necessary.

According to the same source, the family doctor may determine sick leave of up to 15 days, while beyond that period the Fund’s medical commission decides. The change from 7 to 5 days does not mean the leave automatically ends on the fifth day — after that period the medical criteria for the respective diagnosis apply, while the family doctor’s 15-day limit remains unchanged.

The new regulation brings other reliefs as well: for some diagnoses, laboratory referrals will no longer be needed, the family doctor’s assessment sufficing; time limits are extended for certain diagnoses; the family doctor’s proposal after day 15 will be submitted electronically instead of through a manual procedure; cases are added in which sick leave is determined without the insured person’s physical presence — such as the seriously ill, immobile persons or hospitalised patients; existing diagnostic findings may be used for chronic illnesses within their validity period; conditions are set for retroactively determining leave, for example after hospital treatment; reliefs are foreseen for pregnant women and breastfeeding mothers in connection with radiodiagnostic examinations with ionising radiation, with a specialist’s report; as well as exemptions from the obligation of a consilium opinion for leave longer than 60 days for some serious illnesses.

The Fund stresses that the solutions are the result of months of expert work on criteria dating mainly from 2012, with the aim of adapting to modern medicine and reducing the administrative burden.