Sick pay

The applicant authorizes the health fund to submit the application and medical data to the fund's confidential physician. In some cases, the applicant may expect that more detailed data will be required or that the applicant will be called for a medical assessment by the confidential physician. The health fund may reject an application for daily sickness benefit based on the confidential physician's assessment.

A member is entitled to daily sickness benefit from the Efling sickness fund if the person concerned has paid into the fund for at least the last six months before the person concerned becomes unemployed due to illness/accident.

In the private sector, employers pay 1% to the fund. Public companies, i.e. the state, municipalities, private institutions such as nursing and residential homes and private preschools, pay a lower premium to the fund and in return their employees have a much longer sick leave entitlement than in the private sector, but they in turn have a shorter entitlement to daily allowance payments from the fund.

If one has been paying to the Sickness fund for 5 years or longer, the income connection in addition to daily allowances from the Icelandic Health Insurance can amount to up to 100% of the income loss, but to a maximum of ISK 1,029,693 per month. Members who meet this condition are entitled to daily allowances for up to 6 months.

Payments to the fund must have been received for a minimum of 54 of the last 60 months to meet this requirement.

If membership in the fund is less than 6 consecutive months, a member is not entitled to daily allowance, unless the member has come directly to Efling from another association within ASÍ.

Transfer of rights from another trade union within the Icelandic Confederation of Trade Unions or BSRB to Efling can take place if the person concerned has paid to the fund for at least one month and to another health fund with a union within ASÍ or BSRB for at least the previous six months. The number of months at Efling is then divided by the number of months, so that there is 6 months of continuous membership in two or more unions before the fund member became unemployed due to illness.

Daily allowances are paid for up to 4 months for members working in the general market, but for 3 months for employers who pay less than 1% premium to the fund, such as the State, municipalities and private foundations.

The right is established from the time the contractual or mandatory payment of wages ends with the employer.

To maintain rights in other funds at Efling, such as vacation and education funds, a 0.7% membership fee is calculated on daily allowances.

Daily allowances are only paid temporarily to those who become unemployed due to illness and are not entitled to other payments than sickness allowances from the Health Insurance Fund and daily allowances from the Icelandic Health Insurance. Payments are not made when/if a fund member becomes entitled to payments from the Social Insurance Institution or a pension fund such as disability benefits-rehabilitation pension/old-age pension/retirement. Payments are also not made for compensable accidents such as traffic accidents, which are considered mandatory payments and the insurance company is therefore obliged to pay the victim temporary loss of employment.

The right to daily allowance is renewed every 12 months, proportionally to how much it is used, calculated from the day on which daily allowance payments end each time and premium payments begin again, cf. ASÍ's rules on this matter.

Duration of daily allowance, conditions and types - Fund member operating in the general sector (i.e. employer paying 1% to the fund)

• Daily allowance for up to 180 days due to your own illness or accident.
• Child illness: Daily allowance for up to 180 days.
• Spouse's illness: Daily allowance for up to 90 days, provided that continuous membership is at least 12 months or longer.
• Due to the mother's illness during pregnancy, ***pay is made for the seventh month of pregnancy,***although not longer than according to the aforementioned rules. A woman may apply for up to two months of extension of maternity leave due to illness during pregnancy without reducing her right to maternity leave after birth according to the provisions of Act No. 95/2000.
• Alcohol or drug treatment: Daily allowance for up to 90 days.

Continued payments due to prolonged illness or accidents:

In special cases and after consultation with the Fund's occupational rehabilitation consultant and/or confidential physician, it is permitted to pay a fund member who has worked in the general market for up to 120 additional days, provided that the fund member is not entitled to other payments such as disability, rehabilitation or old-age pensions, and a daily allowance is then paid based on the minimum income.

Duration of daily allowance, conditions and types – Fund member who works for the state, municipalities and non-profit organizations that pay less than 1% premium to the fund and have longer sick leave entitlement with the employer (Family and Support Fund).

• Daily allowance for up to 90 days due to your own illness or accident.
• Due to children's illness: Daily allowance for up to 180 days.
• Spouse's illness: Daily allowance for up to 90 days, provided that continuous membership is at least 12 months or longer.
• Due to illness of the mother during pregnancy, maternity leave is paid for the seventh month of pregnancy , although not longer than according to the aforementioned rules. A woman may apply for up to two months of extension of maternity leave due to illness during pregnancy without reducing her right to maternity leave after childbirth according to the provisions of Act No. 95/2000.
• Alcohol and drug treatment: Daily allowance for up to 90 days.

Continued payments due to prolonged illness or accidents:

The following applies in special cases and after consultation with the Fund's occupational rehabilitation consultant and/or confidential physician, it is permitted to pay a fund member who has paid less than 1% of the premium to the Fund for up to an additional 90 days, provided that the fund member is not entitled to other payments such as disability, rehabilitation or old-age pensions, and a daily allowance is then paid based on the minimum income.

To verify the member's entitlement, the fund management also needs information about other payments, if any, such as from the Social Insurance Institution, a pension fund or an insurance company. In the event of a prolonged illness, the member must submit a medical certificate at least every two months.

• A photocopy of a sickness allowance certificate from a doctor. If you are also applying for daily allowance from the Icelandic Health Insurance, an original copy of the sickness allowance certificate must accompany that application.
• A certificate of employment from the employer stating the employee's hours of work and work rate for the past 6 months, the day the person lost their pay due to illness/accident, and how many sick days were used.
• Information on whether/how to use a personal tax credit (tax card).

• The application for sick pay must include a photocopy of a sick pay certificate from a doctor, originating from the health care and hospital computer systems.
• The first certificate and the subsequent certificate must be an Icelandic sickness benefit certificate.
• A foreign first certificate may be submitted if a member suddenly falls ill while on vacation abroad. The member must provide proof that the vacation abroad was pre-arranged.

In addition to daily allowance payments from the Health Insurance Fund, fund members are entitled to sickness or accident daily allowance payments from the Icelandic Health Insurance Fund.

Fund members are obliged to notify the fund when they become able to work again or become entitled to benefits from other parties such as a pension fund or the Social Insurance Institution, subject to loss of entitlement. Fund members are obliged to repay the fund any excess daily allowances.

Sickness benefit may be paid retroactively for up to 3 months from the date the fund received the application.

The right to benefits or grants from the fund expires if not applied for within 12 months of the right being created.