Child sickness benefit: entitlement if the child is sick

If the child is sick, it cannot go to daycare or to the childminder. If you are working, you have to report sick to look after your child. This article clarifies what rights you have in this case.

the essentials in brief

Child sickness benefit is a statutory health insurance benefit for parents whose children are not older than 12 years
Can be claimed if a parent is unable to go to work because of caring for a sick child
Parents are entitled to sick pay of 10 working days per child, and a maximum of 25 days for more than two children
Sickness benefit in the event of illness of the child is less than the regular salary
Privately insured persons are not entitled to sickness benefit

The child sickness benefit has different names, such as B. Child care sickness allowance or child care sickness allowance. It is anchored in Section 45 of the Social Code V and is actually officially called "Sickness benefit if the child is ill". It is a benefit of the statutory health insurance.

Who can get child sickness benefit??

employee

If you have statutory health insurance as an employee and your child cannot go to kindergarten or school due to an illness, then you do not have to take days off or even work overtime. You are then released from work by law. If the continued payment of wages is not excluded in your employment contract (or collective agreement), you are entitled to up to 5 days of paid special leave (§616 BGB). Only then, from the 6th day in the calendar year, can the employer suspend the salary for the day and you are entitled to child sickness benefit from the health insurance company.
Incidentally, it is possible to agree a sickness benefit subsidy with the employer if continued payment of wages has been excluded. Together with the sick pay, the regular monthly net wages may not be exceeded by more than 50 euros. If the employer pays more, this can jeopardize the child’s right to health insurance.

self-employed

If you are self-employed and voluntarily insured by law, you are only entitled to child sickness benefit from the child’s 43rd day of sickness, the day on which you would also be entitled to sickness benefit. However, there are health insurance companies that also cover this sickness benefit from the child’s first day of illness. If in doubt, contact your health insurance company to inquire how this is handled there.

As a member of private health insurance, you are generally not entitled to payment in the event of your child becoming ill. With some insurance companies, however, it is possible to secure this extra with a separate tariff. If your partner is in statutory health insurance, it depends on who the child is insured with.

How and when can you apply for child sickness benefit??

The following conditions must be met:

the employer releases you unpaid
there must be no other person in the household who can take care of the child
the child must have statutory health insurance
the child must not have reached the age of 12 or there is a disability
there must be a medical certificate confirming the need for child care; For those insured by law, there is form 21: Medical certificate for the receipt of sick pay in the event of illness of a child
Complete the insured person’s application (part of form 21)
The employer’s certificate of earnings must be available from the health insurance company (via electronic data exchange between the employer and the health insurance company)

How much is the child sickness benefit?

To calculate the children’s sickness benefit, two formulas and an upper limit must be observed:

1. Calculation without one-off pay

Child sickness benefit per calendar day = (non-existent net wages x 90%) / number of unpaid calendar days

2.Calculation with one-off payment (within the last 12 months e.g. 13th salary)

Child sickness benefit per calendar day = (canceled net wages 100%) / number of unpaid calendar days

Upper limit:
However, the calculated child sickness benefit per calendar day must not be higher than 70% of the contribution ceiling in health insurance. In 2020 there are 156.25 euros, of which 70% = 109.38 euros (in 2019: 151.25 euros, of which 70% = 105.88 euros).

During the period in which you receive child sickness benefit, you do not pay any health insurance contributions and your health insurer also pays half of your contributions to nursing, pension and unemployment insurance.

The above calculation does not apply to sickness benefits for seriously ill children.

How long is child sickness benefit paid??

In a calendar year there is child sickness benefit per child for 10 working days. Together as parents, you are entitled to 20 working days per child. If there are several children in the family, the maximum payment is 25 working days per parent, i.e. a maximum of 50 working days a year.

The entitlement days of one parent can be transferred to the other parent. This only applies if both are legally insured and the other cannot claim these days for professional reasons. The parent’s employer, whose entitlement is already exhausted, must consent to the transfer.

If you are a single parent, there are also 50 working days per year for several children in the household, otherwise 20 days per child. Even with 3 children, the maximum limit of 50 days a year remains.

If your child is seriously ill and has a limited life expectancy of a few weeks or months, you have an unlimited claim.

Child sickness benefit and taxes

Child sickness benefit, like parental benefit, is subject to the so-called progression reservation. The tax office therefore determines two tax rates for your income tax assessment. Once the tax rate for your income without child sickness benefit and once with. The higher tax rate is used to calculate the final tax for the year.

The health insurance company automatically transmits your receipt to your tax office and sends you a corresponding proof of this by post. You transfer the sum of the child sickness benefit in the cover sheet of your tax return in the point other information and applications. If there are different replacement services, these must be added together.

Child care injury benefit

If your child is not sick but injured, for example due to an accident in the daycare center or school, and you therefore have to stay away from work, you are entitled to childcare injury benefit in accordance with Section 45 (4) SGB VII. This section refers to Section 45 SGB V, according to which the child sickness benefit is paid and the regulations apply to childcare injuries benefit as well.

The calculated daily childcare injury allowance must not be higher than 80% of the contribution ceiling in health insurance in 2020: 156.25 euros, of which 80% = 125 euros (in 2019: 151.25 euros, of which 80% = 121.00 euros ). In contrast to child sickness benefits, e.g. tax-free surcharges are also included in the calculation. The payment is usually made through the health insurance company, but the provider is the statutory accident insurance or professional association. This covers half of the contributions for the pension and long-term care insurance.

The times of entitlement to childcare injury benefit and childcare sickness benefit are not to be added together in relation to the determination of the respective maximum entitlement period.

frequently asked Questions

Can you switch care in the event of illness?

Yes, if you want to take turns with the other parent during ongoing care, you must immediately inform your employer and the health insurance company and inform them of the date for the change. If you are insured with different health insurance companies, you must have a new medical certificate or a copy of the first certificate.

What happens if my children are sick at the same time, the claim days are then used up twice?

No, if several of your children are ill at the same time, the entitlement day will only count towards the maximum duration of one child.

As a parent, you can get 20 days of child sick pay and 20 days of child injury benefit from a child in one year?

Yes, the times are to be checked separately for the maximum claim duration, so these are not to be added together.

Is the entitlement transferable from one parent to the other??

Yes, but only if both are covered by statutory health insurance and the other is prevented for professional reasons.

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