Unemployed and sick for a long time: what benefits are i entitled to? "- dgb rechtsschutz gmbh

"Unemployed and sick for a long time: What benefits are I entitled to?"

Unemployed and sick: what needs to be considered?

As long as the employment relationship is running, Maria is protected against loss of earnings due to incapacity to work (AU). Initially, she did for six weeks Entitlement to continued payment of wages against her employer. After that Maria is entitled to sickness benefit. Because of the same illness, she can receive this benefit for a maximum of 78 weeks. The six weeks of continued payment are included in these 78 weeks.

Illness at >terminated after further approval of sick pay – an unfortunate circumstance will be remedied

Social Code (SGB III), Third Book, Employment Promotion and
Social Code (SGB V) Fifth Book, Statutory Health Insurance

Legal basis

Excerpts: Social Code (SGB III), Third Book, Employment Promotion and Social Code (SGB V), Fifth Book, Statutory Health Insurance

Social Code (SGB III), Third Book, Employment Promotion

§ 136 SGB III right to unemployment benefit

(1) Employees are entitled to unemployment benefits
1. in the event of unemployment or
2. in continuing vocational training.
(2) Anyone who has reached the age of life required for the standard retirement pension in the sense of the Sixth Book is not entitled to unemployment benefit from the beginning of the following month.

Section 138 SGB III unemployment

(1) Anyone who is an employee is and is unemployed
1. is not in an employment relationship (unemployment),
2. endeavors to end unemployment (personal efforts), and
3. is available for the placement efforts of the employment agency (availability).
(2) Voluntary work does not exclude unemployment if it does not affect the job integration of the unemployed.
(3) The pursuit of employment, self-employment, work as a helping family member or helping family member (gainful employment) does not exclude unemployment if the working or working time (working time) is less than 15 hours per week; occasional short-term deviations are not taken into account. The working hours of several jobs are added together.
(4) Within the framework of their own efforts, the unemployed person must use all opportunities for professional integration. These include in particular
1. the fulfillment of the obligations arising from the integration agreement,
2. participation in mediation by third parties and
3. the use of the self-information facilities of the employment agency.
(5) The agency’s employment efforts are available to who
1. Can and may exercise compulsory, compulsory employment of at least 15 hours a week under the usual conditions of the job market that is relevant for him or her,
2. Proposals from the Employment Agency for professional integration can be followed promptly and locally,
3. is willing to accept and pursue any activity within the meaning of number 1, and
4. is willing to take part in measures for professional integration into working life.

§ 145 SGB III reduction in performance

(1) A person who is not unemployed is also entitled to unemployment benefit simply because, due to a reduction in their performance of more than six months, they are unable to carry out compulsory, compulsory employment of at least 15 hours a week under the conditions on which they are considered coming labor market without taking into account the reduction in performance if a reduced ability to work in the sense of the statutory pension insurance has not been determined. The responsible institution of the statutory pension insurance determines whether there is reduced earning capacity. If the disabled person cannot register as unemployed personally due to health restrictions, the registration can be made by a representative. The person with reduced performance must immediately report personally to the employment agency as soon as the reason for the prevention ceases to exist.
(2) The employment agency must immediately request the person with reduced performance to apply for benefits for medical rehabilitation or participation in working life within one month. If she makes this application on time, it will be deemed to have been made when the application for unemployment benefit is made. If the disabled person does not make the application, the entitlement to unemployment benefit is suspended from the day after the expiry of the period until the day on which they apply for medical rehabilitation benefits or for participation in working life or for an occupational disability pension. If the person with reduced performance does not meet their obligation to cooperate with the institution of medical rehabilitation or to participate in working life, the entitlement to unemployment benefit is suspended from the day after the participant fails to participate until the day on which the participation is made up. Sentence 4 applies accordingly if the disabled person prevents the determination of the disability by his behavior.
(3) If the person with the disability is awarded a statutory pension insurance institution because of a rehabilitation measure, a transitional allowance or a pension for reduced earning capacity, the Federal Agency is entitled to a reimbursement claim in accordance with Section 103 of the Tenth Book. If the institution of the statutory pension insurance has paid benefits pursuant to sentence 1 to the person with reduced performance or a third party with a liberating effect, the recipient of the unemployment benefit must reimburse them in this respect.

§ 146 SGB III continued payment in the event of incapacity to work

(1) Anyone who is unable to work due to illness through no fault of their own due to sickness or who is hospitalized while receiving unemployment benefit at the expense of the health insurance does not lose the right to unemployment benefit for the period of incapacity for work or inpatient treatment with a duration of up to six weeks (power continued payment). Incapacity for work within the meaning of sentence 1 is also deemed to be incapable of work, which occurs as a result of sterilization by a doctor as a result of illness or as a result of an unlawful termination of the pregnancy. The same applies for one Termination of pregnancy if the pregnancy is terminated by a doctor within twelve weeks of conception, the pregnant woman requests the termination and the doctor has provided evidence that the doctor has given birth at least three days before the intervention has given advice to a recognized advice center.
(2) Benefits continue to be paid even in the case of supervision, care or care of a sick child of the unemployed person with a duration of up to ten days required by a medical certificate, for single parents with a duration of up to 20 days for each child in Every calendar year, if another person living in the unemployed person’s household cannot take on this task and the child has not yet reached the age of 12 or is disabled and is dependent on help. However, unemployment benefits continue to be paid for no more than 25 days in any calendar year, and for single unemployed people for no more than 50 days.
(3) The provisions of the fifth book, which are to be applied if the employer continues to pay remuneration in the event of illness and if sickness benefit is paid in the event of illness of a child, apply accordingly.

Social Code (SGB V), Fifth Book, Statutory Health Insurance

§ 44 SGB V sickness benefit

(1) Insured persons are entitled to sickness benefit if the illness makes them unable to work or they are hospitalized in a hospital, preventive or rehabilitation facility at the expense of the health insurance fund (Section 23 (4), Section 24, 40 Section 2 and Section 41) be treated.
(2) Not entitled to sickness benefit
1. those insured pursuant to section 5 (1) no. 2a, 5, 6, 9, 10 or 13 and those insured pursuant to section 10; this does not apply to those insured under section 5 (1) no. 6 if they are entitled to a transitional allowance, and to insured persons under section 5 (1) no. 13 insofar as they are employed and not under sections 8 and 8a of the Fourth book are marginally busy,
2. full-time self-employed, unless the member declares to the health insurance company that membership should include entitlement to sick pay (declaration of choice),
3.Insured persons pursuant to Section 5 Paragraph 1 Number 1 who, in the event of incapacity to work, are not entitled to at least six weeks’ continued payment of wages on the basis of the Continued Pay Act, a collective agreement, a company agreement or other contractual promises or payment of a social security benefit , the member submits an election declaration that membership should include entitlement to sickness benefit. This does not apply to insured persons who are entitled to a surcharge on wages in accordance with Section 10 of the Continued Pay Act,
4. Insured persons who receive a pension from a public law insurance institution or pension institution in their professional group or from other comparable bodies that corresponds in nature to the benefits specified in section 50 (1). For insured persons pursuant to sentence 1 number 4, section 50 (2) applies accordingly insofar as they receive a benefit that corresponds in nature to the benefits listed in this provision.
Section 53 (8) sentence 1 applies accordingly to the declaration of election pursuant to sentence 1 numbers 2 and 3. Section 53 (6) remains unaffected for the insured listed under numbers 2 and 3.
(3) The entitlement to continued payment of wages in the event of incapacity for work is based on labor law regulations.

§ 46 SGB V emergence of the right to sickness benefit

Entitlement to sickness benefit arises
1. in the case of hospital treatment or treatment in a preventive or rehabilitation facility (section 23 (4), sections 24, 40 section 2 and section 41) from the beginning,
2. otherwise from the day following the day on which the medical incapacity is determined.
For those insured under the Artists’ Social Insurance Act and for insured persons who have submitted an election declaration in accordance with Section 44 Paragraph 2 Sentence 1 Number 2, the entitlement arises from the seventh week of incapacity to work. The right to sickness benefit for the insured persons mentioned in sentence 2 under the Artists’ Social Insurance Act arises before the seventh week of incapacity to work at the time specified in the statutes, but at the latest at the beginning the third Week of incapacity to work if the insured has chosen a tariff in accordance with section 53 (6).

§ 48 SGB V Duration of sickness benefit

(1) Insured persons receive sickness benefit without time limit, but in the event of inability to work due to the same illness, however, for a maximum of seventy-eight weeks within three years, calculated from the day on which the inability to work began. If another illness occurs during the incapacity to work, the benefit period will not be extended.
(2) For insured persons who have received sickness benefit for seventy-eight weeks for the same illness in the last three-year period, there is a new entitlement to sickness benefit for the same illness after the start of a new three-year period if they are insured and entitled to sickness benefit when they become unable to work again and in in the meantime at least six months
1. have not been unable to work due to this illness and
2. were employed or were available for job placement.
(3) When determining the duration of sickness benefit, periods in which entitlement to sickness benefit is suspended or for which sickness benefit is refused are taken into account, such as times when sickness benefit is received. Times for which there is no entitlement to sick pay are not taken into account.
footnotes
Section 48 subsection 2: Compatible with the GG in accordance with BVerfGE v. March 24, 1998 I 1526 – 1 BvL 6/92 –

§ 49 SGB V suspension of sickness benefit

(1) The right to sickness benefit is suspended,
1. to the extent and for as long as insured persons receive a wage or income that is subject to contributions; this does not apply to one-off wages,
2. as long as insured take parental leave according to the Federal Parental Benefit and Parental Leave Act; this does not apply if the incapacity to work occurred before the start of parental leave or the sickness benefit is to be calculated from the wages that were obtained from an employment subject to compulsory insurance during parental leave,
3. to the extent and for as long as insured persons receive pension sickness benefit, transitional allowance, maintenance allowance or short-time allowance,
3a. as long as insured persons receive maternity or unemployment benefits or the entitlement is suspended due to a blocking period under the third book,
4. Insofar as and as long as insured persons receive compensation replacement benefits that are comparable in nature to the benefits mentioned in number 3 from a social security institution or a government agency abroad,
5. as long as the inability to work is not reported to the health insurance company; this does not apply if the notification is made within one week of the beginning of the incapacity to work,
6. insofar as and as long as there is no work owed for periods of exemption from work (Section 7 (1a) of the fourth book),
7. During the first six weeks of inability to work for insured persons who have submitted a declaration of choice in accordance with section 44 (2) sentence 1 number 3.
(2) (dropped out)
(3) Lower wages or compensation payments due to legal provisions may not be increased when applying paragraph 1.
(4) If another institution of social insurance provides injury benefits, medical care benefits or transitional allowance in the course of outpatient medical rehabilitation services, this institution will, upon request, be reimbursed its expenses for these services within the framework of the joint agreement agreed in accordance with Section 13 (2) No. 7 of the Ninth Book Recommendations made.