In what situation can I claim?
A temporary incapacity for work benefit can be claimed when the incapacity for work caused by an occupational accident or disease is temporary.
Work ability allowance can be claimed when no work ability is caused by occupational accident or disease. The same principles apply as described in the chapter “Work ability allowance”.
The benefit from the employer can be claimed when an employee has suffered an injury or permanent harm (including death) in the course of employment, for which the employer is responsible.
The employer must compensate for the damage only if the circumstances on which liability is based and the harm caused are related in such a manner that the damage is a consequence of the circumstances (causation).
What conditions do I need to meet?
For the temporary incapacity for work benefit see chapter “Health insurance for people insured by their employer” and Health Insurance Board homepage.
For work ability allowance see chapter “Work ability allowance”.
An employee has a right to receive compensation for harm caused to his or her health by a work injury or disease (tervisekahju hüvitis) to the extent provided by the Law of Obligations Act.
The legislation states that in case of an obligation for the compensation for harm to personal health or for bodily injuries, the injured party must be compensated for the costs incurred by the harm, including the costs from increased needs, and for the harm caused by complete or partial incapacity for work, including the reduction in income and the harm resulting from limited future economic opportunities. As this is within the scope of civil law, the parties can reach a mutual agreement on the amount of benefit.
To establish that a work injury has occurred, the person must contact a family physician or a medical specialist. In the case of a suspected occupational disease, the family physician or medical specialist must refer the person to an occupational health doctor. To confirm an occupational disease diagnosis, the occupational health doctor must examine the working conditions that the employee is or has been subjected to. To do this, the occupational health examiner must review the workplace, risk analyses, the previous health checks conducted on the employee and other necessary information. In case an occupational disease is confirmed, the occupational health doctor must forward the documents to the family physician or a medical specialist and notify the employer and Labour Inspectorate. All occupational accidents and diseases must be investigated and reported to the Labour Inspectorate by the employer.
What am I entitled to and how can I claim?
In case of temporary incapacity for work an employee receives the benefit from the Health Insurance Fund from the second day of the sick leave. The amount of the benefit is 100% of the reference wage. The reference wage is determined according to the social tax paid by the employer on behalf of the employee for the calendar year before the sick leave/accident. For more information, see Health Insurance Board homepage.
In case of permanent incapacity for work the employee receives work ability allowance. For more information see https://www.tootukassa.ee/eng/content/subsidies-and-benefits/working-ability-allowance .
In addition the employer must compensate the employee for expenses arising from health damage or injury, incl. expenses arising from the increased needs and from a decrease in income or deterioration of the future economic potential.
Forms you may need to fill in
To claim work ability allowance, one must contact the Estonian Unemployment Insurance Fund the following way:
- self-service portal online www.tootukassa.ee ;
- in a local department personally;
- sending digitally signed application by e-mail to firstname.lastname@example.org or
- sending signed application on paper by post to Lasnamäe 2, Tallinn 11412.
If the employer that caused the work injury has been wound up without a legal successor, you are entitled to receive a benefit from the Estonian National Social Security Board.
You must submit the following documents to the Estonian National Social Insurance Board:
- an application;
- an identification document;
- the decision of the incapacity for work examination;
- a notice from the occupational health doctor;
- a certificate regarding the deletion of the employer that caused the personal injury from the commercial register;
- the information on the monthly income prior to the incapacity for work.
Know your rights
- Work ability allowance;
- Estonian National Social Insurance Board Estonian Health Insurance Fund ;
- http://ec.europa.eu/social/main.jsp?catId=849&langId=en .
Who do you need to contact?
For more information, please contact the Estonian Health Insurance Fund.
Helpline (in Estonia): 16 363
When calling from abroad: +372 6696630 - working days 8:30-16:30.
Estonian Unemployment Insurance Fund
For general questions, or if you cannot find the right contact person, please call the help line 15501.
If calling from abroad, the number +372 669 6513 is to be used, or via skype: tootukassa ; an email: email@example.com .
The Estonian National Social Insurance Board
Information is available on telephone number 16106 (in Estonia) or +372 612 1360 between the hours of 9:00-17:00 on all working days and the general phone numbers of the Estonian National Social Insurance Board's offices (please see http://www.sotsiaalkindlustusamet.ee/et/klienditeenindused-loeteluna ).
Applications submitted electronically must be digitally signed.]