In what situation can I claim?
The following are entitled to wage compensation for temporary absence from work due to illness or injury according to the compulsory health insurance system:
- employed insured persons;
- sole traders;
- partners in unincorporated companies, partners in limited liability companies and institution founders, if the company partners or institution founders are managers who regulate business functions as one of the chief members;
- top athletes and chess players;
- farmers paying contributions according to the base defined for pensions and disability insurance;
- unemployed persons with right to benefits determined by ZUJF.
What conditions do I need to meet?
Entitlement to benefit is assessed by a general physician, designated physician or medical commission on the first working day of absence from work.
Reasons for entitlement are:
- transplant of organs and living tissue for the benefit of another person;
- after-effects of giving blood;
- care for an immediate family member;
- isolation and accompaniment on the order of a general physician;
- injury at work or work-related illness;
- other reasons for absence from work.
What am I entitled to and how can I claim?
Work-related illness or injury at work
In the instance that the injury or illness is a consequence of work, the insured person is entitled to benefit until he or she is able to return to work. The first 30 days of benefit are paid by the employee; in the case of further absence benefit will be covered by the compulsory health insurance system.
Illness or injury outside of work
The insured person is also entitled to wage compensation in the case of illness or injury occurring outside work.
If the insured person ceases employment during the time of absence from work, he or she is still entitled to benefit for a maximum of 30 days following termination of employment. If the absence from work is the result of injury or illness from work the insured person is entitled to benefit also on termination of employment until once again able to work.
Care for an immediate family member
One of the parents or guardian of a child younger than 18 years of age is entitled to wage compensation while the child is being cared for.
Child or immediate family member
up to 7 working days
Child under 7 years of age or older child with moderately serious or serious physical or mental handicap
up to 15 working days
In exceptional cases the general physician may extend the period of entitlement.
Period of care
Care for a child under 7 years of age or older child with moderately serious or serious physical or mental handicap
maximum of 30 working days
Care for other immediate family members
maximum of 14 working days
Care for a child resulting from a serious brain damage, cancer or other particularly serious worsening of health on the advice of an expert paediatric college at a university clinical centre
Maximum of 6 months
Longer benefit periods as a result of the child's health conditions are approved by a medical commission or expert college of the University Medical Centre Ljubljana paediatric clinic.
The amount of wage compensation is dependent on the compensation base, reason and length of temporary absence from work and method of indexation. Compensation may not be less than the guaranteed minimum wage or higher than the employee's regular wage. The compensation base is the average monthly wage or average base for payment of contributions in the calendar year prior to the year in which the temporary absence from work occurred.
- 100% of the base for absence from work resulting from work-related illness, injury at work, transplant of living tissue and organs for the benefit of another person and the after-effects of giving blood or isolation ordered by a physician;
- 90% of the base for absence from work resulting from illness;
- 80% of the base for absence from work resulting from injury outside of work or care and accompaniment for a family member, where ordered by a physician.
As general rules, the first 90 days of benefit amount to:
- 90% of the base in the instances of the first bullet point of the previous paragraph except where, in the case of absence from work, this results from work-related illness or injury at work;
- 80% of the base in the instances of the second bullet point of the previous paragraph;
- 70% of the base in the instances of the third bullet point of the previous paragraph, except in the case where absence from work is due to care for a family member.
As an exception, war disabled servicemen and war-disabled civilians have the right to benefit in the amount of 100% of the base also in after the first 90 days. During the first 90 days, the benefit amounts to 90% of the base in all cases, except in the instance of absence from work as a result of work-related illness, injury at work and care for a family member where the benefit amounts to 100% of the base since the beginning.
Forms you may need to fill in
- completed confirmation of approved absence from work;
- in the case of blood donation: signed form confirming that the insured person has given blood.
Know your rights
The links below listing your rights are not European Commission pages and do not represent the view of the Commission:
- Details concerning wage compensation as a result of illness or injury;
- Instructions for entitlement to temporary absence from work and benefit.
European Commission publications and web pages:
Who do you need to contact?
The right to compensation is determined by the decision of a general physician, designated physician or medical commission.