Sickness Benefit

Overview

When an employee or a self-occupied person is sick from the place of work, a Blue Medical Certificate must be completed by a medical practioner and submitted to the Department of Social Security within ten (10) days from the first (1)^st day of sickness. The only exceptions are in cases of hospitalisation or treatment abroad. In turn, the copy of the Blue Medical Certificate must be handed to the employer. If the sickness is longer than fourteen (14) days, the blue medical certificate must be renewed every two (2) weeks, until the employee is fit to resume work.

If eligible, the applicant may be awarded the Sickness Benefit. For this benefit to be awarded, a person must not have reached the retirement age.

Increased Sickness Benefit

From 1 January 2024, the beneficiaries who benefit from the Long-term Sickness Benefit and who have a continuous claim accepted for one hundred and fifty-six (156) days of benefit (or six (6) months), shall have their claim for Sickness Benefit automatically converted to Increased Sickness Benefit (ISB) from the one hundred and fifty seventh (157th) working days onwards. The applicable rate of the Inscreased Sickness Benefit  will be similar to that applicable for Invalidity Pension. The Increased Sickness Benefit will continue to be paid until:

• A final blue medical certificate is submitted, thus closing the claim for Sickness Benefit,
• A date decided by the Medical Board appointed by the Director General of Social Security,
• Exhaustion of social security contributions, or
• Exhaustion of four hundred and sixty-eight (468) days of benefit.

The above is applicable according to whichever comes first.

The payment rate for the Increased Sickness Benefit is thirty euros and thirty-nine cents (€30.39) daily for a married person maintaining a spouse, and twenty-three euros and sixteen cents (€23.16) daily for a single person or to a married person whose spouse works full-time.

There is no need to apply for the Increased Sickness Benefit as the Sickness Benefit will be automatically converted to Increased Sickness Benefit following a current and continuous payment of Sickness Benefit Claim of at least one-hundred and fifty-six (156) benefit days.

No documents are required to claim Increased Sickness Benefit as the claim shall be converted from Sickness Benefit to Increased Sickness Benefit based on the Medical Panel decisions.

Sickness Benefit Credits

An Employed person who is on sick leave on no-pay, or Self-occupied person who are in receipt of Sickness Benefit or has a continued Sickness Benefit Claim after Medical Board Decision but exhausted benefit payment.

Credits are awarded where applicable for each whole week of accepted Sickness, Occupational Injury, or Unemployment benefit claims.

Important Information about the Blue Medical Certificate

Claimants must ensure that the address written on the Blue Medical Certificate matches the official address held with the Department of Social Security, which will be used by the department for all official correspondence. Therefore, no changes will be made to the official address held by the Department of Social Security even if it differs from the one submitted on the certificate.

You can verify and update your official address online, only as per your current address on your Identity Card by clicking here, or visit one of the servizz.gov hubs for further assistance.

Other Information

• A person is no longer required to submit the blue medical certificate to the Department of Social Security if the period of illness is three (3) working days or less.
• Certification of illness of three (3) working days or less does not constitute a claim for Sickness Benefit but the copy of the certificate must still be handed to the employer, if the ‘Kopja għall-Prinċipal’ is demanded.
• A First and Final Certificate means that the applicant has started sickness from work and the certificate shows the starting date of sickness and also the date when the claimant is to return to work. This certifies that the insured person is unfit for work for a specified period of days, but not exceeding fourteen (14) days.
• A First Only Certificate or an Open Certificate means that the applicant has either started sickness from work, or is still on sick leave and the certificate is showing the start date of sickness if it is a First Only Certificate but no date of return to work is indicated. This may also mean that if it is an Open certificate there is no date showing start date of sickness and also no date indicated when the applicant is fit to return to work. This certifies that the insured person has been medically examined for the first time, within a period of sickness, and will be unfit for more than fourteen (14) days.
• An Intermediate Certificate means the same as an Open Certificate. It certifies that the insured person is still incapable to attend work for a period not exceeding fourteen (14) days from the examination date on the same blue medical certificate. This means that the claimant has already submitted a First or First Open Certificate and is continuing with the claim. It is important to note that until an Intermediate Certificate follows a open First Certificate no sickness benefit will be paid to the applicant until the submission of a next Intermediate or Final Certificate.
• A Final Certificate means that the certificate is showing the date when the applicant is to return to work though it does not indicate the date when the sickness started. It certifies that the insured person may resume work on the date specified (return to work date) for a period not exceeding fourteen (14) days from the examination date on the blue medical certificate.
• A person who suffers from Fibromyalgia or Myalgic Encephalomyelitis (ME) will be paid sickness benefit from the first day of illness as from the second certified request of illness in the same year.
• A person undergoing therapy for cancer will be paid sickness benefit from the first day of illness as from the second certified request of illness in the same year.
• Parents with breaks in employment due to children undergoing treatment for rare diseases, may be eligible to contribution credits for a maximum period of eight (8).

For information regarding cross-border situations please click here.

What you’ll get

An employee is paid for Sickness Benefit according to eligibility conditions, starting from the fourth (4)^th working day of sickness, since the first three (3) working days are payable by the employer. The date of sickness starts from the date of the medical examination date showing on the blue medical certificate. An employer may either:

1. Pay the wage of the employee in full for the first three (3) working days of sickness and then pay the difference between the Sickness Benefit entitlement and the employee’s wage for any additional certified sick leave day; or
2. Pay the wage of the employee in full for the certified sick leave days and in return the employee refunds the employer the Sickness Benefit entitlement once this is issued by the Department of Social Security.

A self-occupied person who submits a blue medical certificate, is awarded Sickness Benefit from the fourth (4)^th working day of sickness and is entitled to a fixed benefit rate.

Sickness Benefit is awarded according to the number of days of the employee’s working week; that is, for a five (5) day or six (6) day week. No payment by the Department of Social Security is effected for public holidays and Sundays.

A person who is unemployed due to a sickness and is awaiting to be awarded a Contributory Invalidity Pension or is not in a position to work and is submitting a blue medical certificate every two (2) weeks, may also be awarded Sickness Benefit. Such entitlement is paid from Monday to Saturday including Public Holidays, excluding Sundays.

Government employees are excluded from being awarded Sickness Benefit whilst on paid sick leave. However, if the government employee’s Entitlement to full-pay Sick Leave days are consumed, he/she may request half-pay sick benefit days. If the entitlement of such days is also consumed, the claimant may request no-pay sick benefit days for such sick leave. The claimant should communicate with the Human Resources department at their place of work when on Sick Leave on Half Pay or No Pay.

The beneficiary will start to receive the Increased Sickness Benefit payment within twenty (20) days after the continuation of sickness after one-hundred and fifty-six (156) continuous benefit days.

Please click here for a Schedule of Benefits Rates.

You may make use of an online Calculator to calculate your Sickness Benefit entitlement.

Eligibility

General eligibility criteria:

• An employee or a self-occupied person who is sick from the place of work and duly pays social security contributions accordingly.

• The blue medical certificate must be properly filled in by both the medical doctor and the claimant for a successul submission.

• To be eligible to a Sickness Benefit married rate, the claimant must be:
  • Married or in a civil union with spouse not working full-time.
  • Legally separated but maintaining an unemployed separated spouse.
  • A single parent having the care and custody of minor child or children. In case of shared custody, claimant must be paying maintenance to his spouse or is in receipt of Children’s Allowance.

• To be eligible to a Sickness Benefit single rate, the claimant must be:
  • A Single Person.
  • Married or in civil union with the spouse working full-time.
  • Legally separated but not maintaining ex-spouse.
  • A single parent not having the care and custody of minor child or children.

• The claimant has paid a minimum of fifty (50) Class 1 and / or Class 2 Social Security Contributions since being registered under the Social Security Act (Cap. 318.) until date of benefit claim.
• The claimant must also have twenty (20) paid or credited Class 1 or Class 2 Social Security Contributions during the last two (2) consecutive calendar years prior to the year of Sickness Benefit Claim.

Sickness Benefit is payable up to one-hundred and fifty-six (156) days, and may be extended up to four-hundred and sixty-eight (468) benefit days in two (2) years in each case depending on the Medical Board’s decision. This payment depends on the number of Social Security Contributions paid during the claimant’s employment.

Documentation required

General documentation:

• Blue medical certificate fully-filled and signed by a registered Medical Doctor.
• Ensure that your banking details held by the Department of Social Security are updated to receive payments by direct deposit in a bank. The IBAN number must be a Savings or Current account, but not a Loan account. The indicated account must be in the name of the beneficiary only. If a person is already receiving payment for any benefit as direct credit in a bank account, the payment of the Sickness Benefit will be deposited in the same bank account. Banking details may be updated on  mySocialSecurity.

Additional Notes and Scenarios

Below are four (4) Sickness Benefit claim scenarios that might guide a claimant to understand further how the ‘Less than four (4) days’ rules applies:

1. An employee, who has a regular employment of a five (5) day week, is certified by his/her doctor as medically unfit for work from Monday to Wednesday in a particular working week. On the certificate the doctor indicates that claimant shall resume work on Thursday. There are no public holidays falling between Monday and Wednesday. The number of sick days in this case are three (3).

• • As a result, the employee is not required to submit the Blue Medical Certificate to the Department of Social Security (DSS) for this Claim. However, the employee’s employer may still demand the blue medical certificate.
  • If for some reason, the employee is still unfit for work on Thursday, the doctor can extend the claim by drawing another Blue Medical Certificate from Thursday until the date the employee is deemed fit to resume work. In this case, both certificates must be submitted to the Department of Social Security, that is, the one starting from Monday to Wednesday, and the one continuing from Thursday onwards for the Sickness Benefit Claim to be submitted correctly.

2. An employee does not work on Saturdays and Sundays, that is a five (5) day week, and is certified by his/her doctor as medically unfit for work from Friday of a particular week to Tuesday of the following working week. On the Blue Medical Certificate the doctor indicates that claimant shall resume work on Wednesday. There are no public holidays falling between Friday and Tuesday. The number of sick days in this case are also three (3).

• • As a result, the employee is not required to submit the Blue Medical Certificate to the Department of Social Security (DSS) for this Claim. However, the employee’s employer may still demand the Blue Medical Certifcate.
  • If for some reason, the employee is still unfit for work on Wednesday, the doctor can extend the claim by drawing another Blue Medical Certificate from Wednesday until the date the employee is deemed fit to resume work. In this case, both certificates must be submitted to the Department of Social Security, that is, the one from Friday to the following Tuesday, and the one from Wednesday onwards for the Sickness Benefit Claim to be submitted correctly.

3. An employee does not work on Sundays, that is a six (6) day week and is certified by his/her doctor as medically unfit for work from Friday of a particular week to Monday of the following working week. In the certificate the doctor indicates that claimant shall resume work on Tuesday. There are no public holidays falling between Friday and Monday. The number of sick days in this case are also three (3).

• • As a result, the employee is not required to submit the Blue Medical Certificate to the Department of Social Security (DSS) for this claim. However, the employee’s employer may still demand the Blue Medical Certifcate.
  • If for some reason, the employee is still unfit for work on Tuesday, the doctor can extend the claim by drawing another Blue Medical Certificate from Tuesday until the date the employee is deemed fit to resume work. In this case, both certificates must be submitted to the Department of Social Security, that is, the one from Friday to the following Monday, and the one from Tuesday onwards for the Sickness Benefit Claim to be submitted correctly.

4. An employee is certified by his/her doctor as medically unfit for work from Monday to Thursday in a particular working week. In the certificate the doctor indicates that claimant shall resume work on Friday. However, Tuesday happens to be a Public Holiday. The number of sick days in this case are also three (3).

• • As a result, the employee is not required to submit the Blue Medical Certificate to the Department of Social Security (DSS) for this Claim.
  • If for some reason, the employee is still unfit for work on Friday, the doctor can extend the claim by drawing another Blue Certificate from Friday until the date the employee is deemed fit to resume work. In this case, both certificates must be submitted to the Department of Social Security, that is, the one from Monday to Thursday, and the one from Friday onwards for the Sickness Benefit Claim to be submitted correctly.

In brief, the first three (3) working days of any Sickness Benefit Claim must not include weekly non-working days (such as Saturdays and/or Sundays, or any non-working days resulting from shift work), and also any Public Holidays falling within.

How to apply

One may submit a copy of the original blue medical certificate online. The approximate time taken to fill in and submit the online application is six (6) minutes.

Alternatively, the original blue medical certificate to the nearest servizz.gov hub. It is the employee’s responsibility to submit this blue medical certificate to the Department of Social Security. Please note that the Department of Social Security does not accept any blue medical certificates submitted online by the employer on behalf of the claimant. Furthermore, blue medical certificates delivered in bulk by employers on behalf of employees will also not be accepted.

You will receive the payment within twenty (20) days if the required details are submitted and you are eligible for benefit payment. To view any related payments, one must access the paymentsdss.gov.mt, where applicable.

With regards to the Increased Sickness Benefit, there is no need to apply as the Sickness Benefit will be automatically converted to Increased Sickness Benefit following a current and continuous payment of Sickness Benefit Claim of at least one-hundred and fifty-six (156) benefit days.

Updated: April 2024