responsibility finder
Schleswig-Holstein

Claiming children's sickness benefit for those with statutory health insurance and transferring children's sickness benefit days to the other parent

Source: Zuständigkeitsfinder Schleswig-Holstein (Linie6PLus)

Service Description

You receive child sickness benefit as compensation for lost wages if you are

  • have statutory health insurance
  • are entitled to sick pay,
  • your child has statutory health insurance, is ill, and is under 12 years old,
  • you have no one else in the household to care for your child..,
  • have to supervise, care for or nurse your child and are therefore unable to work,
  • are exempted by your employer and do not receive continued payment of wages (no paid leave).

For parents of children with disabilities who need help, the age limit of 12 years does not apply.

You apply for children's sickness benefit from your statutory health insurance fund. To do this, you must submit the so-called child sickness certificate (sample 21).

Children's sickness benefit is generally 90 percent of your lost net pay. If you received one-time payments from your employer in the year before the child became ill (for example, a Christmas bonus), the child sickness benefit is 100 percent of the lost net pay. For full-time self-employed persons, children's sickness benefit is paid in the amount of the sickness benefit in case of own incapacity for work. Due to the statutory income threshold, the maximum amount of children's sick pay is capped.

Child sick pay is subject to social insurance contributions. This means that your health insurance fund automatically deducts nursing care, pension, and unemployment insurance contributions. Health insurance contributions are not due.

You can receive

  • 10 working days of sick pay per child per year.
  • If you are a single parent, your entitlement increases to 20 working days.
  • If you have 3 or more children, you can get child sickness benefit for up to 25 working days a year; single parents for up to 50 working days.


Due to the COVID 19 pandemic, the number of working days you can get Child Sickness Benefit has been increased and is 2021:

  • 1 child: maximum 30 working days, single parents maximum 60 working days;
  • 2 children: maximum 60 working days, single parents maximum 120 working days;
  • 3 or more children: maximum 65 working days, single parents 130 working days.

Because of the Corona pandemic, you can also claim child sickness benefit in 2021 if you have to care for your child at home because of:

  • A pandemic-related government-ordered school or daycare closure,
  • an officially mandated or extended company or school holiday..,
  • cancellation of compulsory school attendance,
  • other pandemic-related restriction of care for your child,
  • quarantine of your child (no-entry order), or
  • an official recommendation that your child should not attend daycare or school.

You must prove one of the reasons to your health insurance fund. To do this, your health insurance fund may ask for a certificate from the day care centre or school.

If your employer gives you paid time off from work, this time will count towards your entitlement to child sickness benefit. This means that your entitlement to children's sickness benefit is suspended for as long as your employer gives you paid time off. For example, if your employer has continued to pay you your net pay for 5 days, you will still be entitled to children's sick pay for 5 days out of your maximum entitlement to children's sick pay of up to 10 working days a year (1 child).

If you have already used up your maximum number of days of child sickness benefit, it may be possible for your partner to transfer the days of child sickness benefit to you. You will have to apply to your sickness insurance fund for this too. Your employer must also be prepared to give you unpaid leave again.

If your child is seriously ill and under the age of 12, or if he or she is disabled and needs help, you will get child sickness benefit for an unlimited period. You must still meet the following conditions:

  • You and your child have statutory health insurance,
  • You are entitled to sickness benefit,
  • your child must be supervised, looked after or cared for by you because of a fatal illness, which is why you cannot work,
  • your child's illness must have reached an advanced stage, require palliative medical treatment or you or your partner want this treatment and the illness must result in a limited life expectancy of weeks or a few months,
  • you have been granted leave of absence by your employer and are not receiving any pay (no paid time off).

You must submit a certificate to your health insurer stating that your child has a serious, fatal illness.


Process flow

You can submit the application for children's sick pay and the application for transfer of children's sick days by post and - for many statutory health insurance funds - in person at the office or online.
Normally, the procedure is as follows:

  • You receive a medical child sickness certificate (sample 21).
  • Fill out the application form of your statutory health insurance. This can be found on the back of sample 21. If necessary, your health insurance fund will request further information in a separate application.
  • Submit the child sickness certificate (sample 21) to your health insurance fund together with any other documents that may be required.
  • Inform your employer about the child sickness registration.
  • The health insurance fund will check your application and transfer your child sickness benefit to you. For employees: Your health insurance fund will pay your children's sickness benefit only after your employer has provided the health insurance fund with the required information on your lost net pay.
  • Special rules for childcare due to the Corona pandemic:
  • Complete the application from your public health insurance provider.
  • Attach proof from the school or daycare center.
  • Submit the application together with the proof and any other required documents to your health insurance fund.
  • The health insurance fund will check your application and transfer your child sickness benefit to you. For employees: Your health insurance fund will pay your children's sickness benefit only after your employer has provided the health insurance fund with the required information on your lost net pay.

Requirements
  • Your child is under 12 years old or has a disability and is dependent on assistance.
  • Your child has been diagnosed with a medical condition that requires care, supervision or nursing.
  • There is no other person in your household who can look after the child.
  • You and your child have statutory health insurance.
  • You are employed and are entitled to sick pay.
  • You are granted unpaid leave by your employer.
  • Even if you are self-employed and have statutory health insurance, you can get child sickness benefit from the first day of your child's illness. The condition is that you are entitled to sickness benefit yourself,

If your child is seriously ill:

  • Your child is terminally ill and has a life expectancy of a few weeks or months.
  • Your child's illness is advanced and requires palliative medical treatment, or you or your partner want this treatment.
  • Your child is under 12 years old or disabled and dependent on help.
  • You and your child have statutory health insurance.
  • You are employed and are entitled to sick pay.
  • You are given unpaid leave by your employer.
  • Even if you are self-employed and have statutory health insurance, you can get child sickness benefit from the first day of your child's illness. The prerequisite for this is that you are entitled to sickness benefit yourself, for example through a so-called optional tariff with your health insurance fund.

For the transfer of children's sick pay days:

  • Both you and your partner have statutory health insurance.
  • Both you and your partner are entitled to sick pay.
  • Your employer has agreed to the transfer of sick pay days for children. This means that your employer has agreed to let you take additional days off.

Which documents are required?
  • Medical certificate about the illness and the care needs of your child ("Kindkrankschreibung", sample 21).
  • In addition, if necessary, for seriously ill children:
  • Medical certificate stating that your child is suffering from a serious, fatal illness.
  • In addition, for children with disabilities, if applicable:
  • Medical certificate or, if applicable, proof that your child has a disability and is dependent on your assistance.
  • For quarantined or closed care facilities due to the Corona pandemic, if applicable:
  • Proof that a care facility has been closed, that the facility or school holidays have been ordered or extended, that school attendance requirements have been lifted, that care services have been restricted, that a quarantine (no-entry) order has been issued, or that an official recommendation has been made not to attend the care facility.

Please check with your health insurance provider to see if proof is required.

What are the fees?

You do not have to pay anything for the application.

What deadlines do I have to pay attention to?

You should go to the doctor with your child as soon as possible - preferably on the 1st day of illness - to obtain the child sickness certificate (model 21) and inform your employer of your absence.

Processing duration

The processing usually takes about 4 to 9 working days.

For rapid processing and decision-making, your health insurance fund must be provided with the necessary information as well as any required documents in a complete and meaningful manner.
The health insurance fund decides on applications promptly, whereby the statutory processing period is adhered to in order to protect patients' rights.
Please note that the processing time indicated is an average value for all health insurance funds. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and may be longer accordingly. The same applies if documents or records are sent to you or your health insurer by post.




Legal basis
Appeal
  • Objection
  • Action before the social court

Applications / forms

- Forms: yes

- Online procedure possible: Many statutory health insurers offer an online procedure.

- Written form required: no

- Personal appearance required: no

What else should I know?

If you yourself have private insurance and the other parent has statutory insurance, it depends on where the child is insured: If the child has statutory insurance, the parent with statutory insurance can claim child sickness benefit.
If your child has an accident at school or nursery, you will receive child injury benefit from the accident insurance. This is usually calculated and paid by your health insurance fund on behalf of the relevant accident insurance institution.
If you are unemployed, the Employment Agency will continue to pay unemployment benefit for a limited period if you are unable to continue your job search because of the illness and the resulting need to care for your child.



Author
Technically approved by

Federal Ministry of Health

Process flow

You can submit the application for children's sick pay and the application for transfer of children's sick days by post and - for many statutory health insurance funds - in person at the office or online.
Normally, the procedure is as follows:

  • You receive a medical child sickness certificate (sample 21).
  • Fill out the application form of your statutory health insurance. This can be found on the back of sample 21. If necessary, your health insurance fund will request further information in a separate application.
  • Submit the child sickness certificate (sample 21) to your health insurance fund together with any other documents that may be required.
  • Inform your employer about the child sickness registration.
  • The health insurance fund will check your application and transfer your child sickness benefit to you. For employees: Your health insurance fund will pay your children's sickness benefit only after your employer has provided the health insurance fund with the required information on your lost net pay.
  • Special rules for childcare due to the Corona pandemic:
  • Complete the application from your public health insurance provider.
  • Attach proof from the school or daycare center.
  • Submit the application together with the proof and any other required documents to your health insurance fund.
  • The health insurance fund will check your application and transfer your child sickness benefit to you. For employees: Your health insurance fund will pay your children's sickness benefit only after your employer has provided the health insurance fund with the required information on your lost net pay.

Requirements

  • Your child is under 12 years old or has a disability and is dependent on assistance.
  • Your child has been diagnosed with a medical condition that requires care, supervision or nursing.
  • There is no other person in your household who can look after the child.
  • You and your child have statutory health insurance.
  • You are employed and are entitled to sick pay.
  • You are granted unpaid leave by your employer.
  • Even if you are self-employed and have statutory health insurance, you can get child sickness benefit from the first day of your child's illness. The condition is that you are entitled to sickness benefit yourself,

If your child is seriously ill:

  • Your child is terminally ill and has a life expectancy of a few weeks or months.
  • Your child's illness is advanced and requires palliative medical treatment, or you or your partner want this treatment.
  • Your child is under 12 years old or disabled and dependent on help.
  • You and your child have statutory health insurance.
  • You are employed and are entitled to sick pay.
  • You are given unpaid leave by your employer.
  • Even if you are self-employed and have statutory health insurance, you can get child sickness benefit from the first day of your child's illness. The prerequisite for this is that you are entitled to sickness benefit yourself, for example through a so-called optional tariff with your health insurance fund.

For the transfer of children's sick pay days:

  • Both you and your partner have statutory health insurance.
  • Both you and your partner are entitled to sick pay.
  • Your employer has agreed to the transfer of sick pay days for children. This means that your employer has agreed to let you take additional days off.

Which documents are required?

  • Medical certificate about the illness and the care needs of your child ("Kindkrankschreibung", sample 21).
  • In addition, if necessary, for seriously ill children:
  • Medical certificate stating that your child is suffering from a serious, fatal illness.
  • In addition, for children with disabilities, if applicable:
  • Medical certificate or, if applicable, proof that your child has a disability and is dependent on your assistance.
  • For quarantined or closed care facilities due to the Corona pandemic, if applicable:
  • Proof that a care facility has been closed, that the facility or school holidays have been ordered or extended, that school attendance requirements have been lifted, that care services have been restricted, that a quarantine (no-entry) order has been issued, or that an official recommendation has been made not to attend the care facility.

Please check with your health insurance provider to see if proof is required.

What are the fees?

You do not have to pay anything for the application.

What deadlines do I have to pay attention to?

You should go to the doctor with your child as soon as possible - preferably on the 1st day of illness - to obtain the child sickness certificate (model 21) and inform your employer of your absence.

Processing duration

The processing usually takes about 4 to 9 working days.

For rapid processing and decision-making, your health insurance fund must be provided with the necessary information as well as any required documents in a complete and meaningful manner.
The health insurance fund decides on applications promptly, whereby the statutory processing period is adhered to in order to protect patients' rights.
Please note that the processing time indicated is an average value for all health insurance funds. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and may be longer accordingly. The same applies if documents or records are sent to you or your health insurer by post.




Legal basis

Appeal

  • Objection
  • Action before the social court

Applications / forms

- Forms: yes

- Online procedure possible: Many statutory health insurers offer an online procedure.

- Written form required: no

- Personal appearance required: no

What else should I know?

If you yourself have private insurance and the other parent has statutory insurance, it depends on where the child is insured: If the child has statutory insurance, the parent with statutory insurance can claim child sickness benefit.
If your child has an accident at school or nursery, you will receive child injury benefit from the accident insurance. This is usually calculated and paid by your health insurance fund on behalf of the relevant accident insurance institution.
If you are unemployed, the Employment Agency will continue to pay unemployment benefit for a limited period if you are unable to continue your job search because of the illness and the resulting need to care for your child.



Author

Technically approved by

Federal Ministry of Health

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