CALCULATION AND DURATION OF THE SICKNESS ALLOWANCE
Social Security General Scheme (SSGS)

» The calculation of the sickness allowance consists of the application of a percentage to the value of the reference compensation (RC) of the beneficiary, percentage variable according to the duration of the temporary disablement for the work and the nature of the sickness

» The RR results from the average of the total gross remunerations on which contributions have fallen during the 6 calendar months immediately prior to the second month former to the date of the commencement of the temporary disablement for work

The Holidays and Christmas allowances paid in the reference period are not taken into consideration for determining the RC

» The amount of the allowance corresponds to:

- 55% of the RC, if the disablement has duration lower or equal to 30 days

- 60% of the RC, if the disablement has duration higher than 30 days and lower than or equal to 90 days

- 70% da RR, quando a incapacidade tenha duração superior a 90 dias e inferior ou igual a 365 dias

- 75% of the RC after 365 days

In any case, the amount of the allowance shall not be higher than the net value of the RC that served as the basis for calculation

» In situations of disablement for the work resulting from tuberculosis, the allowance corresponds to 80% or to 100% of the RC, according to the family household of the beneficiary integrates up to 2 or more members of the family in charge

» The commencement of the payment of the sickness allowance is subject to a waiting period of three days, and is due only as from the fourth day of disablement for work

In situations of hospital stay, disablement by virtue of tuberculosis and in cases in which the disablement for sickness occurs during the grant of allowances of clinical risk during the pregnancy, for interruption of pregnancy, initial parental exclusive of the mother, initial parental, initial parental of a progenitor in the case of impossibility of the other or initial parental exclusive of the father and exceeds the term of those periods the waiting period is not to apply

» The allowance is granted for the maximum period of 1095 days (3 years), with exception of the sickness allowance for disablement resulting from tuberculosis that has no time limit

» Once the period of 1095 days has been elapsed without the beneficiary being under conditions of resuming activity, acquires the right to a provisional disability pension, in the framework of protection in the invalidity, being unofficially submitted to the Service of Disablement Checking for assessment of the invalidity situation

» Suspension and termination of the sickness allowance

» The payment of the sickness allowance is suspended, namely:

- During the grant of clinical risk allowances during pregnancy, for interruption of pregnancy, initial parental, in any of the modes and for adoption

- If the beneficiary is absent from his/her residence without medical authorization

- In the case of absence to a medical examination for which the beneficiary has been called

- When the checking commission of disablements declares that it no longer exists

» The right to the allowance terminates, namely when:

- The limit of the period is attained as set out in the certificate of disablement for work

- Before that period has been ended, if the competent services of the National Health Service declare that he disablement no longer exists

- The beneficiary resumes activity for considering himself/herself fit for work

- The beneficiary fulfils professional activity, irrespective of the proof of non-existence of the compensation

» Articulation of benefits

» The sickness allowance shall not be accumulated with other benefits compensatory of the loss of compensation

» The allowance shall be accumulated with compensations for temporary disablement arising from accident at work or of occupational disease, provided that the value of those benefits is lower than the amount of the allowance, case in which the amount to be paid corresponds to the respective difference. This accumulation is not however applicable to situations of accidents at work with public employees, insofar as the respective reimbursement regime, while the convergence is not carried out with the general regime, still provides for the maintenance of the right to the compensation during absences to work

» The allowance is still accumulated with pensions for permanent disablement resulting from accident at work or of occupational disease, as well as with other pensions of an indemnity nature

» Request for sickness allowance

The grant of sickness allowance does not depend upon request