Section 1: General Information


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  1. How do I claim Illness Benefit?

  2. What are the PRSI conditions for Illness Benefit?

  3. Can social insurance contributions in any other country be used to help me qualify for Illness Benefit?

  4. I am self-employed. What can I apply for if I get sick?

  5. Are all Classes of Irish PRSI contributions taken into account to satisfy the PRSI conditions for Illness Benefit?

  6. Can I claim any allowance on my Illness Benefit for my spouse/partner/child(ren)?

  7. What are the current rates of payment for Illness Benefit?

  8. How is Illness Benefit paid?

  9. If I qualify for payment of Illness Benefit, does the payment start from the day I first become ill or from when I send in my first Social Welfare medical certificate?

  10. Can Illness Benefit be paid into my Post Office account?

  11. If I do not have a Bank/Credit Union account,or a Public Service Card how will my payment be made to me?

  12. How long does payment of Illness Benefit last?

  13. Is Sunday treated as a payment day for Illness Benefit purposes?

  14. What should I do if I have a change in my (family) circumstances while claiming Illness Benefit e.g. Change of name, address, get married/separated/divorced, have a new baby, spouse/partner starts work, change bank/credit union account?

  15. Do I have to pay tax on my Illness Benefit payment?

  16. If my employer pays me in full or in part, while I am sick, can I still make a claim for Illness Benefit? If so, from what date should I claim Illness Benefit?

  17. My employer pays me for a limited period only while I am ill and unable to go to work. When this payment from my employer stops, can I continue to claim Illness Benefit if I am still ill and unable to go to work?

  18. I checked my Bank/Credit Union account and my Illness Benefit payment was not credited to the account, what can I do?

  19. My Illness Benefit cheque was lost/stolen/damaged after receipt/destroyed in error. What should I do?

  20. My weekly Illness Benefit cheque did not arrive by post this week, what should I do?

  21. I forgot to cash an Illness Benefit cheque and it is now out of date. What should I do?

  22. How often will I need to send Irish Social Welfare medical certificates to the Department?

  23. I have to send in a medical certificate every month. Will I get a reminder when my next certificate is due?

  24. What about my PRSI record while I am ill and unable to work?

  25. Is there a time limit within which I must make my claim for Illness Benefit?

  26. Will I be charged a fee for any Irish Social Welfare medical certificate that I get from my doctor?

  27. How long does it take to process my claim for Illness Benefit?

  28. If I do not have enough money to live on, can I claim any other payment, while my Illness Benefit claim is being processed?

  29. I am unemployed. What should I do if I get sick while claiming Jobseekers Benefit?

1. How do I claim Illness Benefit?

You should apply for Illness Benefit within 6 weeks of becoming ill. A delay of more than 6 weeks may cause you to lose some or all of your payment. However, if there is a good reason for the delay in applying, your payment may be backdated. For more information, log on to www.welfare.ie.

How to apply:

  1. go to a doctor and get a form IB1 (application form for Illness Benefit and Injury Benefit, and a ‘Certificate of Incapacity for From 01st March 2019 closed certification for Illness Benefit was introduced, this means your doctor can provide you with one medical certificate to cover the entire duration of your expected absence from work.
  2. complete the IB1 application form in full. Ensure you provide your own PPS number and complete all sections and questions that are relevant to you, such as your spouse/civil partner/cohabitants details, and their income details if you wish to claim any increases on your claim.
  3. make sure you sign the declaration on the application form.
  4. Post the application form to:
    Department of Employment Affairs and Social Protection
    P.O. Box 1650
    Dublin 1.
  5. If you are returning to work earlier than anticipated please contact the department. You can contact us at either of the following phone numbers: Telephone: (01) 704 3300, LoCall 1890 92 84 00, If calling from outside the Republic of Ireland please call + 353 1 704 3300,  or by email to ClosemyIBclaim@welfare.ieli>

Note:

The rates charged for using 1890 (LoCall) numbers may vary among different service providers.

Note:

  • You are not required to pay for an Irish social welfare medical certificate as the Department pays the doctor an agreed fee.  However, you may have to pay for the Medical Examination.
  • The "Certificate of Incapacity for Work" is not available on-line or from any office of the Department. They are only available from doctors who are on the Department's panel of medical certifiers.

2. What are the PRSI conditions for Illness Benefit?

Under current Social Welfare law, you must satisfy the following two conditions to qualify for payment of Illness Benefit:

(1) you must have at least 104 weeks of PRSI contributions paid since you first started work.

     AND EITHER (2a) OR (2b)

(2a) 39 weeks of PRSI contributions paid or credited in the relevant tax year, of which 13 must be paid contributions. If you do not have 13 paid contributions in the relevant tax year, then 13 paid in one of the following tax years can be used instead:

    • either of the two tax years before the relevant tax year,
    • or the last complete tax year (before the year in which your claim for Illness Benefit begins),
    • or the current tax year.

OR

(2b) 26 weeks of PRSI contributions paid in the relevant tax year, and
26 weeks of PRSI contributions paid in the tax year immediately before the relevant tax year.

The relevant tax year is the second last complete tax year before the year in which your claim for Illness Benefit begins.

For example:


Relevant Tax Year

If your claim begins in:

The relevant tax year is:

2017

2015

2018

2016

2019

2017

Note:

  • Only PRSI contributions paid at class A, E, H and P count towards Illness Benefit.
  • If you were getting long-term Jobseeker's Allowance, Pre-Retirement Allowance, Invalidity Pension, Carer's Allowance or Carer's Benefit, immediately before applying for Illness Benefit, you do not need to have the 13 paid contributions referred to in part (2a) above.
  • If you were getting Occupational Injury Benefit (OIB) immediately before applying for Illness Benefit you may use the tax year that applied to your OIB claim or the tax year that applies to your Illness Benefit claim, whichever is more beneficial.

 

If you have been discharged from the Permanent Defence Force you may claim Illness Benefit, provided you are unable to work due to illness and you have been certified as unfit for work by your own medical adviser.


3. Can social insurance contributions in any other country be used to help me qualify for Illness Benefit?

To help you qualify for Illness Benefit you may combine your Irish PRSI contributions with your social insurance record from any country covered by EU Regulations (and also the Channel Islands and the Isle of Man, which are covered under a Bilateral Agreement).  EU Regulations apply to people who travel and work within the European Economic Area (EEA). They allow workers to combine periods of social insurance in any of the EEA countries to help them qualify for a benefit or pension.

The countries covered by EU Regulations are:

  • Austria
  • Belgium
  • Bulgaria
  • Croatia
  • Czech Republic
  • Denmark
  • Estonia
  • Finland
  • France
  • Germany
  • Greece
  • Hungary
  • Iceland
  • Ireland
  • Italy
  • Latvia
  • Liechtenstein
  • Lithuania
  • Luxembourg
  • Malta
  • Norway
  • Poland
  • Portugal
  • Republic of Cyprus (Cyprus South)
  • Romania
  • Slovakia
  • Slovenia
  • Spain
  • Sweden
  • Switzerland
  • The Netherlands
  • The United Kingdom

Social insurance contributions paid in countries other than those listed above do not count for Illness Benefit purposes.

Under EU Regulations the country in which you were last insurably employed is generally responsible for dealing with your claim while you are unable to work due to an illness or injury.  If we receive a claim which is proper to another EU country, it will be forwarded to that country on your behalf and you will be advised where to send further documentation.


4. I am self-employed.  What can I apply for if I get sick?

Self-employment is insurable at PRSI Class S.  This does not provide cover for Illness Benefit.  The PRSI classes which provide cover for Illness Benefit are Classes A, E, H and P.  However, if you have paid any of these classes of PRSI in the years preceding your claim you should submit a claim in order to have your entitlement assessed.

If you are unable to work due to illness and have insufficient means to meet your needs, you should contact the Department's representative at the local Department of Employment Affairs and Social Protection office administering Supplementary Welfare Allowance (SWA)

If your illness is expected to last for at least one year you can apply for Disability Allowance or Invalidity Pension

Disability Allowance is a payment for people who  have a disability that is expected to last for at least one year, you are aged between 16 and State Pension age (currently 66), you satisfy a means test and are deemed to be habitually resident in the State.

Invalidity Pension is a payment for people who are permanently incapable of work because of illness or incapacity and who satisfy the Pay Related Social Insurance (PRSI) contribution conditions.  The PRSI classes which provide cover for Invalidity Pension are Classes A, E, H and S (Invalidity Pension was extended to the self-employed with effect from 1 December 2017). 
A person is regarded as being permanently incapable of work if immediately before the date of claim for the said pension:

  1. he or she has been continuously incapable of work for a period of one year and it is shown to the satisfaction of a deciding officer or an appeals officer that the person is likely to continue to be incapable of work for at least a further year, or
  2. he or she is incapable of work and evidence is adduced to establish to the satisfaction of a deciding officer or an appeals officer that the incapacity for work is of such a nature that the likelihood is that the person will be incapable of work for life.

5. Are all Classes of Irish PRSI contributions taken into account to satisfy the PRSI conditions for Illness Benefit?

No, only PRSI at classes A, E, H and P are reckonable for Illness Benefit.  For more information on PRSI classes see information leaflet  SW 19.


6. Can I claim any allowance on my Illness Benefit for my spouse/partner/child(ren)?

Yes, but to qualify for payment of an Increase for a Qualified Adult/Child certain conditions must be satisfied, see information booklet (SW 119) or Operational Guidelines for more detailed information.


7. What are the current rates of payment for Illness Benefit?

Illness Benefit rates are graduated according to your average gross weekly earnings in the relevant tax year - see also response to Q.2.   The current rates of payment (i.e. since March 2017) are:


Average gross weekly earnings:

Personal rate: (based on your income in relevant tax year)

Qualified adult rate:
(based on current income of spouse/partner)

€300 or more

€203.00

€134.70

€220 - €299.99

€159.00

€87.20

€150 - €219.99

€131.00

€87.20

less than €150

€91.10

€87.20


8. How is Illness Benefit paid?

 

Illness Benefit can be paid by one of the following methods:


Electronic Fund Transfer – benefit is paid directly into an account in a financial institution (for example, in a Bank, Building Society, Credit Union or into an An Post Pension Save Account).


Electronic Information Transfer – benefit is paid using a Public ServiceSocial Services Card at a chosen Post Office.

Or

Where your employer requires that the amount due is to be paid directly to them, it can only issue to your employer's account in a financial institution.

REMEMBER: You should always tell us, in advance if possible, if there is to be any change in the payee details either for yourself or your employer.


9. If I qualify for payment of Illness Benefit, does the payment start from the day I first become ill or from when I send in my first Social Welfare medical certificate?

Normally payment of Illness Benefit begins from the 7th day of the illness.  Usually no payment is made for the first 6 days which are known as "waiting days".  The only time that the 6 waiting days are not applied is if you were in receipt of certain other Social Welfare payments within 3 days of the start of your illness.

Payment is made on a 6-day week basis (Sundays are excluded) and is paid weekly, in arrears, up to the date of each medical certificate received. 

Note: In order to avoid any delay in dealing with your claim it is very important that you send in your claim within 6 weeks of becoming ill.


10. Can Illness Benefit be paid into my Post Office account?

Yes, Illness Benefit can be paid at your local post office by Public Service Card (see also answer to Q.8)


11. If I do not have a Bank/Credit Union account or a Public Service card, how will my payment be made to me?

Payment of your Illness Benefit will be made to you by cheque which will be sent to your home address.


12. How long does payment of Illness Benefit last?

If you satisfy the PRSI conditions, see Q.2 and qualify for payment of Illness Benefit:

You may get Illness Benefit for a maximum of:

  • 624 payment days (2 years) if you have at least 260 weeks PRSI contributions paid since you first started work,
  • or

  • 312 payment days (1 year) if you have between 104 and 259 weeks PRSI contributions paid since you first started work.

We will contact you before your payment is due to stop to tell you when payment will stop and what your options are:

  • If you feel that it is likely you will still be unfit for work, for a further minimum period of at least 12 months, after your entitlement to Illness Benefit has ended, you may wish to claim Invalidity Pension (which is based on your PRSI record) or Disability Allowance (which is means tested).
  • If you are fit for work,  or feel that it is likely you will be fit for work, but unable to find work you may wish to apply for Jobseeker’s Benefit (which is based on your PRSI record) or Jobseeker’s Allowance (which is means tested).  You must produce a final medical certificate from your doctor certifying that you are fit for work.
  • If you are not able to meet your needs, and those of your dependants (if any), you may be entitled to Supplementary Welfare Allowance (which is means tested).

13. Is Sunday treated as a payment day for Illness Benefit purposes?

No, Illness Benefit is paid on a 6-day week basis, from Monday to Saturday.


14. What should I do if I have a change in my (family) circumstances while claiming Illness Benefit e.g. Change of name, address, get married/separated/divorced, have a new baby, spouse/partner starts work, change bank/credit union account?

You should always notify the Department immediately, by writing to the section dealing with your claim, of any changes in your circumstances that may affect the details on your claim or the amount being paid to you.  

Furthermore, if you are receiving an Increase for a Qualified Adult and/or Child you should immediately notify us of any change in your spouse/partner’s circumstances, such as any increase/decrease in their earnings or income from other sources. 

It is very important that you notify the Department immediately of any change in your family circumstances.  Failure to do so may result in an overpayment of your Illness Benefit which must be refunded to the Department.

Note: Your PPS number must be quoted on all correspondence as well as your current postal address.


15. Do I have to pay tax on my Illness Benefit payment?

Depending on your circumstances, some or all of your Illness Benefit payment may be liable to income tax.

Tax is not charged on increases paid for any dependent children.
 
The Department pays Illness Benefit without deducting tax.  The Department does, however, notify Revenue of the taxable amount of Illness Benefit to be taken into account for income tax purposes.  This means you do not have to do anything for the correct tax to be paid. 
 
Information about the taxation of social welfare payments is available from Revenue and on the Jobs and Pensions page of the Revenue website www.revenue.ie
PRSI and USC are not charged on Illness Benefit payments


16. If my employer pays me in full or in part, while I am sick, can I still make a claim for Illness Benefit? If so, from what date should I claim Illness Benefit?

Irrespective of whether your employer pays you while you are out sick from work, you should claim Illness Benefit from the first day of your illness and submit your application within 6 weeks of that date.

You should also check with your employer regarding sick pay arrangements in your organisation, before submitting your claim. If your employer pays you your full salary while you are out sick from work you may have to authorise us to send your Illness Benefit payment directly to your employer.


17. My employer pays me for a limited period only while I am ill and unable to go to work. When this payment from my employer stops, can I continue to claim Illness Benefit if I am still ill and unable to go to work?

Assuming that your claim to Illness Benefit has already been approved and that payment of Illness Benefit has been mandated to your employer you or should contact the Department advising the date from which payment is to be made directly to you.  Details of your bank account or post office should also be provided – see response to Q.8   


18. I checked my Bank/Credit Union account and my Illness Benefit payment was not credited to the account, what can I do?

If you are satisfied that you have submitted your most recent medical certificate to the Department, then you should first contact your bank branch or credit union and ask if your account has been updated with any illness benefit EFT (Electronic Fund Transfer) payment due to you.

If you are advised that no such payment has been received on your behalf, you should then contact us at either of the following phone numbers: Telephone: (01) 704 3300 , LoCall 1890 928400 or by email using the secure enquiry form

Note:

The rates charged for using 1890 (LoCall) numbers may vary among different service providers.


19. My Illness Benefit cheque was lost/stolen/damaged after receipt/destroyed in error.  What should I do?

If your cheque was lost, stolen, damaged or destroyed you should contact Illness Benefit and provide details of the cheque in question i.e. date of issue and/or the period of payment.

We will send you a Form of Indemnity which must be completed and returned to us before a replacement cheque can issue.  We will provide you with a pre-paid envelope for this purpose.

NB.  If the original cheque is subsequently found after it has been reported as lost or stolen, you should immediately contact Cheque Replacement Section who will advise whether it is still possible to cash the cheque, or whether it should be returned to the Department to have a replacement issued.

You can contact us at either of the following phone numbers: Telephone: (01) 704 3300 , LoCall 1890 928400 or by email using the secure enquiry form


20. My weekly Illness Benefit cheque did not arrive by post this week, what should I do?

It may be because your medical certificate has not been received or that there has been a change in your circumstances e.g. change of address, which has not been notified to the Department.  You should contact us at either of the following phone numbers: Telephone: (01) 704 3300, LoCall 1890 92 84 00, If calling from outside the Republic of Ireland please call + 353 1 704 3300 or by email using the secure enquiry form

Note:
The rates charged for using 1890 (LoCall) numbers may vary among different service providers.


21. I forgot to cash an Illness Benefit cheque and it is now out of date.  What should I do?

You should take note of the details of the cheque (e.g. date of issue and the period of payment) and return it, with a request for a replacement, to: Illness Benefit, Cheque Replacement Section, Áras Mhic Dhiarmada, Store Street, Dublin 1.

Note: Your PPS number must be quoted on all correspondence as well as your current postal address.


22. How often will I need to send Irish Social Welfare medical certificates to the Department?

From 01st March 2019 closed certification for Illness Benefit was introduced, this means your doctor can provide you with one medical certificate to cover the entire duration of your expected absence from work.
Currently the Illness Benefit scheme is limited to two years duration in respect of all new claims. However, there are a number of people who have been in receipt of payment for a longer period and who have an entitlement to remain on the scheme. These people, along with some others who have longer term illnesses are currently required by the Department to submit medical certificates at monthly or 6 monthly intervals. This will continue to be the case in the future. Where the Department has decided on a certification frequency you will be informed of this and your GP will not be required to carry out an assessment under the closed certification process.
It is very important that you obtain your certificates on the due date and submit them without delay.   
Note: Your PPS number must be quoted on all medical certificates and correspondence as well as your current postal address.

23. I have to send in medical certificate/s every month or 6 months. Will I get a reminder when my next certificate is due?

No, if you are required by the Department to submit medical certificates at monthly or 6 monthly intervals you must keep note of when your next certificate is due. It is very important that you obtain your certificates on the due date and submit them without delay.   

   


24. What about my PRSI record while I am ill and unable to work?

While you are in insurable employment PRSI deductions are made from your earnings each week. If you are sick such deductions may not be made. You may qualify for credited contributions (credits) instead.  You will get credits if you receive payment of Illness Benefit. However, in certain circumstances, you may also get credits even if you are not getting a payment.

Note:
Even if you are not receiving a payment, it is very important that you continue to send in medical certificates for the purpose of obtaining credited contributions which could help you to qualify for future social welfare payments.


25. Is there a time limit within which I must make my claim for Illness Benefit?

Yes, you should apply for Illness Benefit within 6 weeks of becoming ill.  A delay of more than 6 weeks may cause you to lose some of your payment. If there is a good reason for the delay in applying, your payment may be backdated. For more information refer to leaflet SW 101

You should also note that the same time limit applies to making a claim for an increase in respect of a qualified adult dependant on your Illness Benefit claim.  See response to Q.6


26. Will I be charged a fee for any Irish Social Welfare medical certificate that I get from my doctor?

You do not have to pay for a Social Welfare Medical Certificate, because the Department pays the Doctor an agreed fee.  However, you may have to pay for the Medical Examination.


27. How long does it take to process my claim for Illness Benefit?

Processing times depend on the level of claim intake but you should expect to have your claim processed within a week to 10 days of receipt in the Department.


28. If I do not have enough money to live on, can I claim any other payment, while my Illness Benefit claim is being processed?

If you do not have money to meet your needs while awaiting a decision on your Illness Benefit claim or any other Social Welfare payment you should contact the Department's representative at the local Department of Employment Affairs and Social Protection office administering Supplementary Welfare Allowance (SWA)

SWA is a means-tested payment.  If you receive payment of SWA and you subsequently qualify for payment of Illness Benefit, the amount of SWA paid will be deducted from any arrears of Illness Benefit due to you. 


29. I am unemployed.  What should I do if I get sick while claiming Jobseekers Benefit?

Two of the conditions for receipt of Jobseekers Benefit are that you must be capable of and available for work.  If you are sick you are not capable of and available for work.  You should inform the Intreo/Social Welfare Local or Branch Office staff that you are ill and have to move from Jobseekers Benefit to Illness Benefit.   

Your entitlement to Illness Benefit will be assessed based on your PRSI contribution record.  See response to Q.1 for details on how to apply for Illness Benefit and Q.2 for the PRSI contribution conditions.

Any adjustment(s) to be done due to your transfer from one scheme to another will be co-ordinated between the Intreo/Social Welfare Local Office and Illness Benefit Branch.

 

 

Last modified:17/07/2019