Working on the basis of certificate for sick leave

Conclusion of agreement

An employee and their employer may agree on a temporary basis on performance of work corresponding to state of health on the basis of a certificate for sick leave. An employee will have the opportunity to work after the 60th day spent on sick leave. The temporary incapacity for work should presumably last for another 30 calendar days, ie the temporary working conditions corresponding to state of health are provided for a minimum of 30 calendar days.

The agreement must be made in written form (amendment or annex to employment contract). It is possible to perform work corresponding to state of health on a temporary basis only if the employee and employer, ie both parties, agree thereto.

Working is prohibited if the employer cannot provide the employee with working conditions corresponding to the employee’s state of health. If the employer provides the employee with work corresponding to their state of health, the employer has the right to withdraw from it at any time, eg in a situation where the employee is unable to perform their duties due to their state of health. If the employer cannot provide the person with lighter work, a regular insured event of sick leave applies and the Estonian Health Insurance Fund reimburses 70% of the person’s income per calendar day, calculated on the basis of the person’s income subject to social tax of the previous calendar year.

Working conditions

If the employee attends a scheduled doctor’s consultation during the course of treatment involving temporary incapacity for work of at least 90 days, the attending physician should consider whether and when the state of health of the person on sick leave allows them to work under adapted conditions and should discuss the patient’s readiness to perform their duties in the form of lighter work and/or part-time work while the illness is being treated. The employee may also initiate transfer to lighter work, but the attending physician must then consider the employee’s state of health, the hazards and nature of duties as well as explain to the employee in which conditions and with which adaptations it is possible to work during the period of certificate for sick leave, so as not to jeopardise their recovery or access to support services. If the employee takes the initiative, they can, within the available possibilities, express their wish verbally at the doctor’s consultation or inform their family physician electronically, for example, by using the e-Perearstikeskus system.

If the employee’s state of health allows and they are ready to work under adapted conditions during the period of certificate for sick leave, the doctor issues a relevant certificate for sick leave with reason for release from duties, containing a data field with a description of the adaptations needed to continue working, including recommendations for the use of services where necessary. The information contained in the data field of the certificate for sick leave is visible to both the patient, the employer and the Estonian Health Insurance Fund via the eesti.ee solution for certificates of incapacity for work.

Work corresponding to state of health may mean part-time work, adapted working conditions / working environment or lighter duties. Suitable working conditions are determined by the attending physician and they are provided in the certificate of incapacity for work. Where necessary, the attending physician can consult an occupational health doctor to determine suitable working conditions. For instance, in the case of an employee who has physical health problems, necessary adjustments on a temporary basis may include prohibitions on lifting objects of a certain weight, working at height and activities that preclude kneeling and squatting, etc. In the case of mental health problems, it may be necessary to avoid on a temporary basis active communication or decisions requiring rapid analysis or a high level of responsibility. In addition, it may be necessary to adjust the length of shifts and avoid night shifts or working in high or low temperature conditions as well as in a dusty environment, etc.

If the employee works on the basis of a certificate for sick leave, they are subject to the Employment Contracts Act, just as in the case of ordinary work. For example, the employee may go on holiday while working on the basis of a certificate for sick leave, but the Estonian Health Insurance Fund does not pay compensation to the person during holiday.

For working on the basis of a certificate for sick leave, the employer may not pay less than 50% of the wages agreed on the date preceding the date on which the release from the performance of duties commenced as indicated in the certificate for sick leave.

Compensation for difference in wages

The Estonian Health Insurance Fund compensates the person in part for wages not received on the 61st to 182nd day of temporary incapacity for work (in the case of tuberculosis, on the 61st to 240th day), ie for a maximum of 122 days (in the case of tuberculosis, 180 days). A the same time, the person is provided access to services supporting capacity for work where necessary.

When calculating the sickness benefit paid in the case of provision of work corresponding to state of health, the Estonian Health Insurance Fund takes into account the wages in force on the day preceding the day on which the release from the performance of employment or service duties stated by the employer on the certificate for sick leave begins and the wages paid during the period of performance of work corresponding to state of health. The Estonian Health Insurance Fund reimburses to the insured person the difference between the two wages, which can be a maximum of 50% of the previous wages as the wages paid by the employer for working on the basis of a certificate for sick leave may not be less than 50% of the previous wages.

If the person has more than one employer, the monthly wages paid by all employers prior to the beginning of the certificate of transfer to lighter work and the agreed monthly wages during the period of working on the basis of the certificate for sick leave issued for transfer to lighter work are added together. The resulting amount is converted into the average daily wage for one calendar day and the difference in wages is calculated for one calendar day.  The difference in wages paid by the Estonian Health Insurance Fund is the difference in wages for one calendar day multiplied by the number of calendar days of lighter work.

Example 1:

Peeter has been transferred to lighter work (certificate of incapacity for work with reason 21 – Temporary easing of working conditions):

1. on the basis of the wages indicated by the employer, the average wage for one calendar day prior to the beginning of the certificate of transfer to lighter work and the average wage for one calendar day during the period of transfer to lighter work are calculated. The difference in wages for one calendar day is calculated, after which
2. the difference in wages for one calendar day is multiplied by the number of days of lighter work.

Peeter’s monthly wage agreed with the employer prior to the beginning of the certificate of transfer to lighter work was 1,200 euros (average wage per calendar day 40 euros). Peeter’s agreed monthly wage during the period of lighter work is 900 euros (average wage per calendar day 30 euros). The difference in wages compared to the wages paid prior to transfer to lighter work is 10 euros. In this case, the compensation for difference in wages paid to Peeter by the Estonian Health Insurance Fund is 300 euros. The total income received is 1,200 euros (the Estonian Health Insurance Fund compensates the difference in wages of 300 euros and the employer pays wages in the amount of 900 euros).

Example 2:

Kati has been transferred to lighter work for 30 days (certificate of incapacity for work with reason 21 – Temporary easing of working conditions) but feels that she is, in fact, not able to work during her illness and asks for the certificate to be discontinued after 15 days. The doctor issues her a certificate for sick leave from the 16th day (certificate of incapacity for work with reason 1 – illness and domestic injury). In such a case, Kati receives compensation for difference in wages for 15 days and, from the 16th day onwards, she is paid benefit at a rate of 70% of the previous year’s income subject to social tax.

Kati’s monthly wage agreed with the employer prior to the beginning of the certificate of transfer to lighter work was 1,200 euros (average wage per calendar day 40 euros). Kati’s agreed monthly wage during the period of lighter work is 600 euros (average wage per calendar day 20 euros). The difference in wages compared to the wages paid prior to transfer to lighter work is 20 euros. In such a case, Kati is entitled to compensation for difference in wages of 300 euros for 15 days. The total income received is 600 euros (the Estonian Health Insurance Fund compensates the difference in wages of 300 euros and the employer pays wages in the amount of 300 euros).