It has been more than a year and a half since the CSSA launched the live operation of a complete, fully functional, and mandatory sickness system.
Electronic processing has brought simplification in the transfer of information between patients (insured persons in temporary incapacity for work), the CSSA, doctors, and employers. This significantly simplified the flow of information, as eSickness was required to electronically connect the three entities concerned, physicians, employers, and the CSSA.
There has been a fundamental change associated with the issuance of a decision on temporary incapacity for work. The way in which an employer learns of his employee's temporary incapacity for work has also changed. The insured person no longer has to hand over the documents to the employer, the wage and sickness benefits will be paid to him automatically. The patient is left with only an incapable worker paper card for the needs of possible control.
eSickness - obligations concerning the employer
After 14 days of incapacity, the employer is obliged to send the DSSA an Annex to the application for the benefit, in electronic form (a paper form can only be used in the event of a technical failure).
In the annex to the application for the compensation, the employer provides information where the employee's salary is paid (in the same way, the employee will usually receive the sick pay).
At the end of temporary incapacity for work, the employer sends a report with the data necessary for the payment of the last sickness compensation.
The employer has two ways in which he can control temporary incapacity for work.
The CSSA has set up a "Data for employers on temporary incapacity for work" service is based on question-response. This service enables continuous automated download of data into payroll or personnel software containing information on temporary incapacity for the work of employees. The method of incorporation into the employer's SW then depends on his supplier.
Similarly, this information can be downloaded via a data box system. It is necessary to log in to the CSSA portal via the data box, via "Services for employers". In the next section, enter "Request for sending information about DPN", via the "Start" button to set up sending information about employees' incapacity for work.
eSickness - obligations concerning policyholders
Mandatory electronic communication only concerns temporary incapacity for work. It is still an obstacle at work, and the employee is obliged to prove it to the employer. Information from the CSSA in electronic form is proof of the excuse of absence from work and the payment of wage compensation during the first 14 days of temporary incapacity for work. According to the Labor Code, employees remain obliged to immediately inform their employer about temporary incapacity for work. However, the form is not stipulated by law. The employer decides to whom and in what form the employees will communicate this information (email, telephone, etc.). The only printed document is the "Card of a temporarily incapacitated insured person".
The temporary incapacity for work form contains three parts.
- Report on the occurrence of temporary incapacity for work - Part I - e-document
- Certificate of temporarily incapacitated insured person - II. Part - printed document
- Report on termination of temporary incapacity for work - III. part. e-document
The first and third parts are sent by the physician to the Czech Social Security Administration electronically. The physician will hand over the card of the temporarily incapacitated insured person to the employee in paper form.
Confirmation of the duration of temporary incapacity for work is sent by the physician electronically to the social security administration. It is therefore essential that policyholders schedule regular check-ups with treating physicians to avoid delays in the payment of compensation.
Payment of sickness insurance
Payment of sickness compensation is transferred to the bank account number of the policyholder reported with the employer sending a report of incapacity for work. In the event of a change of way of the payment, the policyholder must send his / her application to the relevant social security administration in writing or via his / her own data box. In the case of an application for sending a payment by postal order to an address in the Czech Republic or to a foreign account, the applicant pays the related costs.
Procedure for claiming sickness insurance compensation for Czech insured policyholder in the event of residence or stay in the territory of another Member State
If an insured policyholder becomes temporarily incapacitated for work under Czech law in the territory of another Member State, the insured policyholder will visit the attending physician at his / her place of residence and have a local certificate of temporary incapacity for work issued.
If an employee returns to the Czech Republic during the term of the DPN and goes to the care of the attending physician in the Czech Republic, his DPN will then be assessed by this doctor, who will issue the Czech form "Decision on temporary incapacity for work" from the day he took him into his care.
If an employee has a DPN certificate issued (eg out of ignorance) in another Member State and returns to the Czech Republic after the end of the DPN, it is possible for his Czech attending physician to issue a decision on temporary incapacity for work retrospectively, based on a medical report from abroad, resulting in an incapacity for work. The attending physician will first request the prior consent of the physician of the relevant DSSA for the retrospective recognition of incapacity for work. After granting this consent, the attending physician will issue a decision on temporary incapacity for work.
Other sickness insurance compensation paid by the district social security administration and paid from the state budget (from premium income) are still presented in paper form and are as follows:
- Financial help in maternity
- Nursing
- Pregnancy and maternity allowance
- Paternity postpartum care benefit (so-called paternity care)
- Long-term nursing
