Sickness
Maternity
Employment Injury
Aged / Reduced Aged
Invalidity
Survivors
Funeral
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Sickness
Entitlement.
Sickness benefit is granted to an insured person
who is incapable of work as a result of some
specific disease or bodily or mental
disablement. The insured person shall be treated
as incapable of work for any day during which he
is required to abstain from work because he is
under observation by reason of being a carrier,
or his having been in contact with a case of
infectious disease.
Sickness benefit is not payable in the case
where a person is rendered incapable of work as
a result of some specific disease or bodily or
mental disablement arising out of and in the
course of employment. For this Employment injury
Benefit shall be claimed.
Day from which
benefit is to commence
·
an insured person who is eligible
for sickness benefit can claim for a benefit
from the first days of any continuous period
of incapacity for work, provided that the
period lasts no less than four days. For the
purpose of computing the benefit, public
holidays are included, however Sundays are
disregarded.
·
no insured person shall be
entitled to sickness benefit on or after
attaining the age of sixty.
How to claim and support the claim.
An insured claiming for sickness benefit must
fill out the appropriate claim form and submit
it to any of the N.I.S offices. All claims must
be filled out correctly to insure no delay in
its processing. All claim forms must be
submitted with a medical certificate from a
doctor. Claim forms can be obtained from any of
the N.I.S offices, and at most Doctor's offices.
The Director may, also require the claimant to
submit himself to an examination by one or more
registered medical practitioners appointed by
the Board.
Conditions which must be satisfied.
Sickness benefit is payable only if the insured
person: -
·
was engaged in employment as an
employee immediately prior to the day on which
incapacity commenced; and
·
had been insured for not less than
thirteen weeks; and
·
had been employed during at least
eight contribution weeks in the period of 13
contribution weeks immediately preceding the
contribution week of the incapacity.
Duration
Sickness benefit shall be paid for each day,
(excluding Sundays), as long as incapacity for
work continues, up to a maximum of twenty-six
weeks in any continuous period of incapacity for
work:
However to qualify for a further twenty six
weeks of continuous benefit, the claimant must
have been engaged in employment for at least one
hundred and fifty contribution weeks and had
paid seventy-five (75) immediately prior to
commencement of incapacity.
Rate of benefit.
-
The daily rate of sickness benefit
is sixty-five percent of the average weekly
insurable earnings of the insured person
divided by six.
-
Average weekly insurable
earning for the purpose of this Sickness
benefit refers to the sum of the weekly insurable earnings on which
contributions were based. This also
includes contributions credited to the claimant
from previous claims. The weekly insurable
earnings is calculated from the continuous
calendar period of thirteen weeks immediately
preceding the week in which the incapacity began
or was deemed to have begun. The average weekly
insurable earnings are obtained by dividing this
sum by thirteen.
N.B. A claim is treated as a continuous
(single claim) claim if the incapacity for work
is not separated by more than eight weeks. Both
claims are paid at the same rate.
Disqualification.
An insured person entitled to payment of
sickness benefit can be disqualified from
receiving benefit for a period as the Director
may decide, but this period may not exceed six
weeks if: -
·
the claimant had become incapable
of work through his own misconduct; or
·
the claimant fails, without good
cause, to comply with a notice in writing by the
Director requiring him to attend for and submit
himself for medical or other examination; or
·
to refrain from behaviour
calculated to retard his recovery or to answer
any reasonable enquires by an officer of the
Board directed to ascertain whether he is doing
so;
·
not to be absent from his place of
residence without leaving notice as to where he
may be found; or
·
to do work which is ordinarily
payable,
·
an insured person entitled to
payment of sickness benefit can also be
disqualified from receiving benefit for the full
period during which he was in receipt of normal earnings from his employer in respect
of absence due to illness.
·
was injured on the job, in which
case he/she should claim for Employment Injury
Benefit
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