What are the conditions to be granted certificates of leave qualified for social insurance payouts in Vietnam?

Regarding this matter, LawNet would like to answer as follows:

1. What are the rules for the issuance of certificates of leave qualified for social insurance payouts in Vietnam?

According to the provisions of Article 20 of Circular 56/2017/TT-BYT amended by Circular 18/2022/TT-BYT, the rules for issuance of certificates of leave qualified for social insurance payout include:

- The issuance of certificates of leave qualified for social insurance payouts shall comply with the following regulations:

+ Be issued by a licensed health facility. Practitioners at such health facility may sign the confirmation of eligibility to receive social insurance benefits as authorized by the head of such facility;

+ Be appropriate with the scope of operation of the health facility that issues the confirmation which is approved by a competent authority;

+ Be appropriate with the patient’s medical condition and professional instructions of the Minister of Health.

- Only one certificate of leave qualified for social insurance payout will be issued for each examination. 

+ In case the patient needs to take a leave of longer than 30 days, when the leave period stated on the certificate of leave qualified for social insurance payout expires or is about to expire, the patient must conduct a follow-up examination for the health practitioner to consider and decide.

+ In case an employee is examined by two or more specialties of different health facilities at the same time and is granted multiple certificates of leave qualified for social insurance, that employee will only be entitled to one of the certificates with the longest leave period.

+ In case an employee undergoes medical examination and treatment with many specialties on the same day at the same health facility with many different diseases, only one certificate of leave qualified for social insurance payout shall be issued and he/she is only eligible for the disease with the highest insurance payout.

+ In case a patient is treated for tuberculosis under the National Tuberculosis Program, the maximum leave time shall not exceed 180 days for a certificate of leave qualified for social insurance payout.

+ In case an employee has a miscarriage, abortion, or stillbirth with a gestational age of 13 weeks or more, the maximum leave period prescribed by the Law on Social Insurance shall not exceed 50 days for one certificate of leave eligible for social insurance payout.

- Practitioners at such health facility may sign the confirmation of eligibility to receive social insurance benefits as authorized by the head of such facility; if the health facility is not a juridical person, the practitioner must register his/her signature with the social insurance authority.

- Case of Issuance of hospital discharge notes and certificates of leave qualified for social insurance payout to COVID-19 infected patients treated at health facilities shall comply with the provisions of Clause 13, Article 1 of Circular 18/2022/TT -BYT.

Thus, the conditions to be granted a certificate of leave qualified for social insurance payout must ensure the above principles to ensure objectivity, transparency, and effectiveness in managing the sick leave social insurance regime, as well as to prevent exploitation and fraudulent issuance of certificates of leave qualified for social insurance payout. 

2. What are the forms of issuance of certificates of leave qualified for social insurance payouts in Vietnam?

According to the provisions of Article 21 of Circular 56/2017/TT-BYT, amended by Clause 14, Article 1 of Circular 18/2022/TT-BYT, certificates of leave qualified for social insurance payout are issued in the following forms:

- As for workers or children aged under 7 of workers receiving impatient treatment: The hospital discharge note with the form specified in Annex 3 enclosed with Circular 56/2017/TT-BYT shall be used.

Appendix 3: Download

+ If the person is referred to another health facility during the treatment, a valid copy of the outward referral form shall be provided.

+ If the victim passed away at a health facility, such health facility is not required to issue a discharge note. The social insurance payout during the treatment period of the patient at the health facility before his/her death shall be based on the date recorded in the death certificate prepared in accordance with Circular 24/2020/TT-BYT.

- As for workers or children aged under 7 of workers receiving outpatient treatment: 

+ A certificate of leave qualified for social insurance payout according to the form specified in Appendix 7 issued with Circular 56/2017/TT-BYT shall be used

Appendix 7: Download

+ If a patient needs to take a leave for outpatient treatment after discharged from the hospital, the social insurance authority shall provide social insurance payout according to the leave period (days) written on the discharge note.

+ In case the patient needs to take leave for outpatient treatment after being discharged from the hospital, the social insurance agency will base on the number of days off recorded in the notes section of the hospital discharge paper as a basis for payment of social insurance benefits according to regulations.

-  The form and content of a certificate of leave qualified for social insurance payout shall comply with Appendix 7 issued with Circular 56/2017/TT-BYT.

+ The first day off is the date on which the patient comes for medical examination and treatment;

+ The date on the signature of the health practitioner in the certificate of leave qualified for social insurance payout shall be written as follows:

++ According to the date on which the patient finishes medical examination and treatment;

++ According to the date on which the health facility issues the certificate of leave qualified for social insurance payout in a case where the worker requests for re-issuance according to this Circular;

+ In case of re-issuance, the word "RE-ISSUANCE" must be shown on the certificate of leave qualified for social insurance payout.

- The recording of the code and the name of the long-term disease on the certificate of leave qualified for social insurance payout, the hospital discharge note must comply with the Circular 46/2016/TT-BYT

Note: In case the disease code stated in the certificate of leave qualified for social insurance payout, the hospital discharge note matches the disease code specified in Circular 46/2016/TT-BYT, but the name of the disease does not match the name of the disease specified in the Circular 46/2016/TT-BYT, the disease code specified in Circular 46/2016/TT-BYT shall prevail.

Thus, the forms of issuance of certificates of leave qualified for social insurance payouts have a clear distinction between inpatient and outpatient cases to issue different types of documents. The recording of forms is also regulated in detail to ensure consistency and proper specifications in confirming leave qualified for social insurance payouts.

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