From July 1, 2025, adding cases eligible for sickness benefits for participants of compulsory social insurance policies
From July 1, 2025, additional cases eligible for sickness benefits for compulsory social insurance participants?
Based on Article 42 of the Social Insurance Law 2024, the conditions and cases for sickness benefits are stipulated as follows:
Conditions and cases for sickness benefits
- The following individuals specified at points a, b, c, d, i, k, l, m, and n of clause 1 and clause 2 of Article 2 of this Law are entitled to sickness benefits when taking leave in one of the following cases, except as stipulated in clause 2 of this Article:
a) Treatment for a disease that is not an occupational disease;
b) Treatment for injuries that are not occupational accidents;
c) Treatment for injuries sustained when commuting from home to the workplace or from the workplace to home according to reasonable routes and times as stipulated by the law on labor safety and hygiene;
d) Treatment and rehabilitation for recurrent injuries or illnesses due to occupational accidents, occupational diseases, or accidents specified in point c of this clause;
dd) Donation, retrieval, or transplantation of human tissues or body parts according to legal regulations;
e) Caring for a child under 7 years old who is sick.
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Therefore, the Social Insurance Law 2024 has added two cases for compulsory social insurance participants to receive sickness benefits, including:
- Donation, retrieval, or transplantation of human tissues or body parts according to legal regulations.- Treatment for injuries sustained when commuting from home to the workplace or from the workplace to home according to reasonable routes and times as stipulated by the law on labor safety and hygiene.
From July 1, 2025, additional cases eligible for sickness benefits for compulsory social insurance participants? (Image from the Internet)
In which cases are employees not entitled to sickness benefits?
Based on clause 2 of Article 42 of the Social Insurance Law 2024, employees are not entitled to sickness benefits in the following cases:
- Self-inflicted injuries or self-damage to health.- Use of drugs, narcotic substances listed by the Government of Vietnam, except for cases of using precursor drugs or combination drugs containing precursors as prescribed by medical practitioners at medical facilities.- During the first period of leave for treatment and rehabilitation due to occupational accidents or occupational diseases.- During the period of leave for sickness benefits that coincides with the leave period as stipulated by labor laws or during leave for fully-paid benefits according to other specialized laws, or during leave for maternity benefits or health recovery benefits as stipulated by the law on social insurance.
On what basis are the levels of sickness benefits calculated?
Based on Article 45 of the Social Insurance Law 2024, sickness benefits are as follows:
Sickness benefits
1. The levels of sickness benefits are calculated monthly and based on the following:
a) The salary used as the basis for social insurance contributions of the closest month before taking leave for sickness benefits;
b) The salary used as the basis for social insurance contributions of the first month of participating in social insurance or the month of re-participation if leave for sickness benefits is necessary during the first month of re-participation.
The levels of sickness benefits for employees specified in clause 1 of Article 43 and Article 44 of this Law are 75% of the salary used as the basis for social insurance contributions specified in clause 1 of this Article.
The levels of sickness benefits for employees specified in clause 2 of Article 43 of this Law are calculated as follows:
a) 65% of the salary used as the basis for social insurance contributions specified in clause 1 of this Article if they have contributed to compulsory social insurance for 30 years or more;
b) 55% of the salary used as the basis for social insurance contributions specified in clause 1 of this Article if they have contributed to compulsory social insurance for 15 years to under 30 years;
c) 50% of the salary used as the basis for social insurance contributions specified in clause 1 of this Article if they have contributed to compulsory social insurance for under 15 years.
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According to the above regulations, the levels of sickness benefits are calculated based on the following:
- The salary used as the basis for social insurance contributions of the closest month before taking leave for sickness benefits.- The salary used as the basis for social insurance contributions of the first month of participating in social insurance or the month of re-participation if leave for sickness benefits is necessary during the first month of participation or re-participation.
