Guidance on resolving problems in settlement of sickness benefits for employees in Vietnam

Guidance on resolving problems in settlement of sickness benefits for employees in Vietnam (Internet image) 

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

On November 20, 2023, Vietnam Social Insurance issued Official Dispatch 3858/BHXH-CSXH guiding on resolving problems in settlement of sickness benefits for employees in Vietnam.

Guidance on resolving problems in settlement of sickness benefits for employees in Vietnam

In the process of organizing and implementing social insurance policies, Vietnam Social Security has received feedback from some provinces and cities about problems in settlement of sickness benefits for employees. Regarding these matters, Vietnam Social Security would like to specifically report as follows:

Clause 1 of Article 25 of the Law on Social Insurance 2008 stipulates the conditions for enjoying the sickness benefits as follows: "Employees who have to take leave due to sickness or accidents other than occupational accidents, with the certification of a competent health establishment under the Ministry of Health’s regulations."

Point c, Clause 1, Article 45 of the Law on Occupational Safety and Hygiene 2015 stipulates the requirements for receiving occupational accident benefits as follows: "On the route between home and work within a reasonable period of time and route;"

According to the provisions of Point b of Clause 2 of Article 3 of Circular 59/2015/TT-BYT dated December 29, 2015 of the Ministry of Labor, War Invalids, and Social Affairs detailing and guiding the implementation of a number of articles of the  Law on Social Insurance on compulsory social insurance: "Do not settle sickness benefits for employees who take leave from work for the first time for treatment due to labor accidents or occupational diseases" .

This regulation does not exclude cases of accidents on the route from home to work or from work to home within a reasonable time and route.

Comparing with the above regulations, Vietnam Social Security is currently determining cases where workers have accidents when traveling from their place of residence to their place of work or from their place of work to their place of residence following a reasonable route and time as occupational accidents. Therefore, these cases will not be eligible for sickness benefits during the first injury treatment period.

On August 25, 2023, the Inspectorate of the Ministry of Labor, War Invalids, and Social Affairs issued Official Dispatch 508/TTr-TTLD to the Department of Labor, War Invalids, and Social Affairs of Quang Nam Province with instructions: “In case a worker has an accident while traveling from his/her place of residence to the place of work or from the place of work to the place of residence according to a reasonable route and time, it is not an occupational accident according to the definition in Clause 8, Article 3 of the Law on Occupational Safety and Hygiene 2015; they are entitled to sickness benefits as prescribed in Clause 1, Article 25 of the Law on Social Insurance 2008 when meeting the requirements.

To ensure the consistent implementation of the occupational accident regime nationwide, Vietnam Social Security respectfully requests the Ministry of Labor, War Invalids, and Social Affairs to provide general guidance on this content and, at the same time, provide specific instructions on the basis for determining this type of accident when the application for sickness benefits does not include a record of occupational accident investigation.

Case where an employee is entitled to sickness benefits in Vietnam

According to Clause 1 of Article 3 of Circular 59/2015/TT-BLDTBXH, the employees specified under Points a, b, c, d, dd, Clause 1 and Point b, Clause 2, Article 2 of Decree 115/2015/ND-CP shall enjoy the sickness benefits in the following cases:

- The employees have disease or accident which is not work accident or treatment of injury or disease recurred due to work accident, occupational disease and must take sick leave with certification from the competent medical facility as regulated by the Ministry of Health.

- The employees must take leave to take care of their sick children under 07 years of age with certification of the competent medical facility.

- Female employees return to their work befire the expiration of maternity leave subject to one of the case above

Nguyen Ngoc Que Anh

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