Salary compensation during temporary incapacity for work

Temporary incapacity for work is the absence from work due to illness or injury, or other circumstances that prevent you from performing your work obligations in accordance with the employment contract, other agreement or document. 
Temporary incapacity for work is established by your selected primary health care physician, i.e. selected gynaecologist.
As an insured person in the Croatian Health Insurance Fund, you are entitled to a salary compensation during your temporary incapacity for work.
 
Salary compensation
You are entitled to salary compensation:
  • Until your selected primary health care physician establishes that you are fit to work or
  • Until disability due to general incapacity or professional incapacity for work is established by the finding and opinion of the competent expert assessment authority

Salary compensation is established from the compensation basis.
 
Basis for salary compensation
The basis for determining your salary compensation is the average salary paid to you in the last six months before the month in which circumstances have occurred based on which you are entitled to the compensation.

If you are a craftsman or a self-employed person who carries out professional activity, the basis for determining your salary compensation is the monthly basis of insurance for calculation and payment of contributions for compulsory health insurance for the last six months before the month in which insured case has occurred on the basis of which you acquire the right to compensation, reduced by statutory compulsory contributions, taxes and surtaxes.
 
The highest and the lowest amount of salary compensation
Salary compensation cannot be lower than 70% of the basis for salary compensation. The lowest monthly amount of salary compensation, for full time work, amounts to 25% of the budget base or HRK 831.50.
The highest monthly amount of salary compensation, for full time work, if paid at the expense of the Croatian Health Insurance Fund, is the budget base increased by 28% or HRK 4,257.28.
Previous insurance
An insured person is entitled to salary compensation paid at the expense of the Croatian Health Insurance Fund in the amount stipulated by the Compulsory Health Insurance Act and subordinate legislation, provided that, prior to the occurrence of the case based on which the right to compensation is acquired, he or she has been insured in the Croatian Health Insurance Fund on the basis of employment or self-employment, i.e. on the basis of payment of salary compensation after termination of employment or self-employment, for at least 9 months continuously or 12 months with interruptions in the last two years, unless otherwise specified by a special regulation.
However, this does not apply in case of salary compensation due to a recognized injury at work or occupational disease.
An insured person, who does not fulfil the condition of previous insurance, is entitled to salary compensation, for the duration of temporary incapacity for work, in the amount of 25% of the budget basis for full time work.
 
Loss of right to salary compensation
You are not entitled to salary compensation:
  • If you knowingly caused your temporary incapacity for work
  • If you do not inform your selected primary health care physician that you have been ill within three days of the onset of illness, or within three days of the termination of reasons that prevented you from doing so
  • If you deliberately prevent your healing or treatment.
  • If you work during your temporary incapacity for work or if you perform activities on the basis of which you are insured or activities based on temporary service contracts or any other job (e.g. agricultural jobs).
  • If you fail to respond to a medical examination of the selected physician or of the Croatian Health Insurance Fund’s controller or the body responsible for controlling temporary disability, for no justified reason.
  • If you fail to follow the instructions for your treatment or leave the place of residence without the consent of your selected physician, or if you otherwise abuse the right to temporary incapacity for work.

In the aforementioned cases you are not entitled to salary compensation from the day of occurrence of the said cases until their termination or until the termination of the consequences caused by such cases.
 
More information is available at:
http://www.hzzo.hr/obvezno-osiguranje/pravo-na-bolovanje/
http://www.hzzo.hr/obvezno-osiguranje/naknada-place-za-vrijeme-bolovanja/


QUESTIONS AND ANSWERS

The beginning and duration of the term or the termination of the temporary incapacity for work is established by the selected physician of family medicine, i.e. gynaecologist depending on the type of illness that affects your incapacity for work. The selected physician who established the beginning and termination of your temporary incapacity for work completes and issues the form - “Report on temporary incapacity for work“. The form is available at: http://www.hzzo.hr/wp-content/uploads/2017/12/Doznaka_04122017.pdf?b32def At your request, the selected physician can also issue a “Notice of temporary incapacity for work”.

The insured person exercises the right to salary compensation during temporary incapacity for work due to illness diagnosis, in the amount prescribed by the Compulsory Health Insurance Act up to 18 months of temporary disability. After that period, the salary compensation amounts to 50% of the last paid compensation.

Reduction of salary compensation to the amount of 50% of the last paid salary does not apply to an insured person who is temporarily unable to work due to treatment of malignant illnesses, an insured person with approved status of caretaker of a family member – a child suffering from malignant illness, an insured person who is temporarily unable to work due to haemodialysis or peritoneal dialysis and whose temporary incapacity is related to taking and transplantation of human body parts.

In case you are dissatisfied with the above-mentioned decision, you will be issued a decision within an administrative procedure, upon your request, and on the basis of previously obtained reasoned finding, opinion and assessment of the Medical Commission of the Croatian Health Insurance Fund. The Commission is obliged to examine you before making their assessment, and the request is addressed on an urgent basis.