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Temporary disablement

For the persons insured against temporary disablement, these ones can benefit from the insurance indemnity if they can prove that they are on sick leave.

In case the insured person fulfilled all his/her payment obligations, the quality of insured person must be proved by a justified document (insurance certificate or book) issued by the social security entity where the employee is registered, except for the medical-surgical emergencies or for the Class A infectious-contagious diseases. The payer shall mention in the certificate if the person requesting the sick leave certificate is insured in the public system of health social security as well as the number of days of temporary disablement during the last 12 months.

Granting the sick leave certificates can be done by any doctor with a valid free practice authorization who had closed an agreement in this respect with one of the health social security entities and who is attending the patient. Filling in the number of the agreement on the sick leave certificate is mandatory.

The amount of the social security indemnity in case of temporary disablement caused by a regular illness represents 75% of the average of the revenues obtained during the last 6 months which constitute the calculation basis of the sick leave (art. 17 paragraph (1) of O.U.G. (Emergency Government Ordinance) no. 158/2005); for serious affections like tuberculosis, AIDS, cancer of any type, Class A infectious-contagious disease, medical-surgical emergency, the sickness indemnity can represent 100% of the calculation basis.

The calculation basis of the indemnities is established as an average of the monthly revenues obtained during the last 6 months during which the subscription stage is established, up to the limit of 12 minimum monthly gross salaries per country, based on which the contribution for leaves and indemnities is calculated.

The date of granting and the duration for the granting of sick leave certificates. If by adding the temporary disablement days related to the sick leave certificate which is going to be issued, there are more than 90 days, the attending physician will send the patient to a specialized physician, expert of the social security for a more than 90 days notice, and for the hospitalized patients who cannot move, the doctor will send the medical file, the results of the investigation and the medical paper.

The duration for the granting of the sick leave and of the indemnity for temporary disablement is of maximum 183 calendar days per year, larger in case of special diseases (pulmonary tuberculosis, meningitis, peritonitis, operated pulmonary tuberculosis or any other forms of tuberculosis, some cardio diseases, AIDS). For the maximum period of 183 calendar days per year there are not taken into account the sick leaves periods having the indemnity codes (07), (08), (09), (12), (14), (15).

The sick leaves certificates are filled in and issued at the date of the medical consult. The date when the validity of the sick leave begins can be subsequent to the date of the granting only for the medical certificates which are ,,a continuation". In case it is impossible for the insured person to go to the doctor's, sick leave certificates can be granted with a 24 hour retroactivity.

The sick leave certificates can be issued at a subsequent date, only for the previous month, for the following situations:

• pregnancy and confinement;
• broken legs or other parts of the body put in plaster - only by an orthopedist or by a surgeon;
• hospitalization period;
• situations requiring the notice of the social security specialized doctor in 90 days.
• in case of quarantine (valid since 01.08.2007)

The attending physician in the hospital issues a sick leave certificate only when the patient is released, except for the situations when the duration of the hospitalization exceeds the current month, in which case the attending physician will grant the sick leave certificate on a monthly basis. When the patient is released from hospital a sick leave of 1 to 7 calendar days can be granted, and in special cases, with the approval of the medical chief, up to maximum 21 calendar days. An exception to this rule are the attending physicians in sanitary units with beds, who are attending patients with tuberculosis, AIDS, and who, when the patient is released, can grant up to 30 calendar days sick leave.

After the expiry of the sick leave granted when the patient is released from hospital, the family doctor, based on the medical letter issued by the attending physician in the hospital, can prolong the sick leave by maximum 7 calendar days for the same illness, and if the temporary disablement is maintained, send the patient to a specialized doctor.

Doctors have the obligation to guide the patients towards the sanitary unit they must address to in view of further obtaining the medical assistance and the sick leave certificates.