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Apply for child sickness benefit for persons with statutory health insurance and transfer children's sickness benefit days to another parent


You will receive child sickness benefit as a substitute for lost wages if you

  • are covered by statutory health insurance,
  • are entitled to sickness benefit,
  • your child has statutory health insurance, is ill and is under 12 years of age,
  • do not have another person in the household who can look after the child,
  • have to supervise, care for or care for your child and are therefore unable to work,
  • are exempt from work by your employer and do not receive continued payment of wages (no paid time off).  

For parents of children with disabilities who are dependent on assistance, the age limit of 12 years does not apply.

You can apply for child sickness benefit from your statutory health insurance company. To do this, you must submit the so-called child sick note (model 21).

In principle, child sickness benefit amounts to 90 percent of your lost net salary. If you have received one-off payments from your employer in the year before the child's illness (e.g. Christmas bonus), the child sickness benefit amounts to 100 percent of the lost net salary. For full-time self-employed persons, children's sickness benefit is paid in the amount of the sickness benefit in the event of their own incapacity for work. Due to the statutory contribution assessment ceiling, the maximum amount of child sickness benefit is capped.

Children's sickness benefit is subject to social security contributions. This means that your health insurance company automatically deducts long-term care, pension and unemployment insurance contributions. Health insurance contributions are not due.

You can

  • Receive 10 working days of child sickness benefit per child per year
  • If you are a single parent, your entitlement increases to 20 working days.
  • If you have 3 or more children, you can receive child sickness benefit for up to 25 working days per year; Single parents for up to 50 working days.


Due to the COVID-19 pandemic, the number of working days on which you can receive child sickness benefit has been increased and in 2021 it is:

  • 1 child: maximum 30 working days, single parents maximum 60 working days;
  • 2 children: maximum 60 working days, single parents maximum 120 working days;
  • 3 or more children: maximum 65 working days, single parents 130 working days.

Due to the Corona pandemic, you can also apply for child sickness benefit in 2021 if you have to care for your child at home due to:

  • an official school or daycare centre closure due to the pandemic,
  • officially ordered or extended company or school holidays,
  • abolition of compulsory attendance at school,
  • other pandemic-related restrictions on childcare services for your child,
  • Quarantine of your child (entry ban) or
  • an official recommendation that your child should not attend daycare or school.

You must prove one of the reasons to your health insurance company. For this, your health insurance company may require a certificate from the daycare center or school.

If your employer gives you paid time off from work, this time will be counted towards your entitlement days for child sickness benefit. This means that your entitlement to child sickness benefit is suspended as long as the employer gives you paid time off. If, for example, your employer has continued to pay you your net salary for 5 days, you will still be entitled to child sickness benefit for 5 working days from your maximum period of entitlement to child sickness benefit of up to 10 working days per year (1 child).

If you have already used up your maximum children's sick days, it may be possible for your partner to transfer the children's sickness benefit days to you. You must also submit an application to your health insurance company for this. Your employer must also be willing to give you another unpaid leave of absence.

If your child is seriously ill and under 12 years of age or disabled and dependent on assistance, you will receive child sickness benefit for an unlimited period of time. You must still meet the following requirements:

  • You and your child have statutory health insurance,
  • You are entitled to sickness benefit,
  • Your child needs to be supervised, cared for or cared for by you due to a terminal illness, which is why you cannot work,
  • your child's illness must have already reached a very advanced stage, require palliative medical treatment, or You, your partner wants this treatment and the condition must lead to a limited life expectancy of weeks or a few months,
  • You are released from work by your employer and do not receive continued payment of wages (no paid time off).  

You must submit a certificate of your child's serious, fatal illness to your health insurance company.

Process flow

You can submit the application for child sickness benefit and the application for the transfer of children's sick days by post or – in the case of many statutory health insurance companies – hand them in in person at the office or submit them online.
Normally, the procedure is as follows:

  • You will receive a medical certificate for children (sample 21).
  • Fill out the application form from your statutory health insurance company. This is located on the back of pattern 21. If necessary, your health insurance company will require further information with a separate application.
  • Submit the child's sick note (sample 21) to your health insurance company together with any other documents that may be required.
  • Inform your employer about the child's sick leave.
  • The health insurance company will review your application and transfer your child sickness benefit to you. For employees: Your health insurance company will only pay your children's sickness benefit after your employer has provided the health insurance company with the necessary information about your lost net salary.
  • Special regulation for the care of children due to the Corona pandemic:
  • Fill out the application form from your statutory health insurance company.
  • Attach proof of school or daycare center.
  • Submit the application to your health insurance company together with the proof and any other necessary documents.
  • The health insurance company will review your application and transfer your child sickness benefit to you. For employees: Your health insurance company will only pay your children's sickness benefit after your employer has provided the health insurance company with the necessary information about your lost net salary
     

Requirements

  • Your child is under 12 years of age or has a disability and needs help.
  • Your child has been diagnosed with a medical condition and a need for care or supervision or care as a result.
  • No one else in your household can take care of the child.
  • You and your child are covered by statutory health insurance.
  • You are employed and entitled to sickness benefit.
  • You will be given unpaid leave of absence by your employer.
  • Even if you are self-employed and have statutory health insurance, you can receive child sickness benefit from the 1st day of your child's illness. The prerequisite for this is that you yourself are entitled to sickness benefit,

In seriously ill children:

  • Your child is terminally ill and has a life expectancy of a few weeks or months.
  • Your child's illness is already well advanced and must require palliative medical treatment or you, your partner, want this treatment.
  • Your child is under 12 years of age or disabled and needs assistance.
  • You and your child are covered by statutory health insurance.
  • You are employed and entitled to sickness benefit.
  • You will be given unpaid leave of absence by your employer.
  • Even if you are self-employed and have statutory health insurance, you can receive child sickness benefit from the 1st day of your child's illness. The prerequisite for this is that you yourself are entitled to sick pay, for example via a so-called optional tariff with your health insurance company.

For the carry-over of children's sickness benefit days:

  • Both you and your partner have statutory health insurance.
  • Both you and your partner are entitled to sickness benefit.
  • Your employer has agreed to the transfer of the children's sick pay days. This means that your employer agrees to release you for additional days.
     

Which documents are required?

  • Medical certificate stating your child's illness and need for care ("child's sick note", model 21)
  • In the case of seriously ill children, if necessary, additionally:
  • Medical certificate stating that your child has a serious, fatal illness
  • In the case of children with disabilities, possibly additionally:
  • Medical certificate or, if applicable, proof that your child has a disability and is dependent on your help
  • In the event of quarantine or closed care facilities due to the Corona pandemic, if applicable:
  • Proof of the closure of a childcare facility, the order or extension of company or school holidays, the lifting of compulsory attendance at school, the restriction of the childcare offer, the order of quarantine (prohibition of entry) or the official recommendation not to visit the care facility.

Please check with your health insurance company whether proof is required.
 

What are the fees?

You don't have to pay anything for the application.

What deadlines do I have to pay attention to?

You should take your child to the doctor as soon as possible – preferably on the 1st day of illness – to obtain the child's sick note (model 21) and inform your employer of your absence.

Processing duration

It usually takes about 4 to 9 business days to process.

In order to process and make a decision quickly, your health insurance company must have the necessary information and, if necessary, documents complete and meaningful.
The health insurance company decides on applications promptly, whereby the statutory processing deadline is observed in order to protect patients' rights.
Please note that the stated processing time is an average value for all health insurance companies. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and can be extended accordingly. The same applies if documents or records are sent to you or your health insurance company by post.
 

Applications / forms

- Forms: yes

- Online procedure possible: Many statutory health insurance companies offer an online procedure.

- Written form required: no

- Personal appearance required: no
 

Appeal

  • Contradiction
  • Appeal to the Social Court
     

What else should I know?

If you yourself are privately insured and the other parent is legally insured, it depends on where the child is insured: If the child is legally insured, the parent with statutory health insurance can apply for child sickness benefit.
In the event of an accident involving your child at school or daycare, you will receive child injury benefit from the accident insurance. As a rule, this is calculated and paid by your health insurance company on behalf of the responsible accident insurance institution.
If you are unemployed, the Employment Agency will continue to pay unemployment benefit for a limited period of time if you are unable to continue your job search due to the illness and the resulting need for care for your child.
 

Technically approved by

Federal Ministry of Health

Professionally released on

30.11.2021

Author

The text was automatically translated based on the German content.

Source: Serviceportal Niedersachsen (Portalverbund des Bundes und der Länder)