If an insured person is unable to work to undergo treatment for a nonoccupational sickness or injury and is unable to earn salary or other income during this time, he or she will be paid “Injury and Sickness Allowance”.
When applying for the injury and sickness allowance due to infection by COVID-19, it is temporarily not necessary to attach your doctor's written opinion (3/3 To be entered by the attending physician). Go here for details.
Be sure to attach when applying for the first time.
This needs to be submitted only by those continuing to claim Injury and Sickness Allowance after loss of eligibility. Be sure to attach this the first time you apply to Claim the allowance after the period of leaving employment.
* Attach any of the following documents when submitting the above written pledge:
・Copy of Separation from Employment format (Rishoku-hyo)
・Copy of notice of loss of eligibility as an insured person under employment insurance (Koyo hoken hihoken-sha shikaku soshitsu kakunin tsuchi-sho)
・Copy of notice of extension of benefits (Jukyu kikan encho tsuchi-sho)
Deadline:
Within two years from the day after the date of inability to work
Requirements to claim this benefit
Persons who meet all four of the following conditions may claim this benefit:
Undergoing treatment for an illness or injury under a doctor’s instructions
* As with other illnesses, conditions such as COVID-19 and severe hyperemesis are eligible for this benefit.
* When applying for the injury and sickness allowance due to infection by COVID-19, it is temporarily not necessary to attach your doctor's written opinion (3/3 To be entered by the attending physician). Go here for details.
(Cases of illness or injury suffered on the job or commute are covered by Worker’s Accident Compensation Insurance. In cases of injury due to accidents or incidents resulting from the actions of a third party, payment by the other party’s casualty insurance takes precedence.)
Unable to work for recuperative purposes
Taking four or more days off work, including three consecutive days
* Not paid for the three-day period, the waiting period. These three days must be taken off work in the form of absence, public holidays, or paid leave.
No salary or other allowance is paid.
The Injury and Sickness Allowance is intended mainly to enable the recipient to recover swiftly by concentrating on recuperation from injury or sickness (e.g., treatment at a medical care institution and taking medication). For this reason, it is paid as authorized by the Health Insurance Society based on a doctor’s opinion that time off work is required for recovery.
The Injury and Sickness Allowance may not be paid in cases involving visit to a medical care institution without subsequent treatment (e.g., for preventive care or for a healthy pregnancy) or cases involving clear failure to devote oneself to recovery (e.g., suspension of treatment at the patient’s own discretion without good reason or failure to take medication prescribed by a doctor).
Other notes
* Apply after the leave period has passed (i.e., after the fact). You cannot apply in advance.
* When applying for a period during employment, submit the application to the employer’s section in charge of social insurance operations.
* If recuperation takes place over a lengthy period, apply for a period of approximately one month doesn't span three months.
* After the documents are submitted, they will be reviewed and a written notice issued. Refer to the notice for more information on whether payment will be made.
* Payments may be refused based on the results of review in cases of long-term recuperation without a doctor’s treatment.
If you apply by notifying your Individual Number instead of your health insurance card code/number, you must submit separate documents to verify your Individual Number and your identification. See here for more information on the documents that need to be submitted for Individual Numbers.
Submit to:
The application period differs between periods before and after leaving employment.
See the information on where to submit documents indicated by this mark.
Address inquiries to:
Operations Group, Health Insurance Society
0120-501-042 (Choose voice guidance option 2.)
mark.