It is important that in all instances where allowances are paid, adequate documentation is provided, for example that invoices submitted are made out to an individual and that they show the period, and/or number of instances when the person in question has received treatment e.g. for medical massage. For payment of daily allowance (per diem) in lieu of wages there shall be a doctor’s certificate and confirmation from the employer that wages are no longer paid.
Please note that all allowances must be declared on tax returns. Allowances are not backdated, i.e. they shall be declared in the year that they are paid out.
Applications for allowances or sickness daily allowance shall be received no later than the 20th day of the application month.
Counsellors for the Vocational Rehabilitation Fund are Sigurður Þór Sigursteinsson, tel. 580-5228, email sigurdur@storhofdi.is and Hlín Guðjónsdóttir, tel. 580-5227, email hlin@storhofda.is.
Daily allowances are paid from the fund in the following manner:
- Daily allowances are paid from the time that statutory or contractual salary payments from an employee are no longer paid. An application for daily allowances must be renewed at the end of the period of compensation (which is 120 days) should the illness continue. The board of the Fund evaluates whether payment should be made in excess of one compensation period and in such an instance, the daily allowance amount to be paid.
- The amount of daily allowances shall insure loss of earnings of a fund member and shall be calculated on the basis of 80% of average wages for the 6 months immediately prior to illness, as per statement of payments to the support fund. Should significant changes have taken place in the salary of the party in question over this six-month period, it is authorised to lengthen the reference period to up to 10 months. The monthly payment pursuant to this rule can however never exceed the amount of ISK 620,665 per month (from 1 July 2016).
- In the event of payment for temporary disability, it is authorised to reduce compensation from the sickness fund correspondingly. Sickness or accident daily allowances from TR (Social Insurance Administration) do not impair daily allowances from the Sickness Fund.
- For long-term sickness of a partner or children, which cause the fund member to lose salary. In the case of sickness of children, where the 10-day rights have been fully used and where the partner is not able to take care of the child. In the case of sickness of a partner, the duration of the sickness shall be at least 2 weeks.
- The Sickness Fund board is authorised to pay part of the daily allowances if the fund member cannot work full-time as a result of illness or accident.
- When the payment of daily allowances has ended, the fund member does not gain the right to payments from the Fund until 6 months have passed from the date of the last payment.
- Daily allowances are not paid in the case of permanent disability or age-related infirmity.
- The party in question might also qualify for sickness or accident daily allowances from the Social Insurance Administration.
Medical Costs
Condition: That the applicant has paid into the Fund for at least the preceding 12 months.
The Sickness Fund is authorised to participate in members’ costs for expensive medical operations.
The amount of the allowance is assessed in each instance but is never higher than 40% of outlaid costs, where the costs were greater than ISK 100,000. An allowance in excess of ISK 100,000 shall however not be paid, plus travel costs where applicable. It is generally not possible to pay an allowance according to this rule to the same member more often than once in each 3-year period. Dental costs are not supported by the Fund.
Travel costs
Condition: That the applicant has paid into the Fund for at least the preceding 12 months.
To level the position of those who live in the countryside, the Sickness Fund takes part in travel costs for those who need to travel between regions for operations or tests prescribed by a doctor.
An application for support must be made to TR.
If TR rejects payment, a payment is made for 40 to 100 km ISK 5,000; 100 to 250 km ISK 10,000; 250 to 400 km ISK 17,000 and 400 km or greater ISK 25,000. Payments are made for a maximum of 25 trips per annum.
On the death of a fund member the Fund shall:
Pursuant to 15.1 in the Sickness Fund Rules, the base amount is a minimum of ISK 180,000. Today, compensation is ISK 390,000.
Pay the surviving partner, or parent supported by the deceased, the minimum daily allowances for 90 days.
Pay for each child under 18 supported by the party in question, the minimum daily allowances for 90 days.
Pursuant to 15.3 in the Sickness Fund Rules, the amount shall be ISK 150,000.
Benefits:
For preventative health and fitness measures:
Condition: That the applicant has paid into the Fund for at least the preceding 12 months.
If the party in question has been a full member for the preceding year, then he has a right to an allowance for preventative health and fitness measures, i.e. up to half of the fee but never more than an amount equivalent to 40% of contributions for the last 12 months and never a higher amount than ISK 30,000 for each calendar year.
The allowance shall be paid if the fund member shows an original legally valid receipt which shows that he has paid for a subscription in a recognised health and fitness centre or sports club, a swimming season-ticket or skiing season-ticket on condition that the ticket is for a period of 3 months or longer.
If the fund member in question cannot provide the original receipt, he shall submit a copy which shows the contribution to be made by the employer and the rule here above applies, i.e. the allowance can never be greater than a maximum of half of the remainder.
Spectacles allowance
Condition: That the applicant has paid into the Fund for at least the preceding 12 months.
It is authorised to support the purchase of spectacles. The allowance is a maximum of ISK 40,000 during a three-year period. The amount of the allowance will never be greater than 40% of paid Sickness Fund contributions for the preceding 4 years and never greater than the amount of half of the invoice amount. A doctor’s prescription shall be submitted.
Laser eye operations
Condition: That the applicant has paid into the Fund for at least the preceding 12 months.
The amount of the allowance is assessed in each instance but is never higher than 40% of outlaid costs, where the costs were greater than ISK 100,000. An allowance in excess of ISK 100,000 shall however not be paid, plus travel costs where applicable. It is generally not possible to pay an allowance to the same member according to this rule more often than once in each 3-year period.
Medical massage/physiotherapy:
Condition: That the applicant has paid into the Fund for at least the preceding 6 months.
Medical massage, physiotherapy and treatment by a chiropractor. The Sickness Fund pays an allowance for this against legally valid receipts for a maximum of 25 treatments per annum. A payment of 40% of total costs is made for each session, according to a tariff used by TR, on submission of payment receipts and a prescription from a doctor for the treatment.
Stay at health clinic:
Condition: That the applicant has paid into the Fund for at least the preceding 12 months.
An allowance is paid for a stay at a health institution, e.g. NLFI (Association of Naturopathic Medicine). The allowance is paid once at three-year intervals and is 40% of the invoice but never higher than ISK 100,000 which is also the minimum amount of an invoice which qualifies for allowance.
Maternity/paternity allowance
It is authorised to award a maternity/paternity allowance for the birth of a Fund member’s child to the amount of ISK 162,206 for each child. The amount takes into account the percentage of full-time employment for which the party in question is employed.
The amount of the allowance is for each child and depends on the parent having been in 100% employment during the six-month period prior to the birth of the child. The allowance is reduced in the same percentage as the percentage of full-time employment for which the party in question is employed. If a fund member must reduce his work or to stop working as a result of illness prior to maternity/paternity leave, the employee’s work percentage prior to the illness shall be taken into account.
A fund member must be on at least 75% maternity/paternity leave to qualify for an allowance. If maternity/paternity leave is taken for part of a month and is greater than 75% of a full month it is authorised to grant the allowance. Maternity/paternity allowance applies to all those who enjoy rights to maternity/paternity leave from the Maternity/paternity Leave Fund, including rights for adoption. It is possible to use the allowance up to the 24th month age of the child/children.
When applying for maternity/paternity allowance, confirmation shall be provided from the Maternity/paternity Leave Fund of the taking of maternity/paternity leave and confirmation from the employer that the applicant is employed, which shows information on his percentage employment for the 6 months prior to the birth of the child.
In the case of a stillborn child after 18 weeks of pregnancy, 50% of the allowance is paid.
Attention is drawn to the fact that tax must be paid on the maternity/paternity allowance and PAYE income tax is deducted from the amount of the allowance before it is paid to the party in question.
Mental health assistance:
Condition: That the applicant has paid into the Fund for at least the preceding 12 months.
Benefits are paid for mental health assistance. 40% of costs are paid for each session, up to 25 sessions.
Alcohol addiction treatment
Condition: That the applicant has paid into the Fund for at least the preceding 12 months.
The same rules apply as to daily allowance for sickness.
IVF treatment.
Condition: That the applicant has paid into the Fund for at least the preceding 12 months.
The Sickness Fund participates in IVF treatment. An allowance of up to ISK 100,000 is paid and participation in travel costs, where applicable. Payments however never exceed 50% of a Fund member’s invoices. The beneficiary may not apply for another allowance for IVF treatment until 3 years have passed. Documentation that must be provided as follows: certificate from a doctor on the number of treatments and on direct costs for those treatments.