Continuation of pay in case of illness, capture incl. Request for reimbursementThe legal basis for continued payment of wages in the event of illness is the Continued Remuneration Act (EFZG). However, the right to continued payment of wages for a period of 6 weeks (42 calendar days) only exists if the employment relationship has existed for 4 weeks without interruption (§ 3 para. 3 EFZG).
The 6 weeks period begins in principle with the day after the beginning of the incapacity for work. However, if the incapacity occurs on a working day before the employee starts work, this day already counts.
The employer can be reimbursed by the health insurance funds for part of its expenses for continued payment of wages as part of the U1 apportionment procedure (applies to companies with up to 30 employees). The basis here is the Expenditure Compensation Act (AAG). The Reimbursement amount is then calculated as follows: Allocation 1-percentage x continued remuneration. However, the income threshold applies to the continued pay.
For the recording in LobuOnline you can watch a short video
Video for salary earner
Video for hourly wage earners
or you can use the following steps.
For a successful reimbursement by the health insurance company, the following are required Requirements to be fulfilled:
a) the wage types relevant for the reimbursement Wage types must be in the wage type master as"Reimbursable" marked its
b) Your Bank details must be stored in the company master
c) the Reimbursement request must be created
Procedure for a) – Check wage type characteristics
Before you start creating the reimbursement request, you should check once that the wage types you use are eligible for reimbursement. To do this, proceed as follows:
Select the "Wage Types" tab in the main menu under "Edit/Company" from,
Sort the LA via the column heading,
Select the appropriate wage type (z.B. LA 099 Salary, LA 154 Temporary wage, etc.) and
Check whether the "Reimbursable for continued remuneration" is noted under the properties. If not,
Click on "Change", tick the appropriate box and accept the change.
→ For Salary recipientn, a reimbursement is made from the wage types that are used for the employee either in the master data or monthly data as current payments, using the 30th regulation.
→ For employees who are on Hourly wage basis are accounted for, please use for the hours allotted to the illness the wage type LA 140. For the reimbursement request, this amount is used 100%.
Procedure for b) – Check bank details in company master record
Check under "Edit/Company" in the "General" tab whether your correct bank details have been entered here. This is mandatory for the reimbursement by the health insurance company.
Procedure for c) – Create reimbursement request
Using the example of the employee Mr. Walter Ost (salary recipient from our sample company in LobuOnline), the further entries are explained as follows. In this example, the employee is entered in the period from 05.02.2016 – 08.02.2016 sick. Receives continued payment of wages by his employer. 02.2016 – 08.02.2016 sick. Receives continued payment of wages from his employer. 2016 – 08.02.2016 sick. Receives continued pay from his employer.02.2016 falls ill and receives continued pay from his employer. The gross pay is 1.500.00 EUR per month. For the continued payment of wages for the 4 sick days, the employer submits a reimbursement request to the health insurance fund.
To create a reimbursement request for sick pay, proceed as follows:
First select the relevant employee in the "Edit/Personnel" menu
Then switch to the right pane under "Monthly data" in the tab "Reimbursement AAG and start with the button "New the "Reimbursement Wizard"
In the next steps select
First the reimbursement reason "Sickness/continuation of wage payment" from,
Then enter the period of the illness (here 05).02.2016 – 08.02.2016), select the cause of the illness and indicate whether the employee was still working on the first day of the illness.
Finally, save the entered data.
When you save the data, the absence time "Sick with continued pay" is automatically entered in the calendar under "Vacation and absence times entered.
Please check the request for reimbursement in a provisional statement of account (cf. Protocol under the evaluation lists).
The application for reimbursement is then sent to the relevant health insurance fund with the next final pay slip.