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Illness and hospitalisation for members of the Separate Pension Scheme
In the event of an illness that causes a temporary incapacity for work or a hospital stay, those enrolled in the Separate pension scheme are entitled to an allowance.
The allowance is disbursed to workers registered in the Separate pension scheme referred to in article 2, paragraph 26, Law no. 335 of 8 August 1995, who do not hold a pension and are not registered in other mandatory social security schemes.
Start date and duration
The illness allowance is disbursed up to, in the calendar year, for a maximum one sixth of the total duration of the Labour and, in any case, for at least 20 days.
The total duration of the Labour means the number of days worked or, in any case paid, within the reference period considered for contribution and income purposes, i.e. the 12 months prior to the start of the illness.
Therefore, the number of days compensable in the same calendar year cannot exceed the maximum limit of 61 days (INPS Circular no. 76 of 16 April 2007).
The illness allowance is not disbursed for occurrences lasting less than four days.
The hospitalisation allowance covers all admission days up to a maximum of 180 days in the calendar year, including “day hospital” days.
What am I entitled to?
The allowance is equal to 4%, 6% or 8% of the amount obtained by dividing the contribution ceiling by 365 (article 2, paragraph 18, Law 335/1995) provided for in the year of illness onset, based on the contribution allocated in the 12 months preceding the illness (4% from three to four months, 6% from five to eight months, and 8% from nine to 12 months).
The hospitalisation allowance is equal to 8%, 12% or 16% of the amount obtained by dividing the contribution ceiling by 365 provided for in the year of hospital admission, based on the contribution allocated in the 12 months preceding the admission (8% from three to four months, 12% from five to eight months, and 16% from nine to 12 months).
The illness and hospitalisation allowances are due only if credited, in the 12 months preceding the beginning of the event or admission, for at least three months of contributions, even non-continuous, to the Separate pension scheme.
In the calendar year preceding that of the event, the individual income subject to the Separate pension scheme contribution must not exceed 70% of the contribution ceiling for the same year.
To be entitled to the illness allowance, the worker must obtain the illness certificate issued by the attending physician who transmits it electronically to INPS. The worker must also carefully check that the personal data and domicile data inserted by the doctor are correct, to avoid the penalties provided for by law.
The on-line certificate renders the worker exempt from the obligation to send the certificate to the employer, which can receive it and view it through the services made available by INPS.
If the electronic transmission is not possible, the attending physician must issue the hard-copy illness certificate to the worker. In this case, the worker must, in two days from the date of issue, submit or send the certificate to the territorially competent INPS structure and the declaration to the employer to avoid incurring legal sanctions consisting in the loss of the right to illness allowance for each day of unjustified delay past the two-day deadline.
Hospitalisation and sickness certificates issued by hospital facilities must also be sent electronically. If, on the other hand, the certificates are drawn up in hard-copy, they must be submitted or sent, by the worker, to the territorially competent INPS structure and to the employer (without indicating the diagnosis). Hospital admission certificates (but not of any post-hospitalisation illnesses), can be delivered even after two days from the date of issue, but, in any case, within one year of the provision of the service. The admission certificates and the day of first aid not indicating the diagnosis are not considered certifications for social security benefits purposes.
For disbursement of the allowance, the worker must be available at his/her domicile during the on-call periods provided for by law for checks to verify the actual temporary incapacity for work. The on-call periods are reported in the illness certificate (including Saturdays, Sundays and holidays), from 10 to 12 and from 17 to 19.
Absence during the medical visit, unless justified, entails the claim of sanctions and non-compensation of sick days as follows:
- a maximum of ten calendar days, from the beginning of the event, in case of first unjustified absence during the control visit;
- 50% of the allowance during the remaining period of illness, in case of a second unjustified absence during the control visit;
- overall allowance as of the date of the third unjustified absence during the control visit.
The home visiting physicians who ascertains the absence issues an invitation in a sealed envelope for the next outpatient medical examination. Absence from the outpatient visit may result in the claim of penalties for a second visit.
During the period of recovery time of the certificate, if indeed necessary, the worker can change the address for the medical visit by communicating it promptly and with adequate notice, in addition to the employer, to INPS using one of the following methods provided (message no. 1290 of 22 January 2013):
- by sending an email at firstname.lastname@example.org;
- by sending a communication to the fax number indicated by the territorial structure;
- by using the toll-free number +39 803 164 (free from Italian landlines) or +39 06 164164 from mobile phones.
In case of illness that occurred in a European Union (EU) country, current EU regulations provide for the claim of the legislation of the country where the insured resides. Therefore, the worker must submit the illness certificate to INPS and to the employer, within two days of issuance. Otherwise, the worker can contact the competent local authority which carries out the medical verification of the incapacity to work and draws up the certificate to be transmitted immediately to the competent institution.
In the case of illness arising in countries that have not entered into conventions or agreements with Italy in this regard, or in non-EU countries, the certification must be legalised by the Italian diplomatic or consular office abroad and forwarded to the competent offices, even after the return. Certification of the authenticity of the authorised translator's signature is not equivalent to "legalisation" whereby a stamp is affixed and thus the document is valid as a certificate according to local regulations.
How can I claim?
Workers enrolled in the Separate pension scheme must submit a claim to the INPS office to receive the allowance.
The claim must be submitted to INPS online via the dedicated service (INPS Circularno. 52 of 6 April 2012).
Alternatively, claims can be submitted:
- by phoning the contact centre at 803 164 (free from Italian landlines) or 06 164 164 from mobile phones;
- by electronic services offered by patronage institutes and intermediaries thereof.