Work Stoppage: Understanding Daily Allowances In 5 Questions
If your doctor has prescribed a work stoppage, you may receive daily allowances after a waiting period of 3 days, whether you are an employee, seasonal worker, or unemployed. We will explain how these allowances work in 5 questions.
1- What are the conditions to be met to receive daily allowances?
Daily allowances or IJ correspond to the amounts paid by Health Insurance to compensate for the loss of income during a work stoppage. These allowances are paid, after a waiting period of 3 days, under certain conditions.
For a work stoppage of less than 6 months, an employee must:
• have worked at least 150 hours over the three months preceding the work stoppage.
• or have contributed based on a salary at least equal to 1015 times the hourly minimum wage over the 6 months preceding the work stoppage.
Seasonal workers and people who work intermittently must:
• have worked at least 600 hours over the last 12 months.
• or have contributed based on a salary at least equal to 2030 times the hourly minimum wage over the 12 months preceding the work stoppage.
Note: if you are unemployed, your last salaried activity is taken into account to calculate the amount of your allowances. However, RSA beneficiaries cannot claim the payment of IJ.
2- What are the conditions for a work stoppage of more than 6 months?
As part of a long-term illness or ALD, the duration of your sick leave may be more than 6 months.
In this case, you are entitled to daily allowances if you meet the following conditions:
• be affiliated with Health Insurance for at least 12 months.
• have worked at least 600 hours in the 12 months preceding the sick leave.
• or have contributed based on a salary at least equal to 2030 times the hourly minimum wage during these 12 months.
Note: after 3 years of sick leave, the medical advisor may decide on a request for a disability pension. The regional health insurance fund will then take over to perform specific calculations.
3- How are daily allowances calculated?
The daily allowances you receive during a work stoppage are equivalent to 50% of your basic daily salary.
If you are an employee, your basic daily salary is calculated by the Health Insurance based on the average gross salaries of your last 3 months of work. However, if you are a seasonal worker, it is calculated based on your last 12 months of activity.
It should also be noted that daily allowances are capped at €52.28 gross per day in 2024, even if your salary exceeds this amount. Indeed, in this calculation, your salary is considered up to 1.8 times the monthly minimum wage.
However, you can benefit from the maintenance of your full or partial salary during a work stoppage thanks to an individual insurance contract subscribed by your employer. In this case, Social Security sends the allowances to your employer, who continues to pay your salary, following a process called subrogation.
For more information, inquire directly with the payroll service in your company.
4- How is the payment of daily allowances made?
Due to a 3-day waiting period at the start of each work stoppage, sickness daily allowances are payable from the 4th day of stoppage. However, there are exceptions to this waiting period, notably for an occupational disease, a work accident, or a long-term illness.
The Health Insurance will pay you these allowances after processing your file and then every 14 days on average. To know the processing times for files and track your payments, simply check your ameli account.
The daily allowances are credited directly to your bank account every 14 days, unless your employer practices subrogation and continues to pay your usual salary.
5- What steps should be taken during a work stoppage?
In order to receive daily allowances or subrogation, you must send your work stoppage notice to your primary health insurance fund and your employer within 48 hours of the start of your leave. Remember to keep a copy of this document by making a photocopy, so you can justify your rights in case of a problem.
Moreover, as sick leave daily allowances allow you to validate retirement quarters, you must keep track of them indefinitely, just like your payslips. You can obtain a payment certificate for the daily allowances by logging into your ameli account.
Finally, note that allowances paid for a long-term illness or ALD are tax-exempt. You do not have to declare them to the tax authorities, unlike other daily allowances.
For any other illness, these allowances are subject to income tax, CSG, and CRDS because they are considered as salaries. You can view the taxable amount of your benefits, the applied tax rate, and the amount withheld for income tax from your ameli account.
