Illness Benefit

Introduction

Illness Benefit is a short-term payment for employees insured under Pay Related Social Insurance (PRSI) who cannot work due to illness. You are entitled to the payment if you are certified as unfit for work due to illness, you satisfy the Pay Related Social Insurance (PRSI) conditions and are under age 66.

Illness Benefit is not paid for the first 6 days of a claim (up from 3 days). This means that a person will not be entitled to Illness Benefit for the first 6 days of their claim (unless the person was receiving Illness Benefit, Injury Benefit or a jobseekers payment immediately before their claim).


Qualifying for Illness Benefit

To qualify for payment of Illness Benefit, you must satisfy two conditions:

  • you must have at least 104 weeks of PRSI contributions paid since you first started work.

 

AND EITHER (2a) OR (2b)

 

(2a) 39 weeks of PRSI contributions paid or credited in the relevant tax year, of which 13 must be paid contributions. If you do not have 13 paid contributions in the relevant tax year, then 13 paid in one of the following tax years can be used instead:

— either of the two tax years before the relevant tax year

— or the last complete tax year (before the year in which your claim for Illness Benefit begins)

— or the current tax year.

 

OR

(2b) 26 weeks of PRSI contributions paid in the relevant tax year

and

26 weeks of PRSI contributions paid in the tax year immediately before the relevant tax year.

  • The relevant tax year is the second last complete tax year before the year in which your claim for Illness Benefit begins.

For example:

 

2020

 2018

If your claim

begins in:

2021

The relevant

tax year is:

2019
 2022 2020

 

  • If you are getting long-term Jobseeker’s Allowance, Invalidity Pension, Carer’s Allowance or Carer’s Benefit, immediately before applying for Illness Benefit, you do not need to have the 13 paid contributions referred to in part (2a)

 

  • If you were getting Occupational Injury Benefit immediately before applying for Illness Benefit you may use the tax year that applied to your OIB claim or the tax year that applies to your Illness Benefit claim, whichever is more beneficial.

>> back to top


 

Current Rates of Payment

Personal Allowance  €203.00 (maximum rate)
Qualified Adult   €134.70 (maximum rate)
Each Qualified Child 

€ 36.00 (under 12) 

€40.00 (12 and over)

 

Reduced rates of Payment: If your average earnings in the relevant year are below €300 you will qualify for a reduced rate of payment. If you only have credited contributions in the relevant year, you will receive the minimum rate of payment of €88.90. There are some exceptions to this rule – contact the INOU on (01) 856 0088 for more information.

If you receive a reduced rate and your income is below the Supplementary Welfare Allowance rate, you can apply to the Department of Employment Affairs and Social Protection as you may have an entitlement to a top up payment under the SWA scheme.


Duration of payment

  • If you have between 104 and 259 weeks PRSI contributions paid, you can claim Illness Benefit for up to 52 weeks (312 payment days).
  • If you have 260 weeks PRSI paid since you first started work you can claim Illness Benefit for a maximum of 2 years (624 payment days).
  • If you have 260 weeks PRSI paid since you first started work and your claim for Illness Benefit began before January 2009 you may be entitled to receive Illness Benefit for as long as you are unfit for work and are under 66.

While in receipt of the payment you may be required to undergo medical assessments to determine if you still qualify for the payment on medical grounds.

>> back to top


Medical Assessment

During the course of your claim for Illness Benefit, you may be asked to attend a medical assessment by a Medical Assessor for a second opinion as to whether you are incapable of work. The opinion of the Medical Assessor following this assessment is submitted to a Deciding Officer for consideration regarding your continued entitlement to Illness Benefit.

In any case where payment of Illness Benefit is disallowed, you will be notified of the decision and advised of your right to appeal against the decision.

Illness Benefit – Tax

Illness Benefit (excluding any increases for qualified children) is considered as income for tax purposes and it is taxable from the first day of payment. Illness Benefit is paid directly to you without any deduction of income tax. If you are employed, your employer will take your Illness Benefit into account for PAYE purposes.

If you are unemployed, Revenue will take account of the amount of Illness Benefit paid to you when they adjust your tax credits or review the tax affairs of your spouse.

>> back to top


Returning to Employment

Illness Benefit – EmployAbility Services:

The Nationwide EmployAbility Service provides an employment support service for people with a health condition, injury, illness or disability. The supports offered are:

  • Individual Needs Assessment.
  • Vocational Profiling and Career Planning.
  • Job Sourcing
  • On-the-job Support and Coaching.
  • Follow-up Support and Mentoring

Please contact your local Intreo or LES office for further information.

Taking up Employment

If you are in receipt of Illness Benefit (IB) you can only take up employment under the Partial Capacity Benefit (PCB) scheme. However, you must be in receipt of payment of Illness Benefit for a minimum of 6 months to be eligible to apply. Customers on “credits only” cannot apply for PCB.

People who have an underlying entitlement to IB in their own right, but who opt to remain a dependant on a partner/ spouse’s claim can use this period towards the 6 month qualifying period for Partial Capacity Benefit (PCB). Periods spent on Occupational Injury Benefit (OIB) can also be used towards the 6 month qualifying period for Partial Capacity Benefit (PCB).

Community Employment

Participants on Community Employment (CE) and Pobal schemes cannot claim another Social Welfare payment at the same time. This means that if you are in receipt of Illness Benefit (IB) you must close your claim with a final certificate in order to commence a CE Scheme. However, if you are in receipt of IB (for at least 6 months) you can apply for PCB in respect of POBAL schemes.

Back to Education Allowance

If you have been claiming Illness Benefit for 2 years you can apply for the Back to Education Allowance.

Approved Training Courses (not CE)

Persons on Illness Benefit are only allowed to participate on approved Training Courses with the permission and approval of the Department of Employment Affairs and Social Protection. This ‘permission to train’ must be received before you can start the approved training course.

While on the course, if you continue to be entitled to payment of Illness Benefit, the payment will continue. Participants will not receive any training allowance for participation on the course.

Spouse/Civil Partner/Cohabitant Working

You may be entitled to an increase on your Illness Benefit claim for your spouse, civil partner or cohabitant and qualified children subject to income limits. If your spouse, civil partner or cohabitant works, is engaged in self-employment or has an income from a course of training or education, their income could affect the Qualified Adult Payment you receive for them on your Illness Benefit payment.

SWA Payments

The Department of Employment Affairs and Social Protection may have the discretion to allow a person to access certain SWA payments, if a case can be made to show that an exceptional need exists. This includes the Exceptional Needs Payments and Urgent Needs Payments. Persons on Illness Benefit can apply for the Back to School Clothing and Footwear Allowance.


Moving to Invalidity Pension

If you are in receipt of an Illness Benefit payment for 12 months and you have a long-term illness or disability which means that you may be permanently incapable of work you may be able to transfer to Invalidity Pension.

In certain circumstances applicants for Illness Benefit may qualify for Invalidity Pension without the need to be in receipt of Illness Benefit for 12 months. Your eligibility will be determined by a medical assessment by the Department of Employment Affairs and Social Protection.

If you have been getting Illness Benefit for a period of 468 days, you will be medically assessed for continued entitlement to Illness Benefit and possible entitlement to Invalidity Pension.

>> back to top


Contact Us

Telephone

You can speak, in complete confidence, to an Information Officer in the Information and Advocacy section directly at 01 - 856 0088 , Monday - Thursday 9.30 am to 5.00 pm and Friday 9.30am to 4.00pm.

Online

Use the online Contact Us form on the INOU website

E-mail

You can send your query directly to us by e-mail at welfare@inou.ie