Due to the spread of coronavirus, many legal questions also arise for employees, particularly if they are sick with Covid-19. Who pays if I have to go into quarantine? Will I still receive my full salary? In this case, what is the situation regarding claiming daily sickness benefits?
Franziska Venghaus-Eisterer, a lawyer at AXA-ARAG, answers the most important questions about benefits from accident insurance, daily sickness benefits insurance and disability insurance in the event of illness with Covid-19.
You can apply for benefits from accident insurance, for instance, if you are ill with SARS or Ebola. Medically these can be clearly assigned to a particular group of diseases. Additional requirements must be met for this group of diseases, such as working in hospitals in the case of infectious diseases (SARS) or a work-related trip to tropical or sub-tropical areas for symptoms of hemorrhagic fever (Ebola).
Accident insurance covers all the costs of necessary medical tests, even if the suspected illness is not subsequently confirmed. If quarantine is medically required, accident insurance will pay the daily benefits due to the resultant incapacity for work.
Please note: The costs of simple health screening or other prophylactic measures without concrete suspicions of other illnesses are not covered. These are dealt with through the health insurer.
Yes, if you are ill with coronavirus, you will receive daily sickness benefits.
In this case, your employer must arrange for you to carry out your work commitments from home. If this is not possible, your employer must give you equivalent replacement work that you can do from home and for the same salary.
If your presence at work is wholly or partially necessary for operational reasons, you may carry out your normal activities there if protective measures can be followed. If it is not possible to employ you under these circumstances as a vulnerable person, your employer must release you but continue to pay your salary.
Daily sickness benefits insurance compensates for loss of work due to illness-related incapacity for work, such as a painter suffering from acute back pain, a driver unable to use his hand due to tendinitis or employees unable to carry out their work due to mental health problems.
In practice, the definition of incapacity for work for daily sickness benefits insurance is often interpreted as follows: Incapacity for work is the full or partial inability to exercise the previous profession and perform work that can be reasonably expected due to an impairment of bodily, mental or psychological health.
Legally it is still an open question as to whether those who are particularly affected but may not attend work as a precautionary measure despite being healthy are deemed unfit for work. What is certain is that it is unreasonable for vulnerable people to work. According to the Federal Supreme Court, a person is specifically deemed unfit for work if, as a result of health damage, they are no longer able to perform their former activity or only able to perform it to a limited degree or in a manner that risks worsening their state of health.
If a vulnerable person cannot work because there is a special risk of a severe outcome associated with an illness, then strictly speaking, this is health-related incapacity for work. It is therefore advisable to ask the employer to inform the daily sickness benefits insurer.
Yes, disability daily benefits will continue to be paid out in connection with reintegration measures. Regardless of whether the reintegration institution – such as a protected workshop – is closed due to coronavirus, the insured person falls ill or stays home as a precautionary measure.
(NB: This is a decision by the Aargau social security insurance, not an official directive).
If you have to go into quarantine, you will receive up to ten daily benefits per quarantine case. To receive the compensation, you must register with your compensation fund using the registration form for coronavirus compensation for loss of earnings (in German).
You can find more information in English here.