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May 3, 2023

What Is Illness Benefit in Ireland? Eligibility, Coverage & More

Illness Benefit is a social welfare payment you may get if you’re sick and unable to work. Find out who’s eligible, payment rates, how to apply, and more.

Aine Kavanagh

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Aine Kavanagh

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Illness Benefit in Ireland is a public health service payment made to people who are too sick to work.

But you must meet certain requirements to be eligible for the payment. 

Read on to learn everything about Ireland’s Illness Benefit.

What Is Illness Benefit?

Illness Benefit is a weekly social welfare payment you may receive if you cannot work due to sickness or ill health. 

You can apply for Illness Benefit if you meet the requirements and are medically certified as unfit for work. (More on these requirements in a minute).

This payment is covered by Pay Related Social Insurance (PRSI) — a system of social insurance contributions paid by employees, employers, and self-employed individuals. 

But look:

Illness Benefit is independent of your employer’s pay policy for sick leave. 

If you receive sick pay, you should ask your employer what arrangements are in place concerning Illness Benefit. For example, their sick pay policy may cover the difference between your usual pay and the Illness Benefit you receive. 

Who Qualifies for Illness Benefit?

You can apply for Illness Benefit if you:

  • Are under 66 years old.

  • Have been certified unfit for work by a medical doctor.  

  • Submit your application within six weeks of illness. 

  • Have sufficient social insurance (PRSI) contributions under one of the applicable classes (A, E, H, P). 

What’s the deal with the PRSI contributions?

Let’s discuss this now. 

1. PRSI Payment Contributions 

You can qualify with a minimum of 104 weeks of PRSI contribution payments made since you first began work. 

You must also have 26 weeks of PRSI contributions paid in the relevant tax year and 26 weeks of PRSI contributions made in the tax year immediately before the relevant tax year.

The relevant tax year is the second-last complete tax year before your claim year. For example, if your claim begins in 2024, the relevant tax year is 2022.

Alternatively:

You must have a minimum of 104 weeks of PRSI contributions paid since you first started work AND a minimum of 39 weeks of PRSI contributions credited or paid in the relevant tax year.

Of the 39 weeks of PRSI contribution, 13 must be paid contributions. 

Don’t have 13 paid contributions in the relevant tax year?

You can use the same number of paid contributions in one of these tax years:

  • The current tax year

  • One of the two tax years before the relevant tax year

  • Your last complete tax year (before filing your claim for Illness Benefit).

2. Applicable PRSI Classes

To receive Illness Benefit, your contributions must be under one of the applicable classes:

  • Class A: People employed under a contract in industrial, commercial, and service sectors earning €38 or more per week. This includes public and civil servants employed from 6 April 1995.

  • Class E: Religious ministers in the employment of the Representative Body of the Church of Ireland.

  • Class H: This includes all non-commissioned officers and enlisted defence personnel.

  • Class P: Share fishermen or fisherwomen who classify as self-employed and who already pay PRSI under Class S (Self-employed people).

What’s more?

  • You don’t need to have 13 paid contributions if you were getting:

    • Long-term Jobseeker’s Payment (Long-term Jobseeker’s Allowance)

    • Invalidity Pension

    • Carer's Allowance or Carer's Benefit 

       

  • If you received Occupational Injury Benefit (OIB) right before you applied for Illness Benefit, you could choose to base your eligibility on either the tax year that was relevant to your OIB claim or the tax year that applies to your Illness Benefit claim.

    • For instance, if you received OIB in 2022 and apply for Illness Benefit in 2024, you can use either your 2022 or 2024 tax year to determine your entitlement to Illness Benefit.   

    • This way, if you missed PRSI contributions due to injury in 2022, you can use your 2024 tax year instead.

  • To be eligible for Illness Benefit, you can rely on your Irish PRSI contributions and social insurance contributions from a country that falls under the EU regulations or the UK.

    • However, you must have made your most recent social insurance contribution in Ireland. The contribution may depend on your pay period, whether monthly, fortnightly or weekly. 

    • For example, if you are an Irish citizen who has worked in Germany and the UK, you can count the social insurance contributions you made in those countries towards your eligibility for Illness Benefit in Ireland — provided your last contribution was paid in Ireland.

What If You Don’t Qualify for Illness Benefit?

  • You may still get PRSI credited contributions, which may help you qualify for future social welfare payment.

  • You may get a Supplementary Welfare Allowance (also available when waiting for a decision on your Illness Benefit claim). 

Illness Benefit Payment Rates

Illness Benefit is paid each week. 

The rate paid depends on your average weekly earnings in the relevant tax year. 

What does that mean?

Your average weekly earnings are the gross earnings before deductions in the relevant tax year, divided by the number of weeks you worked that year. 

For instance, the payment rate is €232 for average weekly earnings of €300 or more. 

You may also be eligible for an increase in payments if you have an adult/child dependant. For further information, check out our guides on:

How Long Can You Receive Illness Benefit Payments?

Illness Benefit is paid for a maximum of either:

  • 1 Year (312 payment days): If you’ve got 104 - 259 weeks of social insurance contributions paid since first starting work OR

  • 2 Years (624 payment days): If you’ve got at least 260 weeks of paid social insurance contributions since you first started work.

If you make a new Illness Benefit claim within 26 weeks of your last claim, it will be treated as one claim. 

Once you’ve used up your Illness Benefit and returned to work, you need to make at least 13 PRSI contributions before you can qualify again for Illness Benefit. 

However, you may qualify for Illness Benefit again with fewer than 13 contributions if:

  • You received Illness Benefit only for 1 year AND 

  • Additional contributions (after you return to work) bring your total contributions up to 260.

Periodic Review of Illness Benefit

Your Illness Benefit will be reviewed occasionally, and you may have to undergo a medical assessment. 

Assessments are conducted by a medical assessor, a doctor employed by Ireland’s Department of Social Protection (DSP). They will give their opinion on whether you are fit for work. 

When asked, you must attend these medical assessments or risk suspension of your Illness Benefit. If your benefit is suspended, you can appeal the decision. 

What happens when your Illness Benefit ends, but you still can’t work? 

You may be eligible for:

  • Invalidity Pension: If you are ill and most likely incapable of working and satisfy the PRSI conditions.

  • Disability Allowance: If you don’t qualify for Invalidity Pension but have a disability that’s expected to last one year or more. 

  • Supplementary Welfare Allowance: If you don’t qualify for any of the other Social Welfare payments and your income does not meet your needs. 

  • State Pension: If your Illness Benefit is ending because you are turning 66 years old. You’ll need to apply three months before your 66th birthday.

Are Illness Benefit Payments Taxable?

Illness Benefit payments are taxable. 

Increases for qualified adult dependants are also taxable, but increases for child dependants are not taxed.

Remember:

Illness Benefit payments are made to you without any tax deductions. Taxation happens by reducing your tax credits and rate band. 

Revenue will consider the amount of Illness Benefit paid to you when they adjust your tax credits or review the tax of your spouse or civil partner — whether you’re employed or unemployed. 

What Other Social Welfare Payments Can You Claim with Illness Benefit?

You may qualify for Illness Benefit and another social welfare payment at the same time. 

The social welfare payments that can be paid with Illness Benefit are:

1. Blind Pension

Provided you meet the qualifying criteria for both Illness Benefit and Blind Pension.  

To qualify for Blind Pension, you must have an eye test conducted by an ophthalmic surgeon. 

2. Carers Allowance

Half-rate Carer's Allowance can be paid with the Illness Benefit if you meet the qualifying conditions. 

If you get an increase in your Illness Benefit for an adult dependant, your adult dependant may also qualify for a Half-rate Carer's Allowance.

3. Disablement Benefit

You will need to meet the qualifying criteria for both benefits. 

However, your Disablement Benefit should not include an Incapacity Supplement.

4. Domiciliary Care Allowance/Carer's Support Grant

Both benefits can be paid, provided you meet the qualifying criteria for both.

5. Working Family Payment and Back to Work Family Dividend

If you’re receiving Working Family Payment (WFP) and fall ill, you can continue to receive WFP with Illness Benefit for up to 36 days (6 weeks). 

You can continue to receive Back to Work Family Dividend payments with Illness Benefit for 36 days (6 weeks).

6. Widow’s, Widower’s, or Surviving Civil Partner’s Pension

If you’re getting full rate payments for these benefits, you CANNOT get Illness Benefit at the same time. 

But, if you’re getting a reduced rate of one of these payments and become ill, you may get a reduced rate of Illness Benefit. In this case, both payments together will give you the maximum rate of Illness Benefit entitlement.

Illness Benefit Application Process

You must apply for Illness Benefit within 6 weeks of becoming ill. If this is impossible and you have a good reason for the delay, your payment may be backdated. 

To apply for Illness Benefit, you can submit the online form at mywelfare.ie or complete the physical form and send it to the Illness Benefit Section’s office.

The documents required include the Illness Benefit Claim Form (IB1) and a Certificate of Incapacity for Work. You can get the certificate from your doctor. 

Here are some resources to help you out:

Were you refused Illness Benefit? 

You can appeal to the Department within 21 days of getting the decision.

Closing the Illness Benefit Claim

Once you are fit to return to work, you must close your claim. 

Your doctor should mark your last Certificate of Incapacity for Work as final before you return to work.

If you can’t get the certificate marked, notify the Department’s Illness Benefit – Close My Claim section via email: [email protected]

Returning to Work Following Illness Benefit

You cannot work while receiving Illness Benefit. 

Should you wish to start working while receiving Illness Benefit, you can apply for Partial Capacity Benefit (PCB). 

If approved, your PCB payment will replace your Illness Benefit payment.

What Is Partial Capacity Benefit?

It’s a social welfare benefit that allows you to work with a reduced capacity, provided you’ve been getting Illness Benefit for at least 6 months. 

Once you apply, a medical assessor (a doctor employed by the Department of Social Protection) will assess your capacity for work. The rate of PCB paid is based on this assessment.

You can start work (including training, educational courses, or voluntary work) only once you have written approval from the Department of Social Protection.

Moving from Illness Benefit to Invalidity Pension

After 468 days of Illness Benefit, you will be medically assessed to determine if you still qualify for Illness Benefit or if you qualify for Invalidity Pension. 

Invalidity Pension is a weekly payment for those that can’t work due to long-term illness or disability and are covered by social insurance (PRSI).

Are There Any Benefits for Carers?

If you have a full-time, live-in carer who left the workforce to care for you, they may qualify for Carer’s Benefit.  

These are the qualifications they must meet: 

  • Be over 16 years of age. 

  • Be employed for at least eight weeks, consecutively or not, in the previous 26-week period of commencing Carer's leave.

  • Worked for a minimum of 16 hours a week or 32 hours a fortnight within the eight week period.

  • Their maximum salary is €350 a week after taxes.

  • They meet the social insurance (PRSI) contribution conditions — at least 156 contributions paid at any time since they started working AND one of the following:

  • 39 contributions paid in the relevant tax year  OR

  • 39 contributions paid in the 12-month period before the start of Carer's Benefit OR

  • 26 contributions paid in the relevant tax year and 26 contributions paid in the year before that.

  • Only PRSI contributions at Class A, B, C, D, H and E qualify. 

Child carers may qualify for Carer’s Benefit if the childcare recipient receives Domiciliary Care Allowance (DCA).

Carer’s Benefit Payment Rates

  • €249 a week for one care recipient.

  • €373.50 a week if you care for two or more care recipients.

  • Carers with children may be entitled to apply for an Increase for a Qualified Child.

How to Apply For Carer’s Benefit

Anyone applying for Carer’s Benefit should do so at least 10 weeks before leaving work. 

Fill in the application form, including a doctor’s report signed by the person being cared for. 

Send the filled application form and the relevant supporting documentation to:

Carer's Benefit Section

Address: Social Welfare Services Office, Government Buildings, Ballinalee Road, Longford, Co. Longford, N39 E4E0

Website: www.gov.ie

Email: [email protected]

Phone number: 0818 927770

For more information, contact your Social Welfare Branch Office, Intreo Centre or the Social Welfare Services Office. 

Hassle-Free Employee Benefits Management with Kota

If you’re an employer, you want to see your employees well cared for when sick, right?

Fortunately, there’s an easy way to manage employee health insurance and retirement benefits through Kota

On top of Ireland’s Illness Benefit, Kota lets you offer health, dental, and vision plans with hospital care packages for your team. 

What’s more? You can stay on top of everything right from the Kota app. 

Join Kota to manage your firm’s employee benefits effortlessly.

Aine Kavanagh

Article written by

Aine Kavanagh

👋🏻 Hi I'm Aine, Head of Customer Success at Kota. Whether you're a Kota customer, a Kota user, or you're just browsing, I hope to help educate and empower those who want to know more about owning their own benefits, and building financial autonomy 📚

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