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Illness Benefit

Information

You may get Illness Benefit from the Department of Social Protection if you cannot work because you are sick or ill. You must be aged under 66, covered by the appropriate class of social insurance (PRSI) and satisfy the PRSI conditions.

Illness Benefit is not linked to your employer's policy on pay for sick leave (your employer can decide their own policy on sick pay and sick leave). More information is available in our document about sick leave and employment.

Whether your employer pays you or not while you are out sick from work, you should claim Illness Benefit from the first day of your illness – see “Rules” below. If you get sick pay from work, you should ask your employer what administrative arrangements are in place while you are claiming Illness Benefit.

If your income is too low to meet your needs, while you are waiting for a decision on your claim for Illness Benefit, you may be entitled to basic Supplementary Welfare Allowance, which is a means-tested payment.

Rules

You must apply for Illness Benefit within 7 days of becoming ill. No payment is made for the first 6 days of illness which are known as waiting days. (Note that this was extended from 3 to 6 days from 6 January 2014.) The only time that the 6 waiting days are not applied is if you were getting certain other social welfare payments within 3 days of the start of your illness.

Whether you qualify for payment or not, you should always submit a claim for Illness Benefit when you are certified unfit for work. You may be entitled to PRSI credited contributions for each week you are ill and these could help you qualify for future social welfare payments.

Social insurance (PRSI) contributions

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

  1. You must have at least 104 weeks PRSI contributions paid since you first started work

    and either 2(a) or 2(b)

  2. (a) 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 contributions in one of the following tax years can be used instead:
    • Either of the two tax years before the relevant tax year
    • The last complete tax year (before the year in which your claim for Illness Benefit begins)
    • The current tax year

    or

    (b) 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:

Relevant tax year
If your claim begins in: The relevant tax year is:
2012 2010
2013 2011
2014 2012
  • Only PRSI contributions paid at class A, E, H and P count towards Illness Benefit.
  • If you were getting long-term Jobseeker's Allowance, Pre-Retirement Allowance, Invalidity Pension, Carer's Allowance or Carer's Benefit immediately before applying for Illness Benefit, you do not need to have 13 paid contributions.
  • If you were getting Occupational Injury Benefit (OIB) 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.

To help you qualify for Illness Benefit you may combine your Irish PRSI contributions with social insurance contributions from a country covered by EU Regulations (and the Channel Islands and the Isle of Man which are covered under a bilateral agreement).

How long is Illness Benefit paid?

Illness Benefit is paid for a maximum of:

  • 2 years (624 payment days) if you have at least 260 weeks reckonable social insurance contributions* paid since you first started work

    or

  • 1 year (312 payment days) if you have between 104 and 259 weeks reckonable social insurance contributions* paid since you first started work

*Reckonable social insurance contributions paid in Ireland, EU countries, Channel Islands and the Isle of Man may be combined for this purpose.

Before your payment is due to stop you will be contacted by the Department of Social Protection telling you when payment will stop and giving you further information on options available:

  • If you are ill, likely to be permanently incapable of work and satisfy the PRSI conditions you may qualify for Invalidity Pension
  • If you do not qualify for Invalidity Pension and you have a disability that is expected to last for a year or more you may qualify for a means-tested Disability Allowance
  • If you do not qualify for any other payments and your income is too low to meet your needs you may qualify for a basic Supplementary Welfare Allowance
  • If your Illness Benefit is ending because you are turning 66 you may be eligible for a State Pension. You should apply 3 months before your 66th birthday.

If you return to work you must have a minimum of 13 reckonable PRSI contributions paid before you may requalify for Illness Benefit. (All other qualifying conditions must also be satisfied.)

If you were on Illness Benefit for 1 year only you may requalify with fewer than 13 contributions, if additional contributions bring your total PRSI contributions paid up to 260. (So, for example, if you had 250 contributions when your IB expired you could work and pay 10 contributions to requalify.)

Transfer from Carer's Benefit or Carer’s Allowance

If you transfer from Illness Benefit to Carer's Benefit or Carer's Allowance and then back to Illness Benefit, your Illness Benefit will not be paid at a lower rate than that you were paid previously.

Work and Illness Benefit

You cannot work while you are getting Illness Benefit (you can do voluntary work in some cases). If you have a current Illness Benefit claim and have been getting Illness Benefit for at least 6 months you can apply for Partial Capacity Benefit (PCB). PCB is a scheme which allows you to return to work (if you have a reduced capacity to work) and continue to receive a social welfare payment. A Medical Assessor (who is a doctor employed by the Department of Social Protection (DSP)) will assess the restriction on your capacity for work, and the personal rate of PCB paid is based on this assessment. You cannot take up work until you have written approval to do so from the DSP.

You cannot undertake a training or educational course or do voluntary work without prior, written approval from the Department of Social Protection. You must apply to the Illness Benefit section for this approval. From 1 January 2014 new participants on SOLAS training courses can retain Illness Benefit but cannot get a training allowance or training bonus at the same time.

Illness Benefit and other social welfare payments

Blind Pension If you are getting Blind Pension you may also get Illness Benefit if you are ill and unable to work and you satisfy the PRSI conditions.
Carer's Allowance If you are getting Illness Benefit and you satisfy the conditions for Carer's Allowance, you may get half the personal rate of Carer's Allowance along with your Illness Benefit payment.

It may also be possible for you to receive an Increase for a Qualified Adult for someone on your Illness Benefit claim while they receive a half-rate Carer's Allowance for caring for you or someone else.

Disablement Benefit If you are getting Disablement Benefit you may also get Illness Benefit if you are ill, unable to work and satisfy the PRSI conditions (provided that the Disablement Benefit payment does not include an increase for Incapacity Supplement).
Domiciliary Care Allowance/Respite Care Grant Illness Benefit is payable if you are getting Domiciliary Care Allowance and /or the Respite Care Grant.
Family Income Supplement (FIS) If you are receiving Family Income Supplement (FIS) and become ill, payment of FIS may continue with Illness Benefit for up to 6 weeks.
Widow’s, Widower’s or Surviving Civil Partner’s Pension (including occupational widow’s/widower’s pensions) and One-Parent Family Payment, Deserted Wife's Allowance/Benefit or Prisoner’s Wife's Allowance If you are getting any of these payments at the full rate you cannot get Illness Benefit at the same time. However if you are getting a reduced rate of one of these payments and become ill you may qualify for a reduced rate of Illness Benefit (so that the combined amount of both payments is not greater than the rate of IB to which you are entitled).

Payment of Illness Benefit abroad

You can continue to get Illness Benefit if you go to live in another country covered by EU Regulations. You must tell the Department of Social Protection in advance (otherwise you may lose payment or your payment may be delayed).

If you go to live in another country covered by EU Regulations and become ill you may apply for Illness Benefit from Ireland if you paid your last insurance contribution in Ireland or you were getting Jobseeker’s Benefit in Ireland before you went abroad.

Illness Benefit is not paid in countries not covered by EU Regulations. However, if you go to a country not covered by EU regulations to get approved treatment your payment may resume when you return.

Reviews of Illness Benefit

Your Illness Benefit claim will be reviewed from time to time and you may be asked to attend for a medical assessment. This assessment will be carried out by a Medical Assessor, who is a doctor employed by the Department of Social Protection. The Medical Assessor will give an opinion on whether or not you are fit for work. You must attend for a medical assessment when asked, or your benefit will be suspended.

If your Illness Benefit is stopped, you have a right to appeal the decision - see ‘Where to apply’ below. If you are receiving credited contributions only and these are stopped, you can seek a review of the decision but you do not have a right to appeal it.

Rates

Usually no payment is made for the first 6 days of illness and no payment is made for any Sunday during your illness. Note that this was extended from 3 to 6 days from 6 January 2014.

Illness Benefit rates are graduated according to your average weekly earnings in the relevant tax year. Average weekly earnings are calculated by dividing the total reckonable gross earnings (without deductions) in the relevant tax year by the actual number of weeks worked in that year.

Weekly payment in 2014 for claims started in 2009 or after

Average weekly earnings Personal rate, € Qualified adult rate, €
€300 or more 188 124.80
€220 - €299.99 147.30 80.90
€150 - €219.99 121.40 80.90
less than €150 84.50 80.90

Weekly payment in 2014 for claims started in 2008 or before:

Average weekly earnings Personal rate, € Qualified adult rate, €
€150 or more 188 124.80
€125 - €149.99 147.30 80.90
€80 - €124.99 121.40 80.90
less than €80 84.50 80.90

Illness Benefit can be paid directly into your bank, building society account. or to an account in a credit union which offers the facility for Electronic Fund Transfer (EFT).

Spouses, partners and children

You can get an increase in your payment for an adult dependant or child dependant if you meet certain conditions.

Taxation of Illness Benefit

Illness Benefit, both the personal rate and Increase for a Qualified Adult, (excluding increases for child dependants) is considered to be 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 or civil partner. Contact Revenue for more information.

How to apply

You should apply for Illness Benefit within 7 days of becoming ill. A delay of more than 7 days may cause you to lose some of your payment. If there is a good reason for a delay in applying, your payment may be backdated.

You can get a first social welfare medical certificate (known as MC1), which includes an application form for Illness Benefit, from your family doctor (GP) or hospital doctor. The reason you can only get this form from a doctor is because a doctor must complete the medical certificate part of the form.

You must see your doctor and send in an intermediate medical certificate (known as MC 2) each week for as long as you are ill, unless you are told otherwise.

You must get a final medical certificate from your doctor before you go back to work.

Note that in all cases social welfare medical certificates (MC1 and MC2) are not available online or from DSP offices. They are only available from doctors who are on the Department's panel of medical certifiers.

You are not required to pay for a social welfare medical certificate as the Department pays the doctor an agreed fee. However, you may have to pay for the medical examination.

If you wish to make a backdated claim for Illness Benefit you need to supply a First Medical Certificate (MC1) stating the date the illness began, a letter from your doctor giving details of your illness and treatment and a current MC2 certificate.

If you have any difficulties completing the forms, staff in your local social welfare office will be happy to help you. Any questions you have about Illness Benefit should be made directly to your social welfare local office or you can call the Illness Benefit enquiries telephone line - see 'Where to apply' below.

Appeals

If you think you have been wrongly refused Illness Benefit you can ask for the decision to be reviewed. You can also appeal the decision to the Social Welfare Appeals Office, either straightaway or after the review. You must request a review or appeal a decision within 21 days of being informed of the decision.

Where to apply

Illness Benefit

Department of Social Protection
P.O. Box 1650
Dublin 1
Ireland

Tel:(01) 704 3300
Locall:1890 928 400
Homepage: http://www.welfare.ie/

You can email the Illness Benefit section using the secure enquiry form.

Page updated: 11 November 2014

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Contact Us

If you have a question relating to this topic you can contact the Citizens Information Phone Service on 0761 07 4000 (Monday to Friday, 9am to 8pm) or you can visit your local Citizens Information Centre.