Paid Sick Leave and Statutory Health Insurance
DOI: 10.3238/zfa.2012.0162-0169german translation / full article
Introduction: Since 2007, the absenteeism rates and expenditures for paid sick leave in Germany’s statutory health insurance (SHI) system have been increasing. In light of this development, the topic of paid sick leave under SHI is discussed from the perspective of social medicine. The critical assessment of these changes and possible consequences are the topics of this paper.
Methods: We describe the definition of paid sick leave and the incapacity to work, the criteria for determining the need for paid sick leave, its relevance for patients and society’s sense of solidarity, practical information about providing fit notes and assessing the need for paid sick leave.
Results: A distinction must be made between diagnosing a disease and determining that a patient should be placed on sick leave. A patient’s inability to work cannot be determined until the demands of the workplace are reviewed along with the effects of a disease or condition on someone’s ability to work. Medically justified sick leave is a situation which offers relief to patients. Whilst going on sick leave can be necessary, it can also mean removing patients from a key area of their lives, and negative consequences can ensue.
Discussion: Like every other kind of treatment, being placed on sick leave can trigger adverse effects. To minimise their impact, a constructive cooperation between physicians treating patients and those providing medical assessments seems to be necessary. This helps to keep respective patients as integrated as possible in their work lives.