To reduce the issuing of unjustified sick-leave sheets, the Ministry of Health (VM) is considering making it mandatory to indicate the diagnosis, in order to gain an understanding of the most common illnesses among employees.
According to the Ministry’s information report on the supervision of sick-leave sheet issuance and the handling of complaints, in 80.4% of cases last year, the cause on the sick-leave sheet was classified as “other cause.” As specifying the diagnosis is not currently mandatory, it is impossible to determine which illnesses (or causes) most often lead to sick leave.
The proposed solution would require that when a sick-leave sheet is issued with the cause marked as “other cause,” it must also include the name and code of the diagnosis, visible only to the healthcare sector.
Another proposal is to cancel an open sick-leave sheet after a set period if no updates are made to it for a prolonged time.
The Ministry also suggests
developing a mechanism in the sick-leave sheet regulations to reduce employees’ motivation to request them for the maximum possible term.
In its view, situations should be defined in which cancellation would not happen automatically – for example, if there are objective reasons for the lack of updates, such as medical institution errors or other specific cases.
Meanwhile, the Ministry of Justice (TM), responding to the Supreme Court’s (AT) concerns about the misuse of sick-leave sheets, will work with VM to create a form for health status certificates addressed directly to the court, TM told LETA.
To prevent further delays in court proceedings due to unjustified sick-leave sheets being used as an excuse for absence from hearings, the Ministry of Justice organised a discussion in June with representatives from VM, the Health Inspectorate, the Prosecutor’s Office, and the courts. It was agreed that a sick-leave sheet cannot be considered indisputable proof for excusing a party from attending court.
The Ministry stresses that the current sick-leave sheet format and its contents do not meet court needs,
as historically it was not intended to serve as a justification for failing to fulfil court-related obligations. With TM’s support, VM will prepare the necessary amendments to introduce specialised court-addressed certificates more quickly.
VM data shows that last year the Health Inspectorate received 495 employer complaints about possibly unjustified sick-leave sheets, of which 117 cases – or 32.4% – resulted in corrective actions. Compared to 2023, there was an increase not only in the number of complaints examined but also in corrective actions taken – in 2023, there were 404 complaints and 79 corrective actions.
Most often, doctors are instructed to make corrections related to inaccurately stated causes of incapacity. For example, a cause might be listed as “caring for a sick child” (B-type sick-leave sheet), when in fact the child had bone fractures – in such cases, the payment period changes from 14 to 21 days, so the cause must be adjusted.
Cases have also been noted where an employee submits a self-signed declaration to a doctor stating that an injury was sustained outside of work. In such situations,
the cause must be changed from “workplace accident” to “other cause.”
The Ministry says that doctors must be supported through regular updates on changes to sick-leave sheets procedures, discussions on necessary improvements, and clear communication to ensure they always have the most up-to-date information.
VM also believes that discussions should continue to consider introducing a “treatment regime” for employees, to be recorded on the sick-leave sheet form.
According to the Ministry, workplace accidents remain a common cause of sick leave. Therefore, employers should be more involved and responsible, improving safety and working conditions to reduce accident risks and promote sustainable employee health.
Of all sick-leave sheets last year, 62,052 – or 11.6% of all A-type sick-leave sheets – were issued for 1 to 3 days.
In many such short-term cases, related to acute upper respiratory infections or contact with healthcare providers, the situation could be resolved directly between the employee and employer without opening a sick-leave sheet, VM notes.
In 73.4% of cases, A-type sick-leave sheets initially issued for 9 days were extended into B-type sick-leave sheets, most often in large medical centres and hospitals that start with a 9-day sick-leave sheet straight away.
However, the Ministry says it has no convincing data suggesting that sick-leave sheets issued for 9 to 10 days are unjustified. The analysed data does not show a trend of any specific medical institution or doctor issuing sheets for longer than the patient’s actual incapacity period.
No correlation was found between the number of sick-leave sheets issued and weekends, public holidays,
or school breaks.
The report notes that sick leave data should be assessed in the context of changes in other sectors – for example, the rising retirement age, as people tend to get sick more often in the years before retirement. Other influencing factors include changes in healthcare service availability, the introduction of new services, and changes in sick note issuance and payment rules during the Covid-19 pandemic.
VM points out that work will continue on the project Improving Medical Process Data Management, which will allow more detailed analysis of sick-leave sheets data to develop data-driven solutions and decisions.
National Health Service data shows that a total of 1,197,604 sick-leave sheets were registered in the e-Health system last year, compared with 1,238,749 in 2023. Of these, B-type sick-leave sheets made up the majority – 55.6%, and A-type – 44.4%. Since 2022, the number of both A and B-type sick-leave sheets has been decreasing, possibly due to the increased availability of remote work and changing health-related habits since the pandemic.
An analysis of sick-leave sheet holders by age shows that
the most common recipients are employees aged 30–39 and those of retirement age.
The highest numbers of sick-leave sheets are seen in the winter months and in March.
As reported, the question of evaluating the validity of sick-leave sheets has been discussed for several years.
In May, Minister of Health Hosams Abu Meri (JV) told LETA that both the diagnoses and the criteria for issuing sick-leave sheets may need to be reviewed to reduce their increase during court proceedings.
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