Social insurance cardholders can claim sickness and maternity benefits on the National Public Service Portal from June 15

30/05/2022 08:24 AM


HANOI —Vietnam Social Security has decided to launch online public services to settle sickness, maternity and convalescence benefits on the National Public Service Portal.

The sickness benefits are for employees participating in compulsory social insurance who suffer from an illness or accident that is not an occupational accident or receive treatment for recurrent injury or illness due to an occupational accident or disease. They must have a medical certificate issued by a competent medical facility in accordance with regulations of the Ministry of Health.

People will be eligible for the sickness benefits if they are employees who participate in compulsory social insurance and must be off work to take care of their sick children under 7 years old and certified by a competent medical facility. Female employees who go to work before the end of their maternity leave and fall into one of the cases specified above will also get sickness benefits.

The sickness regime will not be settled for cases where the employee leaves work due to sickness/accident as they self-damage their health due to drunkenness or the use of drugs/drug precursors listed in Decree No 82/2013/ND-CP and Decree No 126/2015/ND-CP. The employee who is absent from work for the first time for treatment due to occupational accident and disease or those who suffer an illness/accident that is not an occupational accident while on annual leave, personal leave, or unpaid leave in accordance with the labor law or maternity leave will not be eligible to claim sickness benefits.

VSS launches online public services that deal with sickness, maternity and convalescence benefits. VGP Photo

For maternity benefits, employees are entitled to maternity benefits when falling into one of the following cases: pregnant female employees; female employees who give birth; female employees as surrogate mothers and mothers asking for surrogacy; employees who adopt children under six months old; female employees using an "intrauterine device"; or employees using sterilisation measures.

Male employees who are paying social insurance premiums are also eligible for maternity benefits when their wife gives birth.

The eligible employees must pay social insurance for full at least six months within the 12 months before giving birth or adopting a child. An employee who has paid social insurance premiums for the full 12 months or more but has to take a leave of absence from work to take care of the pregnancy under the direction of a competent medical facility, must pay social insurance premiums for full at least three months during the 12 months before giving birth.

To enjoy healthcare benefits after sickness, maternity, occupational accidents and diseases, employees who took sick leave for a full period of one year in accordance with regulations, including employees suffering from diseases that require long-term treatment following the Ministry of Health Health's regulations, within the first 30 days of returning to work but their health has not recovered.

The eligible also includes female employees, who after enjoying the maternity regime, within the first 30 days of returning to work but have not yet recovered their health.

Employees participating in compulsory occupational accident and occupational disease insurance after being treated for injuries caused by occupational accidents/diseases due to occupational diseases suffer a decrease of at least 15 per cent of their working ability, within the first 30 days of returning to work, but their health has not yet been recovered can claim the benefits too.

Dossiers for the insurance claim include:

Sickness regime for inpatient treatment: A copy of the hospital discharge certificate of the sick employees or their children who are under 7 years old. In case a patient dies at a medical facility, a copy of the death notice shall be required. In case the death notice does not show the time of admission, another document from the medical facility may be added, showing the time of admission. In case of referral for medical treatment during inpatient treatment, a copy of the referral letter or hospital transfer note is required.

For outpatient treatment, the employee prepares the original certificate of leave to enjoy social insurance. In case both parents take a leave of absence from work to take care of a child, the certificate of leave of either parent is a copy; or the hospital discharge certificate indicated by the doctor, the treating doctor gives additional leave after the inpatient treatment period.

In case the employees or their child is abroad, the medical examination paper issued by the overseas medical facility must be translated into Vietnamese.

The maternity regime is for female employees going for antenatal care, miscarriage, curettage, abortion, stillbirth or pathological abortion; employees who take birth control methods and receive inpatient treatment need a copy of the employee's discharge certificate; in case of referral for medical treatment during the treatment, a copy of the referral letter or a copy of the hospital transfer note is required.

In case of outpatient treatment, a certificate of leave for social insurance benefits or a copy of the hospital discharge certificate indicated by the physician or treating doctor for additional leave after the inpatient treatment period is required.

Female employees giving birth need to prepare a copy of the birth certificate or a copy of the confirmation of medical facilities about the child's birth.

In case a child dies after being born, employees need to prepare a copy of the birth certificate or a copy of the hospital's confirmation about the child's birth, a copy of the death certificate or a copy of the child's death notice.

In case the child dies right after being born but the birth certificate has not been issued, a copy or summary of the medical record or hospital discharge certificate of the mother or the surrogate female worker shall be substituted, showing that the child is dead.

In case the mother or female surrogacy worker dies after giving birth, a copy of the death certificate or extract of the death declaration of the mother or female surrogacy worker is required.

In case the mother after giving birth or the mother who asked for surrogacy after receiving the child is no longer healthy enough to take care of the child, there is also a record of medical treatment of the mother or the mother asking for surrogacy. In case of payment of inspection fee, there must be an invoice and receipt for collection of assessment fee; a list of inspection contents of the medical assessment-implementing establishment.

If employees have to take a leave from work to take care of their baby during pregnancy as prescribed in Clause 3, Article 31 of the Law on Social Insurance No 58/2014/QH13, additional documents are required.

In case of inpatient treatment: A copy of the hospital discharge certificate or Summary of medical records showing maternity leave.

In case of outpatient treatment: Certificate of leave to enjoy social insurance showing maternity leave. In case of having to undergo a medical review: Minutes of the preparation of a certificate of registration. In case of payment of inspection fee, there must be an invoice and receipt for collection of the assessment fee; and a list of inspection contents of the medical assessment.

In case the female employee is a gestational surrogacy worker, or the mother asks for a gestational surrogacy to receive the child, an additional copy of the agreement on surrogacy for humanitarian purposes as prescribed in Article 96 of the 2014 Law on Marriage and Family is required; and a written certification of the time of handing over the child of the surrogacy requesting party and the gestational surrogacy party.

In case the employee adopts a child under 6 months old: A copy of the adoption certificate.

In case a male employee or the husband of a female employee who is a surrogate mother quits her job when his wife gives birth to a child: A copy of the birth certificate or a copy of the birth certificate or an extract of the child's birth certificate; In case the birth requires surgery or gives birth to a baby under 32 weeks of age but the birth certificate does not show it, there is an additional document from the medical facility showing that the birth requires surgery or gives birth to a baby under 32 weeks of age.

In case the child dies immediately after being born without a birth certificate, it shall be replaced with a copy or summary of the medical record or hospital discharge paper of the mother or the female surrogate mother showing the death of the child.

The male employee or the husband of the mother who asks for surrogacy to receive a one-time allowance when the wife gives birth to a child: A copy of the birth certificate or a copy of the birth certificate or an extract of the child's birth. In case the child dies after being born without a birth certificate, a copy or summary of the medical record or a copy of the hospital discharge certificate of the mother or the surrogate mother showing that the child died. In case a male employee is simultaneously entitled to leave from work when his wife gives birth and a one-time allowance when his wife gives birth, he/she shall submit one application./.

VSS