This gives general information on Sickness Benefit provided by the Turks and Caicos Islands National Insurance Board. For more specific information about your case please contact an office of the National Insurance Board nearest you.
Who Can Receive Sickness Benefit?
Sickness Benefit can be paid to an insured employed person between the ages of 16 and 65 years (with the exception of a public officer) who is found to be incapable of work as a result of some specific disease, or bodily or mental illness and satisfies the necessary contribution conditions.
What Are The Contribution Conditions For The Payment Of Sickness Benefit?
To qualify for Sickness Benefit, an employee or self-employed person
- must have paid at least 26 contributions into the National Insurance Board;
- must have paid at least 8 contributions in the first 13 weeks of the last 26 weeks just before the week in which he/she became ill and could not work;
- must have worked immediately before the first day that he/she became ill.
When To Apply?
You should apply within 6 days of becoming ill. If the claim is submitted late, sickness benefit will be paid in arrears for six days from the date that the claim is submitted. In exceptional cases, however, where the claimant can prove that there is good cause for claiming late, the period of 6 days may be extended to 13 weeks. If your illness does not extend beyond three days, you are not entitled to a Sickness Benefit and therefore should not apply.
How To Apply?
You can apply by first collecting a Sickness Benefit application form from the National Insurance Board’s office. Complete the application form (we will need information from you and your employer) and return it to the Board’s office along with a medical certificate from your doctor, therapist, hospital or clinic.
What Is The Payment Period For Sickness Benefit?
Sickness Benefit is payable after the third consecutive day of your illness e.g. if you are sick for 4 days, sickness benefit is payable for one (1) day only. As from the 4th day, sickness benefit will be paid for each day that you are ill (excluding Sundays) and unable to work. Sickness Benefit may continue for up to a maximum of 156 days.
How Much Is Sickness Benefit?
How much you can receive from the National Insurance Board depends on your average weekly earnings over a specified period. That means the higher the earnings, the higher the benefit will be. The weekly rate of Sickness Benefit is 60% of your average weekly earnings. It is calculated on the average weekly earnings paid or credited on your behalf during the first 13 weeks of the last 26 weeks immediately before you became ill. The daily rate of Sickness Benefit is 1/6th of the weekly rate.
How Is Payment Made?
Sickness Benefit schedules are prepared for beneficiaries on a weekly basis. Schedules can be collected at a convenient National Insurance Board office and must be cashed within 6 months from the date of issue. If you prefer, you can include the name of your bank along with your current or savings account number and your benefit will be directly deposited.
Under What Conditions Is The Beneficiary Disqualified From Receiving Sickness Benefit?
The beneficiary is disqualified from receiving Sickness Benefit up to 6 weeks if:
- he has become incapable of work through his own misconduct;
- he fails to obtain a medical examination or take the prescribed treatment;
- he behaves in a manner that will retard his recovery; or
- performs remunerative work.
Duplicate Rights
When an insured person is entitled to two or more benefits paid at the same time, he/she will be entitled to receive the benefit which is payable at the highest rate.
If You Disagree With A Decision We Have Made
The Director decides claims for benefits. If there is a decision to disallow your claim for Sickness Benefit, a letter explaining the decision will be sent to you. If you disagree with the decision you may appeal to an Appeals Tribunal within 21 days from the date of the decision; in this way you will be asking for a review of your specific case. If the decision was wrong, it will be changed. If you are dissatisfied with the decision of the Appeals Tribunal, a further appeal can be taken to the Supreme Court, but on a point of law only.
Claimants with questions about Sickness Benefit should contact the nearest Board office. Board offices are open to the public from 9:00 a.m. to 4:30 p.m., Monday through Friday.