If you take time off from work due to sickness

Injury and Sickness Allowance

Amounts paid

Average standard monthly remuneration over the most recent 12 months ÷ 30 × 75%, per day off work, aggregating the days paid up to the total payment period of 18 months from the date on which payment begins

Injury and Sickness
Allowance
Amount equal to two-thirds of the average standard monthly remuneration over the most recent 12-month period ÷ 30

＋

The association's
additional benefits
Amount equal to 9% of the average standard monthly remureration over the most recent 12-month period ÷ 30

When an insured person is unable to earn a salary or other income while taking time off work due to a nonoccupational sickness or injury, insurance will pay him or her an amount equal to two-thirds of his or her average standard monthly remuneration over the most recent 12-month period ÷ 30 per day off work, to help protect the livelihood of the insured person and his or her family. This is called “the Injury and Sickness Allowance”. Even if the insured person receives a salary or other income from his or her place of work, if the amount of such income is less than the Injury and Sickness Allowance then the difference in amounts is paid as Injury and Sickness Allowance.

The Association's additional benefits

Conditions for payment

This benefit is paid when all four of the following conditions are met.

• You are recuperating under treatment for sickness or injury (recuperation at home is acceptable).
• You are unable to perform your previous job because you are recuperating from sickness or injury.
• You have taken at least three consecutive days off.
  • * Payment of this benefit begins on the fourth consecutive day off.
  • * The first three days are referred to as the waiting period, and no benefits are paid for those days.
• You are unable to receive salary or other income
  • * Even if you are receiving a salary or other income, if the amount of such income is less than the Injury and Sickness Allowance then the Association will pay the difference.

Cases in which you are eligible to receive the Injury and Sickness Allowance and Maternity Allowance concurrently

If you become eligible to receive the Injury and Sickness Allowance and Maternity Allowance concurrently, payment of the Maternity Allowance will be granted priority. However, if the Maternity Allowance paid is less than the Injury and Sickness Allowance, the difference between the two amounts will be paid.

If you become eligible for Disability Employees' Pension

If you become eligible to receive Disability Employees' Pension under Employees' Pension Insurance (including the Disability Basic Pension under the National Pension program), payment of the Injury and Sickness Allowance will end.

Injury and Sickness Allowance benefits will not be paid after retirement if you receive Old-Age Employees' Pension or similar benefits.

Reference link

• After you leave your employer

However, the Association will pay the difference if the amount paid by the pension or other program in any of the above cases is less than the amount of the Injury and Sickness Allowance.

Information for those receiving Injury and Sickness Allowance or undergoing treatment for illness or injury

Many people receiving the Injury and Sickness Allowance or undergoing treatment for an illness or injury file claims for a disability pension late because they do not understand the structure of the disability pension system or how to file a claim for any subsequent exacerbation of a disability (claim filed by a person who did not have a disability pension grade at the date of certification of the disability but does qualify later due to worsening condition).

Be sure to file claims promptly. Filing late may reduce the total pension amount you are eligible to receive.

Reference link

• Information on disability pensions

Contact your local pension office or pension consultation center if you have any questions.
[Addresses of pension offices and pension consultation centers]
https://www.nenkin.go.jp/section/soudan/index.html

If the cause is a workplace accident

If the cause is an accident at the workplace or while commuting, Worker's Accident Compensation Insurance applies instead of health insurance. Check with the person responsible at your establishment for more information.

• * When even illnesses and injuries on-the-job are not targeted for benefits of the Worker's Accident Compensation Insurance, benefits of the health insurance are provided except the duties as the officer of the corporation (except for a corporation less than five employees).

When a person receiving injury and sickness allowance leaves the company

You can apply for Injury and Sickness Allowance even after leaving your employer if the following conditions are met:

• You were an insured person for an uninterrupted period of at least one year at the time you left your employer.
• You remain unable to work after leaving your employer due to an illness or injury incurred during employment.
  (You are not eligible for payment if you are unable to work due to an illness or injury incurred after leaving employment.)
• You were receiving or eligible to receive (*) Injury and Sickness Allowance at the time you left your employer.
  
  • * Eligibility to receive Injury and Sickness Allowance refers to the state of not receiving the Injury and Sickness Allowance due to receipt of salary compensation or other allowances (such as paid leave) although you satisfy the conditions to receive the Injury and Sickness Allowance and have applied for it.
• You are receiving no allowances provided by employment insurance after leaving employment.
  (You cannot receive both allowances provided by employment insurance and the Injury and Sickness Allowance simultaneously.)

As for continued receipt of benefits after leaving employment, you will be paid only statutory benefits, while Injury and Sickness Allowance Additional Sum (independent additional benefits from the Association) will not be paid after leaving employment.