1. Conditions for enjoying sickness benefits
Article 42 of the 2024 Law on Social Insurance, No. 41/2024/QH15, Article 3 of Circular 12/2025/TT-BNV, employees who are subjects of compulsory social insurance contributions will be entitled to sickness benefits if they fall into one of the following cases:
- Treatment when sick and not a occupational disease.
- Treatment when suffering from an accident that is not a labor accident.
- Treatment when having an accident when traveling from residence to work or from work to residence according to reasonable routes and times according to the provisions of law on occupational safety and health.
- Treatment and occupational rehabilitation when injuries and illnesses recur due to work accidents, occupational diseases or accidents specified in clause (iii).
- Donating, taking, transplanting human body tissues and organs according to the provisions of law.
- Taking care of children under 7 years old who are sick.
The following subjects, if they fall into one of the above cases, are considered for settlement of sickness benefits:
- Female workers return to work before the end of maternity leave when giving birth. Maternity leave is as follows:
+ Female workers are entitled to maternity leave before and after giving birth for 6 months; the pre-partum leave period is no more than 2 months.
+ In case of female twins or more, from the second child onwards, for each child, the mother is entitled to an additional 1 month of leave.
- Father or person directly raising does not quit their job as prescribed in Clause 6, Article 53 of the 2024 Law on Social Insurance.
- Female employees using surrogacy, husbands of female employees using surrogacy or direct caregivers who do not quit their jobs as prescribed in Article 55 of the 2024 Law on Social Insurance.
- Employees during the period of temporary suspension of contributions to the pension and survivorship fund as prescribed in Clause 1, Article 37 of the 2024 Law on Social Insurance.
2. How to calculate sick leave benefits for social insurance in 2026
According to Article 6 of Circular 12/2025/TT-BNV, Article 45 of the 2024 Law on Social Insurance, No. 41/2024/QH15, the sickness benefit level for 2026 for employees is calculated according to the following formula:
Benefit level = (Monthly salary for social insurance contributions of the month immediately preceding the leave/24 days) x 75% x Number of days of leave as prescribed
In which:
- The salary used as a basis for social insurance contributions is implemented according to the provisions of Clause 1, Article 45 of the 2024 Law on Social Insurance, specifically:
+ Salary used as the basis for social insurance contributions of the most recent month before the sick leave month.
+ Salary used as the basis for social insurance contributions for the first month of social insurance participation or the month of re-enrollment if having to take leave to enjoy sickness benefits immediately in the first month of participation or the month of re-enrollment.
The month of re-enrollment is the month of re-enrollment in social insurance after the employee terminates the labor contract, working contract or resigns.
- The number of days of leave entitled to sickness benefits is calculated according to working days, excluding holidays, Tet holidays, weekly holidays and does not include the time coinciding with the leave time according to the provisions of labor law or full-time leave according to the provisions of other specialized laws or leave to enjoy maternity benefits, health recovery according to the provisions of social insurance law.
*Cases where employees quit their jobs due to illnesses on the List of diseases requiring long-term treatment that have passed the sick leave period but are still continuing treatment:
Benefit level = (Social insurance contribution salary of the month immediately preceding the leave/24 days) x Rate of sickness benefit (%) x Number of days of leave as prescribed
In which:
- The salary used as a basis for social insurance contributions is implemented as a worker in normal conditions.
- The benefit rate (%) is calculated as follows:
+ 65% if you have paid compulsory social insurance for 30 years or more.
+ 55% if you have paid compulsory social insurance for 15 years to less than 30 years.
+ 50% if social insurance has been paid for less than 15 years.
- The number of days of leave entitled to sickness benefits is calculated according to working days, excluding holidays, Tet holidays, weekly holidays and does not include the time coinciding with the leave time according to the provisions of labor law or full-time leave according to the provisions of other specialized laws or leave to enjoy maternity benefits, health recovery according to the provisions of social insurance law.
