SGK incapacity for work report is a medical leave certificate indicating that an insured person cannot work for a specified period due to a work accident, occupational disease, illness, or maternity. In SGK regulations the main concept is temporary incapacity for work and the associated temporary incapacity allowance. In other words, the payment commonly called “report money” by the public does not arise automatically with every report; the report must be issued by a physician or medical board authorized by SGK and the conditions of the relevant insurance branch must be met. SGK defines temporary incapacity as the insured’s temporary inability to work during the period of rest stated in the report due to one of these four reasons.
The most commonly confused point is this: obtaining a medical report and being entitled to the report payment are not the same. A person can receive a medical leave for health reasons; however, to receive payment from SGK, insurance status, minimum premium days, the type of report and, in some cases, additional declaration obligations are evaluated separately. Especially, payment rules differ between cases of illness and work accidents.
What Does an SGK Incapacity for Work Report Mean?
An incapacity for work report is an official medical document that shows a worker is unable to perform their job for a certain period. In practice this document produces three main effects:
- It legally documents the employee’s absence from work for the stated period.
- It allows the employer to follow the reported period through the system.
- If conditions are met, it forms the basis for SGK’s temporary incapacity allowance.
According to current SGK explanations, the temporary incapacity allowance is a monetary support paid for the days the insured is absent from work while on leave under the work accident, occupational disease, illness, and maternity insurance branches. Employers can also view the report via “visite” and handle related procedures through electronic systems.
Who Can Be Issued an Incapacity for Work Report?
An incapacity for work report is not only issued for serious work accidents. It is relevant in four main situations:
| Situation | Explanation |
|---|---|
| Illness | Issued when a health problem requires a break from work. |
| Work accident | Issued when an accident causes temporary inability to work. |
| Occupational disease | May be issued for health loss related to the nature of the job. |
| Maternity | Issued within the statutory periods for pregnancy and childbirth. |
The key point is that the worker must actually have a health condition requiring rest. The insured is expected not to work during the period stated in the report. Especially in maternity cases, if the insured works despite having a report, temporary incapacity allowance for the time worked will not be paid.
How Is an SGK Incapacity for Work Report Obtained?
You do not go directly to an SGK office to get a report. The process is handled through health institutions.
Examination and Medical Evaluation
The first step is to apply to an appropriate health provider such as a family physician, public hospital, university hospital, or a relevant specialty clinic depending on the medical condition. After examination, if the physician or, when necessary, a medical board concludes the person cannot work, they issue a rest report. For SGK, it is important that the report is obtained from physicians or medical boards authorized by the Institution. The SGK e-Report application allows health institutions to register reports in the system and, when needed, to correct existing reports.
Report Entered Into the System
Most of the application runs electronically today. When a report is processed through the e-Report infrastructure, related records are reflected in SGK processes. Therefore, in many cases the employee waits for the report information to appear in the system rather than chasing physical paperwork. However, if there is a system error, special situation, or missing record, it should be checked whether the report appears. SGK states that transactions for 4/a and 4/b insureds are carried out via the e-allowance program.
Informing the Employer
Even if the report appears electronically, the employee should inform the workplace. Employers can view report information and manage the required notification processes. According to SGK employer system guidelines, employers can access their employees’ leave information through the system and complete related procedures electronically.
What Are the Conditions to Receive Report Payment?
The critical distinction under this heading is the reason the report was issued.
Conditions for Illness
To be eligible for temporary incapacity allowance due to illness, SGK requires three main conditions:
- The insurance status must still be active on the date the rest begins.
- At least 90 days of short-term insurance premiums must have been reported within the one year before the start date of incapacity.
- The report must be obtained from physicians or medical boards authorized by the Institution.
Additionally, for illness the payment normally starts from the third day of incapacity — meaning SGK may not pay for the first two short-duration days.
Conditions for Work Accidents and Occupational Diseases
The rules are different for work accidents and occupational diseases. SGK states that for temporary incapacity allowance paid due to a work accident, no specific insurance duration, number of premium payment days, or age requirement is sought. If an insured person whose coverage is active becomes unable to work due to a work accident, the allowance applies. In these cases payment is made for every day when conditions are met.
Conditions for Maternity
For maternity, SGK requires that at least 90 days of short-term insurance premiums were reported or paid within the year prior to birth. The insurance status must be active on the date rest begins and the birth must occur. For 4/b insureds, another requirement for maternity allowance is that all premium debts including general health insurance must be paid at the payment date.
Are the Processes the Same for 4A and 4B?
No, they are not identical.
| Type of Insurance | Points to Note |
|---|---|
| 4A (employee) | The report and payment process largely runs electronically and is tracked through the employer system. |
| 4B (self-employed/Bag-Kur) | In some cases a declaration of non-working is required and the status of premium debt is important. |
According to SGK’s current explanations on work accidents and maternity, 4/b insureds must declare on e-Government that they did not work during the rest period. Also, for 4/b work accident, occupational disease and maternity allowances, premiums and related debts including general health insurance must be paid by the payment date. e-Government provides the “4B Incapacity for Work Report Non-Working Declaration Operations” service for this purpose.
How Is the SGK Incapacity Payment Calculated?
The basic rule for calculating the allowance is a percentage of daily earnings. According to SGK:
- For inpatient treatment: half of the daily earnings.
- For outpatient treatment: two-thirds of the daily earnings.
SGK applies these ratios uniformly across illness, work accident, occupational disease, and maternity. However, because illness payments start on the third day while work accident and occupational disease payments are made for every day, total amounts for the same report period can differ depending on the reason.
When Is the Payment Made and Where Can It Be Tracked?
The payment date depends on the file’s entry into the system, processing, and transfer to the bank. SGK indicates that temporary incapacity payments are made through contracted bank branches. 4/a and 4/b insureds can check payment status and amounts via e-Government’s “4A/4B Incapacity Payment View” service. For maternity, SGK also notes that an SMS notification can be sent when funds are transferred if the phone number is registered via e-Government.
If Insurance Has Ended, Is Report Payment Given?
This depends on the reason for the report. SGK’s guidance states:
- For work accidents, payments are generally not made for reports dated after the employment contract has ended.
- For illness and maternity, insurance status is considered lost, with some exceptions, starting from the tenth day after employment termination; reports beginning after that date do not generate allowance.
Therefore, it is not correct to expect automatic payment for every post-employment report. The alignment of employment termination date and report start date is especially important.
Practical Roadmap for 2026
For users seeking a quick answer, the process can be summarized as follows:
- For a health issue, work accident or maternity, apply to an authorized physician or health institution.
- If the physician deems it necessary, a rest report is issued.
- Check that the report appears in the system.
- Inform your workplace without delay.
- If you are a 4/b insured, submit a non-working declaration on e-Government if required.
- Track payment status on e-Government via the “4A/4B Incapacity Payment View” screen.
In short, obtaining an SGK incapacity for work report is handled through a health institution; receiving the report payment depends on meeting SGK regulatory conditions. The most important differences arise according to whether the report was issued for illness, work accident, occupational disease, or maternity.
Frequently Asked Questions
Are the SGK incapacity report and report payment the same?
No. The report is the medical document proving inability to work; report payment is the temporary incapacity allowance SGK pays if conditions are met.
From which day does SGK payment start for an illness report?
For illness, SGK payment generally starts from the third day. Payment may not be made for the first two days.
Is there a 90-day premium condition for work accidents?
No. SGK explicitly states that no specific insurance duration or premium days are required for temporary incapacity allowance due to a work accident.
What should a 4B insured do to receive report payment?
A 4/b insured must declare on e-Government that they did not work during the rest period. Also, outstanding premiums and general health insurance debts may affect eligibility.
Where can incapacity payments be queried?
Payment status can be checked via the e-Government service “4A/4B Incapacity Payment View”. SGK notes that payments are made through contracted bank branches.