Sickness benefit after full continued pay ends: partial pay and suspension under the ASVG

A professional player who is an employee may receive continued pay from the club while also qualifying for Austrian statutory sickness benefit. Section 143 ASVG links suspension of that benefit to the level of continued cash and non-cash benefits. More than 50 per cent and exactly 50 per cent produce different outcomes.

A first review should identify the start of the sickness-benefit entitlement, the continued-pay periods and the full remuneration used as the comparison base. This article covers the social-insurance benefit and its suspension. It does not calculate the separate employment-law entitlement to continued pay or address medical questions.

Sickness benefit is paid through statutory health insurance. Continued pay comes from the employment relationship. When the two overlap, a payroll statement alone does not establish how much sickness benefit is payable. The insurance entitlement and any statutory suspension must be assessed separately.

This article is for professional players who are employees and subject to compulsory insurance, and for people reviewing their payment records. The label “professional player contract” does not, by itself, establish a particular insurance status or sickness-benefit entitlement. The actual employment and insurance position must be confirmed.

The employment-law question of how long and at what level the club must continue pay has its own calculation. The article on continued pay during injury-related absence provides context on that separate issue. This page focuses on the ASVG benefit.

Section 138(1) ASVG identifies the fourth day of incapacity for work due to illness as the start of the sickness-benefit entitlement for persons subject to compulsory insurance. The provision links the entitlement to the insured event and compulsory insurance. The calendar day alone therefore does not confirm insurance status or every other condition in an individual case.

The start of entitlement is different from the amount paid. While statutory or contractual continued pay is due, section 143 ASVG may suspend all or part of the sickness benefit. A useful review separates the date incapacity began, the entitlement to continued pay and the periods used by the insurer.

Ask the insurer to identify the start date, the affected employment and the calculation period in its statement or decision. If the first payment is lower than expected, compare the periods before treating the difference as a final reduction.

Section 143(1)(3) ASVG asks whether there is an entitlement under law or contract to continued pay. The comparison base is the full cash and non-cash benefits before incapacity for work began. The relevant fact is the entitlement to continued pay and its rate, not only the amount already received in the bank account.

If the continued-pay entitlement exceeds 50 per cent of those full benefits, sickness benefit is suspended for the relevant period. If the entitlement is exactly 50 per cent, half of the sickness benefit is suspended. Partial continued pay therefore does not produce one uniform outcome. The entitlement, percentage and comparison base must be clear for each period.

Cash and non-cash benefits belong in the same review. A table showing only monthly base salary may not reflect the statutory comparison base. The topic page on contracts, remuneration and bonuses and the remuneration check can help organise contractual items before the comparison. Neither replaces the insurer’s sickness-benefit calculation.

The outcomes stated in section 143(1)(3) ASVG concern a continued-pay entitlement above or exactly at 50 per cent. A lower rate should not, by itself, be treated as a full or half suspension under this threshold. A rate below 50 per cent also does not automatically establish every other condition for sickness benefit.

The insurance assessment may change when full continued pay ends and a lower rate follows. Ask for each period to be identified by its start and end, legal basis and percentage. A monthly average can conceal that continued pay was first above 50 per cent and later exactly 50 per cent or lower.

Return-to-work part-time is a separate stage of returning to work. Its eligibility requirements differ from the sickness-benefit suspension rule discussed here.

Section 143(4) ASVG sets a special attribution rule where an insured person has multiple sickness-benefit entitlements. The suspension rule in subsection 1(3) applies only to the insurance arising from an employment relationship with a continued-pay entitlement of at least 50 per cent. It should not be applied indiscriminately to every job or insurance entitlement.

If there are other jobs or insurance relationships alongside the player contract, list each entitlement separately. Ask which insurance each benefit has been assigned to, which employment supports the continued pay and how the percentage was determined for that period. Unpaid salary owed by the club is a separate issue; see the article on outstanding salaries in a player contract.

For an initial review, gather the player contract and amendments, pay statements before and during incapacity, and the insurer’s written calculation. Identify the full cash and non-cash benefits used as the comparison base and the legal or contractual basis for continued pay. The article on professional player pay statements explains how to separate base salary, expense payments and deductions.

Then make a period-by-period table. Record the start and end of each continued-pay period, its legal basis, the percentage of full benefits and the related sickness-benefit decision. This can locate a difference in a particular month or at a change in the entitlement.

An initial enquiry does not need a diagnosis or treatment records. The employment and insurance position, relevant percentages and a clear statement of the calculation are central to this legal review. If you would like the figures reviewed, use the contact page. For general Austrian legal updates, see Brandauer News.