How to claim the UIF illness benefit

A serious illness or an operation can keep you off work for weeks or months. Your paid sick leave under the Basic Conditions of Employment Act, 30 days over three years on a five-day week, may not stretch that far, and once it is gone most employers stop paying. The Unemployment Insurance Fund, the UIF, has a benefit for exactly this gap: the illness benefit. Far fewer people claim it than claim unemployment benefits, often because they do not know it exists. This guide explains who qualifies, how it fits with your sick leave, roughly how much it pays, the documents you need, and how to claim.

This guide is part of our UIF in South Africa: the complete guide for workers, which links every guide on the topic.

It deals only with the illness benefit. Claiming after losing your job is covered in our guide on claiming UIF after being retrenched.

What the illness benefit is

Part C of chapter three of the Unemployment Insurance Act 63 of 2001, sections 20 to 22, provides illness benefits for contributors: employees on whose behalf UIF contributions have been paid. Section 20(1) entitles you to the benefit for a period of illness if you are unable to perform work on account of illness, you meet any requirements prescribed for a specified illness, and you apply in the prescribed way.

The regulations define the qualifying illness broadly: any medically recognisable disease, symptom or condition that prevents you from working. Alcoholism and drug dependence qualify only while you are admitted to, and being treated at, a registered rehabilitation centre or psychiatric hospital.

Unlike the unemployment benefit, the illness benefit is for people who still have a job. You remain employed; you are simply too ill to work and are not being paid in full.

The seven-day rule, and who is excluded

Section 20(2) sets out when no benefit is payable:

• if the period of illness is less than seven days. The Act originally said 14 days, and many websites still repeat that figure. The Unemployment Insurance Amendment Act, 2016 replaced it with seven.
• for any period in which you are entitled to unemployment or adoption benefits. You cannot draw two benefits for the same days.
• for any period in which you, without just reason, refuse or fail to undergo medical treatment or to follow the instructions of a medical practitioner, chiropractor or homeopath.

An injury at work or an occupational disease is a different matter. Those are covered by the Compensation for Occupational Injuries and Diseases Act, and our guide on claiming from the Compensation Fund explains that process.

How it fits with paid sick leave

Section 21(2) says that where you are paid sick leave under any law, collective agreement or contract, the illness benefit may not be more than the remuneration you would have received had you not been ill. In other words, sick pay and the benefit together cannot exceed your normal pay.

That produces three situations:

• Full sick pay: while your employer pays you in full from your sick leave, the Fund pays nothing, because you have no loss to replace.
• Reduced pay: where your employer pays part of your wage, for example under a sick pay scheme that pays a percentage, the Fund can top up, but only to the extent that the total stays within your normal pay.
• No pay: once your paid sick leave is exhausted and your employer stops paying, the benefit is payable in full, subject to your credit days.

So the usual order is: use your paid sick leave first, then claim from the UIF for the unpaid period. Our guide to the rules for sick leave explains how to work out how many paid days you have left in your three-year cycle. The employer declares on form UI-2.7 what it paid you during the illness, which is how the Fund applies section 21(2).

One trade-off is worth knowing. Credit days are shared between the Fund's benefits. Days you draw for illness reduce the credit days left if you later need to claim unemployment benefits within the same four-year period.

How much you can expect

The illness benefit is calculated in the same way as the unemployment benefit, not at the flat maternity rate. The Fund works out your daily remuneration from your monthly pay, capped at R17 712 a month, and applies an income replacement rate on a sliding scale: about 60% of daily pay for the lowest earners, falling to about 38% at the top of the scale. You are paid that daily amount for each day of illness that qualifies, up to the number of credit days you have, at one credit day for every four days worked, to a maximum of 365 days in four years.

Our UIF benefits calculator uses the same sliding scale for its unemployment option. It does not model the illness benefit separately, so use the daily benefit it shows as a rough guide and remember that the Fund pays only for the days of illness it approves, reduced by anything your employer paid.

The documents you need

The forms are issued by the Department of Employment and Labour:

• UI-2.2, the application for illness benefits. It contains a medical certificate section that must be completed and signed by a practitioner who has treated you: under the regulations, a medical practitioner, chiropractor or homeopath. The certificate should show the dates you were unfit for work, not just that you were seen.
• Your identity document, a 13-digit barcoded South African ID or, for foreign nationals, a valid passport or permit.
• UI-19, the employer's declaration of your employment details, completed by your employer.
• UI-2.7, the employer's declaration of your remuneration, including what it paid you while you were ill.
• UI-2.8, your banking details, often stamped or confirmed by your bank. Errors and corrections on this form delay payment, so complete it carefully.
• UI-3, the declaration you complete for each further period you claim, if the illness continues.

The Fund may ask you to see a practitioner of its choice, at its cost.

Your employer is expected to complete its forms promptly. If it will not, tell the labour centre; the Fund has ways to obtain the information, and the delay is not your fault.

How to claim

1. Use your sick leave first and ask your employer for a letter or payslip showing when your paid sick leave ended or your pay was reduced.
2. Get the UI-2.2 completed by your treating practitioner. Take it to your doctor at the start, or as soon as you know the illness will last seven days or more.
3. Ask your employer for the UI-19 and UI-2.7. Many payroll systems generate both.
4. Lodge the claim, either through the Department of Employment and Labour's online UIF services or at a labour centre. Section 22 allows someone else to lodge it for you if you are too ill to go yourself, with written authority and proof of their identity.
5. Do it within six months of the date your illness began. Section 22(2) sets that deadline, and the Commissioner may accept a later application only if you show good cause.
6. Keep your reference number and copies of everything, and submit a UI-3 continuation declaration for each further period of illness.

If your claim is turned down, the Fund must tell you in writing why it is defective. Correct the problem and resubmit, or ask the labour centre to explain the decision.

Why illness claims get held up

Most delays on illness claims come from a handful of avoidable problems:

• The medical certificate is vague. A certificate that says you were seen, without stating the dates you were unfit for work, or that leaves out the practitioner's registration details, is likely to be queried.
• The claim covers days you were paid in full. If the UI-2.7 shows full sick pay for the period, there is nothing to pay for those days. Claim from the date your pay stopped or dropped.
• The illness was shorter than seven days. Short illnesses are covered by sick leave, not the Fund.
• Your contributions are not on record. The Fund pays on what your employer declared. If your payslips show UIF deductions but the Fund has no record, raise it with the labour centre straight away and keep the payslips.
• Continuation forms are missing. For a longer illness, payments stop if the UI-3 declarations are not submitted.

Worked example

This example is illustrative. Thandeka works five days a week as a receptionist earning R12 000 a month and has contributed to the UIF for three years. In her current sick leave cycle she has already used 26 of her 30 paid sick days. She then needs surgery and is off work for six weeks.

Her employer pays the four remaining sick days in full. For the rest of the six weeks she is unpaid, so she claims the illness benefit for roughly the remaining 36 calendar days. Her daily remuneration is R12 000 times 12, divided by 365, which is about R394.52. On the sliding scale, her income replacement rate is about 40.6%, giving a daily benefit of about R160.31. For 36 days that is roughly R5 770, against about 273 credit days built up over three years.

Change the facts: Thandeka's contract gives her 60 sick days a cycle on full pay. Her employer pays her in full throughout the six weeks, so the Fund pays nothing, and her credit days stay intact.

What to do

1. Work out your paid sick leave balance and the date it will run out.
2. If you will be off for seven days or more beyond that, get the UI-2.2 to your treating doctor early.
3. Ask your employer for the UI-19 and UI-2.7 in writing, and keep a copy of your request.
4. Lodge the claim well within six months, and keep every reference number.
5. If your employer is threatening to dismiss you because of the length of your illness, read our guide on whether you can be dismissed for being off sick before you agree to anything.