Medical Care and Sickness Benefits Convention, 1969 (No. 130) - Denmark (Ratification: 1978)

Direct Request (CEACR) - adopted 2023, published 112nd ILC session (2024)

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In order to provide a comprehensive view of the issues relating to the application of ratified Conventions on social security, the Committee considers it appropriate to examine Conventions Nos 102 (social security, minimum standards) and 130 (medical care and sickness benefits) together.

Articles 12, 29, 32(b), 56(b), 65, 66, 67, 69, 70 of Convention No. 102 and Articles 16, 28, 29 of Convention No. 130. The Committee takes note of the information provided by the Government in its report concerning: (i) minimum duration of medical care; (ii) suspension of medical care; (iii) right to complain and appeal; (iv) period of residence for calculation of old-age benefits; (v) benefits due to temporary incapacity for work; (vi) replacement rate of invalidity benefits; (vii) determination of the reference wage; and (viii) adjustment of benefits to the cost of living.

Part III (Sickness benefit), Article 22 of Convention No. 130. Calculation of the replacement rate of benefit. The Committee notes from the Government’s report that the replacement rate of the sickness benefit is 58.4 per cent which is lower than the replacement rate of 60 per cent required by Article 22 of the Convention. In this respect, the Government indicates that the reference wage applied by the Government for the purpose of the calculation of the replacement rate is higher than the reference wage which should be determined according to Article 22(6) of the Convention. The Government points out that the replacement rate of 58.4 per cent would be higher if the reference wage was determined according to Article 22(6) of the Convention. The Government also indicates that most employees in Denmark continue to receive their salary during the period of sickness according to the collective agreements.

The Committee observes that the reference wage determined by the Government refers to all unskilled male and female employees, except for managers, regardless of the type of economic activity. The Committee recalls that Article 22 of the Convention sets out the replacement rate of sickness benefits based on the reference wage of a skilled employee. The Committee further recalls that option d) of Article 22(6) of the Convention determines the reference wage as 125 per cent of the average earnings of all the persons protected. The Committee observes that this option refers to similar parameters than those used by the Government to determine the reference wage, particularly coverage of all male and female employees regardless of the type of economic activity.

The Committee requests the Government to calculate the replacement rate of the sickness benefit based on the reference wage of a skilled employee, as provided by Article 22 of the Convention. The Committee further invites the Government to assess the possibility to apply option d) of Article 22(6) of the Convention for the determination of the reference wage. Lastly, the Committee requests the Government to provide information on the provisions of the collective agreements on the payment of wages by employers during the period of an employee’s absence due to sickness, particularly on the average duration of the payment as well as the share of employees covered by such collective agreements.

Article 26 of Convention No. 130. Minimum duration of sickness benefits. The Committee notes the Government’s indication that sickness benefits are provided for 26 weeks in total, including 4 weeks of sick pay provided by employers and 22 weeks of sickness benefits provided by the local authorities. The Government further indicates that by the end of the 26th week, the local authorities shall undertake an assessment of the beneficiary’s health condition to decide on the extension of the payment of sickness benefits. In particular, the Committee observes that the payment of sickness benefits will be extended if it is assessed that a beneficiary is able to return to work. If, as a result of that assessment, it is concluded that a beneficiary is unable to return to work due to incapacity for work, such a person will undergo a job assessment process and receive a resource allowance instead of sickness benefit.

The Committee recalls that according to Article 26 of the Convention, the payment of sickness benefits may be limited to not less than 52 weeks in each case of incapacity. The Committee therefore requests the Government to provide information on the resource allowance and other benefits which may be provided to persons who have exhausted the maximum period of the payment of the sickness benefit and are still unable to work, for a period of up to 52 weeks. In this respect, the Committee requests the Government to provide information on how the benefits provided instead of sickness benefits meet the requirements of Part III of the Convention, including the level of such benefits and qualifying conditions.

Direct Request (CEACR) - adopted 2017, published 107th ILC session (2018)

The Committee has examined the Government’s report on the application of Conventions Nos 102 and 130 received in 2016, as well as the 44th annual report on the application of the European Code of Social Security received in 2017, and the consolidated report on the application of the Code and certain ILO social security Conventions ratified by Denmark (Conventions Nos 12, 42, 102 and 130), for the period 2006–16.

Part II (Medical care), Article 12 of Convention No. 102 and Article 16 of Convention No. 130. Minimum duration of care. The Committee requests the Government to indicate whether any limits to the duration of different types of medical care are prescribed in the national legislation, particularly as regards diseases entailing prolonged care.

Article 69 of Convention No. 102, Article 28 of Convention No. 130. Suspension of benefit. The Committee notes that the Health Act assigns the responsibility for delivering health services to regions and municipalities. The Committee requests the Government to indicate the legal provisions under which municipalities and private providers may suspend or refuse provision of health services to the persons protected.

Article 70 of Convention No. 102, Article 29 of Convention No. 130. Right to complain and appeal. The Committee notes that the 44th report on the Code refers to Act No. 113 of 31 January 2017 to amend the Sickness Benefits Act, Authorization Act and Danish Act on the Right to Complain and Receive Compensation within the Health Service, which introduces a new approach to quality work in health-care services, emphasizing quality development rather than quality control. Patients who complain about a health-care service are offered a consultative dialogue with relevant health-care professionals and have the opportunity, on a permanent basis, to use an independent adviser free of charge in connection with the dialogue. The Committee requests the Government to provide information on how this new approach helps to speed up and streamline the consideration of complaints as to the quality or quantity of medical care and how the resulting decision of the administration may be appealed in court.

Part III (Sickness benefit). Calculation of the replacement level of benefit. The Committee notes, based on the statistics included in the Government’s reports, that the maximum amount of sickness benefit will surpass the level of 45 per cent of the total of the previous earnings of the standard beneficiary required by Convention No. 102, but does not appear to attain the level of at least 60 per cent established by Convention No. 130. The Committee requests the Government to provide information on the replacement rate of the sickness benefit on the basis of the weekly or monthly amounts (not annual), in accordance with Title II under Article 22 of the Report form on Convention No. 130.

Article 18 of Convention No. 102, Article 26 of Convention No. 130. Minimum duration of benefit. The Committee notes that if the employed person is absent from work due to sickness and does not receive pay during sickness, he is entitled to sickness benefit payable by the employer for a maximum period of 30 days as from the first day of sickness. Where a sickness period lasts longer than 30 days, the duty to pay benefit is normally transferred to the local authorities. An employer may also be relieved from his duty to pay benefit by entering into agreement with an employed person accepted by the local authorities, if it is certified that the employed person has a risk of periods of absence owing to a long term chronic disease. The Committee requests the Government to provide information on who, in this situation, pays sickness benefit to this person instead of the employer and under what conditions.

The Committee notes that there is a general limit to the duration of payment of sickness benefit, which is 22 weeks within a period of nine months. The Committee observes that this general limit is lower than the sickness benefit of 52 weeks provided by Article 26(1) of Convention No. 130. The Committee requests the Government to provide information on the measures envisaged to raise this limit to the 52 weeks of benefit in each case of incapacity as required by Convention No. 130.

The Committee notes that if the person reaches the limit of 22 weeks within a period of nine months, and is not able to have the benefit prolonged, but is still unable to work due to incapacity for work, the person can be offered a job assessment process with benefits payable during a process focusing on resources. The Committee requests the Government to provide information on the duration and the level of benefits paid during this process.

Part V (Old-age benefit), Article 29 of Convention No. 102. Period of residence for calculation of benefit. The Committee notes that, according to the information provided by the Government in the 44th report on the Code, Act No. 995 of 30 August 2015 stipulates that refugees who have been granted a residence permit in Denmark in accordance with sections 7 or 8 of the Aliens Act, shall not be subject to more favourable rules for calculating old-age pension. The Act reinstates the harmonization of residency for calculating old-age pension, which was introduced on 1 January 2011, and abolished by 1 January 2015. The Committee requests the Government to explain in detail the said rules for the harmonization of residency for calculating old-age pension.

Part VI (Employment injury benefit). The Committee notes that the 44th report on the Code states that a reform of the workers’ compensation system is part of the Danish Government Platform and is expected to be discussed in the Danish Parliament in 2017–18. The Committee hopes that in developing the reform proposals the Government and the Parliament will fully take into account the obligations outlined in Part VI of Convention No. 102.

Article 32(b) of Convention No. 102. Temporary incapacity for work. The Committee notes the Government’s indication in its report on Convention No. 102 that workers’ compensation in Denmark does not cover compensation for the temporary loss of earnings in connection with incapacity for work, while the report on the Code states that the rules on sickness benefit apply to persons with an injury covered by the industrial injury legislation. The Committee understands therefore that in Denmark protection against the contingency of the temporary incapacity for work in case of employment injury covered by Part VI is ensured not by the special workers’ compensation scheme but by the general sickness benefit scheme under Part III of the Convention. The Committee observes that the conditions of entitlement and the level of the general sickness benefit do not comply with the higher level of protection guaranteed by the Convention in case of employment injury (absence of the qualifying period, no limitation of the duration of benefit, higher replacement rate, among others) and requests the Government to provide detailed information on the national sickness benefit legislation and the application of Part VI of Convention No. 102.

Article 36(3) of Convention No. 102. Conversion of the periodical benefit into a lump sum. According to the consolidated report, up to a degree of earning capacity loss of 50 per cent the periodical payments must be inverted into a lump sum. For degrees of 50 per cent and above, a lump sum payment corresponding to 50 per cent may be granted on the request of the beneficiary. The competent authority does not exercise any supervision as to whether the lump sum will be properly utilized, unless the beneficiary is declared by the Court incapable of managing his own affairs. The Committee requests the Government to provide information on the measures envisaged to bring these regulations into conformity with Article 36(3) of Convention No. 102, which authorizes lump-sum payments only where the degree of incapacity is slight (less than 25 per cent), or where the competent authority is satisfied that the lump sum will be properly utilized.

Article 38 of Convention No. 102. Duration of benefit. According to the consolidated report, the monthly compensation payments cease by the end of the month when the injured person reaches the national pension age. The Committee requests the Government to provide information on the measures envisaged to continue payment of compensation for permanent incapacity throughout the contingency, which in that case means until the death of the injured person in accordance with Article 38. The Committee refers the Government to Article 69(c) of the Convention for coordination of payment of the employment injury benefit with the old-age benefit.

Part IX (Invalidity benefit), Article 56(b) of Convention No. 102. Calculation of benefit. The Committee notes that entitlement to disability pension at the full rate is subject to a period of residence equivalent to not less than four to five of the years between the 15th birthday and the date on which the pension is first payable. Where the condition for pension at the full rate is not complied with, the amount of pension payable will be assessed according to the ratio between the period of residence and four to five of the years between the 15th birthday to the date on which the pension is first payable. The fraction of the pension at the full rate thus calculated shall be reduced to the nearest number of fortieths of the pension at the full rate. The Committee understands therefore that a person who has developed a full disability at the age of 45 years having previously resided in Denmark for ten years (the qualifying period of residence allowed by Article 57(1)(a) of the Convention) after his 15th birthday will be entitled to ten twenty-fourths of the full pension. Taking into account that the resulting pension will be much below the minimum rate guaranteed by the Convention, the Committee requests the Government to provide information on the application of Article 67 with respect to the rate of the disability pension, including all deductions and supplements.

Part XI (Standards to be complied with by periodical payments), Articles 65–67 of Convention No. 102. Determination of the reference wage used for calculating the replacement level of benefits. The Committee recalls that the 42nd report on the Code indicated that male employees in “Manufacturing machinery and equipment n.e.c.” are the relevant reference group in relation to Articles 65–67 of the Code and Articles 65–67 of Convention No. 102, and the 2014 data on employment and wages of these employees would be obtained from the new Eurostat Structure of Earnings Survey (SES), Statistics on Income and Living Conditions (SILC) and Labour Force Survey (LFS) to be published in 2016. The 43rd detailed report however determined the reference wage of a skilled and unskilled manual male employee in the iron and metal industry on the basis of the data provided by the Confederation of Danish Employers for 2014, which is substantially higher than the Eurostat data and negatively affects the calculation of the replacement rate of benefits under Convention No. 102. The Committee requests the Government to determine the reference wage of the skilled and unskilled workers following the methodology laid down in Article 65(6)(b) and Article 66(4)(b) of Convention No. 102 (options 2 and 5 in the ILO Technical Note).

Adjustment of benefits to the cost of living. The Committee requests the Government to provide statistics on the adjustment of benefits for the period 2011–16 requested in the report form on Convention No. 102 under Title VI of Article 65.

Direct Request (CEACR) - adopted 1999, published 88th ILC session (2000)

The Committee notes with regret that the Government's report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the matters raised in its previous direct request, which read as follows:

Article 26, paragraph 1. In its previous comment the Committee pointed out that, under section 22, subsection 1 of Act No. 852 of 1989, sickness benefit is paid for a maximum of 52 weeks over a period of 18 calendar months, unless special circumstances justify a longer period, whereas under Article 26, paragraph 1, of the Convention, the grant of benefit may be limited to not less than 52 weeks in each case of incapacity. In its reply, the Government indicates that payment of benefit may be prolonged in the case where the sick person is considered likely to recover within 26 weeks or 2 x 26 weeks, according to the nature of the disease, from the date of expiry of the benefit period; persons who have ceased to be entitled to sickness benefit and who resume occupational employment for at least 13 weeks will be entitled to benefit without having to await the end of the 18-month period, if they satisfy the conditions for a prolongation. Please specify whether this rule applies also in case of a new disease causing a new period of incapacity before the end of the above-mentioned 18-month period.

Direct Request (CEACR) - adopted 1998, published 87th ILC session (1999)

The Committee notes that the Government's report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the following points:

Article 26, paragraph 1. In its previous comment the Committee pointed out that, under section 22, subsection 1 of Act No. 852 of 1989, sickness benefit is paid for a maximum of 52 weeks over a period of 18 calendar months, unless special circumstances justify a longer period, whereas under Article 26, paragraph 1, of the Convention, the grant of benefit may be limited to not less than 52 weeks in each case of incapacity. In its reply, the Government indicates that payment of benefit may be prolonged in the case where the sick person is considered likely to recover within 26 weeks or 2 x 26 weeks, according to the nature of the disease, from the date of expiry of the benefit period; persons who have ceased to be entitled to sickness benefit and who resume occupational employment for at least 13 weeks will be entitled to benefit without having to await the end of the 18-month period, if they satisfy the conditions for a prolongation. Please specify whether this rule applies also in case of a new disease causing a new period of incapacity before the end of the above-mentioned 18-month period.

Direct Request (CEACR) - adopted 1995, published 82nd ILC session (1995)

The Committee notes the information, in particular the statistics, concerning Part III (Sickness Benefit), Article 22 of the Convention.

Article 26, paragraph 1. In its previous comment the Committee pointed out that, under section 22, subsection 1 of Act No. 852 of 1989, sickness benefit is paid for a maximum of 52 weeks over a period of 18 calendar months, unless special circumstances justify a longer period, whereas under Article 26, paragraph 1, of the Convention, the grant of benefit may be limited to not less than 52 weeks in each case of incapacity. In its reply, the Government indicates that payment of benefit may be prolonged in the case where the sick person is considered likely to recover within 26 weeks or 2 x 26 weeks, according to the nature of the disease, from the date of expiry of the benefit period; persons who have ceased to be entitled to sickness benefit and who resume occupational employment for at least 13 weeks will be entitled to benefit without having to await the end of the 18-month period, if they satisfy the conditions for a prolongation. Please specify whether this rule applies also in case of a new disease causing a new period of incapacity before the end of the above-mentioned 18-month period.

Direct Request (CEACR) - adopted 1991, published 78th ILC session (1991)

The Committee takes note of the information supplied by the Government in its report and of the Act respecting daily cash benefit in the event of sickness or childbirth (No. 852 of 20 December 1989). It would be grateful if the Government would provide additional information on the following points:

1. Part III (Sickness Benefit), Article 21, in conjunction with Articles 22 or 23, of the Convention. The Committee notes the Government's statement in its report to the effect that the provisions of Article 23 of the Convention were used in calculating the amount of sickness benefit. Since the above-mentioned Article 23 in principle applies to social security schemes which pay benefits in a lump sum or provide for a minimum amount of benefit, the Committee would be grateful if the Government would provide the statistical information requested under Titles I and II of Article 23 in the report form adopted by the Governing Body, stating in particular the minimum amount of sickness benefit and the wage of the ordinary adult male labourer as defined in paragraphs 4 and 5 of Article 23.

Should the Government wish to avail itself of the provisions of Article 22 of the Convention which in principle applies to social security schemes under which sickness benefit is proportional to the former earnings of the beneficiary, the Committee would be grateful if the Government would provide the statistical information required by the report form under Titles I and II of Article 22, stating in particular the amount of the wage of a skilled manual male employee as defined in paragraphs 6 and 7 of Article 22, and the maximum amount of the sickness benefit.

Please indicate for whichever of the above Articles is used, the amount of family allowances paid during employment and during the contingency.

2. Article 26, paragraph 1. The Committee notes that, under section 22, subsection 1 of Act No. 852 of 1989, sickness benefit is paid for a maximum of 52 weeks over a period of 18 calendar months, unless special circumstances justify a longer period. It recalls that, under Article 26, paragraph 1, of the Convention, the grant of benefit may be limited to not less than 52 weeks, in each case of incapacity. Accordingly, the Committee would be grateful if the Government would indicate in its next report whether a worker who has exhausted his right to sickness benefit under section 22, subsection 1 of the Act of 1989 and resumes work and completes a new period of employment of 13 weeks in accordance with section 2, subsection 4, may receive benefit for any new contingency, without awaiting the end of the 18-month period.

Direct Request (CEACR) - adopted 1987, published 74th ILC session (1987)

The Committee notes the Government's statement in the framework of the European Code of Social Security to the effect that the consolidated text of Act No. 81 of 1984 respecting daily cash benefit in the event of sickness and maternity is not yet available in an English or French version. The Committee hopes that it will be possible for the Government to transmit with its next report the text of Act No. 81 of 1984 in one of these languages.