Instructions on procedures for receiving sick leave benefits when participating in social insurance

Employees participating in social insurance (SI) are entitled to sickness benefits when meeting the conditions under the amended Social Insurance Law 2024. Decision 863/QD-BNV, effective from July 1, 2025, provides detailed regulations on documents, procedures and settlement time.

The Ministry of Home Affairs has issued Decision 863/QD-BNV effective from July 1, 2025 on procedures for receiving sickness benefits specifically as follows:

Resolve administrative procedures in the field of social insurance.

Implementation sequence:

Step 1: The employee is responsible for submitting the required documents to the employer. The deadline for submitting the documents is no later than 45 days from the date of returning to work.

Step 2: Within 7 working days from the date of receiving complete documents from the employee, the employer is responsible for making a list of employees taking sick leave with the documents submitted to the Social Insurance agency.

Step 3: Within 7 working days from the date of receiving the complete documents as prescribed from the employer, the Social Insurance agency is responsible for resolving. In case of non-resolution, a written response must be provided stating the reason.

How to apply: In person, online or by postal service.

Components and number of documents

For employees or employees' children receiving inpatient treatment, the original or a copy of one of the following documents:

- Hospital discharge papers;

- Summary of medical records;

- Other documents proving inpatient treatment;

- List of employees taking sick leave, prepared by the employer.

For employees or employees' children receiving outpatient treatment, one of the following documents:

- Certificate of leave to receive social insurance;

- Original or copy of hospital discharge paper indicating the time required for outpatient treatment after inpatient treatment;

- Original or copy of medical record summary indicating the time needed for outpatient treatment after inpatient treatment;

- List of employees taking sick leave, prepared by the employer.

For employees or employees' children who undergo medical examination and treatment abroad, the medical examination and treatment documents must show the name of the disease and the duration of treatment issued by the medical examination and treatment facility abroad and must meet the following requirements:

- Have a Vietnamese translation notarized or certified in accordance with the law on notarization and certification;

- Consular legalization, except in cases where international treaties to which the Socialist Republic of Vietnam is a member provide otherwise.

Number of records: Not specified

Processing time: Within 7 working days from the date of receipt of complete documents as prescribed from the employer.

Subjects performing administrative procedures: Employees who are Vietnamese citizens, employees who are foreign citizens working in Vietnam and employers.

Administrative procedure performing agency: Social Insurance agency according to the decentralization of Vietnam Social Insurance.

Results of administrative procedure implementation: List of settlement of sick leave benefits for employees

Fees: No.

Name of form, declaration form: According to regulations of Vietnam Social Security, Ministry of Health .

Requirements and conditions for performing administrative procedures

Employees are entitled to sick leave benefits when they are absent from work in one of the following cases:

- Treatment for diseases that are not occupational diseases;

- Treatment for accidents that are not work-related accidents;

- Treatment for accidents while traveling from home to work or from work to home by reasonable route and time according to regulations of law on occupational safety and hygiene;

- Treatment and rehabilitation of labor functions when injuries or illnesses recur due to work accidents, occupational diseases or accidents specified in Point c of this Clause;

- Donate, take, and transplant human tissues and organs according to the provisions of law;

- Take care of sick children under 7 years old.

Employees are not entitled to sick leave in the following cases:

- Self-injury, or self-harm;

- Use of narcotic substances and drug precursors according to the list prescribed by the Government , except for the use of precursor drugs or combination drugs containing precursors as prescribed by medical practitioners at medical examination and treatment facilities;

- During the first time having to take time off work for treatment and rehabilitation due to work-related accidents or occupational diseases;

- During the leave period as prescribed, it coincides with the leave period as prescribed by the law on labor or is on leave with full pay as prescribed by other specialized laws or is on leave with maternity benefits or health recovery as prescribed by the law on social insurance.

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Source: https://baolaocai.vn/huong-dan-trinh-tu-thu-tuc-huong-tro-cap-om-dau-khi-tham-gia-bhxh-post881617.html