Procedures for Issuance of Sick-Leave Certificates

Issued pursuant to
Sections 9 and 12 of the law On Maternity and Sickness Insurance Section 19,
Paragraph one of the law On Compulsory
Social Insurance in Respect of Accidents at Work and Occupational
Diseases and Section 52 of the Medical Treatment Law

I. General Provisions

[9 July 2013]

1. This Regulation prescribes the procedures by which the temporary incapacity for work of a person (hereinafter - the incapacity for work) shall be certified, and the procedures for the issuance of the relevant documents.

[9 July 2013]

2. [9 July 2013]

II. Types of Sick-Leave Certificates and Conditions for the Issuance Thereof

3. A sick-leave certificate shall be issued:

3.1. regarding a disease (including occupational disease) or trauma (including an accident at work) associated with the loss of the capacity to work;

3.2. if the receipt of medical treatment or preventive medical assistance is required;

3.3. if isolation during quarantine is required;

3.4. if according to medical opinion, the undergoing of medical treatment in a rehabilitation institution for the rehabilitation of the capacity to work is required during recovery after a disease (trauma);

3.5. regarding the performance of prosthetics or orthotics in hospital;

3.6. regarding the performance of an examination in a hospital, where the assignment of a doctor is provided;

3.7. to a person nursing an ill child up to the age of 14;

3.8. during the maternity leave.

[9 July 2013]

4. Where the incapacity for work is related to the conditions referred to in Sub-paragraphs 3.1, 3.2, 3.3, 3.4, 3.5, and 3.6 of this Regulation, except in cases where the occupational disease determined after 1 January 1997 is the cause of the incapacity for work, a sick-leave certificate A shall be issued to the person for the first 10 days of the incapacity for work.

[23 April 2002; 22 December 2008; 9 July 2013; 1 December 2015]

5. If the incapacity to work continues for more than 10 days in cases referred to in Sub-paragraphs 3.1, 3.2, 3.3, 3.4, 3.5, and 3.6 of this Regulation, starting from the 11^th day of incapacity for work, but if the cause of the incapacity for work is an occupational disease determined after 1 January 1997 - starting from the first day of the incapacity for work, a sick leave certificate B shall be issued to the person.

[22 December 2008; 9 July 2013; 1 December 2015]

6. The sick-leave certificates shall be issued to an unemployed person in the cases referred to in Sub-paragraphs 3.1, 3.2, 3.3, 3.4, 3.5 and 3.6 of this Regulation in accordance with Paragraphs 4 and 5 of this Regulation.

7. A sick-leave certificate B shall be issued from the first day of the incapacity for work in the cases referred to in Sub-paragraphs 3.7 and 3.8 of this Regulation. A sick-leave certificate for nursing an ill child up to 14 years of age shall be issued to a person raising a child (to one of the parents, grandparents, foster-parents, guardian or another person nursing and raising a child in accordance with a decision of the Orphan's and Custody Court), provided that the person referred to is not able to attend work due to the nursing of an ill child, and thus loses the income to be obtained at work.

[22 December 2008]

8. [1 December 2015]

9. A document issued in a foreign state certifying the incapacity for work shall be equated with a sick-leave certificate issued in Latvia, provided that the following conditions have been complied with:

9.1. the aforementioned document contains information which allows one to conclude unequivocally that the person to whom it has been issued was incapable of work during the specified period of time;

9.2. the document issued in a foreign state shall be accompanied by a translation into the official language, certified in accordance with the procedures specified in Section 10, Paragraph three of the Official Language Law, except in cases where, in conformity with Section 10, Paragraph four of the Official Language Law, documents are received and examined without a translation into the official language;

9.3. a person to whom the document has been issued has complied with the procedures specified in regulatory enactments and international treaties for the certification of the authenticity of documents issued in the relevant foreign state:

9.3.1. a document certifying the incapacity for work has been issued in a foreign state which has acceded to the Hague Convention of 5 October 1961 Abolishing the Requirement of Legalisation for Foreign Public Documents, and Latvia has not entered into an agreement regarding legal assistance and legal relationships therewith, and the authenticity of the document has been certified in accordance with the procedures specified in Section 3 of the Convention referred to;

9.3.2. a document certifying the incapacity for work has been issued in a foreign state which has not acceded to the Hague Convention referred to in Clause 9.3.1 of this Regulation and Latvia has not entered into an agreement regarding legal assistance and legal relationships therewith, and the document has been validated by the Ministry of Foreign Affairs of the Republic of Latvia or by a diplomatic or consular mission thereof;

9.3.3. a document certifying the incapacity for work has been issued in a foreign state and Latvia has entered into an agreement regarding legal assistance and legal relationships therewith and the validity of the document has been certified in conformity with the provisions of the relevant international agreement.

III. Persons Entitled to Issue and Cancel Sick-leave Certificates

10. A sick-leave certificate shall be issued by a doctor or the assistant to a doctor of a medical treatment institution on the basis of a personal inspection and examination of a person, providing reasons in the medical documentation for the decision taken.

11. If the doctor assigns a person to undergo treatment in a rehabilitation institution within a period of rehabilitation after a disease or trauma, the sick-leave certificate - continuation of the previous sick-leave certificate - shall be issued by the doctor of the rehabilitation institution for the relevant time period. If there has been an interval between the undergoing of outpatient or in-patient treatment and the commencement of a treatment course in a rehabilitation institution, an initial sick-leave certificate shall be issued in conformity with Paragraphs 4 and 5 of this Regulation.

[9 July 2013]

12. A sick-leave certificate shall be cancelled electronically online by making a note in the unified electronic information system of the health sector (hereinafter - the health information system):

12.1. by the manager or the doctor, or the assistant to a doctor of the medical treatment institution, in which the sick-leave certificate has been issued - if the sick-leave certificate is drawn up incorrectly;

12.2. by the manager of the medical treatment institution, in which the sick-leave certificate has been issued - if an opinion of the Health Inspectorate stating unjustified issue of the sick-leave certificate has been received. In this case the manager of the medical treatment institution shall issue an order for the cancellation of the relevant sick-leave certificate within 14 days.

[1 December 2015]

12.¹ The medical treatment institution shall send a certified copy of the order referred to in Sub-paragraph 12.2 of this Regulation to the person for whom the sick-leave certificate was issued. The person has the right to appeal the order in accordance with the procedures laid down in the Administrative Procedure Law.

[1 December 2015]

IV. Time Period for Which Sick-leave Certificate (Certificates) are Issued

13. A doctor shall issue the sick-leave certificate for the whole period of the incapacity for work. An assistant to a doctor shall issue the sick-leave certificate for the first 10 days of the incapacity for work.

[9 July 2013]

13.¹ In the case of a change of a medical treatment institution, a new sick-leave certificate A or B - continuation of the previous sick-leave certificate shall be issued. A new sick-leave certificate A or B - continuation of the previous sick-leave certificate - shall also be issued in cases when a person for whom a sick-leave certificate has been closed a day before Saturday, Sunday, holiday or a day which according to the law is a holiday, incurs repeated incapacity for work on a Saturday, Sunday, holiday or the day which according to the law is a holiday, but a new sick-leave certificate B shall be issued if an occupational disease has been determined for a person.

[9 July 2013]

14. If, after closing a sick-leave certificate A, the incapacity for work continues in the long-term, the doctor, taking into consideration the wishes of the person incapable of work, but not sooner than after two weeks, shall close the existing sick-leave certificate B and issue a new sick-leave certificate B - continuation of the previous sick-leave certificate.

[9 July 2013]

15. If children up to three years of age, as well as seriously ill children up to 14 years of age who require nursing according to the opinion of the doctor, undergo treatment in a medical treatment institution, and a person raising the child (one of the parents, grandparents, foster-parents, guardian or another person nursing and raising a child in accordance with a decision of the Orphan's and Custody Court) is afforded an opportunity to stay in the aforementioned institution together with the child, the sick-leave certificate shall be issued for the period of time during which the presence of the person referred to in the medical treatment institution is required.

[22 December 2008]

16. If a mentally ill person has not sought medical assistance in a timely manner due to the exacerbation of such disease, a sick-leave certificate for the previous period of the incapacity for work, but not longer than a week before the date on which the person sought medical assistance, may be issued thereto on the basis of the opinion of the council of doctors.

17. If a doctor or an assistant to a doctor determines a violation of the therapeutic regimen, he or she shall make a relevant note in the column "Atzīmes par ārsta vai ārsta palīga noteiktā režīma pārkāpšanu" [Notes regarding the violation of the therapeutic regimen prescribed by a doctor or an assistant of a doctor] in the sick-leave certificate A and sick-leave certificate B, and specify the date on which the violation occurred.

[9 July 2013]

17.¹ If the incapacity for work continues for more than 26 weeks, the doctor shall refer the person to the State Medical Commission for the Assessment of Health Condition and Working Ability. The Commission shall provide an opinion on the extension of the sick-leave certificate in the period of the incapacity for work which continues for more than 26 weeks, but not longer than 52 weeks (starting from the first day of the incapacity for work), if it is necessary for the provision of full treatment (including the provision of rehabilitation), or determines disability of a person. The person shall submit the documents necessary for the receipt of the opinion (submission, sick-leave certificate B and form No. 088/u "Referral to the State Medical Commission for the Assessment of Health Condition and Working Ability" provided in laws and regulations regulating the procedures for record-keeping of medical documentation) to the State Medical Commission for the Assessment of Health Condition and Working Ability not later than five working days prior to the end of the 26-week period of a continuous incapacity for work.

[9 July 2013]

V. Separate Conditions for the Issuance of Sick-leave Certificates in relation to Pregnancy and Childbirth

18. In case of the maternity leave:

18.1. from the beginning of the maternity leave two sick-leave certificates B shall be issued to a woman, one of which (regarding the prenatal maternity leave) shall be closed immediately, but the other (regarding postnatal maternity leave) - after childbirth;

18.2. a sick leave certificate for prenatal maternity leave shall be issued from the 32^nd week of pregnancy. If medical care in relation to pregnancy has been commenced by the 12^th week of pregnancy and all instructions of the doctor have been complied with, a sick-leave certificate for prenatal maternity leave shall be issued from the 30^th week of pregnancy.

18.3. in addition to postnatal maternity leave, 14 calendar days shall be included in the sick-leave certificate due to complications of the period following childbirth, irrespective of whether complications have been determined in the medical treatment institution in which the childbirth assistance was provided, or after the discharge of the woman therefrom. If the sick-leave certificate for postnatal maternity leave has been closed, in addition to the postnatal maternity leave a separate sick-leave certificate shall be issued by making a note "dzemdības" [childbirth] in the column "Pārejošas darbnespējas cēlonis" [Cause of temporary incapacity for work] of the sick-leave certificate.

18.4. a sick-leave certificate may be issued for the previous period of the incapacity for work, if the prenatal maternity leave is not specified at the beginning of the 30^th or 32^nd week of pregnancy (medical care has not been provided, a woman or family members thereof have suffered from a disease or in other cases);

18.5. a woman who has waived caring and raising of a child after childbirth in accordance with the procedures prescribed in laws and regulations, the second sick-leave certificate B on the basis of the order of the manager of the medical treatment institution in which the medical assistance was provided shall be cancelled by drawing up a relevant act, and a new sick-leave certificate B shall be issued until the the capacity for work is recovered by making a note "cits cēlonis" [other cause] in the Column "Pārejošas darbnespējas cēlonis" [Cause of temporary incapacity for work] of the sick-leave certificate.

[9 July 2013]

19. If the pregnancy has been terminated artificially, a sick-leave certificate shall be issued in the following cases:

19.1. pregnancy has been terminated due to medical reasons;

19.2. artificial termination of pregnancy due to complications.

VI. Duties of the Issuer of a Sick-leave Certificate

20. A doctor or an assistant to a doctor shall prepare the sick-leave certificate electronically in the health information system in accordance with the laws and regulations regarding the unified electronic information system of the health sector. The sick-leave certificate shall be registered in the health information system in chronological sequence and all columns specified in the section of entry form of the sick-leave certificate relating to the specific case of the incapacity for work shall be filled out precisely and legibly. If due to technical or other difficulties it is not possible to register the sick-leave certificate in the health information system on the first day of the period of the incapacity for work for which the sick-leave certificate has been issued, it shall be registered no later than within five working days. If the registration date of the sick-leave certificate in the health information system does not match with the first day of the period of the incapacity for work for which the sick-leave certificate has been issued, justification shall be indicated in the section of entry form of the sick-leave certificate.

[1 December 2015]

20.¹ Upon a request of a person, a doctor or an assistant to a doctor shall issue form No. 27/u "Extract from the Record of an Inpatient/Outpatient Medical Card" provided in laws and regulations regulating the procedures for record-keeping of medical documentation. Prior to issuing the extract, he or she shall fill out Items 1, 2, 3, 10, 11, and 12 therein. In Item 10 of the extract, he or she shall indicate the therapeutic regimen which has been set for the specific time period according to the health condition of a person (in-patient treatment, treatment at home or unrestricted regimen), as well as make an entry in the medical documentation of the person.

[9 July 2013]

21. Medical treatment institutions and health care practitioners shall obtain forms of sick-leave certificates with their own resources. A sick-leave certificate shall be issued to a person free of charge, except in cases when the sick-leave certificate has been lost and a duplicate thereof is issued. The duplicate shall be issued in accordance with the price list of paid services of the medical treatment institution.

[28 October 2003; 21 September 2010; 9 July 2013]

21.¹ If the incapacity for work continues for 30 days and the person has not been sent to a different doctor during this period, the doctor shall send the person to a different doctor, taking into account the diagnosed illness of the person. The doctor to whom the person was sent to shall within a period of 30 days assess whether the incapacity for work must be continued or terminated. The decision of this doctor shall be indicated in the sick-leave certificate.

[9 July 2013]

21.² In the case referred to in Paragraph 21.¹ of this Regulation, the doctor may not send the person to another doctor if:

21.² 1. the incapacity for work of the person has occurred in the period of pregnancy;

21.² 2. during the 30 day period referred to in Paragraph 21.¹ of this Regulation the person has had medical treatment as an in-patient or at a day hospital;

21.² 3. the incapacity for work of the person has occurred as a result of a trauma, which is associated with fractures;

21.² 4. the cause of the incapacity for work of the person is diabetes, asthma, or a malignant tumour.

[9 July 2013]

21.³ [21 July 2009]

21.⁴ An assistant to a doctor shall assess the incapacity for work of the person and send the patient to a family doctor or specialist.

[9 July 2013]

VII. Duties of Employers and Self-employed in Filling Out Sick-leave Certificates

[1 December 2015]

22. [1 December 2015]

23. [1 December 2015]

VIII. Control and Procedures for the Examination of Complaints regarding the Assessment of the Incapacity for Work

[9 July 2013]

24. The implementation of these Regulations shall be controlled by the Health Inspectorate. By carrying out the assessment and providing opinions on the quality of the assessment of the incapacity for work in medical treatment institution, the Health Inspectorate shall assess whether in the specific case due to established infringements the sick-leave certificate must be recognised as issued without justification.

[1 December 2015]

25. Complaints of persons regarding the procedures for the issuance of sick-leave certificates shall be examined by the manager of the medical treatment institution or the Health Inspectorate. When submitting the complaint regarding the issuance of a sick-leave certificate, the person shall indicate the conditions which allow to question the validity of the issuance of sick-leave certificate.

[22 December 2008]

IX. Closing Provisions

26. The following is repealed:

26.1. Cabinet Regulation No. 419 of 29 October 1996, Procedures for the Issuance of Sick-leave Certificates (Latvijas Vēstnesis, 1996, No. 184/185; 1998, No. 147/149, No. 289/290);

26.2. Cabinet Regulation No. 182 of 19 May 1998, Amendments to Cabinet Regulation No. 419, Procedures for the Issuance of Sick-leave Certificates (Latvijas Vēstnesis, 1998, No. 147/149);

26.3. Cabinet Regulation No. 394 of 6 October 1998, Amendment to Cabinet Regulation No. 419, Procedures for the Issuance of Sick-leave Certificates (Latvijas Vēstnesis, No. 289/290, 1998).

26.¹ A and B forms of the sick-leave certificates which have been purchased up to 31 December 2008 are valid for issuing up to 31 May 2009, making the relevant corrections thereto regarding the period indicated in the form for which it shall be issued.

[22 December 2008]

26.² Up to 31 December 2009:

26.² 1. in the case referred to in Paragraph 17.¹ of this Regulation, persons whose temporary incapacity for work has occurred in the period of pregnancy shall not be sent to the State Medical Commission for the Assessment of Health Condition and Working Ability.

26.² 2. the State Medical Commission for the Assessment of Health Condition and Working Ability shall not issue an opinion on the extension of the sick-leave certificate in the period of temporary incapacity for work which continues for more than 26 weeks to a person whose incapacity for work has occurred up to 30 June 2009 and continues without interruption after 1 July 2009. If the State Medical Commission for the Assessment of Health Condition and Working Ability decides whether disablement is to be determined for the person, the attending doctor or assistant to a doctor shall indicate the decision of the Commission on the sick-leave certificate.

[21 July 2009]

26.³ A doctor or an assistant to a doctor shall send persons whose sick-leave certificate has been issued before 1 September 2013 to a different doctor if the incapacity for work continues 45 days and the doctor or the assistant to the doctor has not consulted with another doctor during this period.

[9 July 2013]

26.⁴ A and B forms of the sick-leave certificates which have been purchased up to 1 September 2013 are valid for issuing up to 31 December 2013.

[9 July 2013]

26.⁵ Until the acquisition of rights for data processing in the health information system, but not later than until 30 November 2016, a doctor or an assistant to a doctor for preparing sick-leave certificates shall use forms of sick-leave certificates in printed form, precisely and legibly filling out all columns specified in the form of a sick-leave certificate which relate to the specific case of the incapacity for work, and shall register it in a sick-leave certificate registration journal in chronological sequence, by recording the relevant registration number in the sick-leave certificate and medical documentation of the person.

[1 December 2015]

26.⁶ If up to 30 November 2016 the sick-leave certificate has been prepared in accordance with Paragraph 26.⁵ of this Regulation and a person is an employee of several employers, the sick-leave certificate A shall be issued in several copies, taking into account the request of the relevant person. Sick-leave certificate B for the same period of the incapacity for work shall be issued only in a single copy.

[1 December 2015]

26.⁷ If the sick-leave certificate has been prepared in accordance with Paragraph 26.⁵ of this Regulation, it shall be cancelled by making a note in the sick-leave certificate registration journal:

26.⁷ 1. by the manager or the doctor or assistant to a doctor of the medical treatment institution, in which the sick-leave certificate has been issued - if the sick-leave certificate is damaged, drawn up incorrectly or with several corrections;

26.⁷ 2. by the manager of the medical treatment institution, in which the sick-leave certificate has been issued - if an opinion of the Health Inspectorate, stating unjustified issuance of the sick-leave certificate, has been received. In this case, the manager of the medical treatment institution shall issue an order for the cancellation of the relevant sick-leave certificate within 14 days and shall send a certified copy of the order to the State Social Insurance Agency, Health Inspectorate and the person to whom the sick-leave certificate was issued for information. The person has the right to appeal the order in accordance with the procedures laid down in the Administrative Procedure Law.

[1 December 2015]

26.⁸ Paragraph 20.² of this Regulation shall come into force on 1 December 2016. Until the day of coming into force of Paragraph 20.² of this Regulation, the sick-leave certificate prepared in the health information system shall be issued in printed form, and have a note "Darbnespējas lapa ir sagatavota un reģistrēta veselības informācijas sistēmā" [Sick-leave certificate has been prepared and registered in the health information system].

[1 December 2015; 1 December 2016]

27. These Regulations shall come into force on 1 May 2001.

Acting for the Prime Minister,
Minister for Economics A. Kalvītis

Minister for Welfare A. Požarnovs

Annex 1
Cabinet Regulation No. 152
3 April 2001

[9 July 2013]

Sick-leave Certificate A

To be submitted to the employer

Cause of temporary incapacity for work:

contracting tuberculosis	road accident			rehabilitation
accident at work	quarantine			accident at work
	prosthetics or orthotics			other cause
Notes regarding violation of the regimen prescribed by a doctor or an assistant of a doctor:
			(Signature of the doctor or the assistant of the doctor)

Leave from work

(specify time from the first day to the tenth day included)

Annex 2
Cabinet Regulation No. 152
3 April 2001

[9 July 2013]

Sick-leave Certificate B

To be submitted to the branch of the State Social Insurance Agency

Cause of temporary incapacity for work:

contracting tuberculosis	occupational disease		pregnancy		childbirth
accident at work	other cause		nursing of an ill child		nursing of an ill child in a hospital
road accident
		(given name and surname of the child)
quarantine		-
prosthetics or orthotics		(personal identity number of the child)
rehabilitation
Notes regarding violation of the regimen prescribed by a doctor or an assistant of a doctor:
Signature of the doctor or the assistant of the doctor

Leave from work

Disability grantedd

Notes on sending to a doctor-specialist and the State Medical Commission for the Assessment of Health Condition and Working Ability

Employer's information

I. I affirm that the employee failed to attend work during the period of incapacity for work (including the first 10 days of incapacity for work)

Utilised leave from work without the retention of work remuneration, annual leave from work which is concurrent to the period of incapacity for work

II. I affirm that the employee failed to attend work during the period of incapacity for work (including the first 10 days of incapacity for work)

Utilised leave from work without the retention of work remuneration, annual leave from work which is concurrent to the period of incapacity for work

Information on the self-employed person

I affirm that I was incapable to work and earn income due to incapacity for work

NOTE:

Paragraph 2 of the Cabinet Regulation No. 683 of 1 December 2015, Amendments to Cabinet Regulation No. 152 of 3 April 2001, Procedures for the Issuance of Sick-leave Certificates:

"2. Sub-paragraphs 1.7 and 1.11 of this Regulation shall come into force on 1 December 2016."

[1 December 2016]

Translation © 2017 Valsts valodas centrs (State Language Centre)