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Old 11.03.2018, 01:23
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Sick leave payment while taking surgery abroad

Dear All,

I am opening this post as I couldn't find a similar situation.

I have to take two important surgeries (in 10 days and and next month) and I decided to perform them abroad (paying with my own pocket as Swiss basic insurance does not cover such planned treatments).

I already mentioned this to HR a while ago (verbally) and just two days ago, while providing the details (i.e. exact day of surgery, period of leave etc.) I was just told that because I go abroad no sick leave payment / employer salary will be provided because I will take this surgery abroad.

My questions for the forum:
- Is this legal?
- Would it be sufficient to have a Swiss doctor to certify this?

Some more details:
- I have a Swiss surgeon confirming (written form) the need for my first surgery
- I decided to do it abroad due to:
1- For the 1st surgery, I trust more the doctors I know abroad, the level of experience is higher
2- For the second sugery, there is only a surgeon in Germany performing this method

I would be very grateful if you could provide your thoughts on this.

Many thanks!!
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Old 11.03.2018, 03:01
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Re: Sick leave payment while taking surgery abroad

Unfortunately, the law is rather vague about payment during sick-leave (whether through illness or accident or operation). Here is the law setting out the default, in case nothing else was arranged in your specific contract, or in an overriding general contract which may apply to the field of work/business your employer runs.

https://www.admin.ch/opc/de/classifi...dex.html#a324a (German)
https://www.admin.ch/opc/en/classifi...dex.html#a324a (English, non-binding version).

Where contracts do not specify the duration of sick-leave pay, this is typically deemed to follow what is known as a "Skala" (= scale). For the canton of Zurich, the "Zürcher Skala": http://www.lohnfortzahlung.ch/lohnfo...bei-krankheit/ (scroll down).

Employers can choose between paying employees on sick-leave themselves, or buying an insurance to cover this. This is called a Taggeldversicherung (literally = "day money insurance").

You will need to read:
  • your employment contract
  • any general, overriding contract which may apply in your field (called, for example, a Normarbeitsvertrag, Generalarbeitsvertrag, or similar)
  • the conditions of any Taggeldversicherung your employer may have taken out.

Even if you do not command enough of the local Swiss language to understand these, you can still ask your employer to supply them to you. You are entitled to be given a copy. Ask your employer to show you the specific paragraphs on which they base their claim that you are not entitled to sick-pay because you are choosing to go abroad.
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Old 11.03.2018, 11:17
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Thank you so much for the prompt reply! Really appreciated, given the urgency.

I will ask / look for a full copy of my employment contract, and check if this is in there.

I found the "Sickness Loss of earning" insurance that the company has (on company intranet): there is a German, English and an Italian version. Funnily enough, while the German and English versions do indicate this, the Italian version does not mention this at all!

Question is now - does the insurance overrule what the employment contract may indicate? i.e. what if no mention of this is in the contract?

Also I am trying to understand why this is and also what happens if I perform the surgery abroad but conduct the "care" period back in Switzerland?

Ok I read the employment contract and it mentions the following:

The sickness loss of earning insurance replaces the company's statutory obligation.

Hence new questions I may have:

- Is this really allowed?
- What about the fact that there are two different versions of the insurance policy?

thank you for all the support in any case!

Last edited by 3Wishes; 11.03.2018 at 14:34. Reason: merging consecutive replies
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Old 11.03.2018, 11:55
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Re: Sick leave payment while taking surgery abroad

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Ok I read the employment contract and it mentions the following:

The sickness loss of earning insurance replaces the company's statutory obligation.

Hence new questions I may have:

- Is this really allowed?
- What about the fact that there are two different versions of the insurance policy?

thank you for all the support in any case!
What is allowed? That they refuse to pay sick leave?

As to the different versions, ask your insurer
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Old 11.03.2018, 12:01
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Re: Sick leave payment while taking surgery abroad

Marks, I know of a sort-of-similar situation where the company's refusal was based on the rationale that if the employee was able to travel abroad for treatment, then the employee must not have been ill enough to merit sick leave. (Not saying they were right or wrong, mind.)

Do you think similar conclusions might be behind this refusal?

What does your Swiss doctor (i.e. the doctor certifying you are unable to work) say about the need to seek treatment abroad?
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Old 11.03.2018, 12:03
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Re: Sick leave payment while taking surgery abroad

I had an operation once abroad (for personal reasons), Swiss insurance covered the general items they would have been covered here, I paid the rest.

Did you check that possibility with your insurance?
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Old 11.03.2018, 12:15
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Re: Sick leave payment while taking surgery abroad

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As to the different versions, ask your insurer
Sometimes, when there are versions in different languages, there will be a clause stating that, if there are any disputes, the text in language X shall be binding.
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Old 11.03.2018, 13:12
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Re: Sick leave payment while taking surgery abroad

Thanks again everybody for replying to me!

@Roegner -
- Yes, I am wondering if it is allowed that they refuse to pay my sick leave?

- to your second porst, did you refer to the medical expenses? I wrote a letter to Assura regarding my first surgery, but I am still waiting for a reply since 2/3 weeks. For my 2nd surgery, I could ask a reimbursement as, in theory, treatment which cannot be provided in Switzerland is covered. This would be the case as the surgeon I am going to in Germany is the only specialist performing a certain method worldwide.

@Meloncollie - so far, actually it was just HR that mentioned (out of the blue and a bit "randomly") and I am quoting "by thew way, I just read that there is this clause in the sickness leave insurance" and then left for the weekend. Tomorrow, I would like to clarify this better and talk to my employer, but I am trying to get as much informed as possible to hold this conversation.

I am currently working regularly but I have difficulties / pain while walking or sitting. The surgery I have to perform is regarding hernia / hip so I would be able to travel because of this.
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Old 11.03.2018, 13:54
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Re: Sick leave payment while taking surgery abroad

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Ok I read the employment contract and it mentions the following:

The sickness loss of earning insurance replaces the company's statutory obligation.

Hence new questions I may have:

- Is this really allowed?
- What about the fact that there are two different versions of the insurance policy?

thank you for all the support in any case!
- Yes
- There are not two version of the insurance, there are multiple translations but the is only one legal contact and it will be in the language of the Kanton.
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Old 11.03.2018, 14:46
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Re: Sick leave payment while taking surgery abroad

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...I am currently working regularly but I have difficulties / pain while walking or sitting. The surgery I have to perform is regarding hernia / hip so I would be able to travel because of this.
In this case, it's probably as meloncollie says - if you can work now, the employer and the insurer are trying to determine why you need sick leave abroad. Your doctor here may have to help justify it - both to the employer's sick leave insurance and to your own medical insurance.

You might also want to check if there is an employee rule book/handbook that accompanies the contract. My contract is pretty brief (a few pages) but it states that all employees are subject to the rules in the handbook. The handbook is much more detailed and runs into the dozens of pages.
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Old 11.03.2018, 15:23
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Re: Sick leave payment while taking surgery abroad

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Marks, I know of a sort-of-similar situation where the company's refusal was based on the rationale that if the employee was able to travel abroad for treatment, then the employee must not have been ill enough to merit sick leave. (Not saying they were right or wrong, mind.)

Do you think similar conclusions might be behind this refusal?

What does your Swiss doctor (i.e. the doctor certifying you are unable to work) say about the need to seek treatment abroad?
An other problem is that there is no proof that OP had necessary surgery (for beauty surgery one gets no payed leave time, btw.) abroad. And the employer is not allowed to ask for medical-details by law.

OP could try to get a doctor's note after returning and allowing the Swiss doctor to study the surgery-details done abroad (which - should there be aftercare - the Swiss doctor will need to know about anyway).
If there is no serious reason (and I kind of doubt there is, except OP's personal opinion/feeling, which is important to OP but not to employer) to get this done abroad, travel time will most likely not be payed but maybe the actual time at the hospital. Do get an entry/exit date documented from the hospital, just in case.
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Old 11.03.2018, 16:20
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Re: Sick leave payment while taking surgery abroad

Thanks again for sharing your knowledge!

To be more specific, and I hope this can help to make things more clear:

As 1st surgery, I have to get a hip replacement. This is something I need to be able to walk and sit without pain, and currently it is affecting not only my private life, but also my work life in being "effective" (i cannot really focus and go the extra mile while being in pain).


Regardless of where I perform the surgery, I will need a 6 to 8 week sick leave. I have this documented from both Swiss surgeons and foreign surgeons as well.

I also found the following:

https://www.admin.ch/opc/en/classifi...dex.html#a324a

From what I read here, there is an obligation from the employer to pay a certain amount of weeks depending on the canton. What am I missing in this case?

Also, I think/hope it wouldn't be a problem for Swiss GP to provide a certificate based on this and all documentation I would provide.

Thanks again for all the thoughts and knowledge you are sharing!
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Old 11.03.2018, 16:40
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Re: Sick leave payment while taking surgery abroad

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What am I missing in this case?
If you go back to post 2, you'll see that same part of the law quoted.
The thing is that the phrasing is annoyingly vague.

The quantifying (for how many days or weeks your salary will will be paid while you are on sick leave) works according to
  • your specific employment contract, or
  • the overriding umbrella contract for your kind of work, or
  • the "Skala".

It could well be that "sick leave abroad" is not mentioned in any of that.

In that case, if your employer were to be paying this out of their own pockets (which seems not to be your case) then I can see nothing that would entitle them not to pay your salary during your sick-leave.

However, since your employer has an insurance for this sick-leave-pay (and that seems to be your case), then, by analogy, the quantifying and indeed the inclusion or exclusion criteria work according to
  • the specific Taggeld insurance that your employer has bought, or
  • any overriding law with regard to how insurances work.

Therefore, I think you need to find out whether the insurance can specifically (or an overriding insurance law generally) exclude sick-leave-pay for any time that you are outside of the country.


Hypothesis:
You understand clearly (and said so in your very first post) that the medical insurance does not pay for procedures performed when one intentionally goes abroad to get that treatment.
My hunch, though of course I cannot know this for sure, is that something has got mixed up, and your HR department may inadvertently be applying the principle of exclusion of your personal medical insurance to the employer's Taggeldversicherung.
It would be interesting to see whether they are able to support their position by showing you the applicable conditions in the insurance contract or overriding law.
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Old 11.03.2018, 16:46
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Re: Sick leave payment while taking surgery abroad

My Taggeldversicherung requires a written permission together with the consulting doctor that you are able to travel. Otherwise, any salary insurance payments will be stopped. It's very much dependent on whether you are now being paid by your employer, or the insurance / Taggeldversicherung.
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Old 11.03.2018, 16:48
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Re: Sick leave payment while taking surgery abroad

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My Taggeldversicherung requires a written permission together with the consulting doctor that you are able to travel. Otherwise, any salary insurance payments will be stopped.
@ZuriRollt
could you perhaps post the clause, here? Or at least the central words, so marks can look through his employer's insurance contract with that vocab? Thanks.
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Old 11.03.2018, 17:06
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Re: Sick leave payment while taking surgery abroad

Thank you Doropfiz and ZuriRollt!

I think Doropfiz you had a structured way to look at it and I really appreciate your input on trying to help / crystallize things: So (in blue your text):

- your specific employment contract This indicates 3 months 100%, then 80%

- the overriding umbrella contract for your kind of work - I work in a consulting company, I don't think we have an umbrella contract to refer to.

- the "Skala" - Indicates 10 weeks for my case (i.e. Zurich, 4+ years work)

It could well be that "sick leave abroad" is not mentioned in any of that - It is mentioned in the sickness loss of earning insurance the employer has.

Therefore, I think you need to find out whether the insurance can specifically (or an overriding insurance law generally) exclude sick-leave-pay for any time that you are outside of the country.

For this, the link you posted (and I re-posted ) indicates:

4 A written agreement, standard employment contract or collective employment contract may derogate from the above provisions provided it gives the employee terms of at least equivalent benefit.

And this is why I am thinking that the law itself doesn't specify abroad / not abroad, therefore why would an insurance have the power to do so?

The insurance contract mentions: no benefits will be paid if the insured person goes abroad for treatement, care or childbirth.
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Old 11.03.2018, 17:09
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Re: Sick leave payment while taking surgery abroad

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My Taggeldversicherung requires a written permission together with the consulting doctor that you are able to travel. Otherwise, any salary insurance payments will be stopped. It's very much dependent on whether you are now being paid by your employer, or the insurance / Taggeldversicherung.

To add on this ZuriRollt, maybe this is a pre-defined policy.

For my specific case, would you say it makes sense to have note about me being able to make a 4-hour train travel and stay there after the surgery (after a hip replacement then I will be really able not to travel )
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Old 11.03.2018, 17:09
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Re: Sick leave payment while taking surgery abroad

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@ZuriRollt
could you perhaps post the clause, here? Or at least the central words, so marks can look through his employer's insurance contract with that vocab? Thanks.
He won't find it in his employment contract. When, and how long you are paid by the company depends on the amount of time you have been employed. The terms and conditions of longer-term sickness are based on and subject to this.

The OP needs to clarify with his employer how his particular situation is impacted. Relevant is, whether he's now being paid by the Taggeldversicherung, or his employer.

There will surely be a more qualified EFer than me to comment on the insurance aspects, where relevant. I am only in this situation currently.
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Old 11.03.2018, 17:12
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Re: Sick leave payment while taking surgery abroad

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He won't find it in his employment contract. When, and how long you are paid by the company depends on the amount of time you have been employed. The terms and conditions of longer-term sickness are based on and subject to this.
No, not in his employment contract. I meant in the insurance contract the employer has taken out for Taggeldversicherung.

It seems, though, that marks already has found exactly that clause.

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The insurance contract mentions: no benefits will be paid if the insured person goes abroad for treatement, care or childbirth.
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Old 11.03.2018, 17:14
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Re: Sick leave payment while taking surgery abroad

Hi ZuriRollt,

Just to re-point this out, currently I am not on sick leave - despite my constant pain I am still making my best efforts to go to work and work as much as I can (min 8/9 hours) before the day of the surgery.

To your question, I am employed by this firm since 4 years and a couple of months, hence I am in the 5th year.

The OP needs to clarify with his employer how his particular situation is impacted. Relevant is, whether he's now being paid by the Taggeldversicherung, or his employer. - probably that's the thing, because the insurance may not provide the Taggeld, then the company may have to pay for the time imposed by the law? (10 weeks in my specific case)
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