Sick leave and inspection control
Sick leave, or temporary work incapacity, is one of the most common employment-related issues and often a source of uncertainty for both employees and employers.
The onset and duration of temporary work incapacity are determined by the selected primary healthcare physician, who assesses the period of incapacity based on the type of illness or other reason for inability to work, in accordance with the insured person’s health condition and medical indications. In other words, only the selected primary care doctor is authorised to determine the beginning and end of temporary work incapacity.
The period of temporary work incapacity for which the insured person is entitled to wage compensation under the Mandatory Health Insurance Act is proven by a Certificate of Temporary Incapacity for Work issued by the selected physician. It is important to note that wage compensation is paid by the employer for the first 42 days of sick leave. After the 42nd day, compensation is paid by the Croatian Health Insurance Fund (HZZO).
The insured person is entitled to wage compensation until the selected doctor determines that they are fit to return to work, or until the competent disability assessment body establishes that, due to permanent changes in health that cannot be resolved through treatment, there has been a reduction in work capacity, partial loss of work capacity, or complete loss of work capacity. In such cases, temporary work incapacity ends on the date the Croatian Institute for Disability Assessment, Vocational Rehabilitation and Employment of Persons with Disabilities notifies the doctor.
Inspection control
Temporary work incapacity may also be terminated by a decision of HZZO’s authorised inspectors in carrying out inspection and control procedures if it is determined that no medical grounds exist for its continuation. This procedure is governed by the Regulation on Supervision and Control of the Croatian Health Insurance Fund.
Control is conducted by HZZO through continuous monitoring and verification of data within its internal information system. Controls are performed by authorised medical inspectors of the Fund in the office of the selected physician, at HZZO premises, and, exceptionally, in the insured person’s home or at contracted specialist providers. As a rule, the control includes an examination of the insured person or a family member, unless the justification for sick leave can be verified solely through documentation.
Controls may be regular or extraordinary. Regular controls are conducted according to HZZO’s annual plan. Extraordinary controls may be initiated by order of the Director or other authorised persons, at the employer’s request (in justified cases of suspected abuse), or whenever HZZO independently becomes aware of potential misuse by the insured person or the selected physician. Extraordinary inspections based on suspected abuse may be carried out without prior notice.
The inspection includes a review of medical documentation, which must contain information on the diagnosis, course of illness, treatment procedures, rehabilitation and other relevant elements. The selected physician and the insured person are obliged to provide access to the documentation. During the inspection, the existence of medical grounds for sick leave is assessed, along with the justification for its continuation, the need for termination, and the correctness of any change in diagnosis. If the inspector determines that temporary incapacity for work is no longer medically justified, a professional medical assessment is issued indicating the date of termination—no earlier than the date of the inspection.
If misuse of sick leave is determined, this may constitute grounds for an extraordinary termination of the employment contract.
