What social rights do I have if my child suffers from an illness in Finland?

According to the information published by the Finnish Social Security institution (Kela), if you live in Finland and you are entitled to social security benefits, in the unwanted event that your child gets ill you can either take him/her to the public health centre of your municipality or to a private doctor.

If you choose the second option, Kela reimburses part of a private doctor's and a private dentist's fees and part of the costs of examinations and treatments prescribed by the doctor. Kela does not reimburse treatments given at municipal health centres.

Kela also covers part of the costs of the medicines prescribed by a doctor. In case you have to travel to undergo the medical examination and receive treatment, it is possible to receive also a compensation for travel and overnight accommodation costs of the child and an accompanying person.

Temporary care leave

When a child under 10 years old suddenly gets ill, you can take a temporary care leave from your work in order to stay home and take care of her/him. This temporary care leave may last a maximum of 4 working days.

The entitlement to temporary care leave is based on the Employment Contracts Act. If you use this right, keep in mind that Kela does not pay benefits during temporary care leave.

But Kela can pay a special care allowance during the hospital treatment of a child under the age of 16 and the subsequent care at home. In order for a parent to be granted this special care allowance, a medical statement D must be issued by the attending physician regarding the seriousness of the illness and the necessity for the parent to participate in the care and treatment.

The special care allowance

The special care allowance is intended to compensate for loss of income in situations when a person has to stay at home from work without pay because his/her child under 16 years old is undergoing medical treatment or rehabilitation.

Kela remarks that in this case there are several factors that affect the award of the special care allowance. Those are for instance, the age of the child, the place of care, the severity of the illness and the stage of the treatment. In order to qualify for this benefit, the child's provider must:

• Participate in the care of a child under the age of 7 in a hospital or outpatient clinic.
• Participate in the hospital or outpatient treatment or rehabilitation of a child, who is between 7 and 15 years of age and severely ill.
• Participate in the rehabilitation of a child, who is between 0 and 15 years of age (a statement detailing the rehabilitation may be submitted instead of a medical certificate on form D).
• Look after a child, who is under 16 and severely ill, at home as part of a hospital or outpatient treatment plan.
• Be on call while their child attends school or daycare on a trial basis in connection with a diagnosed serious illness.

You can get special care allowance for the care and rehabilitation of a biological or adopted child. It can also be granted for the care and rehabilitation of your spouse's or partner's child or some other child if you effectively act as the child's provider.

Children with a diagnosed serious illness

During home care and the care of a child between 7 and 15 years of age in a hospital or outpatient clinic, the special care allowance is paid only if the child suffers from a serious illness within the meaning of the Health Insurance Decree.

The child's doctor should note the severity of the illness and that the illness is rapidly progressive or at a therapeutically challenging stage. The evaluation that the illness is at a therapeutically challenging stage may require you to provide information about the treatments undertaken or a detailed statement from the child's doctor.

According to Kela's classification, serious illnesses are:

• Leukaemia or other malignant neoplasm.
• A serious heart condition, injury or burn.
• Brittle diabetes or the initial stage of diabetes care.
• Severe mental disorder.
• Severe developmental disorder.
• Severe bronchial asthma.
• Severe rheumatoid arthritis.
• Other illness or injury comparable to the above in its severity.

The child's doctor should note and describe the severity of the illness and the stage of therapy on medical certificate D.

Cases in which special care allowance is denied

According to the Finnish Social Security institution, the special care allowance is not available if you are paid a salary or a daily allowance by Kela during the treatment. The latter includes maternity, paternity and parental allowances and the sickness allowance. If you are being paid special care allowance, you cannot be paid an unemployment allowance or labour market subsidy at the same time.

Only parents who are participating in the hospital care of their child can get special care allowance. This means that you cannot get it if you stay off work in order to look after your other children while the other parent participates in the care of the sick child.

The special care allowance is not available for children who are in day care outside the home or who attend school during the day. The exception to this is where the child's parent stands by at home while the child attends school or day care on a trial basis in accordance with the doctor's evaluation.

Disability allowance for children

If your child suffers a disability or is chronically ill, he/she can be granted a disability allowance for persons under 16. Kela can also pay for rehabilitation for your child.

This kind of benefit is intended to provide support in the daily lives of children under 16 years of age who suffer an illness or a disability. The child can be awarded disability allowance if he or she needs regular care, attention and rehabilitation. In this case, the need of care and attention must be greater than normal and last for at least six months.

A right determined by the extent of care needed

Kela stresses that the diagnosis for the illness or disability does not in itself determine the child’s entitlement to the disability allowance. The entitlement to the allowance and the amount of the allowance are determined on the basis of the extent of care, attention and rehabilitation that the child needs.

The care and attention of a child may be demanding and require commitment also in normal situations, depending on the child’s age and development stage. Therefore, an assessment is always made of whether the need of care and attention is related to illness or disability and whether it is greater than normal compared to other children of the same age.

The need for care and attention can be greater than normal due to:

• The child’s illness attacks and medication.
• Transportation of the child to rehabilitation.
• The child’s need of assistance with activities of daily living and schoolwork due to illness or disability.
• The child’s greater need of supervision compared to other children of the same age.

The above are just examples and there can be other accepted situations, but the general requirement stated by Kela is that the need of care and attention must be greater than normal and last for at least six months.

Disability allowance for persons under 16 is usually granted for a specific period of time, though it is possible to apply for an extension of the allowance after this period has ended. While many illnesses can last a lifetime, the need of care may change as the child grows and develops. Therefore, the payment period of the allowance varies according to an assessment of how long the need of care due to illness or disability will continue.

Informal care allowance from your home municipality

In Finland there are also other informal care allowances paid by the municipal social services, not by Kela.

Your municipality can grant informal care allowance to a family member who cares for a severely disabled or chronically ill child at home. If you want to know about the specific benefits provided by your local social services, you must ask for more information from your home municipality.