Social Security Act (Cap. 318), article 18

18. (1) Subject to the provisions of this Act, an insured person who has not yet reached his retirement age and who satisfies th e relevant contribution conditions, shall be entitled to Sickness Benefit in accordance with Part I of the Third Sch edule for any day of incapacity for work, excluding any day in which, whether incapacitated or not, such person would not have been required to attend to work in the normal course of his duties, sohowever th at, and notwithstanding the provisions of article 90, with effect from 1st January 2018, the provisions of this article will also apply to a widow who is in receipt of a Pension under Part IV of this Act, who is in an in surable employment, who has not yet reached pension age, and who has dependent children under the age of 23: Provided that and notwithstanding the provisions of article 90, with effect from 1st January 2023, the provisions of this artic le shall also apply to a widow who is in receipt of a Pension under Part IV of this Act, who is in an insurable employment, and who has not ye t reached pension age: Provided further that in any uni nterrupted period of incapacity for work, the maximum number of consecutive days in respect of which Sickness Benefit may be p aid shall, in no case, exceed si x: Provided further that where an insured person becomes entitled to benefit as aforesaid in this sub-article, if his sp ell of incapacity for work extends int o a new benefit year which is related, in terms of the Eleve nth Schedule, to two consecutive contribution years during which less than twenty contributions had been paid or credited in his res pect, such person shall, noneth eless, but save as provided for in sub-articles (5) and (6), remain en titled to Sickness Benefit as aforesaid in this sub-article till the l ast day of such spell of incapacity for work. (2) Such Sickness Benefit shall not be paid for the first three days of each spell of incapacity for work in respect of which i t would otherwise be payable in te rms of sub-article (1) hereof: Notwithstanding the provisions of sub-article (2), for a person who proves to the satisfaction of the Director that he is under ongoing treatment in or by means of the Sir Anthony Mamo Oncology Centre, the payment of sickness benefit may be approve d by the Director for any further number of days, including the f irst three (3) days of each spell of incapacity for work, during an effective period not exceeding one (1) year f rom commencement o f such treatment, however such eff ective period may be extended f or SOCIAL SECURITY [CAP. 318. 31 more than one (1) year following medical advice obtained from t he Sir Anthony Mamo Oncology Centre: Furthermore, for a person who is certified by a multi-disciplin ary panel, appointed as provided by article 106, to be suffering fr om Fibromyalgia or Myalgic Encephalomyelitis , and satisfies the medical eligibility criteria, as updated from time to time by the Minis try responsible for Health, the payment of sickness benefit may be approved by the Director for any further number of days, includ ing the first three (3) days of each spell of incapacity for work, duri ng an effective period not exceeding the calender year (1) in which t he first claim for sickness be nefit is submitted. (3) A self-employed person shall not be entitled to Sickness Benefit unless the Director is satisfied that the person making the claim for such benefit is normally self-occupied and would have been self-occupied but for that incapacity. (4) For the purposes of this ar ticle, a day shall not be treated as a day of incapacity for work unless the person concerned proves to the satisfaction of the Director that he is incapable for work on that day by reason of some specific disease or bodily or mental impairment or that he is under t reatment or observation for a disease or a bodily or mental impairment as aforesaid. (5) Save as provided for in paragraph ( d) o f t h e p r o v i s o t o article 106, Sickness Benefit shall be paid for any day of inca pacity for work but shall not exceed in the aggregate a maximum of 156 days in any calendar year; sohowever that where the person maki ng a claim for such benefit - (a) undergoes any major surgical operation or intervention o r s u f f e r s a s e v e r e i n j u r y o r i s a f f l i c t e d b y s o m e serious disease which requires a long treatment before such person may resume work, payment of Sickness Benefit as aforesaid in this sub-article may be approved by the Director for any further number of days, not exceeding 156, bey ond the limit aforesaid in this sub-article as may be deemed fit by the Director in the circumstances of the case and provided that in any such case the aggregate maximum number of days p a y a b l e b y w a y o f S i c k n e s s B e n e f i t w i t h i n a n y t w o - year period, calculated on a calendar basis, shall not exceed 468: Provided that, with effect from 1st Janaury 2024 and notwithstanding the provisions of this Act, where the person making a claim for such benefit undergoes any major surgical operation or intervention or suffers a severe injury or is afflicted by some serious disease which requires a long treatment before such person may r e sume wor k, payment of S icknes s B enef it as af or es aid in this sub-article may be approved by the Director for any further number of days, not exceeding one hundred fifty-six (156) days, beyond the limit aforesaid in this sub-article as may be deemed fit by the Director in the circumstances of the case, and provided that in any such 32 CAP. 318.] SOCIAL SECURITY case the aggregate maximum number of days payable by way of Sickness Benefit within any two (2) year period, calculated on a calendar basis, shall not exceed four hundred sixty-eight (468) days, so however that, with the exception of the first one hundred fifty-six (156) days, the person shall be entitled to the Increased Sickness Benefit equivalent to the rate of the National Minimum Invalidity Pension as specified in the Twelfth Schedule; (b) has previously been paid any benefit under the provisions of this article or any Unemployment Benefit or Special Unemployment Benefit under the provisions of article 30, the grand total of benefit days by way of these benefits added together shall, in no case, exceed at any time the grand total number of reckonable contributions paid by the person concerned: Provided that if the person making a claim for such benefit is disqualified from receiving su ch benefit in accordance with sub- article (6), such person shall ha ve his entitlement to Sickness Benefit for that calendar year during which the disqualificatio n is imposed reduced by the number of days of such disqualification. (6) A person shall be disqual ified from receiving Sickness Benefit for any period as may be decided by the Director - (a) if he has refused medical examination as may have been required by the Director or, without good cause, failed to attend for, or to submit himself to, such medical examination as may have been required by the Director or, without a good medical reason, failed to submit himself to such medical treatment as may have been appropriate in his case; or (b) if he has behaved in a manner likely to retard his recovery; or (c) if he is absent without good cause from his place of residence. Types of Medical Assistance.