Health Insurance Fund shortens sick‑leave reassessment period from seven to five days
FZO unanimously approved rule changes; primary care doctors keep authority up to 15 days and a separate rule will regulate controllers.
The Health Insurance Fund (FZO) has reduced the initial sick‑leave assessment period from seven to five days, while leaving the 15‑day threshold for primary‑care decisions unchanged. The FZO's Governing Board approved the change unanimously and said a separate regulation will set rules for controllers who carry out home visits and other checks.
Key changes and who decides
"The primary care physician remains authorized to determine temporary inability to work up to 15 days, and for periods longer than 15 days the Fund's medical commission decides. The change from seven to five days does not mean that the sick leave ends on the fifth day. It refers to the period after which, if the health condition requires extension of the sick leave, the medical criteria provided for the specific diagnosis are applied," the Health Insurance Fund said.
FZO officials said the revision introduces several practical easements: for some diagnoses patients will not need laboratory tests and the family doctor will be able to make the assessment; for other diagnoses the time frames foreseen by clinical criteria are being extended.
The amendments also expand cases in which sick leave may be issued without the insured person's physical presence — notably for severely ill, bedridden or highly immobile patients, those receiving inpatient hospital care, and other justified situations. For chronic conditions, existing diagnostic findings may be used if they remain within their validity period, avoiding unnecessary repetition of the same tests.
The Fund noted additional measures: radiodiagnostic procedures that use ionising radiation may be accepted for pregnant women when the condition is confirmed by a specialist report, and for certain serious illnesses there will be exemptions from the obligation to obtain a consultative opinion for sick leaves longer than 60 days.
The changes were announced by the Health Insurance Fund following the unanimous vote of its Governing Board. Ognen Chančarevic
Photo: press material from the event
