Illness Benefit is the primary short term income support provided by my department to those who are unable to work due to illness of any type and who are covered by social insurance. Eligibility for Illness Benefit depends on the person’s PRSI record and class. The person must have made the required number of contributions under class A, E, H or P to qualify. In general, self-employed people make PRSI contributions at class S which does not provide entitlement to Illness Benefit.
Self-employed contributors pay class S PRSI at a rate of 4.2%. This is 11.25 percentage points lower than the combined employer and employee contribution of 15.45% made in respect of employed contributors. However, self-employed contributors do have access to over 90% of benefits available to employed contributors.
The only benefits that class S PRSI does not provide access to are Health and Safety Benefit, Illness Benefit and Occupational Injuries Benefits. Self-employed contributors who are ill may qualify for Invalidity Pension.
Please see below the qualifying conditions to enable a person to claim Illness Benefit.
Social Insurance Contributions (PRSI)
A person must have at least 104 class A, E, H, or P social insurance (PRSI) contributions paid since first starting work. Only PRSI contributions paid at these classes are reckonable for Illness Benefit.
They must also meet either Condition 1 or
Condition 2 below:
Condition 1
A person must have 39 PRSI contributions paid or credited in the relevant tax year, of which 13 contributions must be paid contributions.
If the person does not have 13 paid contributions in the relevant tax year, then 13 paid contributions in one of the following tax years can be used instead:
- Either of the two tax years before the relevant tax year.
- The last complete tax year (before the year in which a person’s claim for Illness Benefit begins).
- The current tax year.
OR
Condition 2
A person must have 26 weeks of PRSI contributions paid in the relevant tax year, and
26 weeks of PRSI contributions paid in the tax year immediately before the relevant tax year.
The relevant tax year is the second-last complete tax year before the year in which a person’s claim for Illness Benefit begins.
EXAMPLE 1: If you make a claim in 2026, the relevant tax year is 2024.
EXAMPLE 2: If you make a claim in 2027 the relevant tax year is 2025.
In relation to your question, the customer has more than 104 total contributions paid at class A since first starting to work. He does not, however, satisfy condition 1 or 2. He does not have 39 PRSI contributions paid or credited in the relevant tax year, of which 13 must be paid contributions. The relevant tax year in his case is 2024 and he has 52S class contributions paid in this year. This means he does not satisfy condition 2 - 26 PRSI contributions paid in the relevant tax year and in the tax year immediately before the relevant tax year (2023). He has no contributions paid at class A in either 2024 or 2023, therefore, unfortunately, he does not qualify for Illness Benefit.
In circumstances where people are ill but do not qualify for Illness Benefit or Invalidity Pension, my department provides means tested supports under the Disability Allowance scheme and the Supplementary Welfare Allowance scheme. An Additional Needs Payment may also be available to people who have expenses that they cannot pay from their weekly income.
The Programme for Government includes an action to explore the option of giving self-employed workers access to Illness Benefit by means of making a higher PRSI contribution. Any changes to the current system would need to be considered in an overall policy and budgetary context.