In Luxembourg, sick leave is governed by strict rules overseen by the National Health Fund (Caisse Nationale de Santé - CNS). Whether you are a resident or a cross-border worker (from France, Belgium or Germany), your rights are broadly the same, although certain administrative procedures and practical implications may vary depending on your situation.
This guide explains your rights, your obligations, and the key differences according to your status.
How the system works
When an employee is unable to work due to illness or an accident, they must inform their employer as soon as possible, ideally from the very first day of absence. This step is essential, as it allows the absence to be recognised as justified.
If the incapacity for work lasts only one or two days, the employee may, depending on the company’s internal practice, be exempt from providing a medical certificate. However, this flexibility is at the employer’s discretion, and the employer may require proof of incapacity at any time, even for a short absence. In all cases, employees must always be able to justify their absence, regardless of its duration.
However, as soon as the absence reaches three days or more, a medical certificate becomes mandatory and must cover the entire period of absence retrospectively from the first day. The certificate must be submitted no later than the third day of absence. It consists of three separate sections:
- One copy for the National Health Fund (CNS);
- One copy for the employer;
- One copy to be kept by the employee.
If the sick leave is extended, a new medical certificate must be issued and submitted within the same deadlines.
Once the sick leave has been declared, the employment contract is suspended. This means that the employee no longer performs their duties, while the employment relationship itself remains in force. During this period, certain rules must be respected, particularly regarding medical instructions (such as rest requirements) and any restrictions on leaving home (which are generally prohibited during the first five days unless otherwise authorised by the doctor).
In addition, employers may, in certain circumstances, request an administrative or medical check to verify the legitimacy and compliance of the sick leave. This mechanism is intended to ensure the proper use of the system.
Financial compensation
From a financial perspective, employees continue to receive income through a two-stage system:
- Initially, the employer continues to pay the employee’s salary for a specified period.
- Thereafter, the CNS takes over and pays daily sickness benefits.
The amount paid is generally based on the employee’s average gross salary, subject to the limits set by Luxembourg legislation. The aim is to ensure continuity of income while keeping the costs of the social security system under control.
Luxembourg residents: a simpler process
For employees residing in Luxembourg, the management of sick leave is relatively straightforward. All administrative procedures are handled within the country, making case management easier and reducing the number of organisations involved.
The employee deals exclusively with the Luxembourg system for both document submission and compensation, which makes the process more direct, particularly in the event of long-term sick leave.
Cross-border workers: coordination between several systems
Cross-border workers account for nearly half of Luxembourg’s workforce. Their situation is governed by European social security coordination rules. Whether they live in France, Belgium or Germany, they enjoy the same rights as Luxembourg residents.
However, their situation requires coordination between several social security institutions.
French cross-border workers
- Medical treatment covered through coordination between the CNS and/or the French Health Insurance Fund (CPAM);
- Sick leave may also need to be declared to the CPAM, depending on the circumstances;
- Benefits are paid by Luxembourg, not by France.
Belgian cross-border workers
- Dual administration with a Belgian mutual health insurance fund for certain procedures;
- Administrative formalities can sometimes be more complex;
- Sick leave is automatically recognised through the CNS.
German cross-border workers
- Coordination with the German statutory health insurance fund (Krankenkasse);
- Translations or administrative exchanges may occasionally be required;
- Compensation is always paid by Luxembourg.
In all cases, the principle remains the same: whenever the professional activity is carried out in Luxembourg, Luxembourg employment law applies to sick leave matters. This includes compliance with deadlines for submitting medical certificates, adherence to medical instructions, and the possibility of checks and penalties in the event of non-compliance.
Can you be dismissed while on sick leave?
In Luxembourg, employees on sick leave benefit from protection against dismissal for a specified period. However, this protection is not absolute.
Certain circumstances, such as gross misconduct or economic reasons unrelated to the employee’s state of health, may justify the termination of the employment contract. It is therefore important to understand that the suspension of the contract does not provide complete protection against dismissal.
For more information about employment law in Luxembourg, visit our blog.