Sickness Benefit Calculation 2025: Complete Guide

Sickness benefit is one of the most requested benefits from INSS (National Institute of Social Security), providing income for workers temporarily unable to perform their activities. In 2025, calculation rules follow specific criteria based on contribution history.

Understanding how to calculate your benefit amount is essential for planning your finances during the leave period. The amount varies according to your average contributions and can represent between 60% and 100% of the benefit salary.

What is sickness benefit

Sickness benefit is a temporary benefit paid by INSS to insured individuals who become temporarily unable to work due to illness or accident. Unlike disability retirement, this benefit assumes the worker will return to activities.

The benefit is granted after medical examination that proves temporary incapacity. During receipt, the worker cannot engage in paid activities, under penalty of cancellation.

Who is eligible

The following insured individuals are entitled to sickness benefit if they prove:

• Active insured status or grace period
• Minimum qualifying period of 12 monthly contributions
• Temporary incapacity proven in medical examination
• Absence exceeding 15 days (after this period, INSS assumes payment)

Basic requirements

To request the benefit, you must meet the following criteria:

• Be contributing to Social Security
• Have completed the qualifying period of 12 months
• Present detailed medical certificate
• Undergo INSS medical examination
• Prove inability to perform usual function

Qualifying period exceptions: work accidents, occupational diseases, and serious illnesses listed by law do not require a qualifying period.

How to calculate the amount

Sickness benefit calculation follows specific rules that consider the entire contributory history of the insured. The final amount corresponds to 91% of the benefit salary, respecting minimum and maximum limits.

Benefit salary

The benefit salary is calculated by the arithmetic average of all contributions since July 1994. For sickness benefit, it considers:

• 100% of contributions made
• Monetary correction up to the calculation date
• Exclusion of the 20% lowest values (when there are more than 60 contributions)

Average contributions

The average considers all contribution salaries from the basic calculation period:

• Monetarily updated salaries
• Regularized overdue contributions
• Proportional values when necessary
• Application of official correction indexes

Example: Worker with average contributions of R$ 4,000.00 → benefit salary = R$ 4,000.00 → sickness benefit = R$ 3,640.00 (91%)

Minimum and maximum amounts 2025

Sickness benefit amounts in 2025 follow limits established by Social Security, based on minimum wage and social security ceiling.

Benefit floor

The minimum amount of sickness benefit corresponds to the current minimum wage:

• 2025 minimum wage: R$ 1,518.00
• Minimum sickness benefit: R$ 1,518.00
• Constitutional guarantee of value not less than minimum

Social security ceiling

The maximum amount is limited by the INSS ceiling:

• 2025 INSS ceiling: R$ 8,157.41
• Maximum sickness benefit: R$ 7,423.24 (91% of ceiling)
• Percentage application even at maximum value

Step-by-step calculation

Sickness benefit calculation involves specific steps that determine the final benefit amount. Each step is fundamental to reach the correct amount.

Basic calculation period

INSS considers all contributions since July 1994 or since the beginning of contributions:

1. Identify contributions in CNIS (National Social Information Registry)
2. Update values by official indexes
3. Calculate simple arithmetic average
4. Exclude 20% lowest salaries (when applicable)

Factor application

After defining the benefit salary, apply the 91% percentage:

• Sickness benefit = Benefit salary × 91%
• Minimum value: R$ 1,518.00
• Maximum value: R$ 7,423.24
• Rounding to cents

Practical example: Benefit salary R$ 3,500.00 → R$ 3,500.00 × 0.91 = R$ 3,185.00

Practical example

Let’s simulate the calculation for a worker with 15 years of contributions and different salaries throughout their career:

Benefit salary calculation:

• Average contributions: R$ 4,033.33
• Benefit salary: R$ 4,033.33

Sickness benefit amount:

• R$ 4,033.33 × 91% = R$ 3,670.33

To calculate your benefit accurately, use our sickness benefit calculator that considers all variables of your contributory history.

How to apply for the benefit

Sickness benefit application must be made exclusively through INSS digital channels, following specific procedures:

Required documentation

• CPF and identification document
• Detailed medical certificate (ICD code mandatory)
• Complementary exams and reports
• Work permit or contribution booklet
• Updated proof of residence

Application process

1. Access meu.inss.gov.br website or app
2. Log in with CPF and password
3. Select “Request sickness benefit”
4. Fill out form with personal and medical data
5. Attach digitized documents
6. Schedule medical examination
7. Attend examination on scheduled date

The analysis period is up to 45 days after examination. During this period, track progress through Meu INSS.

Frequently Asked Questions

What is the minimum sickness benefit amount in 2025?

The minimum sickness benefit amount in 2025 is R$ 1,518.00, corresponding to the national minimum wage. Even if the 91% calculation of benefit salary results in a lower value, the constitutional floor is guaranteed.

How is sickness benefit calculated?

Sickness benefit is calculated by applying 91% to the benefit salary. The benefit salary corresponds to the arithmetic average of all contributions since July 1994, properly monetarily updated.

How many contributions do I need to receive sickness benefit?

You need 12 monthly contributions (qualifying period) to be entitled to sickness benefit. Exceptions include work accidents, occupational diseases, and serious illnesses listed by law, which don’t require a qualifying period.

What is the maximum sickness benefit amount?

The maximum sickness benefit amount in 2025 is R$ 7,423.24, resulting from applying 91% to the INSS ceiling (R$ 8,157.41). This is the upper limit regardless of contributory history.

Can I work while receiving sickness benefit?

Working is not allowed while receiving sickness benefit. Engaging in paid activities may result in immediate cancellation of the benefit and repayment of amounts received improperly.

How can I track my sickness benefit request?

Track your request through Meu INSS (website or app), using your CPF and password. The system shows request status, scheduled examination date, and results after medical analysis.

When does sickness benefit payment start?

Payment starts from the 16th day of absence for employed insured individuals, or from the incapacity start date for other categories. The first 15 days are the employer’s responsibility when applicable.