The Impact of Long-Term Hospitalization on the Stability of Livelihood Requirement in Japan#

For foreign residents living in Japan, unforeseen long-term hospitalization due to illness or injury poses not only health challenges but also significant concerns regarding visa status. This is particularly relevant for those applying for Permanent Residence (PR) or visa renewals, where the “Stability of Livelihood Requirement” is a critical criterion. This article provides an objective analysis of how gaps in income or employment due to hospitalization influence Immigration Services Agency decisions.

Understanding the “Stability of Livelihood” Requirement#

To accurately assess the impact of hospitalization, one must first understand what the Immigration Bureau means by the “Stability of Livelihood Requirement” (Dokuritsu Seikei Yoken). This requirement stipulates that an applicant must have sufficient assets or skills to earn an independent living.

However, this does not solely imply a requirement for high wealth. The core intent is to ensure that the applicant:

Does not become a burden on the public in their daily life.
Is expected to maintain a stable life in the future based on their current assets or skills.

Therefore, a temporary reduction in income does not automatically lead to a rejection. Immigration examiners evaluate the application comprehensively, looking not only at past financial data but also at the prospect of future stability. If the hospitalization was a temporary setback and the applicant has since recovered and resumed work, the “future stability” aspect remains intact.

Income Reduction and Documentation#

In applications for Permanent Residence, the applicant’s annual income over the past few years is scrutinized. Naturally, long-term hospitalization often leads to a leave of absence, resulting in a decrease in taxable annual income for that specific year.

Crucially, examiners look at the cause of the income drop and how the applicant sustained themselves during that period. Unlike quitting a job voluntarily and remaining unemployed, a leave of absence due to medical reasons is a mitigating circumstance.

If the applicant received an “Injury and Sickness Allowance” (Shobyo Teatekin) from their health insurance, this is a vital point to highlight. While this allowance is non-taxable and does not appear on the tax certificate (Kazei Shomeisho), it proves that the applicant had a legitimate financial safety net provided by the social insurance system, rather than relying on public welfare.

It is essential not to assume that a lower income year guarantees rejection. Instead, transparency is key. Applicants should submit additional documentation, such as medical certificates explaining the leave duration and proof of reinstatement to their position, to demonstrate that the income drop was an anomaly and that normal earnings have resumed.

A common misconception is that using the Japanese healthcare system’s benefits will negatively impact a visa application. Japan has a “High-Cost Medical Expense Benefit” system (Kogaku Ryoyohi Seido) that caps monthly out-of-pocket medical costs.

Using these insurance-based benefits is a right of the insured person who pays premiums. Therefore, utilizing High-Cost Medical Expense Benefits or Injury and Sickness Allowances does not negatively affect immigration examinations. In fact, it demonstrates proper participation in Japan’s social security system.

However, there is a strict distinction regarding “Public Livelihood Assistance” (Seikatsu Hogo), also known as welfare. Receiving welfare payments indicates that the applicant cannot maintain an independent livelihood. Regardless of the reason—even if due to long-term hospitalization—reliance on welfare is a major negative factor for visa renewal and is often a disqualifying factor for Permanent Residence, as it directly contradicts the requirement of financial independence.

The Issue of Physical Presence and Residence History#

Another dimension of long-term hospitalization is the requirement for continuous residence.

Hospitalization in Japan: If the applicant is hospitalized within Japan, they are physically present in the country. Therefore, the period of hospitalization counts towards the continuous residence requirement (e.g., the 10 years needed for PR).
Hospitalization Abroad: If the applicant returns to their home country for long-term treatment, the continuous residence record may be broken. Generally, leaving Japan for more than 3 consecutive months or a total of about 100 days in a year can reset the “continuous residence” count. Immigration authorities may view the center of the applicant’s life as having shifted away from Japan during that period.

Strategy for Application: The “Statement of Reasons”#

When applying for a visa extension or Permanent Residence after a period of long-term hospitalization, submitting standard documents is often insufficient. It is highly advisable to attach a “Statement of Reasons” (Riyu-sho) to clarify the situation.

This statement should objectively cover:

Chronology: The specific dates and medical reasons for the hospitalization.
Financial Sustainability: Explanation of how living expenses and medical bills were paid during the hiatus (e.g., savings, insurance payouts, spousal support).
Current Status: Evidence of recovery (medical certificate) and proof of return to work (employment certificate showing current salary).

By providing this context, the applicant shifts the narrative from “a year with low income” to “a year of medical recovery followed by a full return to productivity.”

Conclusion#

Long-term hospitalization presents a challenge in Japanese immigration procedures, but it is not an insurmountable barrier. The Immigration Services Agency primarily seeks assurance that the applicant is not, and will not become, a permanent burden on the state. By distinguishing between insurance benefits (acceptable) and public welfare (problematic), and by proving that the medical issue is resolved and financial stability has been restored, applicants can successfully navigate the process. Honest, detailed, and well-documented explanations are the most effective tools in these circumstances.