Social Insurance Institution (ZUS) massively controls sick leaves

The Social Insurance Institution is resuming mass inspections of L4. In the first quarter of 2021, officials carried out more than 80 000 controls of sick leave in total and issued almost 4 000 decisions to suspend the payment of sickness allowance.

With the pandemic slowing down, the Social Insurance Institution is returning to increased L4 checks. According to statistics, in the second quarter of 2020, only 43 thousand sick leaves were checked, while in the first quarter of 2021, this number doubles (80 thousand).

As a result of large-scale inspections, the Social Insurance Institution (ZUS) issued 3.7 thousand decisions to withhold sickness allowance payments, in the total amount of PLN 3.5 million.

Moreover, the number of sick leaves issued by psychiatrists (1.5 million in total) has increased significantly over the past months. There was also a high number of sick leaves due to alcohol abuse.

ZUS inspections – what do they consist of?

The Social Insurance Institution (ZUS) carries out controls on the appropriateness of adjudicating temporary inability to work on the basis of the Act on cash benefits from social insurance in the event of sickness and maternity.

Learn more: ZUS inspections – what do they concern?

Inspections carried out by the Social Insurance Institution may be conducted:

  • at the workplace or place of business,
  • at the place of residence,
  • at the place of temporary residence (as indicated in the medical certificate),
  • at another place, if it is necessary according to the available information.

If the Social Insurance Institution (ZUS) finds any malpractice, the insured person may lose the right to receive sickness allowance for the entire period of sick leave.

Sickness allowance from ZUS and the right to sick pay

Sick pay is paid during sickness and is financed from the employer’s funds. It is paid to employees who are unable to work due to illness for the first 33 days of such inability to work in a calendar year and, if they are over 50 years of age, for the first 14 days of inability to work in a calendar year.

However, if inability to work due to illness in a given calendar year lasts for a total of more than 33 days, the employee acquires the right to sickness allowance paid by the Social Insurance Institution. For people over 50, the period is not 33 days but 14 days.

The amount of sickness allowance is usually between 70 and 80 per cent of remuneration, except for the case in which the inability to work was caused by an accident at work, on the way to or from work, or in the case of undergoing tests for donors of marrow, tissues and organs and during pregnancy, when the employee receives 100 per cent of remuneration.

Learn more: Annual vacation leave – rules for taking the leave and penalties for breaching the regulations

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