Rehabilitation benefits - ZUS
3 November 2020
The rehabilitation benefit is granted to a person who is covered by sickness insurance and has already used up the entire sickness allowance, but is still incapable of work. However, the benefit will only be granted if further treatment or rehabilitation can help the person restore his/her earning capacity.
The rehabilitation benefit is payable for a maximum of 12 months, at a rate of:
- 90% of the assessment basis of the sickness allowance during the first 90 days of its receipt,
- 75% of this basis for the remaining period,
- 100% of this basis, if the incapacity for work occurred during pregnancy.
The rehabilitation benefit from accident insurance in the event of incapacity for work caused by accident at work or occupational disease is payable to persons covered by accident insurance. It amounts to 100% of the assessment basis.
The rehabilitation benefit is not available, inter alia, to persons entitled to:
- an old-age pension,
- a disability pension,
- an unemployment benefit,
- a pre-retirement allowance,
- a pre-retirement benefit,
- a health leave,
- a teachers’ compensatory benefit.
It is also not payable to persons on unpaid or child-care leave.
The decision whether the health condition justifies granting the rehabilitation benefit is made by ZUS evaluating doctor. The person concerned who does not agree with doctor’s decision, may appeal to ZUS medical board. He/she must do it within 14 days of receiving the decision. In turn, ZUS president may raise an objection that the decision is defective and refer the case to ZUS medical board for consideration. He/she may do so within 14 days from the day when ZUS evaluating doctor issued the decision.
The assessment basis of the rehabilitation benefit is equal to the assessment basis of the sickness allowance after adjustment.
In 2018, an average of 86.0 thousand people received the rehabilitation benefit per month. Its monthly average amount was PLN 1,675.52.
The expenditure on the rehabilitation benefits in 2018 amounted to PLN 1,728.0 million.
The Social Insurance Institution pays rehabilitation benefits to employees of work establishments that employ up to 20 persons. Whereas in work establishments with more than 20 employees, the rehabilitation benefit is paid by the employer. In both cases, the benefit is financed from the Social Insurance Fund.