Correctness control of certifying temporary incapacity for work
30 October 2023
The Act on cash social insurance benefits in respect of sickness and maternity introduced provisions aimed at strengthening the control of correctness of certifying the incapacity for work and control of taking advantage of sick leaves. Their aim was also to rationalise expenditure on these benefits. To achieve this aim, the following measures have been introduced:
- the right to allowance due to incapacity for work after cessation of sickness insurance has been restricted,
- the basis for allowance assessment after cessation of sickness insurance has been limited to 100% of the average wage/salary from the previous quarter,
- a waiting period has been introduced:
- 30 days for persons insured compulsorily,
- 90 days for persons insured voluntarily.
The Social Insurance Institution controls the correctness of certifying temporary incapacity for work and the correctness of use of sick leaves. The use of sick leaves may be also monitored by allowance payers. In 2021, ZUS carried out 353.2 thousand such inspections. Due to improper use of sick leaves, it suspended payment of sickness allowances to 18.3 thousand people in the amount of PLN 15.1 million. ZUS must also reduce the assessment basis for sickness allowance and rehabilitation benefit when the insurance entitlement has ceased. The total amount of benefits reduced in this respect in 2021 for 155.9 thousand people was PLN 176.2 million. The total amount of sickness insurance benefits reduced and withdrawn in 2021 was PLN 191.2 million.
Legal status as of 2022