New rules on sick leave. Who is gaining and who is losing?

Since this year, new regulations have been in force regarding the use of sick leaves, as well as the receipt of sickness benefits – ZUS has decided to inhibit the possibility of employees taking advantage of sick leaves issued for various disease entities. The chronically ill will lose out on shifts, while pregnant women and those requiring hospital treatment will benefit.

1. Since the new year, the rules on sick leave have changed
2. From January 1, ZUS pays a higher allowance for hospital stay
3. Sickness benefit is now paid for no more than 182 days, even if the sickness is discharged for various diseases
4. This period is extended to 270 days when incapacity for work is caused by tuberculosis or during pregnancy
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6. You can find more about the coronavirus on the TvoiLokony home page

The government tightened the system of benefits paid by the Social Insurance Institution (ZUS). for sickness benefits. The new regulations are intended to prevent unlawful use of sick leaves and their indefinite extension. The changes are the result of the amendment to the Act on the Social Insurance System and some other acts.

PLN 2020 billion was allocated to sickness benefits in 14. As Stanisław Szwed, deputy head of the family ministry, announced, the data indicated that a change in the system was necessary.

No more using continuous sick leave for various disease entities

Every insured citizen can now receive a sickness benefit per year for no longer than 182 days, or 270 if the incapacity for work was caused by tuberculosis or during pregnancy – this is a key change that has taken place since this year in the area of ​​sick leave. .

The change was dictated by the desire to prevent employees from taking sick leave for various disease entities. By doing so, ZUS wants to avoid a situation in which the insured person will use the L4 extension for a period longer than 182 days.

Until the end of 2021, the period of incapacity for work resulting from the same disease entity was summed up. However, in the case of various diseases, the benefit period was calculated anew.

New calculation of the benefit period

Under the new regulations currently in force, it is irrelevant what disease caused the inability to work before and after the break. The standard period of the unemployment benefit is 182 days, which determines the total period for which the insured person may receive Illness Benefit. This benefit period now includes all uninterrupted periods during which the employee was unable to work, even in the event of an incapacity caused by various factors – sick days will be added together.

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The sick person may be left without benefit

As ZUS explains, in the event of breaks in incapacity for work, the period of incapacity for work that occurred before the break is included in the benefit period, provided that it was caused by the same reason and the break is not longer than 60 days.

For some, such a system for counting the time of incapacity for work may be problematic – there may be situations where people on sick leave at the turn of the year – and who previously took L4 regularly – will not receive sickness benefits. This state of affairs is related to the break between consecutive medical certificates. It should be remembered that each disease entity will be included in one settlement period, in the absence of a 60-day break between them. In such a situation, the patient remains only a rehabilitation benefit.

You are working on sick leave – you need to return sick pay

The new regulations clarify the issue of irregularities in the use of sickness benefit – anyone who worked while receiving sickness benefit, and did not receive treatment, must return the benefit. This rule had been in force before, but has now been entered into the act.

The Social Insurance Institution denies the information appearing in the media that officials should control employees on sick leave, including asking how they spend their time on sickness, e.g. neighbors. The new regulations do not give us such rights – emphasizes ZUS.

New ZUS authorizations

The new act includes issues related to the provision of information to ZUS. Currently, ZUS has the right to obtain both data and information to the extent necessary to determine the entitlement to benefits, their amount, calculation basis, as well as their payments from the insured and contribution payers.

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The new regulation in force is to be an effective measure that will enable the collection of data necessary for the granting of entitlement and payment of sickness benefits or their verification from contribution payers and insured persons. We are talking about situations where, for example, a person who is employed by two employers is ill. In such a case, ZUS will be able to obtain information whether someone on sick leave for one employer has not worked for another during this period.

Termination of employment and sickness benefit

The period of receiving sickness benefit after termination of employment has been reduced to 91 days (this rule does not apply to tuberculosis patients or those unable to work during pregnancy). The period of receiving sickness benefit in the event of termination of employment will not include incapacity for work that lasted during the employment relationship.

If the period of receiving the sickness allowance has expired, it will be possible to apply for a rehabilitation benefit – this type of benefit is granted to a person who is still ill for a maximum of 12 months, but who is likely to regain ability to work as a result of further treatment or rehabilitation.

Maintaining the sickness benefit despite the delay in paying the premium

An important change introduced by the new regulations is the maintenance of the sickness benefit despite late payment of contributions. What does this mean for the insured person? If you are covered by voluntary sickness insurance, you will continue to receive the benefit, even if the premium paid is received late. Until now, the insured had to apply to ZUS for this option.

Pregnant women and those insured requiring hospital treatment benefited

The introduced changes will benefit pregnant women, those whose employment contract will expire (e.g. as a result of the death of the employer or the liquidation of the company) will be able to count on the allowance paid until the day of childbirth.

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The new regulations introduce a higher allowance for the period of stay in the hospital – 70% of the total amount in force so far. the basis of the allowance assessment has been changed to 80 percent.

People suffering from chronic diseases will lose out on sealing the system

The purpose of the new regulations is to tighten the Social Insurance Institution (ZUS) in order to prevent dishonest employees from being on sick leave for a long time. In the opinion of the Social Insurance Institution, up to PLN 2022 million will be saved on sickness benefits in 670. People suffering from chronic diseases will lose out under the new regulations – their period of unemployment benefit has been significantly shortened.

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