Discontinue L-4 without risking losing your entire benefit

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Sick leave is issued by doctors in order to regain working capacity. While on sick leave, the employee may not perform work because he or she may lose the benefit. However, in some situations it is possible to stop L-4 without risking losing all of your benefits. When?

Sickness benefit

Insured persons who become temporarily incapable of work due to illness or accident are entitled to sickness benefit. The proof of incapacity for work is a sick leave, which must be delivered to the employer within 7 days of being issued. This is important as the allowance may be reduced by 25% for each day of delay.

Attention!

In order to be entitled to sickness benefit, you must be covered by sickness insurance.

Sickness insurance is obligatory for:

  • workers,

  • persons on alternative service,

  • members of agricultural production cooperatives and cooperatives of agricultural circles.

They can also apply for sickness insurance voluntarily:

  • contractors or persons performing work on the basis of an agency contract or other contract for the provision of services and persons cooperating with them;

  • persons conducting non-agricultural business activity, as well as persons cooperating with them;

  • persons performing work for remuneration on the basis of an assignment to work, while serving a sentence of imprisonment or pre-trial detention;

  • homeworkers;

  • clergy.

The sickness allowance is granted for the entire period of incapacity for work, but not longer than 182 days or 270 days (when the incapacity for work is caused by tuberculosis or occurs during pregnancy). If, after the end of the benefit period, the employee is still unfit for work, he / she may apply for a rehabilitation benefit, which is granted for a maximum of 12 months.

Sickness benefit - who is entitled to it?

The right to unemployment benefit is due:

  • after a waiting period:

    • 30-day - for employees;

  • from the first day of insurance:

    • if the incapacity for work due to illness occurred in:

      • graduates of schools or universities who are covered by sickness insurance or joined it within 90 days of graduating from school or obtaining a university diploma;

      • persons covered by compulsory insurance who have had at least 10 years of compulsory sickness insurance;

      • deputies and senators who joined sickness insurance within 90 days from the end of their term of office;

    • if the incapacity for work is caused by an accident on the way to or from work.

How much is sickness benefit?

The sickness benefit is paid in the amount of:

  • 80% of the allowance calculation basis;

  • 70% of the allowance calculation basis - allowance paid for the period of hospital stay;

  • 100% of the allowance calculation basis - if incapacity for work:

    • falls during pregnancy;

    • results from undergoing medical examinations for candidates for donors of cells, tissues and organs and the procedure of their submission;

    • caused by an accident on the way to or from work.

The basis for calculating the sickness benefit is the average monthly remuneration paid for the period of 12 months preceding the month of incapacity for work.

When is there a risk of losing benefits?

The insured person may lose the right to the allowance if he or she performs paid work during the time of incapacity for work confirmed by a doctor or if he uses the allowance in a manner inconsistent with its purpose. This is what the Benefit Act says. The consequence of this will be the return by the insured person of the entire benefit received for the last L-4 period, together with interest.

When an employee is on sick leave, checks are possible from the Social Insurance Institution, which checks whether L-4 is used in accordance with its purpose. In case of doubts as to its use, it may oblige the insured to return the benefit.

The patient may also be called for examinations by a ZUS certifying doctor, who checks whether the incapacity for work has been correctly assessed.

An employer who employs more than 20 people also has the right to inspect.

Interrupt L-4 - is it possible?

Many people wonder what will happen if L-4 is interrupted. In such a situation, would you risk losing your full benefit?

Example 1.

Mr. Jan received a sick leave for two weeks. In the second week of sick leave, he felt better and made an appointment to see a doctor. During the visit, the doctor issued a certificate of regaining the ability to work. Therefore, the next day, Mr. Jan showed up at work.

In such a situation, the provision that provides for the loss of the entire allowance for the period of sick leave does not apply. This provision only applies to cases of abuse of the right to unemployment benefit.

Interrupting L-4 by coming to work or shortening the period of sick leave by a doctor is not an abuse of the right to unemployment benefit.

Attention!

The employer is obliged to notify ZUS about the faster return to work of the employee who received the sickness benefit.

This is a very rational approach, because employees who recover faster and the doctor has no objections will be able to return to work, which is also more beneficial for employers.