Rehabilitation benefit for an entrepreneur - formalities

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The principles of granting the rehabilitation benefit are regulated in particular in the Act of 25 June 1999 on cash benefits from social insurance in the event of sickness and maternity, hereinafter referred to as u.ś.p.u.s. (Journal of Laws of 2017, item 1368, as amended). The insured person is entitled to the above-mentioned benefit after the sickness benefit period has expired, in a situation where his inability to work continues, but further treatment is likely to recover by the health worker. When can a rehabilitation benefit for an entrepreneur be granted?

Rehabilitation benefit - for whom?

Pursuant to Art. 18 u.ś.p.u.s. the rehabilitation benefit is granted to an insured person who, after exhausting the sickness benefit, is still unable to work, and further treatment or rehabilitation is likely to regain the ability to work. Rehabilitation benefit is granted for the period necessary to restore the ability to work, but not longer than for 12 months. The above is decided by a certified doctor of the Social Insurance Institution. Rehabilitation benefit is not granted to a person entitled to an old-age or disability pension, unemployment benefit, pre-retirement allowance, pre-retirement benefit, teacher's compensation benefit and health leave granted on the basis of separate regulations.

It is worth recalling that the sickness allowance is granted for the period of incapacity to work due to illness or inability to perform work for reasons specified in art. 6 sec. 2 u.ś.p.u.s. - but not longer than 182 days, and if the incapacity for work was caused by tuberculosis or occurs during pregnancy - not longer than 270 days (Art. 8 of the Act on

Rehabilitation benefit for an entrepreneur - preparation of the required documentation

When applying for a rehabilitation benefit by an entrepreneur, he should collect full documentation on the rehabilitation benefit and submit it to ZUS. The entrepreneur fills in and sends the following documents to ZUS:

● ZUS ZNp-7 declaration on the form;

● health certificate (OL-9 form) completed by the treating physician not earlier than one month before the date of submitting the application;

● job interview from the workplace (form OL-10) - this form is not required if the application is submitted by a person whose incapacity for work occurred after the end of insurance or a person conducting non-agricultural activity;

● a protocol establishing the circumstances and causes of an accident at work or an accident card, if the incapacity for work was caused by an accident at work;

● decision on the recognition of an occupational disease - if the incapacity for work is related to an occupational disease.

The entrepreneur should correctly and in a timely manner fill in the above-mentioned documents, which, together with the certificate of the certifying physician or the ZUS medical commission, will be a necessary condition for the insured to purchase a rehabilitation benefit. The insured should have continuity in the payment of the benefit, therefore the above deadlines should be met. Start a free 30-day trial period with no strings attached!

Accident documentation and the decision confirming an occupational disease need not be submitted again if the entrepreneur has previously submitted these documents to a ZUS branch when submitting the application for sickness benefit.

In the case of payment of the rehabilitation benefit by ZUS, the Z-3b contribution payer certificate is submitted by the insured who conduct non-agricultural activity, the insured cooperating with persons conducting non-agricultural activity, while Z-3a is submitted by other insured persons.

In addition, when applying for a rehabilitation benefit for an entrepreneur, the following information should be provided:

● NIP and REGON number of the entrepreneur (possibly PESEL number or passport series and number);

● name and address of the entrepreneur (possibly the entrepreneur's stamp, if applicable);

● detailed data of the entrepreneur - first name, surname, PESEL number or series and number of passport and date of birth and address of residence;

● information whether the entrepreneur is covered by sickness and maternity insurance or by insurance against accidents at work and occupational diseases as a person referred to in Art. 6 sec. 1 points 5 and 10 of the Act of 13 October 1998 on the social insurance system (Journal of Laws of 2016, item 963, as amended);

● declaration whether the incapacity for work was caused by an occupational disease, accident at work or an accident on the way to or from work, and submission of a document confirming this circumstance;

● information on the insured's bank account number;

● place, date, signature of the person authorized to issue the certificate and stamp of the authorized person, if any;

● indication of the type of benefit and the period for which the entrepreneur is applying.

The above list of specified documents is indicated in Annex 3 - Scope of data, which includes the certificate of the contribution payer in the case of the insured conducting non-agricultural activity, the insured cooperating with a person conducting non-agricultural activity and a clergyman - attached to the ordinance of the Minister of Family, Labor and Social Policy of December 8 2015 on the scope of information on the circumstances affecting the right to social insurance benefits in the event of sickness and maternity or their amount, and on the documents necessary for the granting and payment of benefits (Journal of Laws of 2017, item 87, as amended).

It is worth recalling that the rehabilitation benefit is not payable if the insured person is entitled to an old-age or disability pension, is entitled to unemployment benefit, teacher's compensation benefit and health leave granted on the basis of other regulations, pre-retirement allowance, pre-retirement benefit, performs gainful activity, resides on unpaid leave or childcare leave, is in pre-trial detention or imprisonment.

Form ZUS ZNp-7 part I is completed by the person applying for the rehabilitation benefit, part II is completed by the contribution payer, and part III is completed by the sickness benefit payer. Part III provides information on the period of the insured's incapacity for work, including the period for which he was paid for the period of incapacity for work, for which period he received sickness benefit, and the date when the benefit period ends.

According to the information provided on the ZUS ZNp-7 form, the insured is obliged to submit the indicated form if he / she wants to purchase a rehabilitation benefit for the next period, after the period of receiving the benefit for a period shorter than 12 months has expired.

During the period of waiting for the employee to be granted a rehabilitation benefit by ZUS, he does not perform any work and is not entitled to any benefits.

Summary

In conclusion, it is worth remembering that an entrepreneur may apply for a rehabilitation benefit if the period of sickness benefit has been exhausted, he has still not regained his ability to work, the prognosis for improving health and returning to work is favorable. The complete set of documents together with the application on the ZUS ZNp-7 form should be submitted to the appropriate field unit of ZUS at least 6 weeks before the end of the benefit period. It is worth remembering that while receiving the sickness allowance and then the rehabilitation benefit, the entrepreneur cannot provide any work or other professional activity due to the loss of the right to the above-mentioned benefits. The entrepreneur should suspend the activity or authorize another person to run the company's affairs while he is receiving the rehabilitation benefit, if he employs employees.