Sickness benefit and territorial jurisdiction of the Social Insurance Institution

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The winter period is favorable for diseases. The flu can put you to bed for up to a month or more. In order to be sure that the employee receives the sickness benefit due, both the employer and the person employed by him must bear in mind several important issues.

Sickness benefit - payment

In each case, the sickness benefit is financed by ZUS. On the other hand, the employer is obliged to pay the remuneration for the duration of the illness after the waiting period, if the sum of days of incapacity for work does not exceed 33 days or 14 days if the employee is 50 years old. If the employee has been ill for a total of more than 33 or 14 days, then the sickness benefit is financed by the Social Insurance Institution.

However, if the employer registered more than twenty people for sickness insurance as of November 30 of the previous calendar year, and in relation to contribution payers who did not report anyone for sickness insurance as at that date - as of the first month in which they made such notification , then the right to the payment of benefits on behalf of ZUS is taken over by the employer - the contribution payer.

Documents necessary to receive sickness benefit during employment

In order to receive sickness allowance, you must submit a medical certificate completed on the ZUS ZLA form on temporary incapacity to work due to illness or hospital stay. The employee is obliged to provide the employer with this certificate within seven days from the date of its receipt. If he or she exceeds this time limit, the sickness benefit will be reduced by 25% for the period from the eighth day of incapacity for work until the date of delivery of the medical certificate.

If the employer is not entitled to the payment of benefits, then together with the medical certificate ZUS ZLA is obliged to provide a certificate of the contribution payer ZUS Z-3, on the basis of which ZUS pays the benefit.

Receipt of sickness benefit after termination of employment

It is possible to receive sickness benefits after termination of employment, if the incapacity to work continued without interruption for at least 30 days and arose no later than 14 days from the termination of employment or 3 months (90 days) in the case of an infectious disease, the incubation period of which is longer than 14 days or any other disease the symptoms of which show up more than 14 days after the onset of the disease.

Evidence for the payment of sickness benefits by ZUS for the period after termination of employment are:

  • ZUS ZLA medical certificate,

  • statement of the former employee on the ZUS Z-10 form,

  • certificate of the former employer issued on the ZUS Z-3 form.

Due to the fact that the sickness benefit for this period of incapacity for work is paid by ZUS, the former employee should submit an application for its payment to ZUS competent for his place of residence.

Sickness benefit - territorial jurisdiction of the Social Insurance Institution

If the employee performs work in a place other than the place of residence, then the right to sickness benefit and its amount will be determined by the branch of the Social Insurance Institution, which is competent for the seat of the contribution payer.

After termination of employment, the sickness benefit is paid by ZUS in accordance with the place of his residence. In the event that the money was paid out while the employment was still in progress, after its termination, the ZUS branch in accordance with the seat of the contribution payer continues to do so.

However, if the ZUS ZLA form and any other documents are delivered to the wrong ZUS branch, the enterprise is obliged to send the documentation to the territorially appropriate branch. It also informs the insured and the contribution payer about it.