From now on, ZUS controllers checking the correct usage of L4 gained fresh rights. This includes the right of access to the control site. The conditions for the failure of entitlement to sickness benefit were besides clarified.
The amendment of the Act on the Social safety strategy and any another laws is based on 2 pillars – improvement of medical jurisprudence in the Social safety Office and improvement of medical exemptions. fresh regulations come into force in stages. The first, concerning the verification of the correctness of the judgement on temporary incapacity for work and the issue of medical certificates, began to apply in January. Another part of the improvement came into force on Monday. The last of the fresh rules will begin to apply at the beginning of 2027.
The regulations that entered into force on Monday specify the conditions for the failure of entitlement to sickness benefit.
In accordance with the provisions already in force, the insured individual may lose his or her entitlement to sickness allowance for the full period of dismissal if, at the time of his or her incapacity for work, he or she is engaged in work or engage in activities incompatible with the intent of the dismissal.
The fresh rules specify paid work as any activity which is of a commercial nature, regardless of the legal relation underlying it. It is not alleged "accidental" activities, i.e. those which require crucial circumstances during the period of dismissal, but cannot be an employer's recommendation.
Non-exemptive activity is in turn any activity that impedes or prolongs treatment or recovery. They do not include average regular activities or incidents which require crucial circumstances during the period of release.
In addition, provisions on the control of the usage of exemptions have been amended. The Social Insurance Institution is entitled to control medical certificates with temporary incapacity for work due to illness and medical certificates with temporary incapacity for work for care of a sick household member. Persons may besides be controlled after the termination of the sickness insurance title.
The fresh rules presume that specified control is to find whether a individual is taking action to exclude him from the right to temporary dismissal. In the case of the dependant, the check is intended to find whether there are no another household members another than the insured who can supply care.
Control of the correct usage of dismissals according to their intent may be carried out by contributors and ZUS, but controllers from ZUS can now identify the individual checked for identification. They are besides entitled to enter the place of inspection and to receive information from the controlled person, its contributor and the treating physician.
The audited individual will be required to let the inspection to be carried out, to supply the controller with information on his/her request or to supply an explanation of the inspection.
APW, PAP
