Since January 2025 Social Insurance Institution (ZUS) will receive enhanced competences in the field of checks on sick leave. The intent of the changes is to reduce abuses involving the usage of L4 for non-treatment purposes, specified as extra work, trips or another activities that are not associated with recovery. Regulations introduced are intended to increase effectiveness of controls and reduce the number of persons who usage medical exemptions in an inappropriate way.
New ZUS powers – control without restrictions
Until now, ZUS could carry out checks on medical exemptions only in companies employing 20 people. With the entry into force of the fresh regulations, the scope of the control of the Social safety Office will be importantly expanded. There will be no more restrictions As far as the size of the company is concerned, which means that inspectors will be able to check medical exemptions besides in large companies. Entrepreneurs, regardless of the number of persons employed, will gotta number on the anticipation of control by ZUS.
Moreover, ZUS controllers will gain the right to check not only the place of residence or residence of the individual on sick leave, but besides locations related to economical activity and another places that may be applicable in the context of verification of the correct usage of the exemption. This will enable ZUS to monitor more closely whether exemptions are utilized for purposes not related to the disease.
Controls will besides include persons after termination of the contract
The fresh government besides applies to those who have terminated their employment relation but proceed to collect rehabilitation services or sickness benefit. Until now, only those in employment were subject to control. From 2025, ZUS will have the right to verify the correct usage of medical leave besides for erstwhile employees who proceed treatment after the conclusion of the employment contract.
The aim of this amendment is to prevent people from continuing to benefit from the sickness benefits in an unjustified manner, for example by utilizing an exemption for non-treatment purposes.
Consequences of irregularities – cessation of benefits and reimbursement of money
Where irregularities are detected during the inspection, ZUS will have the right not only to suspension of payments of benefitsbut besides to request reimbursement of benefits already paid. This may include reimbursements for periods where the individual on sick leave was not actually unfit for work but utilized the exemption for individual or professional purposes.
This solution aims to increasing fairness in the usage of sickness and rehabilitation benefits, which can aid reduce the number of abuses in the social safety system.
Control scale – numbers talk for themselves
In the first half of 2024 ZUS conducted almost 261 000 controls sick leave. As a consequence of these checks, payments of benefits of around PLN 24 million. In turn, together with the reduced sickness benefits, almost PLN 117,5 million. This data shows how much money can be saved through effective controls that let the elimination of abusers of the system.
The fresh powers of the Social safety Office are aimed at uncovering irregularities even more effectively, which could lead to a simplification in fraud and even greater savings from the state budget.
Responses to change – concerns and expectations
Although the introduction of fresh powers of the Social safety Office has met any concerns from employees, experts point out that these changes are primarily aimed at improving the functioning of the social safety system. Workers who benefit from medical leave in accordance with their intent request not be afraid of changes. In turn, those who have so far abused dismissals will face serious consequences.
From a View entrepreneurs changes may entail additional obligations related to monitoring medical dismissals in companies. They will gotta guarantee that any medical exemptions are indeed justified in order to avoid unnecessary complications related to ZUS checks.
Proposals for amendments
The fresh government aims to improving the system and Reduction of fraud, and reduce the burden on the state budget. Thanks to wider rights, ZUS will be able to verify who actually requires disease supportAnd who benefits from the exemption in a dishonest way.
ZUS checks are expected to become more versatile and precise, which will let a more accurate verification of the correct usage of L4 and, in the event of abuse, of fast response.
Read more:
ZUS will gain fresh control powers. Check the L4 licence
