The coronavirus pandemic has not suspended sick leave controls carried out by the Social Insurance Institution (ZUS), but it has changed the rules. Priority has been given to the safety of both the workers on sick leave being examined and the certified doctors.
In 2020, the number of sick leave controls conducted by ZUS fell from 149 689 to just 55 004, but this does not mean that the Social Insurance Institution has stopped verifying the correctness of declaring inability to work and the correctness of use of sick leave by employees. Of all the sick leaves controlled in 2020, the authority questioned as much as 20 percent, with a total amount of PLN 15 468 604.95.
The Social Insurance Institution controls both the correctness of declaring inability to work and the correctness of using sick leave.
In the first case, the control involves the verification by ZUS certified doctor whether the employee on sick leave is ill and whether he or she must continue to use the leave or can return to work earlier.
In the second case, on the other hand, the control involves checking whether the employee taking sick leave is actually not working or performing other activities that are incompatible with the doctor’s recommendations and may hinder recovery.
In both cases, any irregularity detected results in the withholding of sickness benefits and even in the necessity to return them with interest.
An employer who has doubts about the appropriateness of sick leave or the way in which it has been used by an employee may apply to the Social Insurance Institution for a control.
The SARS-CoV-2 epidemic has significantly affected both the number of ZUS controls and the way they are carried out. Control of sick leaves during the pandemic looks different than usual. Among other things, the rules have changed to ensure the safety of those involved, and a lot of the controls are now carried out on the basis of medical records and additional explanations provided by the certified doctor, if necessary.
Those on sick leave who receive invitations to examinations conducted by the ZUS certified doctors, and this is still the case, can also be directed to an additional examination or to a consultant doctor.
When verifying the correct use of sick leave, controls can also be carried out by employers as long as they employ more than 20 insured persons.
Moreover, the Social Insurance Institution ensures that all direct examinations are carried out with all precautions adapted to the current sanitary-epidemiological situation and in compliance with governmental recommendations and applicable legal regulations.
It is also worth noting that, in order to avoid losing the right to sick pay for the entire period of sick leave, it is necessary to agree with the employer the fact of performing additional tasks during sick leave, such as transferring data or access to other employees or making validations of, for example, financial settlements.
It should also be noted that sickness benefit may be paid for a maximum of 182 days, and up to 270 days for TB or incapacity to work during pregnancy.
For employees with an employment contract, sickness benefit is payable from the 34th day of incapacity for work in a given calendar year, and in the case of an employee over 50 years of age, from the 15th day of such incapacity.
Learn more: Work accident insurance contribution 2021