Following the Social Insurance Institution’s (ZUS) inspection of sick leave in the first three quarters of 2021, the benefits of over PLN 148 million were withdrawn or reduced.
Every year, Social Insurance Institution medical examiners check whether certificates of temporary inability to work are legitimate and whether sick leaves are used according to their purposes. The inspections are carried out under the Act of 25 June 1999 on cash benefits under social insurance in the case of sickness and maternity.
If non-compliance is detected, it is possible to suspend the payment of sickness benefits or to limit the basis for the assessment of sickness benefits and rehabilitation benefits after the termination of the sickness insurance title to 100% of the average remuneration.
In only the third quarter of 2021 ZUS carried out 88.3 thousand inspections of persons holding certificates of temporary inability to work. As a result, in this period 5.1 thousand decisions were issued withholding further payment of sickness benefits for the total amount of PLN 3 905.1 thousand and the basis for the assessment of benefits was reduced for 33.8 thousand persons for the amount of PLN 39 458.4 thousand.
The total value of reduced and withdrawn cash benefits from social insurance in case of illness and maternity in the period from January to September 2021 amounted to PLN 148,832.6 thousand, and in Q3 2021 it was PLN 43,365.2 thousand.
By contrast, in 2020, between January and September, the total amount of reduced and withdrawn cash benefits from social insurance in case of illness and maternity amounted to over PLN 160 million, while in the entire year 2020, ZUS withdrew or reduced benefits for over PLN 226 million.
However, before the institution issues a final decision on withdrawal or reduction of the benefit, the employee concerned has the right to review the evidence gathered by ZUS.
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