New sick leave control rules in 2022

15.10.2021

From 2022, the Social Insurance Institution (ZUS) will gain a new tool to control people on sick leave and demand the return of undue benefit.

New sick leave control rules in 2022

On 1 January 2022, the regulations giving the Social Insurance Institution new powers will come into force, enabling it to obtain the data necessary to verify the correctness of granting sick leave benefits.

L4 control - what are the new powers for ZUS?

The amended provisions of the Act of 24 June 2021 amending the Act on the social insurance system and certain other acts are intended to facilitate the control of the correct use of sick leave (for example, in the case of persons employed by two employers) and they assume:

  • The possibility for ZUS to refer a person on L4, using electronic means of communication, for an examination to a medical examiner or consultant in order to confirm whether the granting of the sick leave is justified (the provisions became effective on 5 October 2021),
  • The possibility for ZUS to obtain data and information to the extent necessary to establish the right to benefits, their amount, basis for their calculation and for their payment from the insured persons and the payers of contributions who are obliged to make them available without charge (the provisions will enter into force on 1 January 2022).

It should be noted, however, that ZUS will not be able to request mobile phone records from a mobile network operator in order to verify the L4, nor will it have the right to request information on card transactions from a bank. The data collected will come from employers/payers of contributions and they are to help verify whether an employee working in two or more places staying on sick leave has not been working at the same time in one of the workplaces.

Moreover, the collection of additional data and the control of the correct use of L4 will mainly concern people staying on sick leave for more than 30 days, but this will not be the rule.

Unjustly collected L4 benefits - ZUS will demand the return

Under the amended regulations, the Social Insurance Institution (ZUS) will also be able to demand the return of a benefit for inability to work due to illness if it considers that it was unjustly granted. Prior to the amendment, there were doubts about the legitimacy of requesting the return of the benefit. After 1 January 2022, the situation is expected to change, and the amended regulations will clearly specify that the unjustly collected benefit is to be returned to ZUS together with interest.

 

Learn more: 10 most important changes to the Act on Social Security System

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