In the event of temporary incapacity for work (illness), employees under employment contracts or contractors under contracts for the performance of work or provision of services (umowy zlecenia) can count on wage compensation under social insurance. We discuss the conditions for payment of temporary incapacity (illness) benefits, the factors that determine their amount, and the period for which they are issued – we explain these and other conditions for receiving sickness benefits in our article.

To receive temporary incapacity benefits, which may include breaks from work due to pregnancy (maternity), guardianship, or illness, you must be insured under this type of social insurance (ubezpieczenie chorobowe).

The premiums for this insurance cover the following:

• sickness benefit (zasiłek chorobowy) in the event of illness of the insured person,
• care benefit (zasiłek opiekuńczy) when caring for a sick family member or a healthy child (e.g., in the event of kindergarten closure),
• maternity benefits and parental benefits during maternity leave.

The right to sickness benefit arises after a specified insurance period or waiting period. This period varies depending on whether the sickness insurance is compulsory or voluntary.

1. In the case of compulsory insurance, the right to benefits may be realized after 30 days of continuous sickness insurance.

2. In the case of voluntary insurance, the right to benefits arises after 90 days of continuous sickness insurance.

The insurance period will include previous periods of sickness insurance if the interruption in insurance coverage does not exceed 30 days or is related to parental leave, unpaid leave, or military service as a non-professional soldier.

The waiting period includes periods of:

• maternity benefits to which you were entitled during the sickness insurance period,
• insurance coverage under the Farmers' Social Insurance.

The following are eligible for sickness benefits without a waiting period:

• School or university graduates,
• Insured persons whose incapacity for work is caused by an accident on the way to or from work,
• Compulsory insured persons who have at least 10 years of compulsory sickness insurance,
• Certain civil servants.

How are sickness benefits paid?

Sickness benefit payments vary depending on whether you have compulsory or voluntary sickness insurance.

With compulsory insurance, the employer pays wages for employees from its own funds (in accordance with Article 92 of the Labor Code) during periods of incapacity for work of up to 33 days in total per calendar year.

For individuals who have reached the age of 50, the employer pays remuneration from its own funds for periods of incapacity for work of up to 14 days.

The right to sickness benefit financed by the Social Insurance Institute (ZUS) begins on the 34th or 15th day of incapacity in a calendar year.

Furthermore, whether the employer pays the benefit to the employee depends on whether it is the benefit payer. Organizations that employed 20 people as of November 30 are the benefit payers for the following year. This means that the employer calculates and pays sickness benefits to its employees, and this amount is then returned to the employer by reducing the social insurance contributions paid to the Social Insurance Institution (ZUS).

In the case of voluntary insurance, e.g. a contractor under a contract of mandate, receives benefits paid by the Social Insurance Institution (ZUS) from the first day of incapacity for work.

What is the amount of temporary disability (illness) benefits paid?

Sickness benefits are paid at 80% of the average monthly gross salary for the previous 12 months, reduced by 13.71% of the employee's (contractor's) insurance premiums.

A monthly benefit of 100% of the benefit calculation base is paid if the disability arose during pregnancy, was caused by required medical examinations for donor candidates, or was caused by an accident on the way to or from work.

What documents are required to receive sick leave benefits?

To receive sick leave benefits (wynagrodzenia chorobowego lub zasiłku chorobowego ZUS), a certificate of incapacity (zwolnienie lekarskie, zaświadczenie) is required, confirming that the employee is unable to work for a specified period. Currently, an electronic sick leave certificate (elektroniczne zwolnienie lekarskie, e-ZLA) or L4 is issued.

Based on this certificate, the employer or contracting authority submits a form to the Social Insurance Institute (ZUS) indicating the employee's income, which serves as the basis for calculating contributions for sick leave benefits.

How are benefits paid if I have outstanding social security contributions to the Social Insurance Institute (ZUS)?

If you have outstanding social security contributions of at least 1% of the minimum wage, benefits will not be paid until the outstanding amount is paid.

The sickness benefit payment period covers the entire period of incapacity, but no more than:

• 182 days,
• 270 days – if the incapacity is caused by tuberculosis or occurs during pregnancy.

After this period, the benefit payment period ends, and if the insured person remains incapacitated, they can apply for a rehabilitation benefit (świadczenie rehabilitacyjne).

You are not entitled to benefits for the period of incapacity for work if:

• the right to wages remains during this period,
• this period falls within unpaid leave or parental leave,
• you are temporarily arrested or serving a prison sentence during this period,
• you are justifiably absent from work during this period (due to the death of your employer),
• the illness resulted from an intentional crime or misdemeanor confirmed by a court decision,
• the incapacity was caused by alcohol abuse (within the first five days),
• is covered by a falsified sick leave certificate,
• is covered by a sick leave certificate during which paid work is performed or the sick leave certificate is used for other purposes, as determined by an inspection of the correct use of sick leave certificates conducted by the benefit payer.

A ZUS medical expert may shorten the period of sick leave by indicating an earlier date of termination of incapacity for work.

The right to sickness benefits ceases on the day following the scheduled date of the medical examination (or the deadline for submitting documents) if:

• you prevent the medical examination,
• you fail to provide test results within the required timeframe upon request.

The link on the Social Insurance Institution (ZUS) portal provides additional information on receiving sickness benefits.