What is allowed on sick leave? In some situations… even getting married

Last year, the Social Insurance Institution checked 461.2 thousand sick leave certificates nationwide. As a result, it questioned 28.9 thousand sickness benefits for the amount of PLN 29 million 273 thousand. In the first quarter of 2024, ZUS has already carried out 137.2 thousand checks, issued 9.8 thousand decisions, and the amount of benefits suspended in this respect reached almost PLN 12 million – we read on the Co w zdrowie website.

What should you not do while on sick leave?

The service asked Grzegorz Dyjak from the Social Insurance Institution headquarters about what not to do during sick leave, so as not to risk losing benefits. The unpleasantness may be the result of an inspection carried out by ZUS inspectors or employees indicated by the employer. The problems begin if they do not find the sick person at home.

Grzegorz Dyjak reminded that absence from the place of residence or stay during the inspection does not necessarily have to mean improper use of sick leave from work. Such absence may be justified if it was caused by, for example, a check-up visit to a doctor, the need to buy medicines at a pharmacy, or undergoing rehabilitation.

When can ZUS check L4?

In the event of refusal to provide an explanation regarding the reason for absence from home during the inspection or failure to provide an explanation within the specified time limit, it is considered that the sick leave is being used contrary to its purpose.

– A doctor’s note indicating that the patient can walk does not mean that the insured person can perform strenuous activities during the period of sick leave from work, and in particular that he or she can work during this period of sick leave – he said.

The main targets for control are people who often use successive short-term sick leave certificates from different doctors or long-term sick leave certificates, as well as people who have already been proven to have used their sick leave incorrectly. ZUS often also receives information about incorrect use of sick leave from employers or “well-wishers”.

Wedding while on sick leave

This was the case with a woman from Toruń. Her colleague at work did not like the fact that a woman on sick leave got married instead of recovering at home. She filed a complaint with ZUS, and the Social Insurance Institution demanded a refund of part of the paid sickness benefit. Mrs. Aneta admitted that she had considered that getting married while on sick leave could violate the rules, but she found the Supreme Court ruling, which had previously ruled in similar cases. It concluded that it was not prohibited. Besides, the engaged couple had arranged the wedding before Mrs. Aneta went on extended sick leave.

After reviewing the complaint, the Social Insurance Institution in Toruń demanded that Mrs. Aneta return the unduly received sickness benefit in the amount of PLN 2.3 thousand. It accused her of improperly using the period of sick leave. The woman appealed the decision of the Social Insurance Institution and the case was referred to the 4th Labor and Social Insurance Division of the District Court in Toruń.

ZUS lost the case for sick leave

The court did not agree with the woman’s argument. It found no violations of the rules for using sick leave.

– Firstly, in the insured’s sick leave certificate, the doctor indicated that the insured “can walk”. Secondly, it results from the insured’s testimony that the doctor even recommended that she take short and frequent walks. Considering the location of the Civil Registry Office, the building where the insured person works and where she lives, as well as the fact that she travelled from the Civil Registry Office by car, it cannot be said that the insured person abused this recommendation. Her conduct was exactly in line with it – noted Judge Andrzej Kurzych, quoted by “Nowiny”.

ZUS also selects some sick leave certificates for inspection randomly, so each certificate can be checked regardless of the doctor’s indications, i.e. regardless of whether it contains the note “the patient should lie down” or “the patient can walk”.