Sickness benefit under the new rules. What’s changing?

From January 1, 2022, the delay in paying contributions will not be an obstacle to receiving sickness benefits from the Social Insurance Institution. From January, also, among others, the amount of benefits and the period of their collection. The new provisions result from the amendment to the benefit act of June 24, 2021.

The changes relate to, inter alia, people covered by voluntary sickness insurance – that is, first of all, running a business and their associates.

The insurance will no longer terminate due to late payment of premiums. Entrepreneurs will be able to receive benefits from sickness insurance also in the case of late payment of contributions – emphasizes Paweł Żebrowski, spokesman for ZUS.

Every year, ZUS received over 150 thousand. applications for reinstatement of the deadline for payment of contributions from entrepreneurs who were late with their payment and wanted to retain the right to the allowance. From the new year, such applications will no longer be needed.

In addition, in the case of people whose incapacity for work arises in the period when they have arrears due to contributions in an amount higher than 1%. minimum wage, the newly introduced regulations will make it possible receipt of the benefit after debt repayment – adds Żebrowski.

However, the right to these benefits will be statute-barred if the debt is not settled within 6 months from the date of the entitlement to benefits – he explains.

However, the obstacle in the payment of the allowance will not be a debt of no more than 1%. minimum wage. Similar rules apply to accident insurance benefits.

Sickness benefit for the duration of hospital stay will be calculated on a more favorable basis.

Currently, the sickness benefit for the period of stay in hospital is lower than the standard percentage and, as a rule, amounts to 70%. the allowance calculation basis. Monthly from the new year the sickness benefit will be paid in the amount of 80%. regardless of whether it concerns a hospitalized person or a person staying at home – says Paweł Żebrowski.

Another amendment stipulates that from 2022 the allowance calculation basis will not be recalculated if there was no break between the periods of receiving benefits (regardless of their type), or the break was shorter than a calendar month.

Until now, the regulations referred to a break of less than 3 calendar months.

The so-called the standard benefit period is 182 days and indicates the total amount of time for which you can get Illness Benefit.

All uninterrupted periods of incapacity for work are included in the same benefit period, even if you are unable to work for various reasons. If the break in incapacity for work was shorter than 60 days, and the reason for the sick leave before and after the break was the same, the sickness before the break was also included in the benefit period.

ZUS points out that from January it will not matter what disease caused the inability to work before and after the break. The break will be counted the same, regardless of whether it is the same or different diseases.

There is supposed to be an exception to this rule incapacity for work during pregnancy. Periods of incapacity for work prior to a break of up to 60 days, if the incapacity for work occurred during pregnancy after the break, are not included in the benefit period.

According to the new regulations after the end of your insurance, you will be able to receive sickness benefits for up to 91 days. This rule will not apply to, inter alia, people suffering from tuberculosis or unable to work during pregnancy.

ZUS would like to remind you that a person whose benefit period has expired will still be able to apply for rehabilitation benefit.

It is granted to a person who continues to be ill for a maximum of 12 months, but who is likely to regain ability to work as a result of further treatment or rehabilitation.

From January, women who gave birth to a child after termination of employment, if the insurance ended during pregnancy due to the death of the employer, will be entitled to maternity allowance. Until now, they were not entitled to an allowance in such a situation.

If the insured person was employed under an employment contract and this contract expired due to the death of the employer, the woman will receive an allowance equal to the maternity allowance until the day of delivery.

It means that pregnant women who lose their contract due to the death of the employerwill be secured in the same way as those whose employer has been liquidated or bankrupt.

–