A court has ruled in the case of a woman ZUS wanted to repay over PLN 60,000. Here is how the case ended.
The District Court in Lublin ruled that the woman does not have to repay the amount exceeding PLN 60,000 that the Social Insurance Institution (ZUS) demanded as unduly paid sickness benefit. The court held that the repayment obligation applies only to benefits unduly received, and that the woman did not knowingly mislead the social security authority.
The Supreme Court points out that “a thorough factual determination must be made regarding the state of awareness of the entitled person” and the premises of knowingly misleading someone.
In other rulings, meanwhile, courts have overturned ZUS decisions and granted the right to keep sickness benefits when the person proved that they had not violated sick leave rules or had not acted knowingly to the detriment of the social insurance fund.
In a high-profile case, a woman who while on sick leave brought lunch to her husband was ordered by ZUS to repay the PLN 60,000 benefit she had received. The reason? “Using sick leave in a way inconsistent with its purpose, that is, performing activities requiring physical fitness and leaving the place of stay without permission” – one of the people familiar with the case explained in an interview with the media.
What activities are not allowed while on sick leave?
The Social Insurance Institution (ZUS) clearly states that while on sick leave, you must not:
- take up paid work,
- carry out strenuous household work, such as renovations or gardening,
- leave the home without a ban from a doctor and without reporting this to ZUS,
- engage in activities that may hinder recovery.
“Violating these rules may result in a demand to repay the benefits paid out, as well as financial penalties” – warns a social insurance expert in an interview with Money.pl.
Consequences of improper use of sick leave
In the case described, ZUS stated that the woman “did not respect the rules of sick leave, which led to the unduly paid sickness benefit in the amount of PLN 60,000”. As a result, she was ordered to repay this money. It is one of the highest amounts imposed by the Social Insurance Institution (ZUS) in similar situations.
A ZUS expert adds: “Checks on sick leave are becoming increasingly thorough, and abuses result in sanctions that may also affect the employer”.
How to defend yourself against such a decision?
A person who receives an order to repay the benefit may appeal the decision to the labour court. “In some cases, courts have sided with patients when they proved that the actions taken during sick leave were aimed at improving their health” – says a lawyer specialising in employment law.
However, the key is documenting what activities were carried out and whether they were recommended by a doctor. “Failure to report a trip or leaving the place of stay without ZUS permission is a serious breach” – experts emphasise.
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