One-off compensation for an accident at work or occupational disease

< Wróć
Drukuj

One-off compensation for an accident at work or occupational disease

An insured individual who has suffered permanent or long-term health damage as a result of an accident at work shall be entitled to one-off compensation. Compensation shall be granted too to the members of the deceased’s family if death was caused by an at-work accident or occupational illness. The claim must be submitted after the end of the treatment and rehabilitation period, and in the case of a single claim after the deceased, the claim may be submitted at any time.

Legal basis:

Act of 30 October 2002 on social insurance for accidents at work and occupational diseases

Regulation of the Minister of Labour and Social Policy of 18 December 2002 on detailed rules for adjudicating permanent or long-term damage to health, the procedure for determining this damage and the procedure for the payment of one-off compensation.

The amount of one-off compensation is 20% of the average wage for each percentage of permanent or long-term damage to health. The damage extent and its relationship to an at-work accident or occupational disease are assessed by a medical examiner or medical committee of the Social Security Office (ZUS), after the end of treatment or rehabilitation.

ZUS pays compensation within 30 days after the decision. It may refuse to give compensation if an employee who applies for payment has deliberately or through gross negligence violated the provisions on the protection of life and health (BHP). In addition, if the accident occurred while you were under the influence of alcohol or drugs, ZUS will not award compensation.

When can I claim compensation?

If you pay pension contributions, you are covered by accident insurance. Such contributions shall be paid on the contract of employment, the contract of mandate and the contract for the provision of services. Contract for specific work is not covered. Accident insurance allows you to apply for benefits from ZUS in case of accidents and events that result in health damage. You can claim compensation for occupational disease, caused by certain factors related to the work.

The employer is obliged to register you for insurance. It happens, however, that dishonest employers do not do this. You have the right to information about contributions paid from your salary – you can always ask your employer to present you with an RMUA report, i.e. information about contributions paid.

Amount of one-off compensation

One-off compensation shall be 20 per cent of the average salary for each percentage of permanent or long-term health damage. The rate of compensation changes year to year on 1 April. Currently, the rate equals  1,133 PLN gross for one per cent of health damage. It is assessed by a medical examiner or medical committee of ZUS, after treatment or rehabilitation.

For example loss of a tooth in an accident at work means 1% of a permanent health loss and you can expect PLN 1,133 compensation for it in 2022. Damage to the cervical spine can be estimated at up to 50% of permanent damage to health. After such a serious accident, the employee can count on at least several dozen thousand zlotys.

Application to ZUS and documents

To receive compensation, you must apply for ZUS. The complete documentation includes a request for a one-off compensation, a post-accident report along with the documentation, prepared and approved by the workplace, and an OL-9 form completed by the doctor, containing an annotation that treatment and rehabilitation have been completed. The application must be submitted through the contribution payer – usually the employer.

In the case of a person conducting non-agricultural and other activities – the application should be submitted:

– in person or through a plenipotentiary in any ZUS organizational unit (in writing or orally for the protocol)

– via postal operator, Polish consular office

When arranging formalities, you can use the help of ZUS employees:

– by phone 22 560 16 00

– via e-mail cot@zus.pl

– in the nearest ZUS organizational unit

When a one-off compensation is not due

One-time compensation is not due to the insured individual if the worker was proven to violate health and safety regulations. The compensation is not payable to you, if you contributed significantly to the cause of the accident intentionally or as a result of gross negligence or intoxication, under the influence of narcotic drugs or psychotropic substances. This does not apply to fatal accidents.

Persons engaged in non-agricultural activities and persons cooperating with them and members of their families may not receive a benefit when they have a debt due to social security contributions by the time of application – until the repayment of all debt. The right to one-off compensation shall be time-barred if the debt is not repaid within 6 months of the date of the accident or the date of the application for one-off compensation for occupational disease.

The application for a one-off compensation may be withdrawn, however, not later than the date on which the decision on it becomes final, i.e. if no appeal has been lodged with the court – within one month from the decision delivery date.

How to appeal against the decision?

After receiving a negative decision, you can appeal in writing or orally to the protocol to the district labour court through ZUS that issued the decision. This must happen within one month from the decision delivery date.

The appeal proceedings shall be free of charge.