Any insured person can apply for compensation for an accident at work. From April 1, 2022, new, higher amounts apply. Currently, for each percentage of permanent or long-term damage to health, PLN 1133 is due. In 2021, it was PLN 1,033 and in 2020 – PLN 984 – reminds the Social Insurance Institution.

In 2021, in Lower Silesia, the Social Insurance Institution paid 3669 one-off compensation for an accident at work for a total amount of PLN 28,691,142.01. Of these, only 163 applications concerned people running a business, which is 4.4% of applications submitted to branches in Wrocław, Wałbrzych and Legnica. Throughout the country, last year, 44,956 applications were received by ZUS, on the basis of which compensation in the amount of PLN 308,045,680.5 was paid.

„Only 4.4 per cent of the total compensation pool was paid to people running a business in our region. Last year, entrepreneurs submitted only 163 applications for compensation from the back of an accident at work – says Iwona Kowalska-Matis, regional spokesperson for ZUS in Lower Silesia.

As ZUS reminds, a one-off compensation for an accident at work is due to every insured person who, as a result of an accident at work, suffered permanent or long-term damage to health. It is also granted to eligible family members of a person who has died as a result of an accident at work or an occupational disease. The amount of one-off compensation is 20% of the average salary for each percentage of permanent or long-term damage to health.

Currently, 1% of damage to health is PLN 1133. The degree of this damage and its relationship with an accident at work or an occupational disease is assessed by a ZUS medical examiner or the ZUS medical commission after completing treatment or rehabilitation. In order to obtain compensation, a complete application must be submitted to the Social Insurance Institution.

It should contain an application for one-time compensation, a post-accident report with documentation, drawn up and approved by the workplace and a form OL-9 completed by the doctor, containing an annotation that the treatment and rehabilitation have already been completed.

– After providing complete documentation to ZUS, the degree of damage to health and its relationship with an accident at work or occupational disease is assessed by a ZUS medical examiner or the ZUS medical commission, but only when the patient has already completed treatment – emphasizes Kowalska-Matis. And it explains that the decision granting or refusing payment is issued within 14 days of receipt of the decision of the medical examiner or the medical commission or of the clarification of the last circumstance necessary to issue the decision. Compensation shall be paid within 30 days of the date of the decision.

– It is extremely important that the post-accident proceedings are conducted in a prescribed manner, and the post-accident documentation is prepared reliably. It depends on whether the insured will have the right to pay compensation – warns Kowalska-Matis.

The amount of one-off compensation is 20% of the average salary for each percentage of permanent or long-term damage to health. From April 1, PLN 1133 is entitled to each percentage. For example: a person who is found to have 5% damage to health will receive PLN 5665 gross (PLN 5×1133.00).

The new amounts of one-off compensation for an accident at work or an occupational disease will apply until 31 March 2023, and amount to:

• PLN 1133 for each percentage of permanent or long-term damage to health;
• PLN 1133 for each percentage of permanent or long-term damage to health, due to an increase in this damage, by at least 10 percentage points;
• PLN 19,819 due to the ruling of total incapacity for work and inability to independent existence of the insured;
• PLN 19,819 due to the declaration of total incapacity for work and inability to live independently as a result of deterioration of the pensioner’s health;
• PLN 101,926 when the spouse or child of the deceased insured or pensioner is entitled to one-off compensation;
• PLN 50,963 when a family member of the deceased insured or pensioner other than a spouse or child is entitled to a one-off compensation;
• PLN 101,926 when the spouse and one or more children of the deceased insured or pensioner are entitled to one-off compensation at the same time, and PLN 19,819 for increasing this compensation for each of these children;
• PLN 101,926 when two or more children of the deceased insured or pensioner are entitled to one-off compensation at the same time and PLN 19,819 for increasing this compensation for the second and each subsequent child;
• PLN 19,819 when, next to the spouse or children, other family members of the deceased insured or pensioner are entitled to one-off compensation at the same time; each of them is entitled to this amount, regardless of the compensation due to the spouse or children;
• PLN 50,963 when only family members other than the spouse or children of the deceased insured or pensioner are entitled to one-off compensation, and PLN 18,086 for increasing this compensation for the second and each subsequent beneficiary.

However, there are situations when a one-off compensation is not due to the employee. This is the case when the sole cause of the accident was a proven breach by the insured of health and safety regulations caused by him intentionally or as a result of gross negligence. Money will also not be given to an employee who was under the influence of alcohol or psychotropic substances and contributed significantly to causing the accident. This does not apply to fatal accidents.

Source: https://www.prawo.pl/kadry/wysokosc-odszkodowania-za-wypadek-przy-pracy-zus,514521.html

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