Working on L4, sick leave from a nurse and stricter ZUS inspections? Revolution in “sickness”
From January 1, 2026, revolutionary changes in the regulations on sick leave will come into force. The new law will allow you to legally work for one employer while staying on L4 with another, provided that it does not harm the treatment process. Moreover, sick leave certificates will be able to be issued by nurses and physiotherapists, and ZUS will gain the power to control the validity of L4 even after the end of the disease.
– From January 2026, numerous changes will be introduced in the social security system. They will include consequences for both employees and employers, as well as for the social security system in terms of judgments and the powers of the President of the Social Insurance Institution. The existing regulations, very scattered, are to be consolidated and clarified – says Dr. Anna Banaszewska, legal advisor, in an interview with the Newseria agency.
Weedthe nurse and physiotherapist will give L4
One of the key changes for employees will be the expansion of the list of persons authorized to issue certificates of temporary incapacity for work. According to the new regulations, from 2026, such certificates will be able to be issued not only by medical practitioners, but also by nurses and physiotherapists. This is intended to improve access to services and partially relieve the burden on the health care system.
The scope of such certificates of temporary incapacity for work and the basis for issuing them will be completely different than when done by a doctor. A nurse will be able to issue such a certificate only when the person is unable to function independently, and a physiotherapist in the case of exercise prevention. The employee will be able to obtain such a certificate depending on the circumstances, explains Dr. Anna Banaszewska.
Data from the Social Insurance Institution show that in 2024, over 27.4 million certificates of temporary incapacity for work were issued. Therefore, precise rules for the use of exemptions and their control are of key importance.
What is contrary to the purpose of dismissal?
The changes clarify the concept of action contrary to the purpose of sick leave. It is to become the key criterion for assessing the behavior of a person on sick leave, also in the context of possible financial consequences.
– When reviewing the grounds for issuing a sick leave, it is determined whether the actions of the person who received the sick leave are related to the purpose or contrary to the purposee. Let's imagine, for example, that a person goes shopping or goes for rehabilitation because, for example, he or she is injured, or goes for long walks according to doctor's recommendations. If these actions do not contradict the essence of the dismissal, the employee may be absent from the place of stay at the time when the reasons for such dismissal are checked. But if someone wanted to go on a bicycle trip during this time, it would be contrary to the purpose of the exemption – says the legal advisor.
Work for one employer, but L4 for another
The principle of actions contrary to the purpose of dismissal is also intended to apply to the performance of professional duties for various employers. Today, a sick leave issued for one company means that an employee cannot also work in other companies if he is employed in several places. In the first half of 2025, ZUS conducted over 69,000 inspections, which showed that 8.1 thousand people used sick leave incorrectly. For this reason, benefits amounting to PLN 16.6 million were suspended. From 2026, this ban will be lifted.
– Imagine a situation in which an academic lecturer is also an operating surgeon. Due to a hand injury, he cannot operate, but he can conduct classes. He will therefore be able to conduct classes at the university while on sick leave from the hospital. The only condition is that the employee will have to inform the employer for whom he or she intends to work that he or she is on leave from another employer and for what reasonof course without specifying the disease entity. The point is to ensure that the activities he undertakes for another employer do not contradict the purpose of the sick leave – explains Dr. Anna Banaszewska.
“Double-edged sword” and the risk of disputesthe one from ZUS
At the same time, as lawyers point out, the broad nature of the definition of action contrary to the purpose of the exemption may in practice lead to divergent interpretations and disputes with the control body.
This is a double-edged sword because, on the one hand, the definition is very broad and requires a sense of the purpose of sick leave, but on the other hand, we will be able to engage in frequent polemics with ZUS as to whether this purpose has actually been violated or not – says the expert.
Pursuant to the applicable regulations, ZUS and contribution payers registering more than 20 people for sickness insurance have the right to control both the correctness of decisions and the manner of using sick leave. The scale of these inspections has been systematically increasing in recent years. In 2024, ZUS conducted 486.4 thousand inspections of persons with a certificate of temporary incapacity for work. As a result, he spent PLN 36.6 thousand. decisions suspending further payment of sickness benefits, and the amount of withheld benefits reached almost PLN 53 million. The total amount of reduced and withdrawn cash benefits from social insurance in the event of sickness and maternity in 2024 amounted to approximately PLN 260 million. In the first half of 2025, ZUS conducted 227,000 control of sick leave, withholding payment of PLN 14.8 thousand benefits amounting to over PLN 22.2 million.
– Employers will still be obliged to check the cause and justification of absence from workhowever, they will have the opportunity to ensure the performance of work by an employee who is on sick leave at another workplace, and they will also be able to adjust the scope of activities so that this scope does not contradict the purpose of the sick leave – emphasizes Dr. Anna Banaszewska.
Minor activities allowed on L4
The legislator also introduces the concept of the so-called minor activities that may be performed during sick leave in certain situations, including: by members of the management boards and shareholders of companies. At the same time, the new regulations are intended to prevent situations in which sick leave would be used to actually perform work.
– These minor activities will not mean that the employer will be able to constantly disturb the employee during the leave and order him to perform various minor activities. In such a case, there will be doubts as to whether the employee has the conditions for a proper recovery process. This is why the concept of minor activities will include, for example, adopting resolutions by a member of the management board of a capital company or performing activities necessary for the functioning of the company by a partner in a partnershipj – indicates the legal advisor.
The new act also interferes with the judicial system itself. From 2026, decisions on temporary and permanent incapacity for work will be issued by one certifier, and not – as before – by three-person teams.
– It seems that this may raise significant doubts as to equal treatment and judicial reliability – says Dr. Anna Banaszewska. – Each time an employee does not agree with ZUS's decision, he or she will be able to file an appeal in due time. As before, he will be able to appeal to the court against a ruling he does not agree with – it is still possible and will continue to be possible – he adds.
The changes will also cover the terms of employment of ZUS certifying doctors. The project provides for various forms of cooperation and the introduction of a system of remuneration multipliers depending on qualifications and workload. This should increase access to medical examiners and, consequently, shorten the waiting time for a decision.
The most far-reaching change will be the extension of the powers of the President of ZUS to control decisions, including the possibility of verifying them after the end of the sick leave period.
– Today, at the end of the sick leave period, the sick leave can no longer be audited retroactively. According to the new regulations, this will be possible on the basis of medical documentation – explains the legal advisor. – The inspection team will have the right to request the doctor to provide medical documentation, and will also be able to ask for additional documents that will be used to check whether there were actually grounds for issuing the certificate after the period of the temporary incapacity for work has expired.
