A person incapable of work means a person who has lost, completely or partly his/her earning capacity due to a disturbance of body fitness, and for whom retraining does not promise the restoration of earning capacity. Completely incapable of work is a person who has lost his/her capability for any work. Partly incapable of work is a person who has lost – to a considerable degree – his/her capability for work corresponding to qualifications.
Disability pension insurance guarantees cash benefits in the case of loss of cash incomes of the insured person, related to the occurrence of a disability risk (work incapacity or death of the bread winner).
Contributions to disability and survivor’s pension insurance (8.0%) are financed by insured persons from their own resources (1.5% of the assessment basis) and by contribution payers (6.5% of the assessment basis).
The disability pension insurance gives the insured person a right to:
- pension in respect of work incapacity,
- training pension,
- survivor’s pension.
Requirements which must be met by a person to be granted a right to a pension for work incapacity are set forth by the provisions of the Act on old-age pensions and disability pensions payable from the Social Insurance Fund of 17 December 1998 (Journal of Laws of 2015, item 748, with later amendments).
A disability pension is granted to an insured person who meets all of the following conditions:
- 1 year – if work incapacity occurred before a person reached 20 years of age,
- 2 years - if work incapacity occurred when a person was 20 to 22 years of age,
- 3 years - if work incapacity occurred when a person was 22 to 25 years of age,
- 4 years - if work incapacity occurred when a person was 25 to 30 years of age,
- 5 years - if work incapacity occurred when a person was above 30 years of age.
In the case of a person, who reached 30 years of age the period of the required 5 years must fall within the previous 10 year period before the day on which this person submitted a disability pension application or before the day on which work incapacity occurred.
The incapacity for work must have occurred during contributory and non-contributory periods or not later than within 18 months after the cessation of these periods; this requirement does not relate to a person insured who has proved the contributory and non-contributory period of at least 20 years for women and 25 years for men and is completely incapable of work. Insured person who has proved a contributory and non-contributory period of at least 25 years in the case of women and 30 years in the case of men and has been recognized as completely incapable of work, does not need to document at least a 5-year period of insurance during the last 10-year period before the claim is filled or before the incapacity occurred.
Agreed Medical Evaluator of Social Insurance Institution evaluates the incapacity for work, its degree and also establishes:
Incapacity for work is certified for a period of up to 5 years or longer – if there is no prognosis as to the restoration of earning capacity before the lapse of the 5 years. During a period of certified incapacity for work (indicated in the decision), the pension is payable. The person concerned may appeal to a medical board against ZUS doctor’s decision within 14 days of the decision being delivered.
The amount of pension in respect of work incapacity is calculated on the basis of the following formula:
24% of the base amount + 1.3% of the assessment basis for each contributory year + 0.7% of the assessment basis for each non-contributory year + 0.7% of the assessment basis for each year short of the full 25 years of contributory and non-contributory periods, from the day of claiming the benefit to the day when the pensioner would have reached the statutory retirement age.
A pension in respect of partial work incapacity amounts to 75% of pension in respect of complete work incapacity.
Those who are assessed as not only completely unable to perform work but also unable to live independently, in addition to the pension in respect of complete work incapacity receive also a nursing supplement.
A training pension is payable to a person meeting the conditions for receiving a disability pension, who has been issued a decision on the advisability of vocational retraining due to an incapacity for work in an earlier practiced occupation. It is awarded for a period of 6 months, which may be reduced or extended.
A training pension is payable at the rate of 75% of the basis of assessment or 100% of this basis if the incapacity for work was caused by an accident at work or an occupational disease. The pension may not be lower than the minimum pension for a person who is partly incapable of work. The pension is not paid if the pensioner receives any remuneration or income, irrespective of its level.
A survivor’s pension is awarded to entitled family members of a person who – on the day of death – held the established entitlement to an old-age pension (including a bridging pension) or a disability pension or who met the requirements for the award of one of these benefits. When the right to a survivor’s pension is established, it is assumed that the deceased person was completely incapable of work. A survivor’s pension is also awarded to the eligible family members of a person who – on the day of death – was a recipient of a pre-retirement benefit, a pre-retirement allowance or a teacher’s compensatory allowance. In such a case it is assumed that the deceased person has satisfied the conditions to be awarded the pension in respect of a complete incapacity for work. A survivor’s pension is not awarded in respect of a periodic funded pension.
The survivor’s pension is payable at the following rates:
All entitled family members acquire the right to one joint survivor’s pension, which is divided – if necessary – in equal parts among all the beneficiaries. If a survivor’s pension is received by an orphan, s/he is entitled to a supplement for orphans.