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Sick leave, commonly known as L4, is a document that allows an employee to take a break from work due to illness. It is not only an option, but also a right that can be exercised by people with health insurance. Although it is most often the case for contract workers, contract workers can also benefit from L4, under certain conditions. Furthermore, employees who have to care for sick children are also entitled to sick leave.

L4 is a form of health protection for both the employee and his or her colleagues. When we are sick, we should not avoid taking sick leave, because continuing to work in a weakened state does not benefit us - or the company, or ourselves.

When is sick leave due?

Sick leave can be obtained in various health situations. If our illness prevents us from functioning normally at work, we should consider L4. This could be due to an infectious disease, stomach problems, injuries or even pregnancy complications. Certain medical conditions, such as respiratory, osteoarticular or muscular problems, may also warrant a leave of absence. In addition, a doctor can issue an e-leave to people suffering from poisoning, cancer, as well as various other ailments.

What is included in sick leave?

On each sick leave there is a disease code, based on the International Classification of Diseases (ICD-10). This code is sent to ZUS, but is not visible on the copy of the document that the patient receives. The code can inform the doctor of what restrictions are in place for the patient during the sick leave - for example, whether the patient needs to be on bed rest or can go out for injections or other necessary appointments.

Remember, while you are on sick leave, you cannot work or undertake other gainful activities. The Social Insurance Institution and your employer have the right to control whether the leave is used as intended.

How long can you stay on leave?

Normally, sick leave can last up to 182 days, but in certain cases the period can be longer. For example, in the case of tuberculosis or pregnancy, L4 can be extended up to 270 days. In addition to this, employees are entitled to 14 days of sick care and 60 days for the care of children up to the age of 14.

Who can issue sick leave?

In Poland, sick leave must be issued in electronic form (e-ZLA). A doctor, irrespective of his or her specialisation, can issue such a sick leave either during a face-to-face visit or by telemedicine. The exemption goes directly to ZUS and the patient can monitor his or her profile on the Platform for Electronic Services (PUE).

Do I get paid on L4?

Yes, while on sick leave, you will normally receive 80% salary. The exceptions are pregnant women, people after an accident and organ donors - in these cases the salary is 100%. For the first 33 days, the remuneration is covered by the employer, after which the responsibility is assumed by the Social Security. The remuneration may be lower, e.g. in the case of hospitalisation without special indications, it is 70%.

Skin allergies, a form of dermatosis, can take many forms, such as pimples, pustules or other skin lesions. Although these symptoms are the most obvious, allergies can also cause other discomforts that affect daily functioning. What are the main symptoms of skin allergies and how should they be dealt with?

What are skin allergies?

Skin allergies are reactions of the body to various factors that manifest themselves as itching, redness, rashes, blisters, dry and flaky skin and even swelling and pain, among other symptoms. These symptoms can make daily life much more difficult and, in particularly troublesome cases, lead to social or psychological problems.

The diagnosis of skin allergies includes a thorough medical history as well as a physical examination and specialised skin tests. Treatment varies, depending on the cause and severity of symptoms, from avoidance of contact with the allergen to the use of topical medication and immunological therapy.

A key element in the fight against skin allergies is proper skin care - moisturising, using gentle cosmetics and detergents and avoiding irritants.

What causes skin allergies?

The triggers of skin allergies can be very varied. Here are some of the most common ones:

• Food (e.g. dairy products, eggs, cereals)
• Animal hair
• Cosmetics (fragrances, dyes)
• Insect venom
• Sunshine
• Metals (Nickel in jewellery)
• Some plants (e.g. poison ivy)

The most common allergic skin diseases

1. Atopic dermatitis (AD)
   A chronic disease manifested by dry and itchy skin and eczema. Symptoms can be variable in severity, occurring in periods of exacerbation and remission.
2. Urticaria
   The sudden appearance of itchy blisters, red patches or swellings, often as a reaction to food allergens, medication or insect bites.
3. Contact dermatitis
   Reaction to direct contact with an irritant such as cosmetics, latex, metals or chemicals.
4. Allergic eczema
   An inflammation of the skin caused by contact with allergens that leads to itching, blistering and peeling of the skin.
5. Allergic conjunctivitis
   It manifests as red, itchy and watery eyes, often associated with inhalant allergens such as pollen or dust.
6. Allergy to drugs
   Some drugs can cause allergic reactions, leading to hives, swelling or other skin symptoms.

Treatment of skin allergies

Skin allergies require an individual approach to treatment. In addition to avoiding allergens, it is a good idea to consult a dermatologist or allergologist for appropriate medication and care recommendations. Treatment options include:

• Antihistamines
• Topical anti-allergic agents (creams, ointments)
• Phototherapy
• Immunotherapy (in some cases)

If you notice symptoms of a skin allergy, it is important to see a specialist as soon as possible for diagnosis and appropriate treatment. It is also possible to take advantage of online e-consultation, which speeds up the process of diagnosis and referral for allergy tests.

Today's telemedicine capabilities have meant that we can do many things without leaving home - including sick leave. Thanks to e-sick leave, which has been available since December 2018, an employee no longer has to deliver sick leave to their employer in person. The entire process takes place online and the doctor handles the paperwork electronically, issuing an e-ZLA, or electronic sick leave.

The e-leave, like the traditional paper leave, confirms the employee's inability to perform his or her duties due to illness. The employer, on this basis, is obliged to pay the employee sick pay. The amount of this pay is usually 80% of standard salary, although in certain situations (e.g. pregnancy, accidents at work) the employee may receive 100% of salary. Who pays sick pay depends on the number of employees and the type of employment.

Employee rights during sick leave

The basic right of any insured employee who has received sick leave is the right to receive sick pay or sickness benefits. However, being on sick leave also entails complying with the doctor's recommendations and the restrictions imposed by the illness. A key objective of sick leave is for the employee to recover as quickly as possible, so undertaking other activities - such as paid work or recreational outings - can lead to serious consequences.

During sick leave, the employee should follow the doctor's instructions and, in most cases, stay at home. Failure to do so, such as leaving home without justification or taking on extra work, can lead to sanctions such as loss of benefit entitlement and, in extreme cases, even dismissal.

E-exemptions and employer obligations

E-leave significantly simplifies the process of employees informing their employer of their inability to work. Thanks to the electronic system, the employer is automatically notified that the sick leave has been issued, eliminating the need to deliver the document in person. The employer is obliged to pay wages in accordance with the applicable legislation and to respect the employee's rights under their sick leave.

You can obtain additional information from our doctors by starting a medical e-consultation at any time.

In today's busy world, many people struggle with stress, fatigue and bad moods. Daily pressures and numerous challenges can adversely affect physical and mental health. In such situations, the question often arises - can an employee receive L4 due to fatigue or ill-health?

In this article, we will explain what symptoms may be an indication for sick leave, and how to deal with fatigue and stress.

Can a doctor issue a L4 due to exhaustion?

Yes, it is possible for a GP to issue sick leave for fatigue if he or she considers it justified. Fatigue is a serious condition that can significantly affect your health, reducing your work performance and quality of life. During your visit, your doctor will take a medical history and assess the degree of fatigue to determine whether you require rest and temporary time off work.

Is it possible to receive L4 due to stress?

Yes, an L4 can also be issued in cases of severe stress, which negatively affects health. Chronic stress can lead to serious problems such as heart disease, depression or digestive problems. If stress significantly hinders your work duties, your doctor may decide that you need a recovery break.

Can you get a L4 for malaise?

Feeling unwell due to various ailments, such as infections, colds or allergies, can be grounds for a L4. In cases where ill health prevents daily functioning, a doctor may issue a sick leave, although for minor ailments he or she may only recommend rest and over-the-counter treatment.

Symptoms of body fatigue

Fatigue can manifest itself in many ways, the most common being:

• Extreme fatigue and lack of energy
• Concentration and memory problems
• Sleep disorders (insomnia or excessive sleepiness)
• Headaches and muscle pains
• Decrease in efficiency at work
• Changes in appetite
• Irritability, anxiety and depression
• Mood swings

If you are experiencing many of these symptoms and they are affecting your daily life, it is worth seeing your doctor for further diagnosis.

How to deal with fatigue?

In order to deal effectively with fatigue, it is important to introduce healthy habits to help the body recover:

• Regular sleep: Ensure you get the right amount of sleep each night by going to bed and getting up at regular times.
• Healthy diet: Ensure a balanced diet, rich in vitamins and minerals, to provide your body with adequate fuel.
• Physical activity: Regular exercise not only helps to improve physical fitness, but also to combat stress.
• Rest and relaxation: Find time to relax using techniques such as meditation or yoga.
• Stress management: Use stress-reduction techniques such as deep breathing and walking outdoors.

How to deal with stress?

Stress management is key to maintaining mental and physical health. Here are some effective methods:

• Planning and organisation: Organise your responsibilities to minimise the feeling of being overwhelmed.
• Time for yourself: Find time to relax and do activities you enjoy.
• Support: Talk to your loved ones and do not hesitate to seek professional help if you feel that stress is overwhelming you.
• Healthy habits: Take care of your diet, physical activity and sleep to increase your resistance to stress.
• Relaxation techniques: Meditation, deep breathing and other mindfulness methods can be effective tools in the fight against stress.

Can a doctor issue sick leave for exhaustion or stress?

Yes, your GP can issue a L4 for fatigue, stress or ill-health if your condition makes it difficult for you to function normally. It is important to remember that your mental and physical health are just as important as other aspects of your life, so if you are experiencing health problems, it is worth consulting your doctor and taking the appropriate steps to recover.

More information can be obtained from our doctors by starting a medical e-consultation at any time.

In the age of modern technology, e-counselling, e-prescriptions and also e-referrals are becoming increasingly popular. Particularly during the pandemic, telemedicine has become extremely important, allowing patients to access medical care without leaving their homes. Nowadays, if you are unable to work due to illness or have to care for a child, you can easily obtain sick leave online.

How do I get an e-call?

If you are experiencing a deterioration in your health, the first step is to find a doctor who offers e-discharge. If you have a suspected health condition, it is a good idea to prepare test results that may be crucial for the doctor in deciding whether to issue an exemption. It is usually sufficient to make the documents available during the e-consultation and the doctor will verify them and assess the appropriateness of issuing a L4.

During the consultation, the doctor, as in the case of an inpatient visit, may ask about the medicines you are taking, co-morbidities and other relevant information. If he or she deems it necessary, the sick leave will be issued electronically. Once the process is complete, the e-leave will be automatically sent to your employer and the Social Insurance Institution (ZUS).

What are the benefits of e-clearance?

The biggest advantage of e-recall is the time saving. Thanks to this solution, patients do not have to visit clinics, stand in queues or arrange appointments in person. E-clearance is offered by many specialists, available online 24 hours a day. The process is quick and simple - from the consultation to the issuing of the exemption to the transmission of the documents to the Social Insurance Institution.

In addition to the e-recall, patients can also obtain an e-prescription, which further streamlines the entire treatment process.

How does the e-call work and who can issue it?

Any doctor, regardless of his or her speciality, can issue a sick leave online. The procedure is not automatic - the doctor must carefully analyse the patient's condition based on the information sent and a conversation, which may take place over the phone or via video conference.

In some cases, the doctor may ask for additional test results, such as:

• X-RAY, ECG, TK, RM, EEG
• Urine and faecal tests
• Morphology

After analysing the results, if the doctor deems it justified, he or she will issue an e-certificate, which will be forwarded to the relevant institutions.

Why use e-clearance?

There are many benefits to using e-communications, such as:

• Security: During a pandemic, being able to get a waiver without having to leave home is invaluable. You gain professional medical assistance without the risks associated with personal contacts.
• Speed: The whole process from the moment of notification to the issuing of the release is quick - usually taking about 30 minutes. In addition, the doctor may recommend preventive care or examinations.
• Easy access: E-records are available 24 hours a day, so you don't have to wait for appointments or stand in queues.
• Professionalism: The e-referral service is offered by a number of experienced doctors, ensuring that you receive quality medical care.

More information can be obtained from our doctors by starting a medical e-consultation at any time.