What ZUS Entitlements Are Granted Through the PR-4 Form?

Almost 1.8 million people have already utilized ZUS medical rehabilitation, a program marking its 30th anniversary that helps individuals at risk of losing their ability to work recover and return to professional activity.

ZUS Medical Rehabilitation Program

The ZUS disability prevention program is celebrating its 30th anniversary of operation. Since 1996, ZUS has been running a medical rehabilitation program for people at risk of losing their ability to work. Thanks to rehabilitation, they can regain fitness, return to work, and active life.

Treatable Medical Conditions

Rehabilitation covers conditions that most frequently cause inability to work. These include musculoskeletal diseases, including after injuries and accidents, cardiovascular and respiratory diseases, psychosomatic disorders, oncological conditions after breast cancer treatment, voice organ disorders, and central nervous system diseases.

– Individual rehabilitation profiles were introduced in various years. From the beginning, i.e., since 1996, we have been implementing rehabilitation in the scope of the musculoskeletal system and cardiovascular system. The shortest – since 2016 – is the musculoskeletal system after an accident. As a pilot – in the years 2019–2021, and permanently since 2025 – a rehabilitation program is implemented for people with central nervous system damage – informs Elżbieta Dobrowolska, director of the ZUS Prevention and Rehabilitation Department.

Eligibility for ZUS Rehabilitation

ZUS medical rehabilitation is primarily directed at professionally active individuals who, due to their health condition, are at risk of losing their ability to work, but there is a real chance that they will recover it after rehabilitation. The program can also be used by people receiving sickness benefits or rehabilitation benefits after the termination of sickness or accident insurance, as well as people receiving periodic disability pensions.

Old-age pensioners can also apply for rehabilitation if they are still working and covered by social security, e.g., under an employment contract or a mandate contract. The condition, however, is that the rehabilitation gives a real chance to regain the ability to work. Similar rules apply to people receiving bridging pensions, uniformed services pensions, teacher compensation benefits, or pre-retirement benefits. They can also use the program if they are still working and there is a chance that rehabilitation will allow them to maintain or regain the ability to work.

– The most numerous group among those using rehabilitation in the years 2016–2025 were people aged 50–59, of whom over 57.57 percent were women. However, in some age groups and profiles, the trend is reversed – adds Elżbieta Dobrowolska.

Application Procedure and PR-4 Form

To receive a referral for ZUS medical rehabilitation, one must contact the attending physician. They fill out the rehabilitation application on the PR-4 form. It is worth attaching medical documentation to the application and then submitting it to any ZUS branch or sending it by mail. The physician can also send the form electronically via the eZUS portal or the mZUS for Physician application. In such a case, it is not necessary to deliver a paper application to ZUS, but it is worth providing the medical documentation.

After submitting the application, the ZUS certifying physician issues a decision regarding the need for rehabilitation. They can issue it after conducting an examination or based on medical documentation. From April 13, 2026, physiotherapists employed by ZUS also have the authority to issue such decisions.

Costs and Organization of Rehabilitation

ZUS medical rehabilitation is completely free of charge. It covers treatment, accommodation, board, and the reimbursement of travel costs to and from the center by the cheapest means of public transport. A standard tour lasts 24 days and takes place in facilities cooperating with ZUS across the country. With ZUS consent, a physician at the rehabilitation center may extend or shorten the duration of rehabilitation. Rehabilitation can take the form of an inpatient stay at a center or an outpatient form without overnight stay.