Major Changes to ZUS Adjudication Rules Aim to Cut Queues

New regulations in Poland allow physiotherapists and nurses to issue specific social security rulings and introduce flexible employment terms for medical adjudicators to reduce waiting times.

Waiting for ZUS Adjudications

Receiving a ruling from ZUS, which conditions the granting of social insurance benefits, requires patience. Although the exact waiting time for a final decision depends on individual circumstances, staff shortages can prolong the procedure by several months. Will admitting new specialists and changes in the employment system effectively shorten the queues?

Physiotherapists and Nurses as a Remedy for ZUS Queues

Regulations on medical adjudication in ZUS effective from April 2026 and the planned increase in positions by nearly 300 people aim to shorten the waiting period for a ZUS ruling and thereby facilitate access to numerous benefits. The most important change is granting persons performing an independent medical profession the authority to adjudicate for the purposes of establishing the right to social benefits and other benefits belonging to the jurisdiction of ZUS.

Who is a person independently performing a medical profession? According to the provisions of the act, these are persons who possess:

• the right to practice as a nurse, female nurse, and physiotherapist;

• a specialist title in the field of nursing or physiotherapy;

• at least a five-year period of practicing as a nurse, male nurse, or physiotherapist (this does not apply, however, to practicing the profession on the basis of a conditional right to practice it or practicing it for a specified scope, period, and place).

Matters Handled by Physiotherapists and Nurses

Until April 2026, ZUS tasks consisting of issuing rulings were carried out exclusively by specialist doctors who were employed on the basis of an employment contract. Current solutions are intended to relieve medical adjudicators and thereby accelerate the obtaining of relevant documents by beneficiaries.

Physiotherapists have received the right to adjudicate in matters of medical rehabilitation within the framework of pension prevention, while nurses can decide in matters regarding the inability to live independently. Persons performing an independent medical profession have also gained powers to control the adjudication of temporary incapacity for work.

The provisions determining the rules for issuing rulings by specialist doctors apply accordingly to the rulings of physiotherapists and nurses. What does this mean in practice? An objection analogous to the objection to a doctor’s ruling can be lodged against a ruling issued by these entities, which will be considered by a three-person medical commission.

Flexible Employment of Medical Adjudicators

A way to accelerate the issuance of ZUS rulings is also to increase the number of doctors issuing rulings. Currently, both medical adjudicators and persons independently performing a medical profession can perform work both on the basis of an employment contract and a contract for the provision of services.

It is also significant to be able to establish cooperation with doctors who do not yet have the title of specialist. A medical adjudicator can currently be a person who:

• has the right to practice as a doctor;

• holds the title of specialist or

• is undergoing specialist training in a specific field of medicine, having completed the basic module appropriate for the given specializing training or the third year of training (in the case of specialization with a single training module) or

• has at least a five-year period of practicing as a doctor (excluding periods of practicing the profession in order to complete a postgraduate internship, practicing the profession on the basis of a conditional right to practice the profession, practicing the profession on the basis of the right to practice the profession for a specified scope of professional activities, period, and place).

It is worth noting that for the Chief Medical Officer of ZUS and their deputy, the requirements have been set at the level of:

• the right to practice as a doctor;

• holding the title of specialist in one of the fields of medicine that applies in medical adjudication;

• at least three years of experience working in medical adjudication.

The chief medical adjudicator, their deputy, and the medical inspector for the supervision of medical adjudication must in turn demonstrate at least a ten-year period of practicing the profession in the scope of one of the fields used in adjudication.

Legal Basis

Ustawa z dnia 13 października 1998 roku o systemie ubezpieczeń społecznych, Dz. U. 1998 nr 137 poz. 887

Ustawa z dnia 18 grudnia 2025 rok o zmianie ustawy o ubezpieczeniach społecznych oraz niektórych innych ustaw, Dz. U. 2026 poz. 26

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