Appealing against ZUS decisions - everything you need to know
Sooner or later, each of us will have a matter to deal with at the Social Insurance Institution, i.e. at ZUS. The catalog of cases dealt with by ZUS is very wide, but the most common cases include:
- for a pension for total or partial inability to work,
- for a survivor's pension,
- for compulsory social insurance,
- for a one-off compensation for an accident at work.
However, it does not always happen that a decision issued by ZUS is favorable for us. Therefore, in such a situation, if we do not agree with it, it is necessary to appeal. What should an appeal against a ZUS decision look like? We explain!
How and when to appeal against ZUS decisions?
The appeal is filed with the court via the Social Insurance Institution within one month from the date of delivery of the decision against which we appeal.
Mr. Jan received a decision refusing to grant him a pension for total incapacity for work. It was delivered to him on March 31. In such a case, Mr. Jan must submit an appeal to the Social Insurance Institution no later than 30 April, because after this deadline he loses the possibility to appeal against this decision. As April has fewer days than March, the appeal must be brought on its last day, April 30, even though Mr. Jan received it on March 31.
It should be noted that an appeal may also be lodged when ZUS does not issue a decision resolving the case within two months of our submission / application initiating the proceedings, provided that in such a situation the party has no time limit to file an appeal
On April 1, 2021, Ms Janina applied for a survivor's pension. Until June 1, 2021, no decision was issued, despite the fact that it submitted all the documents required to issue the decision. In such a situation, after June 1, 2021, Ms Janina will be able to appeal.
Rejection of the appeal against the decision of the Social Insurance Institution filed after the deadline
Filing an appeal within the time limit is extremely important, because if it is exceeded, the court will reject an appeal brought after the deadline pursuant to Art. 4778 § 3 of the Code of Civil Procedure. However, the quoted provision allows the court to consider an appeal that was submitted in excess of the deadline provided for by law, when the following conditions are met: the exceeding of the deadline is not excessive and occurred for reasons beyond the appellant's control.
The court's assessment whether exceeding the time limit for bringing an appeal was independent of the appellant
As indicated in the judgments of the Supreme Court - the judgment of March 21, 2006 (III UK 168/05) - and common courts - the judgment of the Court of Appeal in Łódź of July 5, 2013 (III AUa 1359/12) - assessment of whether the deadline was exceeded for reasons beyond the appellant's control, it is left to the discretion of the court.
Moreover, as indicated in the judgment of the Court of Appeal in Gdańsk of December 19, 2016 (III AUa 1404/16): "The reasons for violating the time limit beyond the appellant's control include: illness, stay abroad, temporary arrest, ignorance of the law, helplessness, introduction of misled by the pension authority, etc. ”.
Mr. Jan received the ZUS decision on May 2, and on May 5 he had a serious accident, as a result of which he stayed for over a month in the Intensive Care Unit. After regaining consciousness on June 12, he appealed against the ZUS decision, with which he did not agree. In such a case, the court should not dismiss the appeal despite submitting it late, because in the case of Mr. Jan both conditions are met, i.e. the delay is not excessive and was due to reasons beyond his control.
It should be pointed out that the solution provided for in Art. 4778 § 3 of the Code of Civil Procedure excludes the possibility of submitting an application to restore the deadline for submitting an appeal.
What should an appeal against ZUS decisions contain?
The appeal against the ZUS decision is not too formalized. It should contain the following elements:
- designation of the court and authority through which it is brought;
- designation of the appellant;
- the exact identification of the contested decision;
- claims, conclusions, evidence;
When drawing up an appeal, the data of the person lodging the appeal should be precisely specified by indicating the data identifying it, i.e. name, surname, PESEL number and address of residence.
The decision against which we are making the appeal should be clearly marked in the appeal. This should be done in such a way that its date, mark and what it relates to will be indicated.
Appeal against the decision of the Social Insurance Institution, Jasło Branch of June 17, 2020, refusing to grant Anna Kowalska the right to a rehabilitation benefit, Ref. No. 350000/212236/2020 / MON1.
The content of the appeal should precisely describe why, in our opinion, it was issued incorrectly and we do not agree with it, as well as indicate the evidence that confirms our arguments, including in particular documentary evidence or witness testimonies.
The person submitting the appeal does not have to indicate specific allegations, e.g. in the form of violation of the law, it is sufficient to demonstrate dissatisfaction with the content of the issued decision, which leads to harm to the appellant. It is good to justify the arguments presented by us. In addition, the content of the appeal must indicate what we are demanding, and here it will most often be about changing the decision and issuing a judgment in accordance with the application we submitted to ZUS.
It is extremely important that the written appeal we submit be signed with a legible handwritten signature.
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Bringing an appeal to the court record
The appeal is usually made in writing, however, the law allows for an oral appeal to the protocol drawn up by an employee of the relevant organizational unit of ZUS.
In addition, it is allowed for the insured to file an oral appeal to the protocol in the court competent to hear the case or in the court competent for his place of residence, however, this form of appeal will not be applicable in the event of an appeal regarding the inactivity of the pension body and the failure to issue a decision by the insured person. a period of 2 months from the submission of the application. Submitting the appeal orally to the court competent for the place of residence of the insured person results in the fact that the court immediately transmits the protocol containing the appeal to the Social Insurance Institution (ZUS), from which the appealed decision originated. However, if the court to which an appeal has been lodged orally is competent to hear it, it shall immediately request the case file from ZUS and proceed with the appeal submitted to the protocol, at the same time sending a copy of the protocol to the authority from which the appealed decision originates.
Which court is competent to appeal against ZUS decisions?
As a rule, an appeal against a ZUS decision is submitted to the District Court of the Labor and Social Insurance Department competent for the insured person's place of residence through the competent ZUS unit, which issued the decision against which the insured appealed.
Mrs. Anna lives in Rzeszów. ZUS Rzeszów Branch issued a decision denying her the right to a pension for partial incapacity for work, with which she does not agree. In such a case, the appeal must be submitted through the Social Insurance Institution to the District Court in Rzeszów.
Filing an appeal through the competent ZUS branch means nothing else than the fact that it must be submitted to the unit that issued the decision or sent to the address of that unit, and after the appeal is received, the ZUS branch transfers it to the competent court.
The following exceptions are provided for from the rule of examining appeals against ZUS decisions by the District Court, specified in Art. 4778 § 2 of the Code of Civil Procedure, according to which cases for sickness, compensatory, care, maternity and funeral benefits, for rehabilitation benefits, compensation for an accident at agricultural work, an accident on the way to work or from work, an accident at work or an occupational disease, or an occupational disease related to active military service or service in the Police, Internal Security Agency, Foreign Intelligence Agency, Military Counterintelligence Service, Military Intelligence Service, Central Anticorruption Bureau, Border Guard, Marshal's Guard, Government Protection Bureau, State Protection Service, Prison Service , The State Fire Service and the Customs and Tax Service, are recognized by the local district courts.
Filing an appeal against ZUS decisions and what next?
Submitting an appeal may result in ZUS finding that it is justified, which will lead to a change or revocation of the issued decision within 30 days from the date of receipt of the appeal.
On June 15, Mr. Jan appealed against the decision of the Social Insurance Institution, and until July 15, ZUS may amend or revoke the challenged decision, if it deems the appeal justified.
If, in the opinion of ZUS employees, the appeal is unfounded, then they submit it to a competent court for examination.
It is extremely important to remember that - as indicated by the Court of Appeal in Poznań in its judgment of December 14, 2017 (III AUa 2227/16) - at the stage of court proceedings, the appellant must prove that the circumstances indicated by him in the appeal actually took place. These circumstances can be proved by all available evidence.
Costs related to lodging an appeal against ZUS decisions
Filing an appeal is free of court fees. Moreover, usually in proceedings before the court of first instance, the appellants are not charged with the costs of the proceedings, including the costs of the case and possible costs of representation of professional attorneys representing ZUS.
In the event that a decision unfavorable to the appellant is issued and the appeal is dismissed by the court, it is necessary to submit an application for a justification of such a judgment, and after its delivery, the appellant may appeal to a higher court within 14 days. And so, in the event of a judgment issued by the District Court, the appeal will be examined by the Court of Appeal, and in the case of the judgment of the District Court, the appeal will be examined by the District Court.
Office representative in the matter of appeal against the decision of the Social Insurance Institution
In the course of the proceedings as a result of an appeal against the decision of the Social Insurance Institution, the insured person may file an application to the court for the appointment of a representative ex officio. It must contain statements about family status, income, assets and livelihood, which show that the insured is not able to pay the fees of a lawyer or solicitor without prejudice to the subsistence required for himself and his family. When submitting an application for the appointment of an ex officio attorney, you can indicate a specific lawyer who would represent us. Failure to do so will result in the appointment of a lawyer from the lists kept by professional associations of advocates or legal advisers.
Although it is difficult to predict in advance what decision will be issued by the court hearing the appeal, but it is not worth giving up the right to submit it, because there are known cases in court practice where the submitted appeals to the court turned out to be effective.