Disability in mental disorders
A number of mental disorders are characteristic of rekapses or chronic maintenance of symptoms, such as the lack of energy or motivation to any activity, mental and motor retardation, high mood variations, disturbances of attention and memory, anxiety, the feeling of danger, hallucinations and delusions, as well as disorganisation of thinking and acting.
All this may lead to disability, which impairs partially or totally the ability of the mentally ill patient to engage in gainful employment or even to such impairing disability which disturbs meeting everyday needs and results in the necessity of constant care and assistance of another person.
The persons, which have intermittently lost their capacity to gainful employment - if are insured by the employer or if they paid insurance premiums themselves (to the Social Insurance Institution - ZUS or to the Farmers' Social Security Fund - KRUS) - are entitled for sick leave and sickness benefit, paid during the sick-leave period.
The sickness benefit, pursuant to issued sick-leave, is granted for a period of 180 days. After that period, if the status of disability is maintained, while the patient is employed and insured and his/her health condition provides prospects for return to good health and ability, then the patient may be granted with a rehabilitation allowance for the period of 6 - 12 months without cessation of the labour contract.
If, after 180 days of sick-leave or even earlier, the patient is not qualified by the doctor as promising return to full fitness, then the doctor issues a health certificate to be submitted to a commission at the Social Insurance Institution.
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The commission may determine the degree of disability as mild (ability to work with some limitations), moderate (inability for gainful employment) or major (inability for gainful employment and for fulfilling basic living needs with the necessity of constant assistance of another person(s)).
Depending on the patient's age and the total number of years of pension contributions, the Social Insurance Institution may grant such a patient a disability pension. Such a disability pension is usually granted for a specific period of time and its amount depends on the confirmed disability degree.
A person, which has never been employed, but is mentally ill with disability, identified before school completion (including academic education) and before the 25th year of age, is entitled to receive the, so-called, social pension, paid by the Social Insurance Institution on the basis of a certificate from an authorised medical board of the Social Insurance Institution.
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There are two systems of assessment of disability: for benefit purposes - the assessments are provided by a commission of the Social Insurance Institution, for -non-benefit purposes - the assessments are provided by the Commission for Disability Assessments, appropriate for the patient's residential address.
The Commission for Disability Assessments provides its decisions against applications of interested persons, medical certificates of patient's health status, medical examination results or medical documentation.
A person, which has not been insured or not worked long enough to be qualified for social benefits and with assessed disability in moderate or severe degree, may be granted a constant benefit from the social aid and a benefit of health insurance, if the income per person in the patient's family does not exceed a limit, established by separate regulations.
When disability assessment for non-benefit purposes is issued, the affected person may benefit from reliefs and privileges, e.g. in city transport, some reimbursement of rehabilitation aids and physiotherapy services or the right to participate in occupational therapy workshops.
The assessments, issued by the commission of the Social Insurance Institution and the Commission for Disability Assessments are independent documents, issued for different purposes. For example, a mentally ill person, qualified to some disability degree and to pension benefit by decision of the commission at the Social Insurance Institution, may on the basis of the assessed disability degree with recommendations for rehabilitation in occupational therapy workshops, may participate in such a workshop.