Excess temporary work incapacity increased substantially during and after the COVID-19 pandemic in Poland (104,392 more rehabilitation benefits than expected), while permanent work incapacity declined below expected levels (49,281 fewer disability pensions), revealing a divergence likely reflecting health system disruption, delays in benefit adjudication, and pandemic-related mortality displacement.
Key Findings
Results
Temporary work incapacity increased substantially and remained elevated throughout and after the acute pandemic phase, resulting in 104,392 more rehabilitation benefits than expected during 2020–2024.
The study used quarterly Social Insurance Institution administrative data from Poland covering 2015–2024.
Expected pre-pandemic trends were modelled using log-linear regression based on 2015–2019 data.
The largest increases in temporary work incapacity occurred mostly after the acute pandemic phase.
Excess temporary incapacity affected both sexes, though specific patterns differed by sex and diagnostic category.
Results
Mental disorders showed the largest relative increase in temporary work incapacity, exceeding expected levels by over 80% by late 2024.
Mental disorders were identified using ICD-10 chapter classifications.
The over-80% excess above expected levels was observed by late 2024, indicating continued deterioration well beyond the acute pandemic phase.
This finding underscores the need to strengthen mental health care and return-to-work pathways according to the authors.
The pattern persisted long after the acute COVID-19 pandemic phase ended.
Results
Musculoskeletal diseases showed substantial increases in temporary work incapacity, particularly among men, exceeding expected levels by over 30% in some periods.
The over-30% excess for musculoskeletal diseases was observed particularly among men.
Musculoskeletal conditions were notably the only diagnostic group showing excess permanent incapacity as well.
For permanent work incapacity (disability pensions), musculoskeletal excess primarily affected women.
This sex-differentiated pattern was identified through stratified analysis by sex and ICD-10 chapter.
Results
Permanent work incapacity (disability pensions) declined below expected levels during 2020–2024, with 49,281 fewer disability pensions awarded than expected.
The deficit in permanent disability pensions was predominantly observed among men.
The largest reductions were observed for circulatory diseases (up to 27% below expected levels) and neoplasms (19% below expected levels).
The authors attribute this decline partly to pandemic-related mortality displacement and delays in benefit adjudication.
Musculoskeletal conditions were the only diagnostic group that showed excess (rather than deficit) permanent incapacity.
Results
Circulatory diseases and neoplasms showed the largest reductions in permanent work incapacity (disability pensions), falling up to 27% and 19% below expected levels, respectively.
Circulatory disease disability pensions fell up to 27% below expected levels.
Neoplasm-related disability pensions fell up to 19% below expected levels.
These reductions are consistent with the hypothesis that pandemic-related excess mortality removed individuals who would otherwise have received disability pensions.
Health system disruption and delays in adjudication are also cited as contributing factors.
Discussion
The study identified a divergence between excess temporary work incapacity and reduced permanent disability, attributed to health system disruption, delays in benefit adjudication, and pandemic-related mortality displacement.
This divergence is described as a key overall finding of the study.
The authors note that delays in benefit adjudication may have shifted some cases from permanent to temporary incapacity categories.
Pandemic-related mortality displacement may have reduced the pool of individuals eligible for disability pensions, particularly for circulatory and neoplasm diagnoses.
The findings have implications for social insurance and rehabilitation policies in Poland and potentially other countries.
Methods
The study used population-level administrative data from Poland's Social Insurance Institution covering 2015–2024, with quarterly observations stratified by sex and ICD-10 chapter.
Data covered rehabilitation benefits (temporary incapacity) and disability pensions (permanent incapacity).
Pre-pandemic baseline trend was established using data from 2015–2019 modelled with log-linear regression.
Excess incapacity for 2020–2024 was identified by comparing expected to observed incapacity rates.
The study was observational in design using administrative records.
What This Means
This research examined how the COVID-19 pandemic affected people's ability to work in Poland, using official government insurance records from 2015 to 2024. Researchers compared what actually happened during and after the pandemic to what would have been expected based on pre-pandemic trends. They found two very different patterns depending on whether they looked at short-term work incapacity (rehabilitation benefits for people temporarily unable to work) versus long-term permanent disability pensions.
Short-term work incapacity increased dramatically and kept rising even after the most acute phase of the pandemic passed — with about 104,000 more rehabilitation benefits granted than would have been expected. The biggest driver was mental health conditions, which were more than 80% above expected levels by late 2024. Musculoskeletal problems (like back pain and joint disorders) also rose sharply, especially among men. At the same time, the number of people being granted permanent disability pensions actually fell below expectations by about 49,000 — with the biggest drops seen for heart and circulatory diseases and cancers. The researchers suggest this unexpected decrease in permanent disability may be partly because people with serious conditions died during the pandemic before they could receive pensions, and partly because health system disruptions delayed assessments and decision-making.
This research suggests that the pandemic's impact on working capacity in Poland was complex and long-lasting, and did not end when the acute health crisis subsided. The sharp rise in mental health-related work incapacity in particular points to a need for stronger mental health services and better support for helping people return to work. The unexpected drop in permanent disability awards also raises questions about whether some people who needed long-term support may have fallen through the cracks of the social protection system.
B. Łyszczarz, J. Wojtasik. (2026). Excess work incapacity during and after the COVID-19 pandemic in Poland: evidence from population-level social insurance data.. Health Policy. https://doi.org/10.1016/j.healthpol.2026.105614