ZUS Z-15B Care Allowance for a Sick Family Member: Fill In

What is ZUS Z-15B care allowance claim for a sick family member?

Z-15B (Wniosek o zasiłek opiekuńczy z powodu sprawowania opieki nad chorym członkiem rodziny) is the ZUS application for the care allowance when you look after a sick family member other than a child. The form lists family members as a child's parent, spouse, parents, stepfather, stepmother, adoptive parents, parents-in-law, grandparents, grandchildren and siblings; the Information pages add children over 14 who share your household. For a child, ZUS uses the sister form Z-15A.

Besides your own details and your employer's, the form asks about the person you care for, your spouse, and other family members who drew care allowance this year, because the yearly day limits apply to the whole family. It also asks whether someone else in the household could provide the care and whether you share a household with the sick person.

FileIt walks you through each part in plain English, checks every PESEL, NIP, REGON and bank account number, ticks the day-count boxes for you, and prints your answers in capital letters into ZUS's own PDF. You print it, sign it and hand it in yourself. FileIt never sends anything to your employer or to ZUS.

Who fills it: The insured person caring for a sick family member
Given to: Whoever pays your allowance: your employer, or ZUS
Day limit: 14 days a year for a sick family member other than a child under 14, within 60 days a year for the whole family
Signatures: You sign it
Edition: ZUS file of February 2026 (printing order 3812/22)
Also needed: A medical certificate (e-ZLA); if ZUS pays, your payer's certificate Z-3, Z-3a or Z-3b

Who needs to fill out ZUS Z-15B care allowance claim for a sick family member?

Employees and others covered by sickness insurance in Poland who stay off work to care for a sick spouse, parent, parent-in-law, grandparent, grandchild or sibling.
Parents caring for a sick child over 14 who lives in the same household.
Self-employed people with voluntary sickness insurance who claim the allowance from ZUS.

When to use ZUS Z-15B care allowance claim for a sick family member

When a doctor has issued a medical certificate (e-ZLA) for caring for a sick family member.
For each further period of care you claim for.
When your employer or ZUS asks you for the application.

What you need before you start

Your PESEL (or an identity document and date of birth), name and address.
Your employer's NIP (or REGON or PESEL) and name.
Your bank account number if you want payment into it.
The dates of care and, if you remember it, the medical certificate's series and number.
The sick person's PESEL, name and relationship to you.
Your spouse's details and any care allowance days they used this year, and the same for other family members.
The number of care allowance days you used this year with a previous employer, if you changed jobs.

What’s on ZUS Z-15B care allowance claim for a sick family member

The 2026 edition has 8 pages. FileIt asks for it in 11 parts, and it is signed by Applicant:

Your details (Twoje dane)Applicant
Your payer of contributions (Dane płatnika składek)Applicant
Bank account (Rachunek bankowy)Applicant
Period of the claim (Okres, za który ubiegasz się o zasiłek opiekuńczy)Applicant
The family member you are caring for (Dane osoby, nad którą sprawujesz opiekę)Applicant
Your statements (Oświadczam, że)Applicant
Your spouse (Dane Twojego małżonka)Applicant
Another family member who drew care allowance for the same person (Dane innego członka rodziny — 1)Applicant
Another family member who drew care allowance for someone else (Dane innego członka rodziny — 2)Applicant
Other information (Inne dane)Applicant
Remarks and signature (Uwagi, Podpis)Applicant

How to fill out ZUS Z-15B care allowance claim for a sick family member, step by step

1 Your details and your payer

Your PESEL, name and address, then your employer's NIP (or REGON, PESEL or identity document) and name. FileIt can pre-fill names from your People records and checks each number's check digits.

2 Bank account and period of the claim

Optionally your 26-digit account number (otherwise the allowance comes by postal order), then the dates of care and the e-ZLA series and number.

3 The person you are caring for

Their PESEL (or identity document and date of birth), name and relationship to you, e.g. MATKA (mother) or MĄŻ (husband).

4 Your statements

Whether another household member could provide care (and on which days), whether you share a household with the sick person, and, if you changed employer this year, how many days of allowance you received through the previous one, in each category.

5 Your spouse and other family members

Your spouse's details, whether they work and whether they drew care allowance this year (or tick 'I have no spouse'). Then any other family member who drew the allowance this year for the same person, or for children or other members of your family.

6 Other information, remarks and signature

The question about other children under 14 (or 'not applicable'), any remarks, the date, and your signature.

Common mistakes to avoid

Using Z-15B for a child. That is form Z-15A.
Forgetting care allowance days your spouse or another family member already used this year.
Answering 'no' about another household member when someone could in fact provide care.
Counting the extra newborn allowance (up to 56 days) in the day totals. The form says not to.
Not attaching the medical certificate or, when ZUS pays, the payer's certificate.

After you fill it out

Print the form and sign it. Give it to whoever pays your allowance: usually your employer, or ZUS if ZUS pays you. FileIt never sends it for you.

Attach the medical certificate (e-ZLA, its printout, or a foreign certificate as the Information pages describe). When ZUS pays, it also needs your payer's certificate Z-3, Z-3a or Z-3b (ZAS-12 for a further period).

A copy stays in your FileIt vault, so the day counts are easy to reuse for the next claim in the same year.

Fill out ZUS Z-15B care allowance claim for a sick family member online with FileIt

Pick the person. Choose someone from People and FileIt fills in their name, date of birth, address and other details it already knows.
Answer plain-language questions. One part of the form at a time, with the official help text beside each question — 69 fields in all. Your answers save as you go.
Check the live preview. Watch your answers land on the real Zakład Ubezpieczeń Społecznych — Social Insurance Institution of Poland (ZUS) form, and let FileIt do any worksheet arithmetic.
Generate the official PDF. FileIt prints your answers into the agency’s own PDF and files it in that person’s folder in your vault. Sign it, or send it for e-signature.

FileIt fills the form — it never files or submits anything for you. Deliver the finished form to whoever asked for it, the way the form’s instructions say.

Start ZUS Z-15B care allowance claim for a sick family member now — it’s free

ZUS Z-15B care allowance claim for a sick family member: frequently asked questions

How many days of care allowance can I get for a sick family member?

According to the form's Information pages, 14 days in a calendar year for a sick child over 14 or another sick family member. All care allowance for the whole family together cannot exceed 60 days a year.

What is the difference between Z-15A and Z-15B?

Z-15A is for a child. Z-15B is for a sick family member other than a child, such as a spouse or parent. They share the same Information pages.

Who counts as a family member?

The form lists a child's parent, spouse, parents, stepfather, stepmother, adoptive parents, parents-in-law, grandparents, grandchildren and siblings. The Information pages add children over 14, if you share a household with them during the care.

Can I get the allowance if someone else at home could help?

Generally no. The allowance is paid if no other family member can provide care. The Information pages list people who don't count as able to, for example someone who is ill, or resting after a night shift.

Does FileIt calculate the allowance?

No. FileIt checks identifiers and account numbers, ticks the day-count boxes and checks that the days you report stay within the 60-day family limit.

Official sources

Blank form (PDF), published by Zakład Ubezpieczeń Społecznych — Social Insurance Institution of Poland (ZUS): https://www.zus.pl/documents/10182/788036/Z-15B_do+wype%C5%82nienia+i+wyduku.pdf/23d58ec5-a199-4d52-a4e7-b1033a4a6bbf
Official instructions and guidance: https://www.zus.pl/wzory-formularzy/zasilki/zasilek-opiekunczy
Edition shown on this page: Z-15B, ZUS file of February 2026 (form printing order 3812/22(E), Information order 569/26) (checked 2026-09-28).

FileIt is not affiliated with or endorsed by Zakład Ubezpieczeń Społecznych — Social Insurance Institution of Poland (ZUS) or any government. This page explains the form in general terms and is not legal, tax or immigration advice. Always read the official instructions, and check that you are using the edition the recipient accepts. Page last reviewed 2026-09-28.