The "eZLA” tab is used to issue electronic medical exemptions. The tab is active only for doctors who have entered their doctor's certificate into the jHIS system and have marked it as active (see the description of the "Certificates (eZLA)" functionality in the "Staff" chapter) otherwise it is inactive. The tab contains a list of all exemptions issued for a given patient or his guardian. Each doctor has the option of viewing the exemptions issued by all doctors, or issued only by themselves (for this purpose must check the box "Show only my exemptions"). In the case of viewing exemptions issued by other doctors, the list contains only documents sent to ZUS. Working versions of exemptions are visible only to the doctor who is the author of the document. The presented exemptions may occur in one of three states:

• not sent - this is the exemption draft, not yet sent to ZUS
• sent - this is an exemption that has already been sent to ZUS
• canceled - this is an exemption that was sent to ZUS, but was subsequently canceled (an AZLA document was issued for it)

It is only possible to edit or delete exemptions that are in the "not sent" state. To edit / remove the exemption, click the pencil or minus icon respectively.

It is possible to print only those exemptions that have been sent to ZUS. To print the exemption, click on the printer's icon. The same icon allows you to print a cover letter if a cancellation document (AZLA) was issued for exemption. A red exclamation mark may appear on the printer icon, it means that the exemption and / or cover letter must be printed because the payer or insured does not have an account in PUE. Detailed information on which documents and why they need to be printed will appear when you hover the mouse over the printer icon.

Exemptions that have been sent to ZUS can be canceled by clicking on the blue button with the "×" sign. A button with the same sign and the arrow " " applied to it also ↻ appears on exemptions that have already been canceled and clicking on it allows you to issue a new exemption on the basis of the canceled one (this button will not appear if such exemption was issued earlier).

In the case of dismissals in the state "canceled" or "sent" in the column "Status" an icon in the form of a yellow triangle with a black exclamation mark can appear. Such a situation means that the release was sent to ZUS, but during the sending process system in response received warnings about the document at which the icon is located. After hovering over this icon, detailed information with the warning returned by the ZUS system will be displayed. The "Status" column may contain additional information that the exemption was issued in place of the canceled one, then the column and the exemption number are displayed in the place where the exemption was issued.

With some exemptions, the "⇈" character may be displayed instead of the ordinal number in the first column. It means that it is the retroactive exemption assigned to the exemption in the line above. The retrograde exemptions can only exist in conjunction with the current exemption, so they always appear in the exemption list after the document with which they are associated. This presentation only applies to documents sent to ZUS - in the case of working versions of exemptions, the period of dismissals is presented within one line.

To issue a new exemption, click on the "Add leave" button. The form for issuing a new exemption includes the following fields, which may be supplemented by a doctor:

• Inability to work from - the beginning of the period for which the exemption is issued
• Inability to work until - the end of the period for which the exemption is issued
• Insurance institutions and payers - a list of payers and insurance institutions to which exemptions will be sent (one exemption is always assigned a maximum of one payer). This list can be supplemented in two ways: by selecting a payer from the list "Payers downloaded from ZUS" and clicking the "+" button or by checking the "Add payer manually" option, completing the data yourself and clicking the "+" button next to the completed fields.
• Medical exemption for a guardian - allows you to release exemption for a guardian instead of a patient scheduled to visit. After selecting this field, additional fields are displayed in the form where the guardian's data should be entered. After entering the PESEL number or series and the passport number and date of birth, it is possible to click on the "Download data from ZUS" button which will download the relevant data from the jHIS or from ZUS system (if they are missing in the jHIS system). Checking this box will also automatically mark the "Exemption for care" box and complete the date of birth of the person under care (inserting the date of birth of the patient scheduled for the visit in the field).
• Exemption for care - allows you to release exemption to a patient for the care of another patient (eg a child). After marking this field, additional fields "Code of relationship of the person under care" and "Date of birth of the person under care" appear in the form, which must be supplemented by a doctor.
• Medical indigation - indigation on the exemption whether the patient can walk or just lie.
• Statistical disease number (ICD10) - a disease code from the ICD-10 classification constituting the reason for issuing an exemption
• Codes - additional codes to be entered to exemption (after hovering over a given code, information about what code means is displayed)

The address and identification data of the patient (apart from the exemption for guardian) are automatically taken from the system when the exemption is saved. After completing the data, the doctor can save the release using one of the "Save" or "Save and send to ZUS" buttons. The first one saves the working version of the exemption in the system, without sending it to ZUS. This exemption can be edited or deleted later. The second one causes the saving of the exemption with its simultaneous sending to ZUS, its clicking causes an additional request for confirmation from the doctor if he wants to continue. Confirmation means that the exemption is signed with a doctor's certificate and sent to ZUS, if the sending succeeds, later editing or removal of the exemption is impossible. After saving, system may display a message saying that the saving did not go through with this state of affairs, then the doctor should correct the entered data and retry the attempt to save with sending to ZUS. If the exemption has been correctly saved, the system will automatically return to the list of exemptions. If the exemption was sent to ZUS, the system may display a message that some documents require a printout together with the question whether the doctor wants to print now.

When canceling the exemption, the doctor has three fields to complete:

• Cancellation reason - list of reasons for canceling the release; the reasons "błąd w danych identyfikacyjnych ubezpieczonego" and "błąd w danych adresowych ubezpieczonego" will only appear if the system detects that the patient's data in the system is different from those on the canceled release or if the release was issued for the guardian
• Additional informations - the content of the information that is provided in the cover letter that is sent to the patient when issuing the AZLA document
• Issue exemption in place of canceled - after marking this field, a form with data appears that will be inserted into the new exemption issued in place of the canceled one. The fields for the exemption issued in place of the canceled are the same as for the new exemption, the only difference is that depending on the reason for cancellation, some fields of this form may be inactive and then in the new exemption these fields have the same value as in the canceled exemption.

If the patient's exemption was issued in paper form, it should be entered into the system (electronised). To electronise the exemption, in the form of issuing a new exemption, the mode "Alternative (Electronisation)" should be selected in the drop-down list. After selecting this value, three additional fields "Date of issue", "Series and number of eZLA" and "Series and number of reverse eZLA" will appear in the form. The selection of the value for this last field will be possible only if the dates of inability introduced cause that also a retroactive exemption will be issued (the date of commencement of the exemption earlier by at least 3 days than the date of issue). The fields with number and series are drop-down lists where the values of yet unused and unutilized eZLA numbers are reserved using the functionality described in the chapter "Reservation / Canceling numbers (eZLA)". The process of issuing the exemption is the same as in the current mode, the only difference is that in addition the above-mentioned fields must be filled in, and only one payer may be selected for electronisation. Additionally, after saving (without sending) the exemption and its subsequent editing, it is no longer possible to change the mode of its issue from the alternative to the current one or vice versa.