Sick leave for IVF. Maximum term

In recent years, more and more often, married couples have a problem with conceiving offspring, that is, natural fertilization does not occur for a number of reasons and such couples resort to assisted reproductive technologies. Among these methods, IVF is widely popular - this is a method of in vitro fertilization, which is an auxiliary method that allows most infertile couples to conceive a child and give birth to a healthy one. This is a rather complex method, which consists of several stages and a number of examinations, so the woman is entitled to sick leave for the period of its implementation. Let us dwell on some of the features of its issuance during the IVF procedure, after it and some other features.

What is diferelin eco short protocol? Eco and ureaplasma, can this happen?

Sick leave for IVF - Order of the Ministry of Health and Social Development No. 624 dated June 29, 2011 states that sick leave is issued only by medical institutions that have the appropriate licenses to carry it out. There must be licenses for the provision of medical services in the field of gynecology and permits for examination to determine the temporary disability of citizens. In the absence of one of them, the woman has every right to take the discharge summary from the outpatient card and apply for issuance to the state antenatal clinic at the place of residence to obtain a certificate of incapacity for work, where, based on the results of the discharge summary from the clinic where the IVF was carried out, the antenatal clinic is obliged issue sick leave.

A sick leave for IVF (repeat IVF) can be issued for the entire duration of in vitro fertilization: from the first day of the start of the protocol until the receipt of blood results for hCG, which indicates the onset of pregnancy. If pregnancy has not occurred and the blood hCG level does not indicate the presence of pregnancy, then the sick leave is also closed.

hCG by eco days.

At the same time, the patient always has every right to open a sick leave at any stage of fertilization: either from the beginning of stimulation, or after puncture, or after embryo transfer. At the same time, do not forget that a medical institution opens a sick leave certificate only on the day the application for its issuance is submitted, and it will be impossible to issue it retroactively.

Before undergoing IVF stimulation and the IVF procedure, a woman should know that the procedure itself includes several successive stages following each other: stimulation of hyperovulation, puncture of oocytes to obtain eggs, their fertilization and cultivation in a thermostat, replanting them in the uterine cavity and confirmation of pregnancy tests. This entire period takes about 1 month and therefore a long period of separation from production outrages some employers, since they do not understand that any physical activity and exposure to stress at the time of IVF can adversely affect the results.

Sick leave for IVF pregnancy is issued by the institution that performed in vitro fertilization if it has the appropriate licenses, which are discussed below. If the procedure was carried out in a private medical institution, then the fertility specialist together with the chief physician will issue a sick leave, and if in a public hospital, then it will be issued by the therapist. If a private clinic does not have a license to issue sick leave, then together with an extract from the outpatient card you go to the antenatal clinic at your place of residence and on its basis you will receive a certificate of incapacity for work. Sometimes a private clinic opens a sick leave, but a public institution closes it. If the medical institution refuses to issue you sick leave for the entire period of IVF, then you should contact higher authorities - the Department of Health or the prosecutor's office, and only if the higher authorities are not able to resolve the conflict situation, then you should submit an application to the judicial authorities, which will make a decision on this situation.

Normative base

The issuance of sick leave (SL) when undergoing IVF is carried out on the basis of Order of the Ministry of Health and Social Development No. 624 of June 29, 2011. Article 54 of the regulatory act in question states that a certificate of incapacity for work can only be issued by licensed clinics. In particular, licenses must be obtained:

for the provision of gynecological services;
for examination of incapacity for work.

The Order states that sick leave is issued for the entire period of IVF, including stimulation of ovulation, embryo transfer, etc.

IMPORTANT! If the clinic does not have a license, a sick leave certificate can be obtained from the public clinic at the woman’s place of residence. To do this, you need to obtain an extract from the outpatient register. It is issued by a clinic that performs IVF. Based on the extract, a certificate of incapacity for work is provided.

That is, BL can be obtained both in public and private institutions. However, for this you will need to collect the appropriate package of documents.

What is written in the document and what code is included?

All columns of the sick leave sheet are filled out in the usual manner. Be sure to indicate:

last name, first name and patronymic, date of birth, place of work of the patient;
opening date;
name of the issuing organization;
the name of the doctor who issued the certificate.

Entered:

doctor's signature;
organization seal;
disability reason code.

Ladies who do not want to disclose the reason for their absence from work need not worry about this. The sick leave certificate does not indicate the cause of disability itself - only its code. The code for the cause of disability during in vitro fertilization is 10, this is indicated in paragraph 58 of Order No. 624n dated June 29, 2011.

Women who have undergone IVF may benefit from articles on sick leave during pregnancy and childbirth:

subtleties of sick leave for pregnant women;
b/l during multiple pregnancy;
how to issue a certificate of incapacity for work, including if you are tired of working;
payment b/l.

Duration for which a certificate of incapacity for work is issued for IVF

A sick leave certificate can be obtained for the entire IVF period. It is drawn up from the first date of the protocol. The sick leave expires on the date of blood donation for hCG. The document is closed regardless of whether the woman managed to get pregnant.

IMPORTANT! A woman has the right to open and close sick leave at any stage of IVF. For example, an employee does not want to break away from the work process and wants to go on sick leave only after taking a puncture. In this case, sick leave opens from the corresponding date.

ATTENTION! The state medical institution issues a sick leave certificate on the date of receipt of the application for its issuance. That is, you need to contact the institution immediately. It will not be possible to issue a document “retrospectively”.

How long does IVF take?

IVF includes a number of steps:

Taking hormonal medications that stimulate ovulation.
Retrieval of eggs by puncture.
Combining the resulting cells in the laboratory.
Transfer of the resulting embryos to the uterus.
Taking tests to determine whether pregnancy has occurred.

The IVF procedure takes approximately a month. This is quite a long period, and throughout its entire duration the woman is exempt from doing work. This position causes a lot of controversy. Some believe that during the IVF period, an employee can continue to work if her position does not involve heavy physical labor. Others are convinced that possible stress received at work can interfere with pregnancy.

For what period is it issued?

BL is received both for the entire time provided for by the regulatory legal acts, and for individual procedures. The answer to the question of whether sick leave is given for stimulation before IVF is yes, as well as for the period of taking tests and determining the result.

Past date sheets are not issued or issued. We also use this rule to determine from what day sick leave is given for IVF - on the day of treatment.

Now they offer the procedure using a cryoprotocol. From what day is sick leave given for a cryoprotocol - after embryo transfer?

The moral side of the issue is ambiguous, so many do not want to disclose information to strangers. The certificate of incapacity for work obliges you to indicate the basis for its issuance, which is written on the sick leave certificate for IVF: code 10 - other condition (clause 58 of order No. 624n).

Clause 54 of the current order answers the question of how many days of sick leave after IVF: all days of treatment plus the period of taking tests and waiting for results, as well as travel time to the clinic and back.

ConsultantPlus experts discussed how to fill out a sick leave register. Use these instructions for free.

The procedure for obtaining sick leave during the IVF procedure

If IVF was performed in a private clinic, a certificate of incapacity for work is provided there. It is completed by the doctor together with the chief physician. However, this is only possible if the clinic has a license to issue BC. If there is no license, you need to ask a private clinic for an extract from the outpatient card. On its basis, a sick leave certificate is issued at the antenatal clinic at the patient’s place of residence. If IVF is done by a government agency, a certificate of incapacity for work is obtained there. Sick leave can also be issued by a local physician. In this case, the document is also issued on the basis of an extract from the outpatient card.

IMPORTANT! It is possible that the sick leave is opened by a private clinic and closed at the antenatal clinic. The document can also be renewed by a government agency.

Contents of documents accompanying IVF

The form and content of the sick leave issued for IVF are standard. The document must indicate the following points:

Sick leave opening date.
Personal details of the woman: full name, date of birth.
Information about the doctor who issued the sick leave.
Mark with reference to the outpatient card number.
The name of the organization where the woman works.
Name of the clinic issuing the sick leave
Code 10 in the “reasons for disability” line, indicating that fertilization has taken place.

Upon completion of all medical procedures, the woman receives an extract from the outpatient card in 2 copies. One of the documents remains with the patient, the second is needed to present to the local doctor. The extract contains detailed information about IVF. Let's take a closer look at the contents of the document:

Dosage of medications taken during the IVF process.
Date of prescription of medications.
Information obtained from ultrasound.
Results of the analyses.

From the extract you can get all the information about the IVF performed.

Refusal to issue

To receive sick leave, you only need to provide an extract from your outpatient card. Refusal to issue sick leave may occur if the woman did not provide an extract from the outpatient card.

In all other cases, such a refusal is considered unlawful: that is, if an extract is provided, but the issuance of a certificate of incapacity for work is still refused, then such a refusal is illegal. In this case, the woman should file a complaint with the chief physician or the local health department .

If in this case there is a refusal, you can contact the prosecutor's office or file an application in court.

How is sick leave paid for IVF?

Payment for sick leave for IVF is carried out in the standard manner. You first need to determine the employee’s average daily salary for the last 2 years. It is calculated using the following formula:

Ʃ = NW / 730 × N

The formula contains the following values:

Ʃ – amount of sick leave payments.
SZ – the employee’s total earnings for the last 2 years.
N – number of days indicated on the certificate of incapacity for work.

The amount of the benefit may depend on length of service.

Calculation example

The duration of the IVF procedure is 21 days. This period is indicated in all relevant documents. The employee’s work experience is 8 years, and therefore she will receive benefits in full. In 2014, the woman’s total earnings amounted to 240,000 rubles, in 2015 – 300,000 rubles. The following calculations are carried out:

Determination of total earnings for 2 years: 240,000 + 300,000 = 540,000 rubles.
Determination of average daily earnings: 540,000/730 = 739 rubles.
Determination of the benefit amount: 15,519 rubles.

That is, for the entire period of sick leave, a woman will receive 15,519 rubles.

IMPORTANT! The indicated amount is the minimum. If the employer wishes, he can pay the employee extra while she is on sick leave. The payment procedure, as well as its amounts, must be fixed in internal regulations. The amount of payment is set at the request of the employer.

Do I need to take it after embryo transfer?

The patient has the right to receive sick leave, but she is not obliged to take it. In this matter, it is important to take into account the opinion of the attending physician and the nature of the patient’s work. Some experts believe that it is necessary to take sick leave, because worries associated with the work process can negatively affect the conception of a child.

Other doctors argue that it is not worth interrupting work. The opinions of all doctors agree on one thing: if the work is associated with constant stress or is physically difficult, then it is necessary to take sick leave .

You can also take sick leave for the days of the procedure itself - this will provide the opportunity to be legally absent from work and receive payment for the missed day.

IVF is a sufficient basis for issuing a paid certificate of incapacity for work. You can receive it for the entire period - from preparation to finding out the results, or you can only partially. It is up to the patient to decide whether to use this right or not.

Pros and cons of taking sick leave during IVF

A woman has the right to choose whether she needs to go on sick leave during IVF or not. To do this, you should weigh the pros and cons.

Pros:

Optimal conditions for fetal development. For the development of the fetus, good conditions are needed, which do not include unnecessary stress or greater physical activity.
Visit your doctor at any convenient time. Pregnancy, especially one not conceived naturally, is unpredictable. During fertilization, difficulties may arise that will require immediate consultation with a doctor.
Avoiding stress and conflict situations. During work, it is often impossible to avoid stress and difficult situations that require immediate solutions. Excessive emotional stress can lead to termination of pregnancy.
Sufficient time for rest. A woman can completely calm down and relax. Avoiding unnecessary physical activity will allow the fetus to attach to the uterus without unnecessary labor.

Minuses:

Loss of part of your wages. Payment for sick leave is somewhat lower than the salary, and you will have to forget about the bonus. Financial difficulties are inevitable in this case.
Worsening attitude on the part of the boss. An employee who is absent for a long time loses his position in front of his superiors. Even subsequent conflict is possible.
Losing contact with colleagues. In case of a long absence, a woman may fall behind her colleagues in work, or miss important moments.

Of course, you should discuss all possible developments with your partner or loved ones in advance. In addition, extracorporeal planning is quite expensive, so you should approach the matter responsibly.

What does IVF include?

To move on to discussing sick leave issues, you should understand the features of the procedure itself. In vitro fertilization is not as simple as it seems. It consists of several stages

and in order for it to be successful, in most cases the patient needs
peace
and
rest
: both during all stages and after IVF.

So, in vitro fertilization includes:

Ovarian stimulation. Stimulation is needed in order to obtain not one, but several eggs capable of fertilization. The stage takes place under the influence of hormones.
Follicle puncture. Through a puncture, the doctor collects the eggs.
Transfer of fertilized eggs to the uterus. The most difficult stage, the most viable eggs are selected for it.
Control over the onset of pregnancy. To complete this stage, the patient needs to donate blood.

The procedure is complex and very difficult. moral problems during the operation.

and
physical activity
.

But with this procedure you may not need a sick leave - the IVF cryoprotocol does not have such complex and difficult procedures for women’s health as with standard IVF. However, even taking these circumstances into account, the patient has the same right to receive a certificate

, as when undergoing fertilization using the basic method.

As a rule, hospitals and other organizations provide expectant mothers with sick leave for the entire period of such treatment. To whom exactly does it rely, for what period is it issued, and how to receive the ballot, read in the following sections.

Before the IVF procedure, a woman should know that the procedure itself includes several successive stages following each other: stimulation of hyperovulation, puncture of oocytes to obtain eggs, fertilization and cultivation of them in a thermostat, implantation of them into the uterine cavity and confirmation of pregnancy tests. This entire period takes about 1 month and therefore a long period of separation from production outrages some employers, since they do not understand that any physical activity and exposure to stress at the time of IVF can adversely affect the results. Sick leave for IVF pregnancy is issued by the institution that performed in vitro fertilization if it has the appropriate licenses, which are discussed below.

General recommendations for the patient

Can a woman undergoing IVF procedure be denied a sick leave certificate?

In accordance with the legislation of the Russian Federation, neither a representative of a private clinic nor an employee of a state clinic has the right to refuse to issue a sick leave certificate to a woman who has decided to undergo IVF for the entire duration of the protocol.

If, despite this, an unpleasant situation occurs, the patient can file a complaint and contact the following authorities:

District Health Department;
Prosecutor's Office;
Courts;
Health Committee;

How the procedure works

The first stage includes examination of the married couple. Diagnostics are carried out to determine the cause of infertility and possible contraindications. There are a number of mandatory tests that are prescribed to all couples without exception.

Women are prescribed:

Tests for sex hormones, blood and urine, biochemical, for infections.
Examination of fallopian tubes for patency.
Microscopy of a vaginal smear.
Ultrasound of the pelvic organs, thyroid gland, mammary glands (after 30 - mammography).
ECG.
Fluorography or x-ray of the lungs.
Consultation with an endocrinologist.
Physician's report on health status.

Men are required to:

Submitting a spermogram.
Consultation with an andrologist.

Both spouses must undergo mandatory tests:

For syphilis, blood for HIV, hepatitis B and C.
Microscopy smear from the genital organs.
Blood for group determination.
Smear for chlamydia, herpes, etc.

After receiving all the results, the doctor selects the appropriate IVF method. Sometimes additional examination may be prescribed for both women and men.

At the next stage, the woman is prescribed hormonal drugs that stimulate maturation.

Next comes puncture of the follicles. It is necessary to give a special injection for the final maturation of the egg. After collection, the eggs are sent to the embryology laboratory placed in a nutrient medium.

Fertilization of the egg is also possible on the same day. Sperm is used for this. That is why on the day of follicle puncture, a man needs to come to the clinic to donate sperm.

The embryo culture stage takes place from fertilized eggs, which produce embryos. They are kept in a special nutrient medium. They develop within five days in the incubator. The closest and most natural conditions have been created for them.

This is followed by the transfer of 1 or 2 embryos into the uterus, it depends on the chances of pregnancy. This procedure is not complicated: it is absolutely painless and lasts a couple of minutes. Thanks to this, with successful implantation of the embryo, pregnancy occurs.

The final part is support and control of pregnancy. After embryo transfer, the patient is prescribed hormonal medications to develop a normal pregnancy cycle.

Opening a certificate of incapacity for work is permitted by law at any of the above stages.

It is also useful to read: Duplicate sick leave

State quota for IVF

In some cases, a woman can count on government help and receive a free in vitro fertilization procedure under a quota.

Quota for IVF

IVF quota in the Russian Federation is provided in two cases:

Payment based on compulsory health insurance. It is provided if a woman cannot become pregnant naturally due to diseases and abnormalities such as anomalies in the development of the reproductive system, hormonal imbalance, disruption of the ovaries, lack of ovulation, or male infertility.
Patients with immunodeficiency syndrome and diseases similar in their etiology. Such patients are not very common, since the probability of transmitting the disease to a child is 70%.

All necessary procedures for conception and embryo transfer are performed free of charge.

It is worth noting that patients with immunodeficiency syndrome have a wider range of services offered. But performing the procedure on such people is much more dangerous and difficult.

Additional services are paid separately, they include the provision of a surrogate mother and egg freezing.

What has changed in payment for children's sick leave from September 1

From September 1, 2021, the Social Insurance Fund will pay 100% of average earnings to employees who take sick leave to care for a child under 8 years old (Article 4 of Federal Law No. 151-FZ of May 26, 2021).
This means that when a child seven years of age or younger is ill, the length of service of the parent and the procedure for treatment (at home or in the hospital) do not matter. For children aged 8 years and older, the rules will remain the same (Article 7 of Federal Law No. 255-FZ of December 29, 2006). Sick leave is paid in the following amounts:

when treating a child on an outpatient basis: for the first 10 calendar days - depending on the insurance period, for subsequent days - in the amount of 50% of average earnings;
when treating a child in a hospital setting (in a day hospital) - depending on the insurance period.

Another important change is that the amount of sick leave when recalculated for a full month should not be less than the minimum wage, taking into account the regional coefficient (if it is applied). This procedure has been in effect since April 1, 2021; you can read more about it in the article “Calculation of sick leave in 2021 - comparison with the minimum wage and regional coefficients.”

Work with electronic sick leave according to the new rules in Externa

Is sick leave given for IVF and is it necessary to take it? The nuances of obtaining a b/l