How long can sick leave last and when must it be paid?

Labor relations at enterprises are regulated by many laws of the Constitution of the Russian Federation. One of the main ones is the Federal Law “On compulsory social insurance against accidents at work and occupational diseases” (dated July 24, 1998, No. 125 FZ (as amended on December 25, 2015)) and the law “On compulsory social insurance in case of temporary disability and connections with motherhood" (dated December 29, 2006 No. 255-FZ (as amended on March 9, 2016)). It is on their basis that every employee has the opportunity to receive insurance during his absence from work due to temporary disability, and therefore not be left without a livelihood. According to these laws, compensation is paid to the insured person in the following cases:

• when an employee becomes ill;
• when he or she is injured (not at work);
• due to caring for a sick family member;
• quarantine of an employee, his child or incapacitated relative;
• during follow-up treatment in a sanatorium or resort;
• on pregnancy and childbirth.

As a result of these factors, the employee receives a sick leave certificate (disability certificate) from a medical institution, which is a mandatory element of insurance. It is presented in the form of an official form containing all the necessary information, certified by seals and signatures.

Such a form proves the authenticity of the employee’s excused absence from work on specific days and makes it possible for the accounting department to accurately calculate the amount of the insurance benefit.

A small share of compensation payments falls on the organization itself, the main share goes to the Social Insurance Fund (SIF).

Each employee is required to pay benefits, as stated in the Labor Code of the Russian Federation. Articles 21 and 183 of this Code provide that any organization is obliged to provide insurance to employees without fail, and its effect begins from the moment the worker signs the contract and begins to perform his duties.

Upon expiration of the employment contract, the opportunity to obtain insurance remains for another 30 calendar days.

Many enterprises have a Standard Regulation (according to Decree of the Federal Insurance Service of the Russian Federation dated July 15, 1994 No. 556a), on the basis of which worker insurance is regulated by a special commissioner or insurance commission . They are elected at a general meeting from representatives of the personnel department, labor collective or accounting department. They are required to develop the Regulations on the Commission. The main function of the commission or commissioner is to monitor the timely and full payment of hospital benefits and resolve disputes.

Each party has its own rights in accordance with the Regulations on the Social Insurance Fund of the Russian Federation and the Law “On the Fundamentals of Compulsory Social Insurance”.

Rights of the recipient of temporary disability compensation:

• receiving free information on insurance issues;
• timely receipt of benefits in accordance with the legally established procedure;
• protection of your rights personally or through legal representatives.

Rights of the FSS of the Russian Federation:

• conducting an examination to clarify the occurrence of an insured event;
• verification of accounting documents and transfer of insurance premiums;
• providing social insurance to people who are self-employed.

The FSS also has its responsibilities :

• carrying out timely payment of benefits;
• regulation of the procedure and accuracy of calculating security and payment of the amount for sick leave.

If complex controversial issues arise, every person who has social insurance can contact the Federal Social Insurance Fund of the Russian Federation to resolve them, and if the situation remains unresolved, they can turn to the court or a higher authority.

Legal relations of Social Insurance for entrepreneurs and organizations are regulated by a separate Law, since they apply their own tax regimes. But the process of calculating and paying benefits to employees follows general rules.

Keep in mind! If a person works in several organizations at once, then in case of illness he can receive benefits from each of them. From the date of closing the certificate of incapacity for work, you can apply for payment within six months.

Accounting department's calculation of the amount of compensation for sick leave

In order for the Social Insurance Fund to be able to pay the required amount to an employee due to his temporary disability, the organization’s accounting department must first establish the amount of compensation individually for a specific employee, since the amount of the benefit depends on many factors - length of service, average earnings and the cause of disability.

Sick leave due to illness

To calculate such sick leave, accounting takes into account two criteria - “average annual” earnings and “average daily” earnings.

The first is determined by income for the previous two full years of work, that is, if an employee went on sick leave in 2015, then the accountant will calculate the average earnings for 2013 and 2014. This results in one total amount.

Now, based on this amount, the average daily earnings are calculated - the resulting amount of average annual earnings must be divided by the total number of days for two years, i.e. by 730, and then multiply by a percentage depending on the insurance period. The longer the work experience, the higher this percentage. In accounting, the following criteria apply for its definition:

• of experience or less - 60 percent;
• experience of at least 5 years, but no more than 8 years - 80 percent;
• experience of 8 years or more - 100 percent.

The resulting amount is the average daily earnings. In order to calculate the amount of the benefit, all that remains is to count the number of sick days and multiply the resulting value by this number.

Important! The calculation of the benefit amount takes into account, in addition to the salary accrued for 2 years, quarterly bonuses and vacation pay, that is, all those payments with which insurance contributions are calculated (therefore, other sick leave and maternity leave are not included here).

Sick leave for pregnancy and childbirth

The average annual earnings in this case are calculated as in the previous one, but the method for determining the average daily earnings is slightly different.

Average annual earnings are divided not by 730, but by the total number of calendar days for the two previous years, taking into account the deduction from them of the number of days when the employee was on sick leave, on maternity leave, on paid days off, caring for disabled children, on vacation for childbirth and child care, and other paid days provided for by the law of the Russian Federation.

The resulting value is always multiplied by 100 percent. This is how the final benefit payment amount is obtained.

EXAMPLE .
Employee Kovalev S.A. I was sick from July 5 to July 9, 2021. His experience is 6 years. In 2014, his income was 242 thousand rubles, and in 2015 - 315 thousand. We make the calculation: Average annual earnings: 242,000 + 315,000 = 557,000 Average daily earnings: 557,000/730 = 763 Benefits: 763*0.8 *5=3052 Tax accounting: 3052*13%=396.76, i.e. (3052-396.76) = 2655.24 Thus, Kovalev S.A. will receive benefits in the amount of 2655.4 rubles for 5 days of absence from work due to illness.

Minimum disability benefit

The disability benefit should not be lower than that calculated according to the minimum wage on the day the insured event occurred ( clause 1.1 of Article 14 of Federal Law No. 255

).

In 2021, the size of the minimum wage

:

• 7.5 thousand rub
  . until July 1, 2021;
• 7.8 thousand rubles
  . from July 1, 2021.

In areas with a regional coefficient, the minimum wage is taken into account with the coefficient. Let's calculate the minimum cost of a sick day in 2021:

• until July 1: (7500 * 24) / 730 = 246.58 rubles.
• after July 1: (7800 * 24) / 730 = 256.44 rubles.

Considering that the shortest period for issuing sick leave is 1 day, and the minimum percentage of payment is 60%

, you can calculate the minimum sick leave payment from the Social Insurance Fund in 2017:

• after July 1, 2021 - 256.44 * 1 * 0.6 = 153.86 rubles.

According to the minimum wage, benefits are calculated for workers who had no income in the accounting years, or who had incomes less than 24 minimum wages, as well as for citizens paying voluntary contributions.

Rules and examples of filling out sick leave

The form of the certificate of incapacity for work is filled out manually or on a printer using a special FSS program. If you fill it out using the second method, the task becomes much easier, since the process is programmed.

Below are examples of filling out a sick leave certificate:

FILES

If manually, then the following basic rules must be observed:

• You can only write with a black gel pen;
• the filling must be neat, not extending beyond the cells;
• writing is allowed only in Russian;
• you need to start writing without skipping cells;
• all words must be written in block capital letters;
• in the doctor’s name, an empty cell should be left between his last name and initials (and sometimes between them) (for example, SVIRIDOV□A.G. or SVIRIDOV□A.□G., but SVIRIDOVA.G. is not allowed).

FILES

The certificate of incapacity for work is filled out in two stages - first in a medical institution by a doctor, and then by an accountant of the organization where the employee works.

Who is not paid sick leave

In some cases, employees are not entitled to claim social benefits:

• if the employee is contracted under a contract;
• if the treatment regimen prescribed by the doctor is violated;
• in the absence of entries and appointments in the patient’s outpatient record;
• when issuing a document on temporary disability by an unlicensed medical institution;
• if the document has been extended for more than 30 days and there is no conclusion from the medical advisory commission;
• when issuing sick leave without a doctor’s prescription;
• if the date of issue is falsified;
• if the employee is under arrest;
• when an employee is suspended from work without maintaining his salary;
• during downtime at the enterprise;
• if the temporary disability was the result of a criminal violation;
• when an employee undergoes a forensic medical examination.

How to fill out the form at a medical institution

Typically, a sick leave certificate is issued to a patient on the day of his discharge, but according to the new rules, the patient can pick it up on the first day. The medical employee fills out all the information about the patient and the medical institution. He writes the name and number of the hospital, the address of its location, the date of issue, the full name of the patient to whom this sheet is issued, his date of birth, the name of the organization where the sheet is required, the name of the attending physician, his position, the date of admission of the patient and the date of discharge, as well as the date on which the employee is required to start work.

The form also contains a column indicating the reason for the disability, which is also filled out by the doctor. But if earlier the name of the disease itself was written there, now it is customary to write a conditional code to which a particular disease is assigned (for example, 01, 02, 03, which means disease, injury and quarantine, respectively). This allows you to maintain medical confidentiality.

After discharge, the patient receives a form and submits it to the accounting department. But before doing this, he must carefully check all the data to eliminate possible errors and make sure that all signatures and seals are present, otherwise the form will be invalid and benefits will not be accrued on it.

Illness while on vacation

If a citizen falls ill while on regular vacation, then, according to Article 124 of the Labor Code of the Russian Federation, he has a choice:

1. Transfer vacation days that coincided with illness to another period. (In this case, you must write a statement indicating the transfer dates.)
2. Continue to take your allotted vacation. There is no need to fill out any paperwork, the vacation is extended automatically.

Article 124. Extension or postponement of annual paid leave

Important! Extension due to illness applies only to main and additional leave. If a child falls ill during an employee’s vacation, the issued bulletin will not affect the duration of the vacation in any way.

Application example

How to fill out a form in the accounting department

After the sick leave certificate reaches the responsible person of the organization, he first checks it, and then carefully and accurately fills out the rest of the form - the bottom column. In it, the accountant must enter the following: name of the organization, registration number, department code, employee data (TIN, SNILS), his full insurance record, number of paid sick days (according to the start and end date of sick leave), the amount of average annual and average daily income , the amount of the organization's benefit, the amount of the Social Insurance Fund, the total amount of payment. At the very bottom, the names of the head of the organization and the accountant are indicated, necessarily secured with their signatures and seal.

Important! A prerequisite is to fill out the sick leave form correctly and accurately. So, if a medical worker makes a mistake, the accounting department will not accept the form, and the employee will have to take a new one. If an accountant makes a mistake, it leads to even bigger problems, since the Social Insurance Fund will not pay benefits, and the accounting department will have to change all reporting and calculations in accordance with the Social Insurance Fund budget.

How can an employee control the payment of sick leave benefits?

An important change in sick pay for workers from 2021 is that they can now control the payment of sick leave benefits, in what is called real time.

To do this, the FSS has implemented several free services at once that allow you to find out at what specific stage a particular payment is at and how soon the money will arrive in the employee’s account.

In particular, an employee can now track the status of documents sent for payment of benefits in the Personal Account of the insured person on the official website of the Social Insurance Fund. The login and password in your personal account are the same as in the citizen’s personal account on the State Services website.

Here you can check whether documents have been received by the Social Insurance Fund office, and also track the stages of their passage in the form of certain statuses (document uploaded, document calculated, document paid).

Please note that this opportunity is provided only if the employee has issued an electronic sick leave certificate.

You can also check the payment status through a special mobile application “Social Navigator”. Here you can also get a free consultation from a FSS specialist regarding the procedure for receiving benefits.

In addition, the FSS now operates a hotline. For example, Muscovites can find out when they will be paid sick leave by phone.

Issuing a certificate of incapacity for work retroactively

There are often cases when an employee tries to get sick leave retroactively. This usually occurs if an employee has missed several working days for any reason other than illness. But according to the legislation of the Russian Federation, it is impossible to officially issue such a sick leave. This is clearly and clearly indicated in the Order of the Ministry of Health and Social Development of Russia No. 624n dated 06/29/11 and in the Decision of the Supreme Court of the Russian Federation No. AKPI14-105 dated 04/25/14.

That is, according to the law, if an employee decides to obtain a sick leave certificate retroactively in some way, not only he will be responsible for this, but also the one (medical employee or special organization) who issued him the document.

Due to the fact that previously employees could calmly bring a certificate of incapacity to work retroactively, while they themselves were healthy and simply did not come to work, in 2011 the certificate form adopted a new form that is still used today. It describes all the data in more detail, which complicates the task of applying for sick leave retroactively, which means employees bear a huge risk when trying to hide behind such a document.

By the way! If an employee came to work, worked for some time, but then fell ill, then sick leave can only be opened from the next day, since the organization cannot compensate for the day on which the employee was present at work through insurance.

Some details of issuing sick leave

A certificate of incapacity for work is issued for any health impairment (except for injuries received at work). If sick leave was issued while caring for a family member in need of care, then sick leave benefits are paid in the following order:

• if the child is under seven years old, then a total of 60 days a year will be paid in full;
• if child care is required for more than 7 but less than 15 years, then a maximum of 45 days per year and 15 days per case are paid;
• if care is provided for a disabled child, then 120 days are paid in full for the year;
• in all other cases, it is possible to pay sick leave for no more than 30 days a year and a maximum of 7 days at a time.

In some cases, there are reasons why the Social Insurance Fund has the right to reduce benefits , namely:

• if the patient violated the doctor’s recommendations;
• if the disease occurs due to alcohol or drug intoxication;
• if the patient did not come to the doctor for examination;
• if the court has proven that the disease arose due to intentional infliction of damage to health.

Results

The procedure for issuing and issuing a certificate of incapacity for work, as well as payment of benefits, is strictly regulated by the legislator.
There are a number of regulations, each of which sets strict conditions for both the employer and medical institutions. The main legal acts and their provisions governing the issue and payment of sick leave are discussed in the material. You can find more complete information on the topic in ConsultantPlus. Free trial access to the system for 2 days.

Payment of sick leave to the unemployed

An unemployed person also has the right to receive benefits on a certificate of incapacity for work, but only if he is registered with the employment service (SZN).

The amount of insurance will depend on how long it has been registered. The long period of his registration makes it possible to calculate insurance based on the income that the employment service paid him. If the registration period is short, then the unemployed can contact the accounting department of his last place of work, where he will be given a certificate of income for the last two years. Benefits will be calculated based on them.

It happens that a person, while registered with the employment service, has had no income for the last two years. Then the compensation will be calculated according to the minimum wage (minimum wage), which will be 173.5 rubles per day.

As you can see, several structures are involved in the chain from the onset of temporary disability of an employee to the payment of compensation to him: a medical organization, an employer, and the Social Insurance Fund. In order to receive money on time, the recipient of the certificate of incapacity for work needs to be vigilant himself, trying to eliminate possible errors where he can check the data entered on the sick leave certificate.

Payment terms and rules

In order to receive compensation for sick days from the employer in 2021, the employee must provide the company with sick leave within six months from the date of its closure. Temporary disability benefits for the first 3 days will be calculated within 10 days from the date of the employee’s application. The employee will receive the money along with the first payment - advance payment or salary. But if a situation arises in which a recalculation is required, payment will be received later.

The remaining days of treatment are paid for by the Social Insurance Fund. To do this, the sick leave and a package of documents necessary for the calculation and payment of funds are transferred to the Social Insurance Fund. According to the law, 10 calendar days are given for the transfer of benefits from the date when the fund receives the necessary information.

If an employee who previously quit is applying for benefits, the benefits will be paid no later than 30 calendar days after the termination of the employment contract (Article 5 of the Federal Law of December 29, 2006 No. 255-FZ “On compulsory social insurance in case of temporary disability and in connection with maternity”) .