Electronic sick leave statuses: what do they mean?

What does the reason for disability code mean?

It shows in encrypted form on what basis the person was given a ballot. This code is entered on the sick leave certificate in the “Cause of disability” field. It consists of three blocks:

1. Two cells labeled “code”. They indicate the code of the reason why the employee went to the doctor on the first visit and received a certificate of incapacity for work.
2. Three cells with the signature “additional code”. They are filled out only in certain cases (see table).
3. Two cells labeled “change code.” They are filled out in a situation where the cause of disability has changed (for example, when the original diagnosis is corrected).

All meanings with explanations are given on the back of the ballot form.

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Table with decoding of disability codes on sick leave

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general information

What does sick leave mean? With the help of a sick leave certificate, an illness, injury or other physiological problem of an employee is registered. The form is sometimes called differently - a sheet of temporary incapacity for work. It is allowed to be prescribed only by doctors who have passed a special check by the FSS. An employee can count on payments if the form was correctly filled out and submitted to the enterprise administration within the established time frame.

For a long time now, a single standardized form has been used to fill out sick leave. In 2011, a reform was carried out in this area, the forms began to look slightly different, and new rules for filling out were introduced. Disease codes have become strictly mandatory.

Is the diagnosis written on the sick leave certificate? The diagnosis and cause of disability are now indicated using two special digital designations. The first is the national designation of the cause (01,02,03), the second is the international form of recording the disease according to the ICD-10 system.

Primarily, the reform was carried out to avoid cases of fraud associated with sick leave payments. That's why there's honey in everything. Institutions forms are received directly through FSS branches. The sheets are marked with serial numbers, so it becomes much easier to track illegal fraud. In addition, new sheets of paper are protected with watermarks, micro-text and some other methods.

It is best to fill out the sheet using printed media, as well as a black pen. Entries must be placed exactly within the boundaries of the cells and frames. Such accuracy is necessary so that the form can be processed by a computer - electronic reading is quite sensitive and demanding. The physician must not cross out, sign, or otherwise change the completed form.

Sample of a completed sick leave certificate:

If you need to change information, you should take a new sheet. The employer has the right to make mistakes and make corrections to the records, but this is highly undesirable. Corrections are written on the back of the sheet, incorrect data is crossed out.

Then you should sign and date it, recording the fact of the corrections. We also recommend that you read the article “Errors when filling out sick leave”, from which you will learn about inaccuracies that FSS employees will not pay attention to.

The form must be filled out by two people: the doctor and the employer. The doctor is responsible for completing sections 1 and 3. The employer, in turn, is for the second. It should be taken into account that the FSS carries out quality control and conducts random checks. In the future, the Foundation plans to switch completely to an electronic sick leave system, which will further simplify the control task.

When registering/using sick leave, you should rely on the Tax, Labor and Administrative Code. In addition, important documents are Federal Laws N212, N125, N255. In any unclear cases, you should contact the FSS department for advice.

On the back side of the sheet you can always find instructions for filling out, as well as a decoding of all codes.

Causes of illness and legal consequences for the employer

Sick leave codes 01, 02

Code 01 on the sick leave means that the employee was absent from work due to illness (flu, pneumonia, sinusitis, etc.).

Code 02 means that the person missed work due to injury.

Having received a bulletin with one of these codes, the personnel officer must reflect the information in the work time sheet (usually they use forms No. T-12 or No. T-13, approved by Resolution of the State Statistics Committee dated 01/05/04 No. 1). The corresponding days are marked with the symbols “B” or “19”.

Next, the accountant calculates the average earnings, and the Social Insurance Fund transfers temporary disability benefits (for more details, see: “Payment of sick leave in 2021”). In this case, the employer pays for the first three days at his own expense. The remaining days, starting from the fourth, are financed by the FSS. This is stated in paragraph 1 of part 2 of article 3 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.”

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Sick leave code 04

Code 04 on the certificate of incapacity for work means that the person missed work due to an accident at work or its consequences.

In the report card in form No. T-12 or No. T-13, days of absence are marked with the symbols “B” or “19”.

Benefits under such a bulletin are issued for the entire time until the date of recovery or until the fact of permanent loss of ability to work is established. The payment amount is calculated based on 100% of average earnings, regardless of length of service, but for a full calendar month cannot exceed the maximum amount. It is equal to the maximum monthly insurance payment approved by law, multiplied by four (Article 9 of Federal Law No. 125-FZ of July 24, 1998).

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Number of days for which benefits will be paid

There are certain deadlines for assigning and paying sick leave:

• The period for consideration and assignment of benefits is 10 calendar days. The countdown begins from the day the sick leave is presented. This is stated in Law No. 255-FZ (Part 5, Article 13, Part 1, Article 15).
• Payment of benefits is made at the earliest (after it is assigned) date of payment of the next salary in accordance with the same Law (Part 8, Article 13, Part 1, Article 15).

On a note! For each day of delay, you have the right to demand compensation in accordance with the Labor Code of the Russian Federation (Article 236).

Mode violation codes 23, 24

Significant information is contained in the field of the sick leave sheet, which is called “Notes on violation of the regime.” A two-digit code and the date of violation are entered here. The following marks are most often used.

Code 23 indicates non-compliance with the prescribed regimen, unauthorized leaving the hospital, traveling for treatment to another administrative region without the permission of the attending physician.

Code 24 indicates late attendance at a doctor's appointment.

If these values ​​are present, then starting from the date specified in this field, the benefit is calculated in an amount that does not exceed for a full calendar month the minimum wage established for the current year and multiplied by the regional coefficient (if any). This rule applies even if the employee’s actual average earnings exceed the minimum wage.

Example

The specialist's experience is 15 years, his average earnings are more than the minimum wage.

From February 10 to February 17, 2021, he was treated in a hospital. On February 14, the employee violated the regime, and the doctor made a note on the bulletin.

Benefit amount:

• for the period from February 10 to February 13 - based on the actual average earnings multiplied by 100%;
• for the period from February 14 to 17 - according to the formula: minimum wage for 2021, divided by 28 (the number of days in February) and multiplied by 4 (the number of days of sick leave, starting from the date when the regime was violated).

Number of paid days on sick leave

If an employee is sick or absent from work due to disability - code 02 (explained above), then the benefit must be guaranteed to be paid for the entire period of exemption from performing his professional activities (or more precisely, for all calendar days indicated in the medical document) . This is clearly stated in Law No. 255-FZ (Part 1, Article 9). Moreover, there are no restrictions on the maximum duration of the paid period. The only exceptions are sick leave benefits for employees hired for temporary work or with disabilities.

Important! If an employee falls ill or is absent from the workplace due to incapacity for work - code 02 (explained above) during the next paid leave, then benefits are paid for the entire period of incapacity for work. The vacation (by agreement) is either extended or postponed to another convenient time. This seems very fair.

Line “Other” (code 31, 36)

It contains additional information in encrypted form. Here are some of them.

Code 31 means that a person needs long-term treatment, and although he was given a certificate of incapacity for work, he continues to be ill. In this case, he submits the primary sheet to the accounting department and receives benefits for the first part of the illness. In this document, the “Get Started” field is not filled in. And in the “Other” field there is code 31, which stands for “continues to hurt.”

Code 36 indicates the following situation. The employee, while on sick leave, missed his next doctor's appointment. And when he showed up (later than the appointed date), he was recognized as able to work. The ballot fields are filled in as follows:

• “Notes on violation of the regime” - worth 24 and the date of the missed appointment;
• “Exemption from work” - the period from the onset of illness to the date of the missed appointment is indicated;
• “Other” - costs 36;
• “Get Started” remains blank.

ATTENTION. The benefit for the ballot, in which code 36 is indicated in the “Other” field, is calculated as follows. From the onset of illness to the date preceding the absence - based on actual average earnings. For a day of failure to appear - in an amount not exceeding for a full calendar month the minimum wage established for the current year and multiplied by the regional coefficient (if any). From the date following the day of failure to appear, benefits are not accrued at all (letter from the Moscow branch of the FSS dated September 01, 2020 No. 14-15/7710-2216l; see “The capital FSS clarified how to calculate benefits if there is a note on the sick leave for violation of the regime ").

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Concept of work injury

What is a work injury?

An industrial injury is harm to health that was caused to an employee performing official duties, the result of which was the need to transfer the employee to another job, the employee’s loss of ability to work, or his death.

An industrial injury is characterized by the presence of the following symptoms:

1. The injury to the employee must occur during the work process, a break established at the enterprise, the time of preparation for the work process, or while on a business trip;
2. The injury must have occurred on the organization's premises.

Labor legislation establishes a certain procedure in which an investigation of an employee’s injury at an enterprise should be carried out (Article 229.2 of the Labor Code of the Russian Federation).

In accordance with it, after the incident, witnesses to the event must provide assistance to the person and arrange for him to be sent to a medical organization. Please note that the area must be fenced and changing anything in it is not allowed.

The employer has the responsibility to create a special commission, which, by investigating the incident, determines whether the employee is at fault.

The period for conducting an investigation of an event cannot be more than 72 hours. After completing the procedure, an act must be drawn up, the form of which is N-1. This document reflects:

1. Employee information;
2. Event data;
3. Indication of norms, legislative acts that were violated and led to consequences;
4. The guilt of the employee and the guilt of the employer are described;
5. A list of actions that need to be taken to prevent situations in the future and the reasons for what happened.

The information reflected in the document must be objective and based not only on the facts found at the scene of the incident, but also on information from eyewitnesses of the event.

This document is drawn up in two copies. One is given to the victim, the second must be kept by the company for at least 45 years.

What codes should an employer provide?

The employer should put the subordination code in the bulletin and fill out the “Calculation conditions” field (the codes are given on the back of the sick leave form).

Doctors indicate all other codes, in particular: reasons for disability, notes on violation of the regime and the corresponding values ​​in the “Other” field.

IMPORTANT. If doctors filled out a sick leave certificate with errors (including incorrect disease codes), and the accounting department paid for it, the Social Insurance Fund will most likely refuse to reimburse the benefit. But the courts support policyholders in such situations.

Deadlines for submitting sick leave to guarantee receipt of benefits

A sick leave certificate issued due to illness, disability - code 02 (deciphering is presented above) - or for other circumstances, the employee must present before six months (or rather, 6 months) have passed from the date indicated in the medical document (and exactly in the column “by what date”).

Remember! In case of delay, sick leave benefits are not paid. For example, if the last day on sick leave is May 15, then the latest date for presenting the document is November 15. If you do this even a day later, you will not receive benefits.