Features of registration and payment of open sick leave in hospital and after, outpatient treatment

Conditions of treatment: how does this affect the timing and amount?

Outpatient treatment involves following the regimen established by the attending physician at home with a visit to a medical facility at the appointed time for diagnosis and testing. All medications under this regime are paid for and purchased by the patient independently.

Inpatient treatment is a round-the-clock (in the daytime mode - only in the first half of the day) stay in a medical institution under the supervision of the attending physician. Medicines in most cases are provided by the clinic itself, a bed and medical procedures are also free (exception: hospitalization in private medical institutions, which is paid for by the patient).

When it comes to paying sick leave benefits to a sick employee, Art. 7 Federal Law No. 255 “On compulsory social insurance in case of temporary disability and in connection with maternity” does not distinguish the difference between the indicated treatment regimes: payment is made based on the insurance period. A similar payment is made if an employee is caring for a sick relative.

The treatment regimen affects the conditions and payment if the employee takes leave to care for a sick child:

• for outpatient treatment, dependence on the insurance period is taken into account only for the first 10 days, subsequent days - in the amount of 50% of average earnings;
• In case of inpatient care , the insurance period is taken into account, regardless of the number of days of sick leave.

The insurance period is calculated as follows:

• less than 6 months - in an amount not exceeding the minimum wage;
• from six months to 5 years – 60% of average earnings;
• from 5-8 years – 80%;
• more than 8 years – 100%.

A former employee whose employment contract was terminated for less than 30 calendar days is also entitled to receive sick leave benefits, but in the amount of 60% of average earnings, regardless of the insurance period.

The benefit itself in both cases is calculated as follows:

Benefit = salary for 2 years / 730 x percentage, depending on length of service x number of sick days.

In both cases, the first three days of sick leave are paid by the employer (unless we are talking about quarantine and caring for a child or other family member), the subsequent days are paid by the Social Insurance Fund. This body also pays for incapacity for work in sanatorium-resort conditions after hospitalization. Meanwhile, the difference is observed in the timing of the established regime.

New rules for issuing and processing sick leave – clarifications from the Moscow Region prosecutor’s office

From December 14, 2021, a new procedure for issuing and processing sick leave will come into effect in Russia. The Moscow Region Prosecutor's Office provided clarifications regarding the innovations. Thus, to issue an electronic document, you will need a passport and SNILS; sick leave for caring for a child from 7 to 15 years old will be issued without restrictions on the number of days. New rules also establish the procedure for issuing sheets during quarantine. Read more in the material mosreg.ru.

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Where electronic sick leave will not be accepted

Still, not all organizations accept electronic sick leave, so before drawing up such a document, you should check with your employer for information.

Only paper certificates of incapacity for work are issued to the unemployed (to confirm a valid reason for failure to appear at the employment service), as well as to women dismissed due to the liquidation of organizations who became pregnant within 12 months before they were recognized as unemployed.

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Rules for issuing electronic sick leave

Source: RIAMO, Alexander Manzyuk

To apply for an electronic sick leave, you must provide your passport and SNILS. To obtain a paper certificate of incapacity for work, you only need a passport.

According to the new rules, electronic sick leave has become unified for people working in several places. A person only needs to inform all employers of the ballot number indicated in his personal account on the government services website.

Also, electronic sick leave can now be extended with a paper sheet, and vice versa.

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Features of issuing sick leave for child care

Child draws

Source: Ministry of Construction Complex of the Moscow Region

When issuing sick leave to care for children from 7 to 15 years old, they no longer indicate the number of days for which a certificate of incapacity for work is issued (previously there was a limit of 15 days). In this case, the benefit is paid only for 15 days for each case of illness and for no more than 45 days a year.

The maximum duration of sick leave for caring for a child over 15 years old is 7 days for outpatient treatment (previously it was 3 days).

If two children are sick at the same time, the parent or guardian, as before, is given one sick leave for all. When drawing up an electronic document, it must indicate data on each sick family member - the period of care for him, the conditions for providing medical care, full last name, first name and patronymic, date of birth, relationship, SNILS and some others.

Also, now parents of preschool children can receive sick leave to care for a child if the kindergarten where the child goes is closed for quarantine.

Another innovation: if the mother is on maternity leave for up to three years, the father can be given sick leave to care for another child.

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Sick leave during quarantine

A doctor from the Moscow region saved a man during a flight

Source: Ministry of Health of the Moscow Region

The new procedure establishes the specifics of issuing sick leave during quarantine, as well as when there is a threat of the spread of diseases dangerous to others. According to the innovations, people forced to self-isolate are issued a certificate of incapacity for work for the entire period of the restrictions.

You can get a sick leave certificate without a personal visit to a doctor, using telemedicine technologies. In this case, the document is generated only in electronic form. It can be issued by a doctor or paramedic, whose information is included in the Federal Register of Medical Workers. The medical organization in which he works must be registered in the Federal Register of Medical Organizations.

Sick leave certificates for pregnancy and childbirth can also be issued electronically using telemedicine technologies.

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24-hour hospital

In a 24-hour hospital, the patient is under the supervision of a doctor 24 hours a day. The procedure for issuing a sick leave certificate is established by Order of the Ministry of Health and Social Development No. 624n.

How many days is provided and are there any restrictions for inpatient treatment?

For inpatient conditions, the maximum duration of sick leave is not established. In itself, being in a hospital means the presence or suspicion of the presence of a serious illness, and if in the latter case the examination may take a week, then in case of illness it is impossible to determine the exact duration of treatment.

All days of such sick leave must be paid (how many days of sick leave are paid per year?). The calculation is made depending on the insurance period established by Art. 7 Federal Law No. 255, without restrictions.

How to fill and then close an open BC?

If the patient was initially treated as an outpatient and was subsequently sent to a hospital, the filling proceeds as follows:

• the line “get to work” is skipped;
• in the line “other” the code “31” is indicated and the stamp of the inpatient department is affixed;
• as a continuation sheet, the number of the new bulletin that will be issued by the hospital is indicated;
• The hospital doctor signs and stamps it again.

The second BL indicates:

• number of the first sheet that was issued during outpatient treatment;
• under the date of issue while in hospital, the day of discharge is indicated;
• All seals and signatures are also affixed by the hospital.

According to the general rule established by Order No. 624n, sick leave is issued on the day of discharge from the hospital.

If the patient no longer needs such conditions, but recovery has not yet occurred, the inpatient attending physician extends the sick leave, but no more than 10 days (a longer period may be established after the operation). In this case, the patient is sent to the local attending physician with an open form. It provides the following information:

• on the second (from the hospital) BL the code “31” is entered;
• the “get to work” column is skipped again;
• signed and sealed.

The third (second, if the inpatient BL was the primary) bulletin indicates:

• primary sheet number;
• date of treatment (after hospitalization);
• date of crime to work;
• signature of the doctor who closed the BL from the hospital, and seal.

When transferred from one hospital to another, the patient also leaves with an open ballot. It is closed by the attending physician of the new hospital, enters the code “31”, and upon discharge he draws up a new sheet. During the period of stay in the hospital, the date of the initial visit to a medical institution (from the first BL) is indicated, but in the table “exemption from work” only the number of days according to the new sheet is indicated.

If treatment ends after discharge from the hospital, the patient will have only 1 ballot in his hands, and the hospital itself will close it.

How is it paid if the employee was in the hospital around the clock?

Payment for any sick leave is carried out for the entire period of recognition of the employee as temporarily disabled.

The number of days is summed up from all ballots, and the average earnings are multiplied by them, depending on the length of service. The amount can be reduced if the patient violates the treatment regimen, for which a corresponding code mark is placed in the bulletin.

How is sick leave issued?

The procedure for issuing sick leave is regulated by Order of the Ministry of Health of Russia dated September 1, 2020 No. 925n.

Who issues sick leave?

The issuance of certificates of incapacity for work is carried out by medical institutions that have a license to carry out medical activities and examine temporary incapacity for work.

The authority to issue sick leave rests with:

• attending physicians;
• paramedics;
• dentists.

You should know! Employees of blood transfusion stations, doctors engaged in private practice, doctors of sanatoriums and hospitals, and ambulance workers are not entitled to issue certificates of incapacity for work.

Who is entitled to receive sick leave?

Certificates of incapacity for work are issued to most categories of citizens. The list includes:

• employees registered under an employment contract;
• state and municipal employees;
• members of production cooperatives;
• clergy;
• convicted persons serving a sentence of forced labor or imprisonment;
• lawyers;
• entrepreneurs;
• members of peasant farms;
• notaries;
• persons belonging to indigenous peoples.

Citizens dismissed from work are also entitled to receive sick leave, provided that the illness occurred within 30 days from the date of termination of the employment contract. A certificate of incapacity for work is issued to foreign citizens and stateless persons.

Important! A citizen has the right to issue a sick leave certificate for himself if he is caring for a child or a disabled relative. A certificate of incapacity for work is also issued to pregnant women. Sick leave cannot be issued for a child over 15 years of age if he is being treated in a hospital, as well as for a chronically ill person during a period of remission.

For how long is sick leave issued?

A certificate of incapacity for work is opened by a doctor on the first day of illness when visiting a medical organization or calling a doctor at home. Sick leave ends on the last day of treatment.

The maximum periods of sick leave are:

• normal case – 30 days;
• child care – 15 days;
• for pregnancy and childbirth – 140 days;
• for dental disease – 10 days.

By decision of the medical commission, sick leave can be extended until the day of restoration of working capacity, but no more than 10 months. In this case, the patient must renew it every 15 days.

We must remember! Calling an ambulance does not provide grounds for issuing sick leave. A citizen needs to go to a hospital or go to a clinic, where the attending physician will open a certificate of incapacity for work.

How is sick leave filled out in a medical institution?

Most of the sick leave form is filled out by the medical organization.

The medical professional must provide the following information:

• name of the medical organization;
• date of issue;
• Patient's name;
• patient's date of birth;
• main and additional disease codes;
• the patient's place of work;
• dates of onset and end of illness;
• Full name of the attending physician;
• start date of work after recovery.

The sick leave certificate is signed and stamped by the doctor, as well as the seal of the medical organization.

Sample sick leave certificate

Important! With the patient’s consent, a sick leave certificate can be issued electronically. In this case, the document is not completed on paper. The electronic certificate of incapacity for work is placed in the FSS information system and signed with an enhanced digital signature.

Download samples of certificates of incapacity for work

At the Research Institute of Balneology Women's consultation (maternity leave) Polyclinic (primary with continuation) Polyclinic (primary) Polyclinic (continued) Polyclinic (unemployed) Polyclinic (duplicate according to VK) Polyclinic (violation of the regime when appearing able to work) Polyclinic (trauma, alcohol intoxication ) Polyclinic (trauma, primary) Polyclinic (MCE, disabled) After a serious incident at work Sanatorium (follow-up treatment, continued) Hospital (follow-up treatment, primary) Hospital (additional maternity leave) Hospital (primary) Hospital (continued) Hospital (nursing) for a sick child) Children's clinic (care for a sick child) Children's clinic (care for a child over 15 years old)

How is sick leave filled out by an employer?

After the certificate of incapacity for work is closed, it must be handed over to the employer. Personnel and accounting department employees enter the following information into it:

• employer's name and registration number;
• TIN and SNILS of the citizen;
• subordination code;
• work start date;
• insurance experience;
• benefit accrual period;
• average earnings for calculating benefits;
• average daily earnings;
• the amount of benefits at the expense of the employer and the Social Insurance Fund;
• Full name of the head;
• Accountant's name.

Finally, the employer's stamp is affixed.

Sick leave can be issued remotely through the Social Insurance Fund by contacting the hotline or the official website. You can track the movement of the certificate of incapacity for work in the fund’s database through a confirmed account on the State Services portal.

Snezhana Pogontseva

Lawyer, author-editor of the website (Family law, 12 years of experience)

certificate of incapacity for work for the employer

Illness for the employer

Day

If the patient does not need round-the-clock supervision, but still requires a daily visit to the clinic to undergo certain procedures, he is placed in a day hospital.

Do they issue a certificate of incapacity for work and according to what rules?

A sick leave certificate for a day hospital is issued without fail , because the employee will still miss most of his working time. However, the patient, if he has an agreement with the employer, has the right to continue working. At his request, the ballot will not be issued. Registration is carried out according to the rules established for outpatient BC (Article 58 of Order No. 624n). That is, there will be no mark indicating that you are in the hospital.

Is it issued for outpatient treatment?

In cases where the patient only needs medication and (or) bed rest, but there is no need to constantly visit the clinic, he is provided with outpatient treatment.

Can there be a limit on days if the employee is at home, how to pay?

In accordance with Art. 11 of Order No. 624n for outpatient treatment, a maximum period of 15 days is established (10 if issued by a paramedic or dentist); the sheet can be extended for the same period by the chief physician of the clinic.

Further extension of the certificate of incapacity for work is carried out only on the basis of the decision of the medical commission (what are the rules for extending sick leave through the VC?).

When being treated in a private medical organization, the attending physician, after 15 days, sends the patient to the clinic at his place of residence to undergo a commission. If the decision to extend the BL is positive, the maximum extension period is 10-12 months - more for treatment after surgery, long-term healing injuries and tuberculosis (what is the duration of sick leave depending on the disease?). In this case, you must visit your doctor every 15 days.

Sick leave is paid according to the general rule (3 days - at the expense of the employer, subsequent days - by the Social Insurance Fund), depending on the length of insurance coverage.

The amount of sick leave can be reduced if the patient violates the regime established by the doctor, about which a corresponding note is made on the sheet.

Any person whose employment is official has the right to paid sick leave. Read our materials about how compensation is calculated and how a certificate of incapacity for work that falls on a weekend or holiday is calculated.

How the amount of sick leave benefits is calculated: step-by-step instructions

The employer's accounting department is required to calculate temporary disability benefits and enter information about it on the sick leave sheet so that the employee can be paid in the future.

The benefit is calculated using the following algorithm:

1. The number of days to be paid is determined.
2. The employee's insurance record is determined.
3. Average earnings are calculated.
4. Average earnings are compared with the minimum and maximum values.
5. The benefit amount is calculated.

Let's look at each step in more detail.

Step 1 – Determining the number of days to pay

First, the accountant determines how many days of sick leave will be paid and how many will remain unpaid. The specific period depends on the causes of disability (main and additional disease codes).

We must remember! In the case of sick leave for pregnancy and childbirth, the total duration of the paid period is 140 days. For the birth of two or more children, 194 days are paid. For complicated or premature births, a citizen will receive payment for 156 days.

Step 2 – Identifying the employee’s insurance record

After determining the paid period, the employee’s insurance length is calculated. Depending on its duration, the benefit will be paid in the amount of 60 to 100% of average earnings

Step 3 – Calculation of average earnings

Next, the average earnings for benefit payment are calculated.

The following formula is used for calculation:

Average earnings = Employee income for two years / 730

For example, in 2021, an employee’s income was 698,000 rubles, in 2020 – 834,000 rubles. Average earnings will be equal to (698,000 + 834,000) / 730 = 2,098.63 rubles.

We must remember! The calculation includes those incomes on which insurance premiums are calculated: wages, vacation pay, bonuses. Previous sick leave and financial assistance will be excluded from the calculation.

Step 4 – Compare average earnings with minimum and maximum values

Then you need to compare the resulting value with the minimum and maximum average earnings. Thus, in 2021, the minimum average earnings were 420.56 rubles, the maximum – 2,434.25 rubles. in a day.

If the amount of average earnings received is less than the minimum, sick leave should be calculated based on the lower limit of payment - 420.56 rubles. in a day. In the event that average earnings exceed the maximum limit, the benefit will be calculated based on the upper payment limit - RUB 2,434.25.