19.07.2019

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7095

4 min.

One of the social guarantees of the Russian state is compensation for a period of temporary disability due to illness. The source of financing for this payment is the social insurance fund, to which the employer makes contributions for all of its employees. The benefit is provided upon presentation of a certificate from a medical institution.

Basic Concepts

A sick leave certificate is a document issued by licensed medical institutions, which indicates the period of temporary incapacity for work of a person. The form has a unified form approved by the Ministry of Health and Social Development. In 2021, an electronic form of the document will also be acceptable. The grounds for issuing a sheet include:

• injury or illness of the employee himself;
• restorative procedures, aftercare;
• illness of one of the family members who requires care;
• pregnancy and childbirth.

Filling out the form is the responsibility of employees of medical institutions, and control over the correct formation of the document is exercised by the employer. His interest is based on the fact that management pays compensation from its own funds and then requests them from the Social Insurance Fund. Errors and inaccuracies in the form will lead to refusal from the fund.

The amount of payment is determined by several parameters:

• average salary;
• insurance experience;
• number of days of incapacity.

It is important to know! The employer calculates the payment based on the provided certificate, which indicates the third point and his information about salary and length of service. If an employee brings data from previous or other places of work about his earnings, then the accounting department must recalculate the amount.

Information from a former employer

The basis for calculating benefits for LVN is the presence of two documents:

• LVN;
• salary papers for the past 2 years.

This is important to know: Is it possible not to cover sick leave?

The paper, which records the amount of income at the previous company (hereinafter referred to as the Certificate), is an important basis for determining the amount of payment in case of disability.

Yes, Art. 13 of Federal Law No. 255-FZ establishes several rules for calculating sick leave funds:

• compensation is paid at the current place of work;
• if a person is employed in several organizations, then payments are made to each of them in full in accordance with the general calculation rules.

If within two years before the benefit was calculated, the employee was employed in several companies, then the amounts are paid from the funds of the current company based on the salary that the person received over a two-year period (they are displayed in the Certificate).

Expert opinion

Lebedev Sergey Fedorovich

Practitioner lawyer with 7 years of experience. Specialization: civil law. Extensive experience in defense in court.

The form of the paper must comply with the rules established by law. Order of the Ministry of Labor of the Russian Federation dated 2013, as amended 2021 No. 182 n, establishes the form of the certificate and the procedure for its issuance.

Since the legislator has established a unified form, the employer does not have the right to draw up the paper at his own discretion. For convenience, the person responsible for issuing the Certificate in the organization always has a template at hand.

The employee who deals with this issue may be a specialist:

• from accounting;
• from the HR department.

Therefore, if necessary, an employee should contact these departments of the enterprise to obtain a Certificate.

Reasons for recalculating sick leave after payment

The accounting department of an enterprise calculates sick leave based on the data it has. Along with this, they may be incomplete, for example, if a person works part-time or has recently joined a specific company. Considering that the basis is the average daily income for the last two years, it is beneficial for the employee to provide information from previous employers.

Reasons for recalculation

There are several grounds for recalculating already paid temporary disability benefits. These include:

1. The emergence of new information about the employee’s earnings, for example, receiving certificates of income from previous places of work.
2. Detection of facts of employee dishonesty - provision of knowingly false information about sick leave or salary.
3. Errors in calculations made by an accountant.

If management has doubts regarding the authenticity of the submitted documents, then an authorized employee has the right to submit a request to the Social Insurance Fund in order to clarify the information.

Regulations

The regulatory act governing the rules for recalculating sick leave is Article 15, Article 255 of the Federal Law. Let's consider several provisions of the document:

1. You can apply for benefits within three years after your right to it arises. If the payment did not take place due to the fault of the employer, the period is not limited.
2. Excessively transferred funds due to the fault of the accounting department will not be recovered from the person.
3. If inaccurate information about income or sick leave is discovered, leading to an overpayment, the employer has the right to write off up to twenty percent of wages as debt.

All of the above aspects apply to both temporary disability benefits and payments in connection with pregnancy and childbirth.

Billing period

In accordance with Article 14, Article 255 of the Federal Law, the calculation period for calculating sick leave benefits is two calendar years. Moreover, all 730 days are taken into account, without excluding weekends, holidays and other periods.

It is important to know! The period counts from the day the illness or other event subject to insurance began (the need to care for a relative, prosthetics, pregnancy, and so on). If a person had no income or it was less than the minimum wage, then the basis for calculation will be the minimum wage established in the region of residence.

An employee who was on maternity leave in the previous two years has the right to change the calculation period to the one when she worked. You cannot take any years, but only those preceding the insured event associated with the birth of a baby.

The need for a salary certificate

In order to legally recalculate the amount of compensation for the period of incapacity for work, you must provide your current employer with a certificate in Form 182H. It is issued to citizens in two cases:

• upon dismissal;
• former employees upon written request.

The employee has the right to receive the document for three years; it is during this period that he has the right to apply for disability benefits, which will take into account income from his previous place of work.

It is required to provide either the original certificate or a certified copy of the document (notarized or by the employer himself). Sick leave will be recalculated even if compensation has already been transferred. Based on the information received, the accountant will be able to determine the difference and transfer it to the employee.

If, for objective reasons, an employee cannot obtain a certificate from his former employer, then he submits a request to the Pension Fund for information about his income. This procedure takes more time, but is used in practice. As a rule, this is done if the company where the person worked is liquidated or located in another region.

Application for recalculation of sick leave after payment (sample)

According to clause 2.1 of Art.
15 of the Law “On Mandatory Social Insurance...” dated December 29, 2006 No. 255-FZ, the employer calculates the amount of sick leave benefits based on the documents that he has at his disposal on the day of calculation. But later, the employee can bring certificates of earnings from previous places of work, and on their basis the benefits are recalculated. You can recalculate only those sick leaves for which benefits were assigned no earlier than 3 years before the moment when the employee brought the certificate. IMPORTANT! Since 2021, the FSS pilot project has been operating throughout the Russian Federation. This means that the employer calculates benefits only for the first 3 days of illness of the employee. The remaining days are paid by the Social Insurance Fund directly to the employee’s card.

Read about the nuances of calculating sick leave in this material.

To recalculate benefits from an employee, you must receive an application in a form approved by the Social Insurance Fund. You can see a sample in ConsultantPlus by signing up for trial demo access to the system. It's free:

No later than five calendar days from the date of receipt of the application and certificate (certificates) about the amount of earnings, send them to the territorial body of the Federal Social Insurance Fund of the Russian Federation (clause 3 of the Regulations on the payment of benefits for VNiM in 2021). In addition, recalculate the benefit paid from the organization’s funds (for the first three days of illness).

ConsultantPlus experts explained how to correctly recalculate benefits if the employee brought a certificate from a previous employer. Get free trial access to the K+ system and proceed to the calculation example.

Recalculation procedure

The recalculation of sick leave on the basis of new certificates from previous places of work is of interest to the employee himself, so the initiative should come from him. This is done in two steps:

1. Obtaining data from previous employers in documentary form.
2. Submitting an application in free form with attached certificates.

Based on the received materials, the accounting department, firstly, checks the accuracy of the information, secondly, makes a recalculation, and thirdly, submits a request to the Social Insurance Fund.
The money is transferred to the employee within fifteen days with the next salary or advance payment. As noted above, if an employee cannot obtain a certificate from a previous employer, then he asks management to make a request to the Pension Fund. Based on data from the Pension Fund, additional payments are calculated and sick leave from the previous period is recalculated.

Recalculation procedure

If circumstances arise that have already been described above, the employer can independently change the calculations for previous years.

This is important to know: In what cases is sick leave paid 100 percent?

The employee has the right to submit an application for adjustment of the deduction amount. The application is written to the director of the enterprise or the head of a structural unit. It is compiled in free form.

There is no single template for writing a paper in the legislative norms, but an employee can ask the HR or accounting department about the availability of a template.

In order for the requirements to be satisfied, the applicant must attach the following documents to the application:

1. Certificate from a medical institution.
2. A document of the established form from the former employer.

If the documents are drawn up in violation of the law, the employer has the right to reject the application.

If everything is in order, the employer will not be able to refuse, since the scales are tipped in favor of the subordinate. The law in this case clearly protects the rights of the employee: if there is evidence for an increase in payments, and the citizen has substantiated the demands, then his application must be granted.

The statement is drawn up according to the rules that are usually used in business communication. Therefore, the petition states:

• details of the enterprise, full name of the manager, applicant;
• name of the paper;
• request for changes in the billing period;
• number and signature;
• Help is also included.

There is no statutory time limit for satisfying the applicant's demands, but it must comply with the rules of reasonableness of time. This means that once the request has been received and a decision has been made, the application must be processed.

The requirement must be complied with immediately. This will allow you to avoid misunderstandings with the employee and fines from the state labor inspectorate or the Fund.

The benefit during illness is accrued to the employee on the nearest date of payment of earnings, part 8 of Art. 13, part 1 art. 15 Federal Law No. 255-FZ. If there is a delay in payments, the employee is entitled to additional compensation provided for in Art. 236 Labor Code of the Russian Federation.

Expert opinion

Lebedev Sergey Fedorovich

Practitioner lawyer with 7 years of experience. Specialization: civil law. Extensive experience in defense in court.

As for changing the amount of benefits from the Social Insurance Fund, the application procedure is similar to that outlined. An application is also written addressed to the head of the Fund and the payment document corrected by the employer is attached along with a certificate of incapacity for work and a Certificate.

Following the above recommendations, difficulties with re-registration of the payroll period should not arise, since conscientious employers usually do not prevent their subordinates from exercising this right.

Recalculation of sick leave is permitted provided that an error was made in the initial calculation of the amount due to the employee.