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.
Sick leave for IVF in a private clinic
Both public and private medical institutions have the right to carry out the IVF procedure. At the same time, a private clinic must have the appropriate license. However, in practice it happens that the license is expired or has not yet been received. Such circumstances do not give medical staff the right to refuse to issue a document indicating a citizen’s incapacity for work. A simple certificate or extract from the outpatient book is required. Subsequently, based on these documents, the local doctor issues a sick leave.
Documents are issued on the actual date of all procedures. In case of refusal, one should refer to Article 68 of the Order of the Ministry of Health of 2011. This provision provides for the liability of medical institutions for refusal to issue supporting documents.
IMPORTANT
Complaints against private clinics must be filed with the Prosecutor's Office, Rospotrebnadzor or the courts. In case of violations in public medical institutions, you should contact the local Departments of Health.
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.
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;
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.
Design features
The ethical side of IVF is not fully settled. Many questions arise here, one of which is how to formulate the procedure on a sick leave certificate if a woman prefers confidentiality.
A typical document is worded something like this: “I order payment for the temporary disability of an employee due to pregnancy.” However, a case of IVF does not 100% guarantee pregnancy, but is only an attempt to achieve one. From this point of view, IVF can be considered a type of infertility treatment. But such wording is already classified as misleading the employer.
Additional Information
Considering the fact that the opening for a certificate of incapacity for work is the IVF manipulation, when issuing it, the doctor writes specifically about this procedure. A certificate from the clinic is issued on a general basis.
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:
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.
Payment
Carrying out IVF is not a special case and does not require a special approach to the workflow of a labor nature. When calculating wages, the period of release from work due to IVF is considered as a normal other illness. Accordingly, the calculation is made as per disease.
To obtain an accurate payment figure, each day on sick leave is multiplied by the average salary accruals for the last 2 years. Further, depending on the number of years worked, position and total length of service in a given company, salaries are calculated in the amount of 60 to 100%.
Regulatory framework
A sick leave for IVF is most often needed. This is a serious procedure that requires time and rest. Don't add work stress to the worries associated with IVF. A certificate of incapacity for work must be provided to the patient upon request. It is important to know the nuances of registration and comply with the deadlines for submitting documents. Then there will be no problems with registration of the BC.
The Order of the Ministry of Health, which came into force in June 2011 under No. 624 N, establishes the rules for the procedure for obtaining a certificate of incapacity for patients who are entering or have entered into an IVF protocol. According to the law, with IVF under compulsory medical insurance, the necessary documentation is obtained from the organization where the procedure takes place. Such an institution has the right to:
- providing services to eliminate gynecological problems;
- performing procedures to assess the patient's disability.
If an institution provides services for the use of ART, but does not have permission to issue BC, the patient can ask for the necessary extracts to require a document at the place of residence.
Women should have no doubt about whether sick leave is given for IVF. Artificial insemination refers to serious manipulations in which a woman is declared incapacitated for the entire period of in vitro fertilization.
How to conduct IVF confidentially
If a woman does not want to talk about the true reason for her temporary departure, then she can try to contact a government agency at her place of residence and get a certificate of incapacity for work for another reason. But this method may not work if complications arise and you have to extend your sick leave.
Another, more successful and proven way, is to do in vitro fertilization during your annual vacation. In this case, you won’t have to explain to your superiors where and why you need to leave.
But none of these methods will work if IVF is done according to a state quota and the date does not depend on the woman’s desires and plans.
Registration procedure
Whether sick leave is given for IVF in the selected clinic for the protocol, you need to find out in advance. Information can be obtained from the doctor who accompanies the couple in the program. If a medical institution has a license to issue a certificate of incapacity for work, then the patient must voice her desire to receive it. It is important to do this in a timely manner, since it will not be possible to obtain such a document retroactively. Registration falls on the shoulders of the attending physician accompanying the couple in the protocol, and the chief physician of the medical institution.
How many days do they give
A woman can independently decide how many days of sick leave she should take during IVF. The patient is declared incapacitated for the entire period of treatment with ART. The sick leave opens from the first day of the protocol and closes on the day of the hCG blood test. When closing the document, the doctor does not take into account the outcome of in vitro fertilization; the patient becomes able to work both when pregnancy occurs and when the IVF result is unsatisfactory.
Sick leave after IVF can be extended for a woman if, as a result of the procedure, she develops health problems that prevent her from working. Typically, disability is prolonged by ovarian hyperstimulation syndrome or if there is a threat of early miscarriage.
The patient can independently reduce the period of disability. Some women prefer to complete the document from the moment of puncture or only after cell transfer. There are cases where patients refused sick leave and combined work with the IVF protocol. This is a financially beneficial option, but during this period a woman should only think about her health in order to increase her chances of pregnancy.
What is written in the document and what code is included?
According to the law, during the IVF protocol, the document indicates the code “10 - other condition and manipulation.” If a woman does not want to tell her employer about her problems, then she may not do so. This code does not specifically talk about the artificial insemination protocol.
Sometimes local therapists accommodate the patient halfway and indicate other data on the sick leave sheet, for example, code “01 – disease”. Such sick leave is usually opened for a period of up to 14 days, and when extended, requires a consultation. Please be aware that this is incorrect information about the patient's condition and is a form of falsification of documents and entails liability.
If after IVF, regardless of the result, a woman is recognized as unable to work, the sick leave is extended and assigned the code “08 - follow-up treatment in a hospital.”
More and more organizations have recently switched to issuing electronic sick leave certificates. At the same time, paper media are still relevant. If the organization in which the patient works is registered on the FSS website, it is better to give preference to an electronic document.
Advantages of filing an electronic sick leave for IVF:
- minimal risk of errors;
- there is no need to store paper media and worry about possible loss;
- minimum time for document preparation, no need to pass papers from hand to hand;
- a certificate of incapacity for work cannot be faked.
What to do if a woman is refused sick leave
If the clinic has permission to issue and issue certificates of incapacity for work, then the woman cannot be refused to receive such a document. The only reason is the untimely provision of an extract from a private clinic.
If the local doctor refuses to issue a sick leave, citing the fact that artificial insemination is not a reason, the patient can safely contact the prosecutor’s office or court.
Registration of a certificate of incapacity for work during the procedure
To obtain a certificate of incapacity for work, you must provide an outpatient card with all extracts and conclusions, as well as specific dates and names of procedures to the medical institution where the IVF procedure is carried out, or at the place of registration.
If the certificate is not obtained from the organization conducting the embryo transfer procedure, then the outpatient card and all accompanying documents should be requested in advance at the place of receipt of services.
In cases where a medical institution refuses to issue documents or open a sick leave certificate, you should contact the prosecutor's office or the Department of Health. If none of the listed authorities is able to exert influence to resolve the conflict situation, it is necessary to write a statement to a higher authority - the court.
Remember that neither a private clinic licensed to provide the relevant services, nor a budgetary medical institution can refuse a patient to receive a certificate of incapacity for work without obvious reasons, since this right is legally confirmed.
Maternity leave for IVF
Maternity leave with IVF begins a little earlier than with natural conception. Pregnancy resulting from artificial insemination is considered complicated. It often leads to the birth of twins.
Maternity leave for women after IVF begins 84 days before the expected birth and continues for another 110 days after it. The average number of sick days in this case will be 194.
Often, expectant mothers who have undergone an IVF procedure encounter difficulties in calculating sick leave for pregnancy and childbirth. Experts find it difficult to choose the starting date for the gestational age. It is correct to count the weeks of pregnancy from the first day of the last menstruation, regardless of the type of IVF protocol.
At the stage of preparation for in vitro fertilization, it is important for a woman to study not only the medical aspects of the procedure, but also the regulatory side. This will help protect your rights in controversial situations and defend your legal rest during the protocol.
How long does in vitro fertilization take?
In vitro fertilization is necessary when a girl or woman is unable to become pregnant naturally. It is necessary to conduct an examination and identify the cause of infertility. In some cases, reproductive specialists may offer their services. But you need to understand that it is almost impossible to do IVF in municipal clinics; you need to go to private ones. This is where some problems begin, since the state requires sick leave from a public clinic to receive some benefits, and when observed in a private hospital, the document will be issued there. But nothing prevents you from going to both clinics at the same time.
The duration of IVF may vary. It is necessary to take hormone tests so that doctors can determine what exactly needs to be done at the preparatory stage to increase the likelihood of pregnancy. It is advisable that the woman does not work at this time. She will need to visit the doctor often, and also need to create greenhouse conditions away from stress. Therefore, doctors recommend receiving a certificate of incapacity for work at an early stage, that is, during preparation.
Important . The duration of IVF can take from several weeks to several months, depending on the required preparatory stage and the speed of obtaining the desired result. Therefore, it is impossible to say in advance how long this procedure will take.
Doctors' opinion
The opinions of doctors themselves on this issue are different:
- Some believe that a sick leave after IVF (after embryo transfer) for a period of two weeks is necessary, this guarantees the absence of fatigue, overwork and nervous stress, and therefore will significantly increase the likelihood of a positive IVF result.
- Other experts are of the opinion that if working conditions are not associated with heavy physical exertion, then issuing a certificate of incapacity for work is inappropriate. Sick leave should be issued depending on individual indications, and if the patient does not have any serious complaints and everything goes according to plan, then this is not at all necessary.
However, in any case, in accordance with the law, a woman has the right to demand a certificate of incapacity for work for the entire period of the IVF procedure - not only from the moment of embryo transfer, but also from the very beginning of the IVF protocol.
Possibility to refuse a certificate of incapacity for work
A potential mother may not go to the newsletter while continuing to work. When the work is quite urgent, but not of a production type, then you can negotiate with the employer. Usually, in order not to let an employee go to work for a long period of time, he agrees to move his workplace home. This requires:
- install the necessary software on your home laptop/computer;
- provide the necessary access;
- configure the communication line if necessary.
After this, the specialist will be able to perform the necessary actions in preparation for IVF. In this case, you will not need to often take time off to visit the required doctors. This way of working suits many managers, accountants, staff of recruitment agencies, and so on.
When is sick leave issued for IVF?
Doctors recommend issuing sick leave at an early stage, when a woman is just preparing for the procedure. But you can refuse it until the embryo is placed in the uterus.
Important . You need to pay close attention to the first week after placing the fertilized egg in the uterus. The success of a further pregnancy depends on how the embryo attaches to its wall. Therefore, it is necessary to protect the potential mother from stress. It is also recommended to take vitamin complexes so that the unborn child receives everything necessary for normal development.
The most important week after fertilization is the first week.
After placing the fetus in the woman’s body, a sick leave certificate is issued without fail. Failure to follow the doctor's recommendations can ruin the results of IVF.
The nuances of issuing sick leave
You can get it only in licensed clinics (Order of the Ministry of Health and Social Development No. 624, Article 54). So, there must be permissions:
- for gynecological activities;
- for examination of incapacity for work.
The law provides for the issuance of sick leave for the entire period of IVF: stimulation, ovulation, embryo transfer, and so on.
A sick leave must be issued for the entire period of IVF.
Important . If a private organization does not have a license to provide certificates of incapacity for work, then the woman must go to the hospital at her place of registration. Having provided the necessary documents, she will receive the desired paper.
Features of contacting a therapist for a bulletin
Sometimes women do not want their employer to know that they have problems with their desire to have children. In this case, it is possible to go to see a therapist. This doctor can issue a bulletin up to 15 days. Usually this is enough for the embryo to attach to the wall of the uterus and begin to develop normally after implantation.
Concealing problems with conception is an important argument against sick leave
Almost all doctors strongly recommend taking a break from work for 14 days after undergoing IVF. However, this is only a woman's right. Therefore, if she does not want to leave work temporarily, no one will force her to stay at home. But all potential risks must be taken into account. This is very relevant if you remember the cost of IVF. The cost varies in different cities and clinics, but on average it is 100 – 170 thousand rubles.
Nuances
There are times when it becomes necessary to extend sick leave for IVF. However, there really must be a reason for this. If you feel unsatisfactory or there are recommendations from your attending physician to follow a special regime, you should contact the antenatal clinic at your place of residence.
Many women are concerned about privacy at work. The information on the sick leave certificate will be indicated as it is - that the employee was absent for IVF. Not attending work for several weeks, while remaining unnoticed by the employer - this is impossible in stationary work.
Taking into account the experience of other women, we can only recommend one thing - to try IVF during the holidays. Then there will be no need to issue a certificate and worry about confidentiality.
There is another option when a woman cannot predict the date of IVF in advance - a state quota. Many citizens strive to obtain a quota. The procedure is quite complex and is subject to strict rules. If it is completed, then there is no way to postpone the procedure for a convenient time; you will have to take out sick leave and visit the clinic.
A quota for IVF is issued on the basis of an official diagnosis of infertility. There are types of infertility established by the state, in which IVF is recommended as the only chance to have a child. But the clinic may require you to re-examine and take tests. In any case, it is worth striving to obtain a quota, since paying for IVF yourself is quite expensive.
