How to calculate and pay sick leave for a work injury

Last modified: January 2021

One of the main responsibilities of an employer is to ensure the safe work of its personnel. But since all risks cannot be completely eliminated, but can only be minimized, accidents at work periodically occur. Their results include damage to the employee’s health, followed by temporary or permanent loss of his ability to engage in active production activities. In this case, the employer must pay sick leave in case of a work-related injury at the enterprise.

What injury is considered work-related?

Anything can happen at enterprises, various factories, even private firms. People can be harmed while performing daily job duties. Security rules have been introduced in organizations to prevent this, but it is impossible to foresee everything.

An injury that occurs while performing one's job duties is called an occupational injury. Table 1

If an employee is injured, the employer must pay him the required compensation. In addition, keep the place while the citizen undergoes treatment and subsequent rehabilitation.

Not every injury is considered a work-related injury.

Table 1

All officially employed citizens carry out activities under a contract.

Differences between domestic and work injuries

It is important to remember that not every injury that a person receives, even at work, is classified as industrial. The latter include injuries received during the working day while performing official duties or on a business trip, also on the way to the place of business trip.

Trauma, in turn, happens:

• severe (if the person who received it needs at least a month to recover);
• moderate severity - up to a month;
• mild (the ability to work is not lost at all, first aid is sufficient).

The remaining damage is considered not work-related and is classified as household damage. It is enough to go to the emergency room and then fill out a standard disability certificate.

With industrial damage, everything is different. In order to clearly establish that the injury was industrial, a special commission is assembled for an internal investigation. If everything is confirmed, a special act is drawn up and then a ballot is issued.

To establish an industrial injury, a special commission is assembled for an internal investigation

The legislative framework

A special commission must recognize the incident as a production incident .

It is created to investigate an accident that happened to the injured employee while he was at work:

· near running dangerous mechanisms;

· workplace, including a regular office;

· on the road towards the enterprise - by work/personal transport ;

· during work, lunch break, changing clothes before/after shift;

· business trip;

· outside the enterprise when performing this official assignment;

· on a ship – the period between shifts;

· eliminating an accident that occurred at work.

Legislation takes into account various factors. After all, people can really get hurt at any time. For example, due to equipment breakdown that occurred outside their competence. This often happens when workers violate accepted safety rules.

The commission must identify the details of what happened, the culprit and understand how to prevent this from happening in the future.

According to the provisions of Article 227 of the Labor Code of the Russian Federation, the main factors that can cause temporary/permanent loss of ability to work (injure a citizen) at work are:

· damage caused to him by another person;

· a fall;

· exposure to the elements (natural forces, electricity, ice, radiation, heat);

· animal and insect bites;

· explosions, accidents and other disasters;

· other emergencies that arise due to which people suffered, they had to undergo long-term treatment, change jobs, they permanently lost their ability to work or died.

Not only the injured worker can receive compensation. If another person became a victim: a trainee, an invited repairman, an investor, a guest of an enterprise, a media employee, an accident liquidator, he has the right to claim financial compensation.

Occupational events leading to compensation

All cases of death or injury while performing the manager’s tasks are subject to a thorough investigation by commissions formed from among the organization’s officials and the labor inspectorate. An accident can happen to a person working under an employment agreement, part-time, or performing a one-time order from a manager under a contract in the interests of the enterprise.

Such employees include:

• persons who carry out practical training or are in training;
• persons performing simple work in occupational therapy – with a mental diagnosis;
• convicts serving a sentence of completing compulsory hours of labor service;
• persons involved in labor in the form of administrative punishment;
• individual entrepreneurs and farmers (members of cooperatives, industries, farms).

All cases of injuries at work are considered by special commissions

Important! If a person performs a labor function and a workplace is assigned to him, but the relationship is not formalized by an agreement, the fact of the relationship is proven in court.

The procedure for investigating an emergency incident

When something like this happens, it is important to determine whether it is a work-related injury and whether compensation will be awarded from the Social Insurance Fund (this is the Social Insurance Fund).

As soon as the employer finds out about the fact of the incident, he writes a special order, where he approves the list of people - the composition of the commission that will conduct the investigation:

· occupational safety specialist;

· representative of the manager (if the enterprise is private, then individual entrepreneur);

· representative of a trade union/elected body.

The composition of the commission is expanded if several people were injured in the incident or someone died:

· state labor inspector;

· representative of the municipality;

· member of the local territorial association of several trade union organizations;

· Social Insurance Fund employee – if there is an insured client among the victims.

The victims of the incident themselves cannot participate in the commission, but they have the right to be witnesses to what is happening. At the same time, tell the details of the accident.

The legislation establishes the time frame for investigation – 3-15 days . After which the commission must provide a comprehensive answer.

The victim, no matter how serious his injury, must be examined by a doctor . Only he, after taking tests, studying ultrasound images and other manipulations, can reveal how serious the situation is. And confirm the fact of the citizen’s temporary/permanent loss of ability to work.

Payments are due if a medical examination officially confirms the relationship between the injury received and an insured event that occurred earlier at the enterprise.

Doctors determine how severe the injuries have become:

• Severe - injuries that pose a serious threat to life: multiple or complex bone fractures (spine/hip/rib/clavicle/leg), blood loss, onset of coma, impaired functionality of a particular organ or system, concussion, temporary/permanent hearing loss/ vision, mental disorder, burns, heart damage.

• Mild degree - minor bruises, broken limbs, frostbite, sprains, termination of pregnancy (the latter is controversial).

The severity of the injury will determine the amount of compensation due.

Current changes

A special procedure for recognizing the degree of disability is valid until March 1, 2021

According to it (Resolution of the Government of the Russian Federation of October 24, 2020 N 1730), examination of citizens in ITU institutions in order to determine the degree of loss of professional ability to work is carried out without personal participation, that is, in absentia. Also, the degree of loss for citizens whose re-examination period occurs in the period from October 1, 2020 to March 1, 2021, in the absence of a referral to medical examination issued by a medical organization, is carried out by extending the previously established percentage of loss of professional ability. It is possible to conduct an in-person examination of citizens (at their request) in case of appealing a decision to a higher bureau.

New criteria for the degree of loss of professional ability to work as a result of industrial accidents and occupational diseases - from July 1, 2021

I degree - persistent minor dysfunctions of the human body caused by an accident at work or occupational disease, in the range from 10 to 30 percent; II degree - persistent moderate impairment of the functions of the human body, caused by an accident at work or occupational disease, in the range from 40 to 60 percent; III degree - persistent severe impairment of the functions of the human body, caused by an accident at work or occupational disease, in the range from 70 to 80 percent; IV degree - persistent, significant impairment of the functions of the human body, caused by an accident at work or occupational disease, in the range from 90 to 100 percent.

What you need to prepare to receive an accident report

To draw up a report on the presence of an accident at work, a business entity is required to prepare the following package of documents:

• order from the manager to form a special commission that will investigate the circumstances of the accident
• documents from the occupational health and safety department indicating that an employee has suffered a work-related injury
• entry from the logbook about an accident at the enterprise
• other documents and evidence indicating that an accident occurred in the organization

What payments can victims expect?

According to the law, citizens are entitled to:

· payment due to temporary disability;

· one-time payment from the Social Insurance Fund;

· monthly insurance support;

· additional payments – compensation of medical expenses.

The list of payments can be clarified by visiting the territorial branch of the Social Insurance Fund. Also study your employment contract, there is a clause dedicated to emergency situations and the procedure for resolving them.

Compensation for lost earnings due to a work injury for an employee

According to the labor code, payment for lost earnings for an employee from the employer will occur on sick leave. After the incident, the employee was treated and could not work for some time - he is entitled to 100% compensation for absenteeism. If, at the end of the sick leave, the employee returns to work, then, as a rule, compensation is expressed in the fact that the employee receives from the employer at the end of the month his standard monthly salary without any deductions. Or several months’ salary at once, if the work injury was serious. Remember that the employer does not have the right to deduct money for sick leave.

How much is a lump sum payment to an employee in case of injury?

A one-time payment to an employee from an employer means compensation for medical expenses in the event of a work-related injury. If we are talking about a serious injury with long-term disability, for example, an eye injury, then the employee can count on compensation from the employer or the Social Insurance Fund for monthly compensation. A one-time monetary compensation applies exclusively to measures that are necessary to restore the employee’s health to the maximum extent possible. It is easy to calculate from documents. The calculation procedure is very simple, we discussed it above.

Sick leave payment: how it is calculated

According to Federal Law 125 (Article 9), the employer pays for hospital treatment for the injured employee. It doesn’t matter how many years he has worked at this enterprise and what position he holds.

The amount of compensation is calculated based on the citizen’s average earnings, taking into account the last 2 years.

You can use a simple formula:

P = C x 24 months / 730 days x D.

Explanation of concepts:

• P – the benefit itself;
• C – monthly income;
• D – treatment period.

If a citizen’s salary has changed, this is taken into account.

Example:

The employee’s salary was 30,000 rubles, subsequently his salary increased - 42,000 rubles. After 5 months of work, an accident happened. The period of treatment completed by a citizen is 20 days. Then the calculation will be like this:

(30000 x 19 + 42000 x 5)/730 x 20 = 21369.86

It can be seen that the periods when he received the usual (30,000) salary and an increased one were taken into account.

Additional payments for rehabilitation

Rehabilitation payments are payments for additional expenses associated with restoring health.

The following expenses are reimbursed:

• medical care, including primary, high-tech;
• purchase of medical drugs and products;
• payment for medical and household assistance when caring for the victim, including family members;
• travel of the victim and his accompanying person (if there are medical indications) to the place of sanatorium-resort treatment;
• costs of sanatorium-resort treatment;
• production, repair of prostheses, orthoses;
• vocational training.

One-time payment

According to the provisions of Federal Law No. 125 (Article 11), a one-time payment is financial assistance, which is calculated and subsequently transferred to the Social Insurance Fund depending on the degree of disability a person has lost. It is determined by doctors.

In addition, 2 other indicators are taken into account: the maximum annual benefit and the value of the regional coefficient (when established). It turns out, following the content of Federal Law-417 (1 article), the one-time insurance payment due to citizens is calculated at 101,689 rubles .

Temporary disability benefit due to an accident or occupational disease (100% of average earnings, but not more than the maximum amount - RUB 334,011.59) for 2021.

How is sick leave paid for a work injury?

The payments in question are provided according to the standard rules provided for sick leave. They are issued on the basis of the following documents:

• a certificate of incapacity for work, which indicates the reason - industrial injury (code 4);
• act N-1, the data from which contains the sick leave.

The final amount provided may vary depending on the indicators. When calculating, it is necessary to take into account the funds paid for social security during the billing period. Payment for sick leave for an industrial injury is generally calculated using the formula:
Ppr.t. = ZPsr.d. x db. Ppr.t. – benefits paid in case of industrial injury; ZPsr.d. – average daily earnings (must not exceed the limit); DB – number of days of incapacity for work (period under consideration – 1 month).
When determining average earnings, all payments made for accidents during the billing period (two years) are considered. The formula is as follows: Payments are funds transferred to the Social Insurance Fund “for injuries.”

When calculating sick leave, the entire amount of average earnings is considered (and not a percentage of it), and regardless of the length of insurance coverage. This is what the Law on Compulsory Social Insurance No. 128-FZ says.

Also see “100% sick leave: when paid in full.”

In cases where the employee did not have payment for work, the calculation for the injury is based on 24 minimum wages. A similar rule is established for incomes not exceeding this value.

Also see “Minimum wage in 2018 for calculating sick leave.”

If an intoxicated worker is injured, a dispute may arise with the Social Security Fund. We recommend that such persons be sent home immediately and subsequently take disciplinary action.

Also see “In what cases is sick leave not paid?”

Monthly payment

According to the provisions of Federal Law No. 125, citizens are entitled to monthly financial assistance. It is calculated using the monthly (average) salary of a citizen for the 12 months preceding the case as a basis.

Only the months he worked are taken into account. The degree of injury (loss of ability to work) identified by doctors, regional and all other coefficients are used. Moreover, the size of the latter depends rather on the time (year) of the payment. For example, for affected citizens receiving assistance later than 2021, a coefficient of 1.04 was used in the calculations.

The maximum assistance provided monthly is 78,189 rubles (provisions of Federal Law-417).

Example:

The citizen worked regularly, receiving an income of 32,000 rubles. After the incident, the degree of his injuries was revealed to be 40%. The region where he lives does not use odds.

Benefit:

32000 x 0.4 = 12800 rubles

This amount will be transferred to the citizen monthly.

Important! If a person dies as a result of a work injury, his relatives will receive 1,000,000 rubles .

Procedure for receiving payment

Payment for rehabilitation is due after the medical commission determines its necessity. The same benefits are not provided for several reasons. This means that a person claims either as a victim of an accident, or as having, for example, the status of a disabled person. The algorithm of actions is as follows:

Step 1. The insured forms a package of documents:

• act on NS;
• ITU conclusion on the degree of loss of ability to work;
• a document confirming the existence of labor relations between the employee and the employer (employment agreement, work book);
• certificate of average earnings;
• rehabilitation program approved by medical experts.

Step 2. The insured submits an application with a package of documents in person, by mail, through the MFC or the government services portal.

The FSS reviews the documents within 10 days. Then, within another 3 days, the order is approved to assign the amount of payments or to refuse.

The amounts are sent to the person within 20 days after a decision on them is made.

Compensation for monthly expenses

A victim who was injured at work must be compensated for the money he spent on rehabilitation.

Learn important things: Sick leave pay and labor relations rules during coronavirus

The assistance covers the following purposes:

· medical service;

· purchasing medicines;

· payment for a hired nurse or caregiver;

· travel of the patient to the place of treatment , for the medical examination procedure, for rehabilitation (in a sanatorium or other institutions);

· sanatorium treatment;

· production of prostheses;

· provision of equipment and transport for disabled people;

· retraining (if, due to injury, a citizen cannot return to his previous job).

This assistance (excluding primary care) is provided by the insurer, in accordance with the rehabilitation program established by doctors.

What to do in the event of an accident

Injury at work requires a consistent response established by law for the employee and the employer.

First of all, management is obliged to provide first aid to the victim or ensure timely delivery to a medical facility. Sequence of further actions:

1. Determine precisely the circumstances under which the injury occurred (location, causes).
2. If the injury is truly industrial and not domestic, the date of the incident is recorded.
3. Receive an application from the employee to conduct an investigation into the incident and pay sick leave benefits, since the organization is obliged to compensate for the damage.
4. Pay monetary compensation ( sick leave pay for a work injury ) provided for such cases.

How to get

Unfortunately, the mechanism for calculating and sending financial assistance is not automatic. The victim needs to take some actions on his own.

However, instead, if the patient cannot move, they can be performed by a relative or trusted person:

1. Contact your immediate supervisor, taking your sick leave. Write a statement expressing your request for benefits due to temporary disability. The employer will have 10 calendar days to study the request and make a decision. The payment will be transferred to the regular payday.

2. Visit the FSS to take a one-time and one monthly payment there. Why prepare in advance the documents necessary for the Fund (you will need an Accident Report, a copy of the work record book, the original ITU (examination) report, your income certificate).

Supplement them with a statement written in your own hand and submit to the FSS. Can be by mail or in person. If the FSS branch is far away, send it through the MFC.

3. Employees will for the next 10 days . Then they will convey the decision to the citizen, documenting it in writing. a one-time payment during this month (when he received the decision), and a monthly payment no later than the end of the specified billing month.

4. Supplement the previous FSS application with another statement indicating a request to cover the costs incurred by the citizen due to treatment. Financial support will be provided if the doctors’ conclusion includes long-term treatment and subsequent rehabilitation.

The application should be accompanied by relevant documents - doctors’ verdict, receipts and other papers reflecting the amount of expenses.

5. The decision is also made within 10 subsequent days . And payments are for 20. Compensation for individual waste is due monthly or quarterly. For example, a nurse is paid monthly.

The authorized person performing the above actions instead of the injured citizen must have a notarized power of attorney. And provide it along with other collected documents.

Examination process

The expert institution begins to investigate the facts and determine the causes and consequences after receiving an incident report. The victim, organization or insurer turns to experts. Disability is established for a period determined by the commission or permanently if the damage was particularly serious. If you disagree with the medical examination, its conclusion can be challenged in court. If the insured person evades the examination without any justification or good reason, or a scheduled examination by experts, the insured person may be deprived of a monthly payment.

Sometimes, due to injuries at work, a citizen may be diagnosed with a disability.

The act indicates the degree of guilt of the victim in percentages, which are taken into account when determining the amount of payment. It cannot be reduced by more than 25%.

Important ! The payment cannot be reduced if the accident resulted in the death of the victim.

If it is established that the insured has direct intent to cause grave consequences, compensation payments are not paid to the victim.

If, during the investigation of the accident, specialists established the employee’s intent, no payments will be made to him.

Payments due to certain categories of employees

People who were injured while performing their civic duty: military, firefighters, police, rescuers or employees of the OIC are entitled to more payments than ordinary citizens.

Employees of the Ministry of Internal Affairs are entitled to Federal Law-52

The above compensations are indexed.

In order to qualify for legal benefits due to a work-related injury, the employee must confirm its existence.

The main documents to be provided to the employer and the Social Insurance Fund are:

· sick leave – where the injuries sustained are described , and the cause of disability is listed as code “04”;

· an act describing the accident.

An accident must be examined by a commission before all payments are made. And provide a detailed verdict.

What you need to know

An industrial injury is an injury that was received by an employee as a result of the performance of his job duties. An injury at work leads to temporary or complete loss of ability to work, as a result of which the employee may be assigned a disability group.

The causes of industrial injuries include the following:

• non-compliance with safety regulations at work
• Negligent attitude to the rules and frequency of safety briefings
• permission to work for an employee who does not have the appropriate education or qualifications
• equipment malfunction resulting in incorrect operation of the mechanism
• employee mistakes

Before recognizing a work-related injury, it is necessary to carry out an appropriate investigation, the results of which are recorded in special documentation.

Employer Responsibilities

Any leader is a responsible person. He must not only manage his subordinates, but also provide them with safe and comfortable conditions.

If an employee is injured as a result of an accident at work, the supervisor must:

1. Take measures to ensure that the victim receives the necessary medical care (there must be a medical worker and the necessary equipment at the enterprise). Call an ambulance.

2. Prevent the dangerous development of the emergency so that other employees do not suffer. For example, turn off the mechanism due to which a person was injured, stop production. Tell other employees to stop working.

3. Restrict other people’s access to the scene of the incident and keep the situation unchanged.

4. Look for witnesses and interview them. View cameras, if available.

5. Draw up an act reflecting what happened.

6. Write an order approving the composition of the commission responsible for conducting the mandatory investigation.

7. Fulfillment of other obligations established by law.

You cannot hide what happened and try to hush up the consequences. This is illegal, and may lead to other similar cases.

It is better to investigate the facts of the accident, and after the investigation, initiate equipment inspections and take other measures to help prevent other accidents. A more detailed memo on the actions of a boss in the event of an injury to a subordinate and what responsibility awaits is in the article.

Payments

After the occurrence of an insured event, the victim has the right to compensation. Minors and incapacitated family members have the right to maintenance if the employee is seriously injured or dies. The fact that a minor is dependent does not require proof.

Payments in case of death at work are received by:

• minor dependents up to 18 years of age, with full-time education - up to 23 years of age;
• persons who have reached retirement age;
• disabled people for a period, establishing a group;
• an interested person raising a child of the deceased until the ward reaches the age of 14;
• persons recognized as dependents of the deceased by a court decision.

If the deceased employee was dependent on his relatives and (or) interested parties, payments will be made to them

Types of insurance compensation.

1. Disability benefits.
2. One-time and monthly payments.
3. Payment for medical care on the territory of the Russian Federation, compensation for the purchase of additional medicines, if there is a cause-and-effect relationship between the insured event and additional treatment costs.
4. Compensation for the costs of providing individual care and care.
5. Compensation for transportation costs associated with treatment and routine examinations, for the purchase of prostheses, to the place of examination.
6. Providing a vehicle if a disability group is established, the inability to move independently.

The employer is obliged to pay an employee who is injured at work, disability benefits, medical care, and transportation costs.

Important . Moral damage is compensated by the person found guilty of causing harm.

If the employer is at fault, the victim is compensated for moral, material damage and lost earnings.

UtZ = СрЗ/24 (number of months).

UTZ - lost earnings.

Average earnings for two years.

The calculator below will help you calculate your lost earnings.

Go to calculations

If the minimum wage value is larger, then it is used.

If the accident is the fault of the employer, the victim is compensated for moral and material damage

Employee actions

Having received an injury, he must first take care of himself and his health:

· after waiting for the first necessary aid to be provided, visit a medical facility where you can undergo an examination (if an ambulance was not taken away);

· follow the recommendations given by your doctor and undergo treatment.

Collect all incoming documents related to this incident: doctor’s report, initial examination report, recommendations, conclusion issued by the medical board. This will help you process payments later.

He provides the employer with the following documents:

· certificate of incapacity for work , written out by a doctor (injuries and the diagnosis are indicated there);

· certificates, receipts, checks - reflect the cost of the treatment received, medications purchased and various medical devices;

· a statement written in your own hand, which includes a request to reimburse expenses.

Based on the papers, the accounting department will calculate the amount of all expenses incurred by the citizen.

Procedure for assigning payments

To assign compensation payments in the event of an insured event, the victim or interested person submits an application to the social security authorities. The application with attached documents is submitted by mail, in person or through the State Services portal.

The documents that need to be provided are listed below.

1. Passport.
2. An act in the approved form (about an accident).
3. Conclusions of the labor inspectorate.
4. A court decision that established the fact of an insured event.
5. A document recording work activity.
6. Agreement on the fulfillment of the employer's assignment in the organization.
7. Final diagnosis.
8. Commission examination.
9. Certificates, receipts, checks for rehabilitation expenses, recommendations for restoring health.
10. Document on family composition (in case of death).
11. Decision on the fact of dependency.

You need to submit an application to the Social Insurance Fund in the event of an accident and attach certain documents to it

There are 10 days to make a decision, and 2 days in case of death.

All legal facts are proven in court and confirmed only after the judicial act comes into force. In case of delay in compensation payments, the employer pays penalties to the victim in the amount of 0.5% of the amount per day of delay. In this case, the victim can contact the insurer with a claim for payment.

Benefit calculation

Carried out by the employer (accountant of the enterprise) in accordance with the amounts and rules adopted by law. The figures are indexed annually.

Calculation process:

1. The average earnings of the victim himself (his income received for the 2 previous years is divided by the number of days of that period - 730).

2. The finished value is immediately multiplied by the actual number of days of treatment .

3. Work experience is not taken into account here, because the benefit will be 100% of the final amount (if there is no fault of the victim).

4. The resulting value is compared with existing legal restrictions. For example, the maximum benefit established for 2019 is 300,728 rubles . When the victim’s income is higher than this figure, his payment is calculated on a daily basis, counting: 9,892.37 rubles X working day.

In 2021, the numbers will not be much higher; if indexation takes place, the data will appear later.

5. When paying, personal income tax is always withheld , and the day of payment coincides with the usual day of issuing the (nearest) advance/salary.

If the victim dies, his relatives are entitled to 1,000,000 rubles , without settlements.

Calculation of compensation covering hospital expenses includes:

1. Identification of the amount of average income (again, the value of a citizen’s two-year earnings is divided by a period of 730 days).

2. The calculation always takes into account the employee’s full income - the initial salary, after an increase. Without inclusion of the specified limit value.

3. The final value is multiplied by the actual number of days of treatment (sick leave period).

4. When the average salary is below the minimum wage, then the minimum wage is taken instead. (for 2021 12,793 rubles)

5. Personal income tax is always deducted from benefits; this is an obligation described in the content of Article 217 of the Tax Code of the Russian Federation.

The benefit is paid on the usual advance or salary day.

What determines the size of the benefit?

The amount of sick leave benefits is 100% of the employee’s average monthly earnings. Average earnings are taken for the previous calendar year without taking into account how much work experience the employee has. The benefit cannot exceed the established limit - RUB 300,728. In addition, he is entitled to a monthly insurance payment in the amount of 75,182 rubles. and a one-time compensation payment amounting to RUB 97,778.70. In the event of the death of an employee, his relatives receive 1 million rubles.

Let us note an important point: the sick leave must contain a code for the cause of disability - 04, but medical organizations may not put it down if there is no report on the presence of an accident. Sick leave must be paid only if the reason for incapacity is indicated. If there is no coding, the document is returned to the employee for re-application to the medical institution in order to correct it.

FAQ

Galina Narrowed

Practicing lawyer, providing consultations, representation in court, writing articles

Will the lump sum insurance payment increase in 2021?

The one-time insurance payment for an accident at work should increase from February 1, 2021. Like many payments after planned indexation. This is not a targeted increase, but indexing. The monthly payment amounts are in the table above in this article.

How is disability determined in case of injury at work and accidents during self-isolation or quarantine?

Currently and until October 2021, the procedure for determining the degree of disability is simplified. The procedure takes place in absentia, without the victim’s requests. The results are reported by letter or by telephone.

Will every incident at work be considered an injury?

In practice, there are several types of injuries that will definitely be recognized as work-related: 1. The employee performed duties under an employment contract 2. Did something on behalf of the boss (this can be confirmed) 3. Went to the workplace or returned

What benefits am I entitled to in case of an accident at work?

Temporary disability benefit - paid by the employer One-time payment and monthly payments - Social Insurance Fund based on the application Additional expenses that are required based on the conclusion of the commission

Mandatory actions of the employer

The employer's responsibilities in the event of an accident are stipulated in Article 228 of the Labor Code of the Russian Federation. This norm defines the following algorithm of actions:

1. Take measures to organize first aid to the victim.
2. Prevent further development of the emergency situation.
3. If possible, keep the scene of the incident intact.
4. Interview witnesses.
5. Conduct an investigation into the circumstances of the incident, for which purpose form a commission, and based on the results of the investigation, draw up a report on the industrial accident (the report is drawn up according to the number of victims).
6. If the accident was a group accident (two or more people were injured) or serious (resulting in the death of a person), the employer is obliged to report it within 24 hours to the prosecutor's office, the labor inspectorate, and the regional government by sending a notice. It is imperative to report any accident to the Social Insurance Fund, since the Social Insurance Fund will make payments to the injured citizen.
7. Fulfill your legal obligations to compensate the victim.

Consequences for the employer

An accident affects more than just the victim. The manager also bears responsibility, even greater than that of an ordinary employee.

If the cause of the incident was violations related to labor protection, the employer will face administrative, possibly disciplinary or criminal liability.

Applicable measures:

· reprimand (written/oral);

· termination of his employment agreement;

· fine, payment of compensation;

· suspension of production until the completion of the investigation conducted by the commission;

· if there is a death of a person - restriction of freedom, criminal investigation, administrative work.

The commission's findings will be taken into account. Law enforcement agencies may be involved.

What threatens the employer

The consequences for the employer of an injury at work depend on the reasons for which it occurred and the severity.

A group or severe case will necessitate the creation of a trauma investigation committee. The commission includes employees of the enterprise, the labor inspectorate, the Social Insurance Fund, the regional trade union, and the administration. The commission is initially not loyal to the employer. The fine depends on the violations and consequences.

Memo in case of injury at work for an employee

1. The injury was received only in the performance of official duties and is then recognized as work-related. Sometimes, with a vague job description that does not cover all cases of life, it is necessary to prove that the damage to health was caused due to a direct connection with the performance of work functions

2. Documentation of the injury is mandatory, otherwise the employer will disown it

3. Notify management after being checked into a medical facility

4. If it is not possible to collect documents yourself, then a power of attorney is issued by a notary

5. The victim has the right to count on all legal payments, subject to an employment contract and a white salary. With black wages, the situation is different; the fact of the existence of an employment relationship takes a long time to prove

6. The severity of the injury and loss of ability to work is the basis for monthly and one-time payments

Occupational diseases

04/30/2003 Resolution No. 76 of the Chief Sanitary Doctor of the Russian Federation recorded in the table the harmfulness and proportion of acceptable chemicals in production.

Categories of occupational diseases are indicated and approved by order No. 417n dated April 27, 2012 by the Ministry of Health and Social Development of Russia in the list:

• chemical poisoning;
• occupational exposure;
• biological component;
• overstrain of the body and overload.

The procedure, conditions and mechanism for conducting an investigation into occupational diseases acquired at work are regulated by the Government of Russia. Resolution No. 967 (December 15, 2000) regulates the application of the established Procedure for recording and investigating diseases (acute and chronic poisoning).

Excerpt from Russian Government Decree No. 967

Acute poisoning is a harmful single exposure to the human body or body of chemical substances that lead to loss of ability to work.

Chronic diseases are harmful effects on the body for a long time of factors that led to the acquisition of one of the disability groups.

Important! The state supervision center, after receiving information about the harmful effects on the employee’s body, begins an investigation within one day, draws up a description of the conditions for performing a work function in production and sends it to a medical institution.

The victim controls the progress of the investigation and, if he disagrees, supplements the description with his own objections. After a diagnosis of an “occupational disease” is made, the employee is sent for a lengthy examination, where a final diagnosis is made. The findings of the medical examination are sent to the employee and the insurance company. An examination is carried out at the pathology center, where the diagnosis is approved or canceled. All interested parties are notified of the conclusions of the examination. The report records the diagnosis, the nature of the disease and the organization where the incident occurred.

The employee is required to undergo a medical examination to make a specific diagnosis.

Compensation amounts are calculated and paid in the interests of the interested person from the funds of the Social Insurance Fund and the organization in accordance with Federal Law No. 125 on compulsory insurance of workers at work against accidents (07/24/1998).

Responsibility for concealment

Federal Law No. 125 (clause 6, clause 2, article 17) obliges the policyholder, that is, the employer, to notify the insurer about it no later than 24 hours from the date of the event. The employer's responsibilities are also defined in Art. 228 Labor Code of the Russian Federation. The algorithm for reporting industrial injuries is established by Art. 228.1 Labor Code of the Russian Federation. Actions are also determined by Decree of the Government of the Russian Federation of December 15, 2000 No. 967.

Since injury to an employee at work falls under an insured event, and by law the employer is obliged to pay compensation (Federal Law No. 125), liability is provided in case of concealment of the incident under Art. 15.34 Code of Administrative Offenses of the Russian Federation. For concealing an injury incident, the company will be fined in the amount of:

• 300-500 rubles (for citizens);
• 500-1000 rubles (for employees);
• 5000-10,000 rubles (for enterprises).

Accident at work due to the fault of an employee

An accident can occur at work due to the fault of the employee himself, when, for example, he does not follow safety precautions. In any case, even if the employee suffered through his own fault, he is subject to compensation payments, but in a smaller amount than if the employer was to blame for the accident.

The degree of guilt of the employee is established by the accident investigation commission.

In any case, the employer will also be considered to be at fault, even if the employee suffered a work injury due to his own negligence. At the same time, for the employee himself, what happened due to his own actions or inaction can lead to disability

Appealing a refusal to pay for an accident through court

It is possible that an accident victim may be denied payment of insurance coverage. What to do? You need to go to court, but first you must follow the pre-trial procedure.

So, before filing a claim in court, you must appeal the insurer’s refusal to the insurer’s higher authority. The complaint must be reviewed within 10 working days and a decision must be made to either approve or reject it.

Next you need:

1. prepare and file a claim in court for damages and challenging the refusal to pay
2. the claim to the court must be drawn up in compliance with procedural requirements.
3. During the consideration of the case, the plaintiff must prove the validity of his claims
4. after hearing the participants in the process and examining the case materials, the court will make a decision based on the arguments of the plaintiff and defendant, as well as the evidence presented, whether to satisfy the plaintiff’s demands or not.

In what cases is an injury considered work-related?

The size, frequency and duration of social payments to a citizen in the event of a health injury depends on whether it was received at work or at home. As a result, the following types of injuries can be distinguished:

• Domestic, for example, resulting from alcohol, toxicological or drug intoxication, actions of the victim, qualified as criminally punishable;
• Production: Obtained directly during the performance of labor duties or other actions on behalf of the employer within the framework of an employment contract, both on its territory and outside it;
• Received while traveling to the place of work or when returning home.

Conclusions regarding the classification of existing damage as industrial or domestic are made by a commission created in the company to investigate the accident. When it occurs, management actions should be as follows:

1. Provide first aid to the victim;
2. Record the condition of the scene of the incident (photo) and, if possible, keep it unchanged;
3. Start an accident investigation:
   Issue an order to appoint a commission and conduct an investigation: within 3 days for a minor injury, within 15 days for a severe injury;
4. Draw up protocols describing the scene of the event, testimony of witnesses -;
5. Draw up an accident report in 3 copies -;
6. Request from the medical organization where the employee is sent a report in form No. 315/u.
7. Notify the territorial body of the FSS of the Russian Federation about the incident within 24 hours from the moment of the incident.
8. If the medical report classifies the injury as severe, then you need to additionally inform: the State Inspectorate, the prosecutor’s office, the regional administration, and the local trade union association.

All specified requirements are mandatory for the employer.

In addition, the attending physician must enter one of the codes on the employee’s sick leave:

• 02 – the injury is of a domestic nature;
• 04 – the injury was received while performing work duties.

Depending on the specified parameters, the list of payments due to an employee after an accident differs. Thus, in order to classify an injury as an industrial injury and apply the appropriate payment procedure to it, the following must be present:

• Sick leave with code “04”;
• Report on an accident at work in form N-1.

On their basis, payments due to the employee are made.