Family relationship on sick leave: codes 38, 39, 40, 41 and 42 and their meaning YurExpert Online

26.06.2019

137

4 min.

A sick leave certificate is the main document indicating a previous illness or injury. It is the only basis for calculating insurance payments, the amount of which is established by the accounting department of the enterprise. The information on the forms is presented in such a way that it can only be understood if you have certain knowledge. Sick leave codes and their decoding allow you to make the correct accruals.

Types of sick leave certificate codes - digital coding of diseases and decoding

Most of the fields of the document are filled in by the doctor of the medical institution, and some fields are filled in by the responsible person or an accounting employee. First of all, the doctor fills out the fields indicating the reason for receiving a certificate of incapacity for work and a note about violation of the regime.

For what diseases and diagnoses is sick leave issued - causes of disability

A sick leave may be issued for the following reasons:

01 – illness;
02 – injury not related to work;
03 – quarantine due to illness;
04 – industrial accident;
05 – gestation;
06 – production of prostheses in stationary conditions;
07 – disease from the list of occupational diseases;
08 – treatment in a sanatorium;
09 – caring for a sick relative, disabled or disabled person;
10 – poisoning;
11 – disease from the list of social diseases;
12 – caring for a child due to illness;
13 – caring for a disabled child;
14 – dangerous symptoms in a child as a result of the vaccine;
15 – HIV code.

Read about sick leave for child care here.

Code 01 and what applies to work-related injuries

Code 01 is the most common. It denotes any disease with the exception of diseases included in the special lists of the Ministry of Health. Domestic injuries and accidents not related to the patient’s work are coded 02. All types of quarantine for infectious diseases are coded 03. Industrial injuries include not only injuries received directly at the workplace, but also those received on the way to or from work.

What does medical status 07 mean?

Code 07 is set if the patient is diagnosed with a disease from a special list. The Ministry of Health document lists all possible diseases associated with the patient’s professional activities. These include toxic hepatitis, metal fever, berylliosis, silicosis and many others. Code 11 implies the presence of a social disease. On this list, tuberculosis comes first, followed by hepatitis, malignant neoplasms and diabetes. After an unsuccessful vaccination, a child may develop negative symptoms. This is indicated by code 14.

Read about sick leave during paid leave in this material.

Codes 14 and 15 can be entered on the sick leave sheet only with the patient’s permission. If a child is diagnosed as HIV-infected, the parents or guardian can give permission to enter the appropriate code.

Child care – how the relationship is coded

If a certificate of incapacity for work is issued to care for a child, the relationship is coded in special cells on the form:

38, 39 – mother or father, respectively;
40 – means a person appointed as a guardian;
41 – code “trustee”;
42 – status “any close person” caring for the patient.

Important for receiving insurance payments are the fields where any violations of the regime are noted using digital codes. They may reduce the insurance compensation you receive.

23 – violation of the treatment process;
24 – failure of the patient to see his doctor within the specified period;
25 – going to work without a sick leave certificate;
26 – refusal of the patient to visit the medical commission;
27 – late arrival at the commission;
28 – violations that are not on the list.

Violation of the treatment process means refusal of prescribed medical procedures, replacement of a drug, non-compliance with a regimen, or unauthorized leaving of a medical institution.

On the certificate of incapacity for work there is a column “Other”. The following codes are entered there:

31 – prolongation (continuation of illness);
32 – the patient has been diagnosed with a disability;
33 – disability group changed;
34 – the patient died;
35 – refusal of the medical commission;
36 – the patient did not arrive for the appointment, but was declared healthy at the next visit;
37 – upon completion of inpatient treatment, the patient was sent for follow-up treatment.

Read about paying sick leave during your next vacation in this article.

Sick leave codes 38-42 - family ties

The main part of the document contains a part that relates to caring for relatives. Here you need not only to indicate the surname, first name and patronymic of your relatives, but also to put down special designations that reflect the kind of family connection that exists with them.

Here is a list of relevant codes:

“38” indicates that the mother was the caregiver;
if we are talking about the father, then the number “39” is used;
“40” is given if the caregiver was caring;
indicate the code “41” when this is a trustee;
in all other cases “42” is used.

This type of notation is used as follows. If a mother is caring for a sick child, then enter “38” in this column and indicate the child’s last name, first name and patronymic.

List of additional ciphers

In addition to the main fields, the document has additional columns. This is “Add. code" and "Code. ism". The first field contains the following list of data:

017 – the sick person is being treated in a special sanatorium;
018 – sanatorium treatment is associated with an industrial injury;
019 – the patient is undergoing rehabilitation at the Research Institute of Balneology;
020 – increased maternity leave;
021 – illness or injury occurred under the influence of alcohol, drugs or other substances.

How much does code 021 reduce the amount of charges?

Code 021 reduces the amount of insurance payments for the entire duration of the treatment process. In this case, the calculation is carried out not on the basis of average earnings, but on the basis of the minimum wage.

This principle of calculating the insurance amount applies even if the patient does not have any indication of violating the regime.

Field "Code. "izm" is filled in if the diagnosis has changed during treatment. If changes are not required, the field remains blank.

Subordination code

This data represents a five-digit number. The first four digits can be deciphered as the branch of the Social Insurance Fund to which the enterprise belongs.

The fifth digit refers to the type of policyholder:

"1" indicates that it is an enterprise or organization.
code “2” means that we are talking about a separate unit.
“3” is indicated for individuals and merchants.
an individual entrepreneur is designated by the code “4”.

What fields are indicated to the employer - employee data and the line “Calculation conditions”

In addition to the information fields where the place of work and other data is indicated, the employer fills out coded fields. This is the line “Calculation conditions”. Two-digit codes fit into it:

43 – if the employee was exposed to radioactive radiation;
44 – work is performed in the Far North;
45 – the employee has an established disability group;
46 – the employment contract was concluded for a period of up to six months;
47 – the insured event occurred within 30 days from the date of dismissal;
48 – the employee violated the treatment regimen for a valid reason;
49 – if the disease lasts more than 16 weeks;
50 – if the disease lasts more than 20 weeks;
51 – the employee did not have time to earn enough to pay for the insurance premium or the amount of earnings is less than the minimum wage.

Read about sick leave payment under the Labor Code here.

Codes 46, 49 and 50 are not indicated if the cause of the illness is code 11. In addition, codes 49 and 50 are indicated only for persons with disabilities. It often happens that an employee is subject to several codes. For this purpose, additional fields are provided in the “Calculation Conditions” column.

The FSS will forgive a number of mistakes when filling out sick leave

… 2.

According to paragraph 57 of the Procedure, in the line “(surname, initials of the doctor)” the surname of the medical worker who issued the certificate of incapacity for work and his initials (with a space in one cell) are indicated, for example, IVANOV AP. At the same time, according to the Fund, putting a space between the doctor’s initials is not a basis for re-issuing a certificate of incapacity for work and refusing to assign and pay benefits for temporary disability, pregnancy and childbirth.

If the doctor’s last name and initials exceed 14 characters in the first row of cells, then it is allowed to move the end of the doctor’s last name and initials to the second row of cells in this line.

If the specified line does not have enough cells to fill in the surname and initials of the medical worker (more than 28 characters), it is possible to fill in only the doctor’s surname without indicating the initials, and if there are not enough cells to fill in the surname, it can be shortened within the available cells.

How to correctly indicate the cause of the disease, and what are the consequences for the manager

Disability reason code

includes several types. Let's look at each of them.

01, 02

The first is indicated due to illness, for example, influenza, pneumonia, sinusitis. The second is if there was an injury.

The HR employee must enter the letter “B” or the number “19” in each cell of the time sheet when the person was not present. The accountant needs to calculate what the sickness benefit will be. The first three days are covered by the head of the enterprise, the rest are covered by the Social Insurance Fund.

04

Work was missed due to an accident that occurred at the enterprise, or due to the manifestation of its consequences.

On the report card, the personnel officer writes the same symbols: either “B” or “19”. The employee receives money for all days missed. If a persistent problem has arisen that prevents work in a given place, then until the day such a fact is established. Without taking into account the length of service, payments are made from one hundred percent of earnings; they should not exceed its maximum amount per month. You can calculate them by multiplying the maximum amount of insurance payment that is paid every month by the number “4”.

It is important to know that the manager pays his own money, but later he has the right to reimburse the costs from the Social Insurance Fund if an investigation is carried out by the commission that called the incident an accident.

23, 24

These are codes that mean that the regimen prescribed by the doctor was violated. “23” is entered in case of non-compliance with the doctor’s recommendations, unauthorized leaving the hospital, or visiting another specialist without the permission of the attending doctor. “24” indicates that the patient did not come to the clinic on time.

These codes help you understand that from the specified date you need to calculate the payment, which should not exceed the minimum wage for the month, multiplied by the coefficient that is present in the area where the person lives. If the employee receives more, the amount should still be the same.

For example, a specialist has worked for 15 years, his salary exceeds the minimum wage. On November 8, 2021, he fell ill and was on sick leave until the 15th. 12, the regimen prescribed by the doctor was violated, and as a result, the doctor made a corresponding note in the bulletin.

Here's how the accountant calculated the allowance:

November 8-11, pay, taking into account the employee’s average earnings, multiplying by 100 percent;
On November 12-15, pay, taking into account the minimum wage, which is divided by 30 (the number of days in a month) and multiplied by 4 (the number of days from the date of violation of the regime).

31, 36

These codes are indicated in the line where other reasons are listed. So “31” means that even after receiving the ballot in hand, the employee did not fully recover. The accountant assigns payment for sick leave, but the person continues to be sick, so he does not go to work.

“36” shows that the person did not come to the doctor when he was prescribed, but when he came at a different time, he turned out to be healthy. Then the ballot should be filled out like this:

You need to enter “24”, indicating the date when the regime was skipped;
In the column where exemption from work is indicated, the date of onset of the disease and the date on which the appointment was missed are written down;
In the “other” item you need to put the code “36”;
The column where the work start date should be indicated is empty.

If code “36” is entered, then until the date of missing a doctor’s visit, the employee receives benefits, taking into account his actual earnings. A day of absence is already paid no more than the monthly minimum wage, which is valid for the current year; if there is a regional coefficient, then the minimum wage must be multiplied by this amount.

Subordination code

This field is filled in by the employer. He must write down 5 numbers, which can be seen in the notice indicating registration at the FSS branch.