How is sick leave paid in 2021?
In 2011, the Social Insurance Fund launched a pilot project “Direct Payments”, aimed at changing the concept of payments for temporary disability certificates. During the pilot project, in which eleven regions and three regional administrative entities took part, a new procedure for accruing sick leave and a procedure for paying sick leave directly through the Social Insurance Fund was developed and studied. Today, more than thirty constituent entities of the Russian Federation are participating in the Direct Payments project.
To implement the project in 2021, a transition to electronic sick leave was made and a full-cycle electronic document management system was introduced, uniting all participants in the process - medical institution, employer, Social Insurance Fund.
As part of the project, both the employer and the Social Insurance Fund calculate sick leave payments, each in relation to their own periods. Where “Direct payments” are not yet in effect, the employer calculates and pays for sick leave in full, and the Social Insurance Fund reimburses or credits part of its expenses incurred at the expense of the Fund against insurance premiums.
What's new in the law, what should you pay attention to?
1 The calculation period is taken the past two years . In our case, these will be 2021 and 2017.
2 The “ceiling” of earnings for calculating sick leave payments in 2021 is legally set at 1,473,000 rubles (718,000 rubles in 2021 plus 755,000 rubles in 2021).
3 The total earnings for two years are divided by 730 (this is the number of days in two years, despite the fact that 2016 was a leap year) and the average “cost” of one day spent on sick leave is obtained.
One day spent on forced sick leave in 2018 “costs” no more than 2,015.04 rubles
4 A new minimum wage (minimum wage) has been established - from January 1, 2021, 9,489 rubles, from May 1, 2021 - 11,163 rubles . They are used to calculate accruals if the employee’s length of service is less than 6 months or if his salary is below the minimum wage.
5 Now both the employer (only the first three days and only in connection with illness or injury) and the Social Insurance Fund (the remaining days) pay sick leave. For employees, this change went unnoticed: the certificate of incapacity for work is still submitted to the accounting department.
Minimum sick leave
Not a single regulatory document establishes a minimum period of sick leave, and the pilot project placed special emphasis on this.
The duration of the certificate of incapacity for work is determined depending on the patient’s condition. Standard practice for general diseases is from 3 to 15 calendar days. However, during a visit, the doctor can issue a sick leave for one calendar day, which will not be a violation, and if the document is drawn up in the prescribed manner, the employer is obliged to calculate and pay for such sick leave.
Features of calculating sick leave in 2021, taking into account the maximum benefit amounts
When calculating benefits, it is necessary to compare income for each base year: if in total they do not exceed the established limit for 2 calculation years, and when considering the employee’s income for each year, an excess of the base is established for one of them, the Social Insurance Fund will refuse compensation, citing its refusal as an overstatement of the amount benefits.
Payments under the BC (minus personal income tax) should be transferred to the employee on the next salary day. Benefits are not included in the calculation base for insurance premiums; when calculating income tax, the base includes only the costs of paying the employer for the first 3 days of illness.
Example 1: procedure for calculating BL for the period established by the medical advisory commission
A company employee (5 years 2 months of experience) was sick for 28 calendar days - from April 16 to May 13, 2021 (according to the VKK) - 15 days in April, 13 days in May. His income subject to FSS contributions amounted to:
- for 2021 – 715,000 rubles,
- for 2021 – RUB 736,000.
When comparing income amounts, it was not established that the base year limit was exceeded:
RUB 715,000 ‹ 718,000 rub. (2016);
736,000 rub. ‹ 755,000 rub. (2017).
- (715,000 + 736,000) / 730 = 1987.67 rubles. in a day
- The benefit amount is RUB 55,654.76. (1987.67 x 28 days),
incl. for April – 29,815.05 rubles. (1987.67 x 15 days),
for May – 25,839.71 rubles. (1987.67 x 13 days).
- Taking into account the length of service, the benefit will be 44,523.81 rubles. (55,654.76 x 80%),
incl. for April 23,852.04 rubles. (29,815.05 x 80%),
for May – 20,671.77 rubles. (25,839.71 x 80%).
- Personal income tax: 5788 rub. (44,523.81 x 13%), including for April - 3101 rubles, for May 2687 rubles.
- Amount to be issued: RUB 38,735.81,
incl. for April – 20,751.04 rubles. (23,852.04 – 3101),
for May 17,984.77 rubles. (20,671.77 – 2687)
When calculating the amounts, the amount of the benefit is distributed and reflected in the accounts on a monthly basis.
Who pays for sick leave?
According to the rules of the pilot program:
- the employer pays for the first three days of sick leave;
- The Social Insurance Fund makes payments based on the certificate of incapacity for work, starting from the 4th day until the day it ends.
Moreover, if the employee’s period of incapacity for work is only three working days, payment of sick leave is made exclusively at the expense of the employer, without attracting funds from the Social Insurance Fund.
Also, the new draft specifies the terms for payment of benefits - 5 days are given for the transfer of documents to the FSS and 10 days for the Fund to pay benefits to the employee. Payment of sick leave in 2021 by the employer must be made together with salary or advance payment, depending on which of these payments is closest to the date of benefit calculation.
Duration of sick leave
Current legislation establishes the maximum duration of sick leave for the calculation of cash benefits. In other words, a certificate of incapacity for work can last for an unlimited period, but only the periods specified in law 255-FZ are subject to payment.
The maximum terms for paying sick leave in 2021 in case of illness of the employee himself have not been established. That is, everything is paid without restrictions. Exceptions are provided for persons who are assigned a disability.
If the sick leave is issued to care for a sick family member, then different rules apply. More details in a separate article: “Sick leave to care for a sick relative: terms and rules of payment.”
Sick leave: how disability benefits are paid in 2021
There are no fundamental differences in how sick leave is paid and the amount of benefits is calculated in the pilot project from the usual principle of calculating sick leave. Here, the calculation indicators familiar to every accountant are used - the average daily salary, the minimum wage for a specified period, the minimum and maximum indicators for calculating benefits, length of service coefficients and insurance experience, taking into account the care of whom sick leave was issued.
Let's look at the basic concept and some features of the sick leave accrual and payment program.
Calculation period for calculating payment for sick leave
To determine the average daily earnings used for calculating and paying disability benefits, two full calendar years preceding the year in which the insured event occurred are taken. Therefore, if an employee provides sick leave in 2018, the payment of sick leave is calculated based on the average daily earnings for 2016-2017.
An employee has the right to change the billing period if at that time he was on maternity leave or childcare leave, and changing the billing period will lead to an increase in the amount of disability benefits.
Seniority coefficients
When calculating disability benefits, differentiated coefficients are applied taking into account the employee’s insurance coverage.
So, if a sick leave is issued due to the illness of the employee himself, as well as for caring for a child under 15 years of age who is undergoing hospital treatment, the employee is paid:
- if you have less than 5 years of insurance experience – 60% of average earnings;
- if you have an insurance period of 5 to 8 years - 80% of average earnings;
- if you have at least 8 years of insurance experience – 100% of average earnings.
If an employee is on sick leave due to a work-related injury or occupational illness, when benefits are calculated, he is paid 100% of the average earnings for the entire period of illness, regardless of his insurance record.
When calculating benefits for temporary disability associated with caring for a child under 15 years of age undergoing outpatient treatment, the specified percentage rates are applied for the first 10 calendar days of sick leave, and 50% for subsequent ones.
Key points when calculating sick leave in 2019-2020
There are 2 blocks of main points that you need to know before starting the calculation.
1st block - initial calculation parameters
1. Who pays for sick leave:
- for illness and injury (non-occupational):
- the first 3 days - by the employer;
- subsequent days - from the FSS budget;
- other reasons:
- for the entire period - from the FSS budget.
- employees under an employment contract;
- recipients of funds from which contributions to the Social Insurance Fund are paid.
2. Who is paid sick leave:
IMPORTANT! Foreign citizens temporarily staying in Russia and working in Russian organizations are also entitled to sick pay if they have an employment contract and the employer (insurer) has paid contributions for the foreigner to the Social Insurance Fund for 6 months prior to the month in which the incapacity occurred (Article 2 of the law “ On compulsory social insurance in case of temporary disability and in connection with maternity" dated December 29, 2006 No. 255-FZ).
3. How sick leave is paid.
Read more: Mortgage benefits for the birth of a third child
Calendar days of incapacity for work (indicated on the sick leave certificate) are paid. An exception (under Article 9 of the Law “On Mandatory Social Insurance.” dated December 29, 2006 No. 255-FZ) is the following periods:
- downtime;
- suspension from work;
- other exemption from work with full or partial compensation, except for annual basic leave;
- the employee’s stay in custody or arrest;
- conducting forensic and medical examinations.
2nd block - indicators for calculation
1. Percentage of earnings depending on length of service. Payment of accrued benefits in 2019-2020 is made taking into account the following ratios:
Working experience (during which insurance premiums were paid), in years
Percentage of average earnings limiting sick leave payment, in %
NOTE! If the incapacity for work occurs as a result of an occupational disease or an emergency at work, 100% of earnings are immediately taken into account. In this case, the maximum payment for sick leave is limited to 4 times the monthly insurance payment in the Social Insurance Fund (Article 9 of the Law “On Compulsory Social Insurance against Industrial Accidents and Occupational Diseases” dated July 24, 1998 No. 125-FZ).
Restrictions on payments based on length of service do not apply to sick pay for maternity leave.
Read about calculating sick leave for pregnancy and childbirth here.
2. Calculation period. It is 2 years before the year of sick leave. Includes all payments from which contributions to the Social Insurance Fund were calculated, including from other employers (Article 14 of Law No. 255-FZ).
3. Divider to obtain the average daily earnings. For sick leave, the figure of 730 is always used. An exception here would be calculations related to maternity benefits. For them, the formula (if we are not talking about determining the minimum or maximum benefit amount) takes the actual number of days in the calculation period, from which the duration of certain periods must be subtracted.
For more information about the features of recording the number of days in a period for sick leave for pregnancy and childbirth, see the material “When you give sick leave for pregnancy and childbirth .
