Insurance period for sick leave: what does it include? Examples and calculation rules

The insurance period is one of the most important elements in calculating the amount of pension and temporary disability benefits.

Since 2010, it has been used to determine the amount of payments for temporary disability, maternity, and child care.

Quick calculation of MTPL insurance for 15 leading companies

The latest changes took place in 2015 - the legislator finally more clearly defined the boundaries of this concept, eliminated ambiguous issues, and the procedure for calculating sick leave benefits is now a very simple and convenient system.

Why do you need sick leave and who issues it?

A sick leave form is a strict reporting form documenting the absence of an employee from the workplace due to illness.
If an employee gets sick and does not provide a certificate of incapacity for work, this is equated to absenteeism. Additionally, sick leave secures the possibility of receiving temporary disability benefits. The form is the same, it does not change depending on the type of disease and the reason for visiting a doctor. The formal form of the document was approved by order of the Ministry of Health and Social Development No. 347n dated April 26, 2011. Who issues and what is the minimum period of sick leave, the procedure for applying the temporary disability certificate is regulated by the following regulations:

• Labor Code (Articles 124, 138 of the Labor Code of the Russian Federation);
• Tax Code (Articles 217, 255 of the Tax Code of the Russian Federation);
• 323-FZ dated November 21, 2011 (payment of BL by social insurance authorities);
• RF PP No. 375 dated June 15, 2007 (calculation of compensation);
• Order of the Ministry of Social Development No. 624n dated June 29, 2001.

The issuance procedure is fixed in order No. 624n. It is issued only by those persons who have a special license for medical activities and examination services. It is completed either by attending physicians at medical institutions or by doctors at clinics at research institutes. Both paramedics and dentists of medical institutions have the right to issue sick leave. Prepared on paper or electronically.

Read more: Instructions: how to obtain consent for an electronic certificate of incapacity for work.

Sick leave is not always issued only in accordance with the disease. It is also issued for pregnancy and childbirth at the 30th week of pregnancy to receive financial compensation. They are issued not only due to illness, but also when it is necessary to care for a sick family member: a sick child, a close relative.

Like any other strict reporting form, sick leave is filled out according to regulations approved by law. If an error has crept into the document, it is corrected correctly.

Read more: Instructions: how to correctly make corrections to a sick leave certificate.

The benefit is calculated based on average earnings for the two years preceding the billing period. Payment for sick leave directly depends on length of service:

• less than six months - calculated from the minimum wage (minimum wage);
• from 3 to 5 years - 60% of the calculated amount will be paid;
• from 5 to 8 years - 80% compensated;
• 8 years or more - temporary disability benefits are paid in full (100%).

Periods included in the insurance period

The current legislation of the Russian Federation divides all time periods taken into account when calculating the insurance period into 2 groups.

The time when the employer paid insurance contributions for the employee to the Pension Fund of the Russian Federation and the Social Insurance Fund of the Russian Federation

According to paragraph 2 of the Rules for calculating the insurance period, approved by Order of the Ministry of Health and Social Development of the Russian Federation No. 91 of 02/06/2007, this group includes the following periods:

1. Work under an employment contract on full and part-time (including part-time) employment.
2. Work in positions of municipal and state civil service.
3. Activity in the status of an individual entrepreneur (individual labor activity), a member of a peasant farm, a tribal or family community of small ethnic groups of the North, as well as engaging in private practice permitted by law (notary, private detective, security guard). In this case, the calculation uses all the time before 01/01/2001 and after 01/01/2003. The time interval between these dates is not taken into account.
4. Work as a lawyer before 01/01/2001 and after 01/01/2003.
5. Work as a member of a collective farm or production cooperative, that is, involving personal participation in the activities of the enterprise.
6. The time of holding elective positions in the Federation Council or the State Duma of the Russian Federation, as well as holding positions at the federal level (speaker, minister, prime minister, etc.), the level of a subject or municipal unit.
7. Activity as a clergyman of any religious denomination.
8. Work to be paid while in prison. In this case, only the time after November 1, 2001 is taken into account.
9. The time of other employment of an employee, equated by law to the time when insurance contributions were paid for him to the Pension Fund of the Russian Federation and the Social Insurance Fund of the Russian Federation. These include:
10. Time of completion of military or any other service provided for by Law of the Russian Federation No. 4468-1 of February 12, 1993.
11. Time to care for a child under 1 year 6 months of age.
12. Time to care for a disabled person of the 1st group, or a disabled child, or an elderly person who has reached the age of 80 years. In this case, the degree of relationship is not taken into account.
13. Periods of so-called “unemployment” are the receipt of unemployment benefits, participation in voluntary work, or the time of moving in the direction of the employment service or the offer of the employer to another area for employment.
14. Periods of detention (house arrest, places of deprivation of liberty) of persons illegally prosecuted, as well as exiles or repressed persons, subject to their acquittal or rehabilitation by court decision.

Credit for insurance experience in the army or military service

Despite the fact that during the period of service in the armed forces of the Russian Federation, insurance premiums are not always paid, this time is also included in the insurance period, as well as the time of service in departments equivalent to the army:

1. Internal Affairs bodies (Ministry of Internal Affairs of Russia), that is, the police and the traffic police.
2. Bodies for control over the circulation of narcotic drugs and psychotropic substances
3. State Fire Service.
4. Institutions of the penal system.
5. For a long time, the issue of including conscription service in the insurance period was controversial. However, changes in the legislation of the Russian Federation in 2015 and law enforcement practice have eliminated uncertainty in this issue.

According to Part 1.1 of Art. 16 of Law No. 255-FZ, periods of military service, as well as other service provided for by Law of the Russian Federation No. 4468-1 of February 12, 1993, are included in the insurance period for receiving temporary disability benefits.

At the same time, the type of military service (conscription, voluntary) is not indicated, which equates it to the period of receiving benefits for temporary disability, child care, etc.

Minimum term

Legislative acts do not establish a minimum number of days of sick leave. The period of incapacity for work is determined only by the attending physician, based on the characteristics of the disease and the current condition of the patient. The exact number of days directly depends on the patient’s well-being and the period of necessary rehabilitation. The following rehabilitation conditions are distinguished:

• outpatient;
• day hospital;
• hospital

Often the minimum rehabilitation period, determined by the attending physician, is 3 days. If the patient is provided with outpatient treatment, then a certificate of temporary incapacity for work is issued for 15 days. If necessary and with the consent of the medical advisory commission, it is extended.

Virt laser

Having collected all the indicated indicators, you can safely use the service of calculating sick leave social insurance online. But before that, we suggest that you independently calculate the payment for the certificate of incapacity for work. If, after calculating on the FSS calculator, discrepancies emerge, it will be easier for you to find the error.

Finding and issuing electronic sick leave certificates in the Social Insurance Fund is not difficult. You need to register in the service and purchase a personal access code for the policyholder to your personal account. This is possible after registering in the Social Insurance system.

Maximum duration

The maximum duration should not exceed 15 days for outpatient treatment, that is, for recovery at home, taking into account periodic follow-up visits to the attending physician. This period can be extended only on the basis of a decision of the medical advisory commission (MCC). Special periods are provided for paramedics and dentists; for them, the maximum number of days on sick leave is 10 days.

If treatment is carried out in a hospital setting, then everything depends on the patient’s condition, diagnosis and the presence of complications in the patient. The maximum duration in inpatient conditions is not defined by law. A certificate of incapacity for work is issued for the entire duration of the employee's stay in the hospital. Extended after discharge - for the period of patient recovery. Typically, the period of such a document does not exceed 10 days. If the patient is recovering from surgery, then the certificate is issued for a maximum period during which procedures that are mandatory in the postoperative period are carried out.

Similar requirements are provided for when treating an employee in a day hospital. The duration is determined directly by the attending physician, depending on the patient’s condition and the type of disease.

Example of calculating sick leave benefits

Security guard Ivanov V.V. worked at Romashka LLC for 11 months, receiving a salary (with all allowances) of 23,000 rubles, after which one day I fell ill. His illness, according to the certificate of incapacity for work, lasted 10 days.

The accountant, calculating the amount of his benefit, established the following:

1. At his previous place of work at Georgin LLC, Ivanov V.V. received 17,000 rubles monthly with all allowances. That is, over the last 2 years, his earnings amounted to 474,000 rubles (17,000 x 13 + 23,000 11), and the average daily earnings were 649.00 rubles (474,000: 730).
2. The duration of the insurance period is only 8 years, which involves payment of only 80% of the average earnings.

Total: (649.00 x 10) x 100% = 5,194.52 rubles.

Based on the results of all calculations by the accountant Ivanov V.V. received 5,194.52 rubles.

Table of diseases with deadlines

The exact duration is determined only by the attending physician, based on the diagnosis, the course of the individual patient’s disease, the effectiveness of treatment and many other factors. Let's present a table of the duration of sick leave by disease (instructions of the Ministry of Health No. 2510/9362-34 of 08/21/2000).

How is such a translation carried out?

Alekseeva Yu.V. has many years of insurance experience, which in summary looks like this:

1. Zenit LLC - from March 21, 1999 to October 26, 2001;
2. CJSC "Stroy-invest" - from 01/14/2005 to 01/14/2012.

Citizen Yu.V. Alekseeva received sick leave. 11/15/2011

Alekseeva’s work experience includes work at Zenit LLC, which amounted to 2 years, 7 months and 7 days, and work at Stroy-invest CJSC, amounting to exactly 6 years. None of the above figures needs translation, since all of them are incomplete, which means that the insurance period is equal to 8 years, 7 months and 7 days.

An employee may qualify for an insurance period, the amount of which will be determined below.

For how long is sick leave issued in case of quarantine and epidemic?

The duration of how many days sick leave is issued in 2020 depends on the medical history, diagnosis and condition of the patient - from 3 to 15 days. To extend for a longer period, you will need the approval of the head physician or medical council. This rule applies to all diseases with complications. What should an employee do in the event of an epidemic or forced quarantine due to coronavirus?

IMPORTANT!

The rules for registering sick leave due to coronavirus quarantine came into force on March 20, 2020. The standards were approved in Government Decree No. 294 of March 18, 2020. This is a temporary measure that is valid until 07/01/2020. The rules apply for:

• citizens who arrived in Russia from the territory of countries with an unfavorable epidemiological situation;
• persons living near such citizens.

If you fall into one of these categories, you will be quarantined. All working isolated persons will be paid a certificate of incapacity for work. The sick leave will be posted electronically in the Social Insurance Fund system. The document is signed with an electronic signature by a doctor from a medical organization that is included in the list of authorized institutions.

Citizens who are quarantined are required to submit an application for the issuance of a certificate through the ESIA. Both registered users and unregistered persons have the right to apply (with their consent). Please indicate in your application:

• FULL NAME.;
• birthday;
• address of place of residence or stay;
• SNILS;
• compulsory medical insurance policy number;
• number and date of issue of a foreign passport of a citizen of the Russian Federation;
• other information.

If you are submitting an application on behalf of a person with whom you live, confirm the consent of this citizen to submit an application for the issuance of an electronic certificate of incapacity for work on his behalf. You will also need scanned copies of documents confirming cohabitation. The application is accompanied by scanned pages of the international passport, which indicate the fact of crossing the state border of a country with an unfavorable epidemiological situation (the first page of the passport with a photo and pages with entry and exit marks). Scan your ticket (or attach an e-ticket).

IMPORTANT!

The duration of sick leave is 14 calendar days (this is how long the incubation period of the virus lasts). The FSS processes the application and transfers it to the medical organization, which issues an electronic sick leave at a time for the entire quarantine period.

The benefit is paid by the territorial bodies of the Social Insurance Fund. The isolated employee notifies the employer about the fact of quarantine by sending details of the electronic sick leave. After this, the organization provides this information to the territorial Social Insurance Fund within 2 working days.

If the sick leave was prepared by a doctor in person, information about the issuance of an electronic document must be transferred to the Social Insurance Fund within the next working day after its registration, but not later.

Full periods cannot be transferred

The main rule on the basis of which benefits are calculated is that the calculation should be made using as a basis a working month of 30 calendar days, as well as a full year equal to 12 months.

This rule is directly indicated in the above-mentioned document from the Social Insurance Fund, according to which every 30 days should be converted into a full month, and the elapsed 12 months should be equated to one year.

It is necessary to make a transfer only when the time at work has not been fully worked, but if the employee’s work experience is equal to, for example, 15 years, no transfer should be made, since full periods are not transferred according to the new insurance legislation.

A month and year worked in full is considered as a full period, while an unfinished working month or year is equated to a partial period and added to the previously existing work experience, let’s look at the example:

How and when is it paid?

The procedure for paying for sick leave is given in Part 1 of Art. 13 255-FZ. Up to 3 days - the deadline for paying sick leave in 2021 by the employer, the rest is paid by the territorial bodies of the Social Insurance Fund.

In those regions where the pilot project operates, payment is made according to the rule: the organization makes calculations and payments in full, and then sends an application to the Social Insurance authorities. Then the FSS reimburses the institution for the funds paid, with the exception of the first three days of the employee’s illness.

The procedure for accruing and paying sick leave in an organization is as follows: the reinstated employee provides the accounting department with a form documenting temporary disability, the accountant checks it for correct completion, and then makes all the necessary calculations and accruals.

Read more: How to fill out a sick leave certificate: step-by-step instructions for the employer.

Payment is made within 10 calendar days after its provision, on the nearest day of payment of income in the institution (salary or advance). The period for transferring funds to an employee, if a pilot project is operating in a constituent entity of the Russian Federation, is 15 days.

Fss Portal 122 Fss.Ru Calculation of sick leave

In accordance with Article 19, Part 2 of the Federal Law of April 6, 2011 No. 63-FZ “On Electronic Signatures” as amended by the Federal Law of July 2, 2013 No. 171-FZ “On Amendments to the Federal Law “On Official Statistical Accounting” and the system of state statistics in the Russian Federation" and certain legislative acts of the Russian Federation" "...An electronic document signed with an electronic signature, the verification key of which is contained in the electronic signature verification key certificate, issued in accordance with the procedure previously established by the Federal Law of January 10, 2002 No. 1-FZ “On Electronic Digital Signature” during the validity period of the specified certificate, but no later than December 31, 2013, is recognized as an electronic document signed with a qualified electronic signature in accordance with this Federal Law...”
Thus, from January 1, 2014, the Social Insurance Fund of the Russian Federation accepts electronic documents signed only with an enhanced qualified signature, the verification certificate of which was issued in accordance with the requirements of the Federal Law of April 6, 2011 No. 63-FZ “On Electronic Signatures” . The Portal has implemented a service for preparing the policyholder's calculations, available to a registered user with extended access rights. To do this, you need to log in (enter your username and password on the Portal). This service allows you to:

1. Prepare the Calculation “Form 4-FSS” and save it in the Portal database, while ensuring the transfer of carryover data from the previous period, the display of hints and other auxiliary information.
2. Perform automatic checks for passing logical control of interconnections in Calculation.
3. Print the Policyholder's Calculation.
4. Upload the Policyholder's Calculation as an XML file.
5. Upload the Policyholder's Calculation from a pre-prepared XML file in an approved format.

How many times a year are you allowed to take sick leave?

There are no legal restrictions on the issuance of sick leave per patient per year. The employee takes as many times as he needs for treatment and recovery.

IMPORTANT!

The maximum duration of a certificate of incapacity for work in case of illness of the employee himself is 12 months. The duration of payment of benefits in case of illness or injury of the employee himself is not limited. All days of sick leave are paid for, regardless of how long it was issued and how many sick days the employee has during the year (Part 1, Article 6 of Law No. 255-FZ). An exception is benefits for disabled people and workers on fixed-term contracts.

If an employee constantly extends his sick leave, he must undergo a medical examination and, if necessary, register for disability. Then during the year the maximum period of sick leave is a total of 5 months, but not more than 4 months in a row.

If an employee is injured at work or has an occupational disease, the actual number of sick days is not taken into account, and the patient extends sick leave for as long as he needs until he fully recovers.

The exceptions are sick leave for pregnancy and childbirth, since they have fixed periods, and temporary disability, for which leaves are issued for 12 months. They are issued in the following cases:

• injuries with a long recovery period;
• tuberculosis;
• periods of rehabilitation after operations.

Special rules apply to certificates of incapacity for work issued for child care. For example, the duration of sick days for payment is limited by annual limits.

For details, see the article “How sick leave is paid for child care.”

Documents confirming the insurance period for sick leave

To confirm information about insurance experience, the following documents are required:

1. Work book , with records of admission and dismissal drawn up in full compliance with current labor legislation. This is the main, and often the only document against which information about the insurance record is checked.
2. Military ID , certificates from commissariats, military units to confirm periods of service in the armed forces of the Russian Federation.
3. Court decisions that have entered into force on rehabilitation and declaring criminal prosecution illegal, as well as certificates from archival institutions on this issue.
4. Certificates or extracts from places of detention about the prisoner’s participation in paid work and his fulfillment of the required plan.
5. A certificate or other supporting document from the department of social assistance (guardianship) regarding the care of a disabled person or a person over 80 years of age.

When determining the duration of the insurance period, employees of the organization need to understand that this basically means only the time when the corresponding contributions were paid to the Social Insurance Fund of the Russian Federation.

Thus, various “gray” or “black” wages are a noticeable blow not only to a future pension, but also to a “helping hand” during illness.

An unscrupulous employer uses them to avoid additional payments and paperwork, but such phenomena greatly harm employees.

Do I need to notify the employer?

Labor legislation does not stipulate the obligation of workers to warn management about illness. No such norm is specified in 255-FZ of December 29, 2006 on temporary disability. The employer does not have the right to force employees to provide mandatory notification of their absences from work due to illness. Such a rule cannot be prescribed in regulatory and local acts and management orders. Reporting illness is exclusively the employee’s right, but in no case is it an obligation.

The employee conveys a warning about temporary disability both orally (directly to the manager or through colleagues) and in writing, by drawing up a notice addressed to the manager. The application is drawn up in free form, indicating the diagnosis and estimated duration of the illness.

FSS calculation of sick leave

— We conducted a special study on this matter. More than 80% of policyholders confirmed to us that all mutual settlements completely coincide with the information they saw on the portal. I think this is a very good result. At the same time, approximately 95% of the portal’s users reported that they would categorically object to its closure.

And about 400 thousand policyholders are registered on our portal. That is about 10%. Moreover, almost 100 new enterprises are registered every hour. But, according to our estimates, the portal’s services are mainly used by relatively large enterprises, which employ approximately 20% of all Russian workers.

Who will get paid sick leave and who will not?

Working citizens who were born on April 6, 1955 or earlier are sent to forced sick leave.

Draw your attention to:

Only those employees who are officially employed can apply for paid sick leave.

Sick leave will not be paid for those who work without registration or are registered as an individual entrepreneur (IP).

They will not pay sick leave for those who continue to work remotely (and therefore receive a salary) or are on vacation and have already received vacation pay.

About the timing of payment of “children’s” benefits in September

The monthly child care benefit for August is paid to insured citizens from September 1 to September 13, 2021 inclusive. Thus, since the beginning of September, about 14 thousand payments worth more than 122 million rubles have already been made, with 40% of payments transferred to cards of the MIR payment system.

You can see information on accrued and paid benefits, as well as print out a benefit calculation certificate using the “Personal Account of the Insured” on the website cabinets.fss.ru. To do this, you will need a confirmed account on the Unified Portal of State and Municipal Services (www.gosuslugi.ru).

FSS personal account

If the user has already registered on the State Services portal, then he can log into the FSS electronic personal account using one of the first three options. We enter the SNILS/mobile number or email address in the login field, and use the password from the Public Services service itself as a password.

• checking maternity sick leave benefits;
• free access to viewing the ENL for the purpose of familiarization and verification of data;
• search and check of sick leave certificates by status, date, name, number;
• the ability to print certificates of incapacity for work;
• the ability to view benefits transferred from the state, including those under the “Direct Payments” social project;
• familiarization with the possibility of further printing of benefit certificates;
• free access to personal data.