How to recalculate sick leave at the request of an employee. How many days can you pay for one newsletter?

The main document confirming an employee’s absence from work due to illness is a sick leave certificate. For the employer, this document is the basis for calculating benefits during the period of temporary incapacity for work of the employee. The legality of reimbursement of benefits from the Social Insurance Fund depends on the correctness of filling out the sick leave certificate.

If errors are detected in the document, the Social Insurance Fund may not accept the specified amounts of expenses for offset.

However, in practice, not every error on the certificate of incapacity for work leads to a refusal to offset expenses, and we’ll talk about this in more detail in the article.

Registration of sick leave

There are two parties involved in the procedure for issuing sick leave: the medical institution and the employer. Each party enters its own information into the document. Doctors indicate in the document the name of the medical organization and its address, the date of issue of the sick leave certificate, the full name of the sick employee, his gender and date of birth, the specialist’s place of work and the name of the company, also indicate the cause and duration of incapacity, and, finally, full name of the attending physician and his position.

Having received the document from the employee, the employer, on the certificate of incapacity for work, indicates the employee’s place of work and the name of the company, the employee’s INN and SNILS, insurance experience, the amount of average earnings for calculating benefits, the amount of accrued benefits, as well as the full names of the manager and chief accountant.

Do not forget that when applying for sick leave, you must check that the document is filled out correctly by the attending physician, as well as comply with the mandatory requirements.

For example, parties can fill out a document either using a printing device or manually. In the second option, information in the cells must be entered in specially designated fields in capital block letters using a black pen.

Pay attention to the pen, it can be gel or capillary, but using a ballpoint pen is prohibited! You cannot go beyond the cells allocated for recording. But it is not prohibited to extend beyond the designated area when placing a seal, but the seal should not fall on the cells of the information field of the sick leave form.

A certificate of incapacity for work is issued by a medical organization to citizens of Russia or foreign persons permanently or temporarily residing in the country and working on the basis of employment contracts. This category of persons is subject to compulsory social insurance (OSI) in case of temporary disability and in connection with maternity.

The employer receives the document from an employee who returned to work after illness. It is the employer who controls the correctness of the compilation of sick leave by the medical institution. This is necessary in order to pay benefits on the basis of the document, receive payment amounts as compensation from the Social Insurance Fund, or count it towards a reduction in payments for accrued contributions for disability insurance. The first three days of illness are paid at the expense of the employer, the remaining days - at the expense of the Social Insurance Fund.

But the opposite situations may also arise when, during an inspection, the Social Insurance Fund, discovering the fact of incorrect registration of sick leave, decides to refuse to offset amounts that are not insurance payments. In this case, the amounts of accrued payments to the employee, which are not insurance payments, are subject to insurance contributions in the generally established manner.

When issuing sick leave, both the employer and the medical institution can make mistakes. If doctors make a mistake, then the company most often cannot influence the situation and therefore is forced to defend its position regarding the legality of offset of benefits in court. But there is good news: the courts almost always side with the companies.

FSS warns: fake sick leave is punishable by law

08/10/2012 The regional department and investigative authorities have strengthened control over the examination of temporary disability and the procedure for issuing sick leave. Specialists of the regional branch of the Social Insurance Fund for the Republic of Mari El remind that the form of certificate of incapacity for work is a document of strict financial reporting.

The Government of the Russian Federation has provided for liability for violations of the law for managers and officials: On the liability of medical workers and medical institutions that unreasonably issued sick leave. For violation of the procedure for issuing certificates of incapacity for work, doctors of the state, municipal and private healthcare systems bear disciplinary or criminal liability in accordance with the legislation of the Russian Federation.

This rule of law is enshrined in clause 68 of the Order of the Ministry of Health and Social Development of Russia dated June 29, 2011 No. 624n

“On approval of the Procedure for issuing certificates of incapacity for work”

. In addition, the medical institution may be subject to civil liability.

Medical workers may be subject to disciplinary liability in accordance with Art. 192 Labor Code of the Russian Federation. Disciplinary sanctions may be due to incorrect or unjustified issuance of a certificate of incapacity for work, violation of the rules for its execution, violation of the procedure for referring patients for medical and social examination, poor quality of primary medical documentation relating to

Due to the fault of the medical institution

The FSS is not always interested in who made a mistake on the sick leave. Therefore, in their judgments they are very unambiguous: if the certificate of incapacity for work is drawn up with violations, then the amount of expenses for temporary disability benefits cannot be accepted for offset.

But the judicial authorities note that if a mistake was made by a medical institution and it is impossible to prove bad faith on the part of the employer or its employee, then such an action is not a sufficient basis for not accepting benefits expenses for credit (Determination of the RF Armed Forces dated July 17, 2021 No. A03-8483 /2018, Resolution of the AS CO dated February 12, 2015 in case No. F10-4991/2014). This means that it is unlawful to hold employers responsible for mistakes made by a medical institution, since in such situations the relationship regarding the expenditure of funds on social insurance arises between the Social Insurance Fund and the organization, and not between the Fund and the medical institution. The principle voiced above can be called global; then let’s look at special cases from judicial practice.

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Recalculation procedure

If circumstances arise that have already been described above, the employer can independently change the calculations for previous years.

This is important to know: Application to the Social Insurance Fund for compensation for sick leave

The employee has the right to submit an application for adjustment of the deduction amount. The application is written to the director of the enterprise or the head of a structural unit. It is compiled in free form.

There is no single template for writing a paper in the legislative norms, but an employee can ask the HR or accounting department about the availability of a template.

In order for the requirements to be satisfied, the applicant must attach the following documents to the application:

Certificate from a medical institution.
A document of the established form from the former employer.

If the documents are drawn up in violation of the law, the employer has the right to reject the application.

If everything is in order, the employer will not be able to refuse, since the scales are tipped in favor of the subordinate. The law in this case clearly protects the rights of the employee: if there is evidence for an increase in payments, and the citizen has substantiated the demands, then his application must be granted.

The statement is drawn up according to the rules that are usually used in business communication. Therefore, the petition states:

details of the enterprise, full name of the manager, applicant;
name of the paper;
request for changes in the billing period;
number and signature;
Help is also included.

There is no statutory time limit for satisfying the applicant's demands, but it must comply with the rules of reasonableness of time. This means that once the request has been received and a decision has been made, the application must be processed.

The requirement must be complied with immediately. This will allow you to avoid misunderstandings with the employee and fines from the state labor inspectorate or the Fund.

The benefit during illness is accrued to the employee on the nearest date of payment of earnings, part 8 of Art. 13, part 1 art. 15 Federal Law No. 255-FZ. If there is a delay in payments, the employee is entitled to additional compensation provided for in Art. 236 Labor Code of the Russian Federation.

Expert opinion

Lebedev Sergey Fedorovich

Practitioner lawyer with 7 years of experience. Specialization: civil law. Extensive experience in defense in court.

As for changing the amount of benefits from the Social Insurance Fund, the application procedure is similar to that outlined. An application is also written addressed to the head of the Fund and the payment document corrected by the employer is attached along with a certificate of incapacity for work and a Certificate.

Following the above recommendations, difficulties with re-registration of the payroll period should not arise, since conscientious employers usually do not prevent their subordinates from exercising this right.

Recalculation of sick leave is permitted provided that an error was made in the initial calculation of the amount due to the employee.

Invalid address

An error in the address of a medical organization cannot prevent benefits from being counted (for example, indicating the wrong building block). This argument is confirmed by the Resolution of the AS SZO dated September 5, 2019 No. A13-7645/2018.

If the address of the medical organization is indicated in the wrong sequence, then the sick leave certificate will not be considered damaged. In this case, the FSS identifies the medical institution by registration number, the Foundation itself announced this in a letter dated October 28, 2011 No. 14-03-18/15-12956.

Incorrect date of birth

From the Resolution of the AS SZO dated May 12, 2021 No. A45-38305/2019, it can be found out that the error in the employee’s date of birth, due to which the Social Insurance Fund refused to pay, was made by the medical institution, while the Fund did not deny the presence of the disease. The courts also noted that the employee attempted to issue a duplicate document, but the medical organization, citing the Fund’s position, refused to do so. Accordingly, we can come to the conclusion that such inaccuracies in the document cannot be grounds for refusal to pay benefits.

Who is given sick leave?

A certificate of incapacity for work is a document officially accepted by the state confirming the fact of excused absence. Serves to pay for this time. Such documents are issued to working citizens. Transferred to the employer.

A sick leave certificate is issued in the following cases:

loss of ability to work due to illness, work injury, or during pregnancy. Includes operations of fertilization, artificial termination of pregnancy;
when you need to look after a sick family member or relative (usually parents, children, spouses);
during quarantine. Usually concerns children of school and preschool age;
staying in a medical hospital for prosthetics for medical reasons;
implementation of follow-up treatment. Relevant for patients undergoing hospital treatment. The procedure takes place in sanatorium-resort institutions located in Russia.

Only medical workers who examine a citizen who has sought medical help have the authority to issue sick leave. The results of the examination are reflected in the medical record.

Remember, not every doctor can issue sick leave. The list of doctors authorized to issue certificates of incapacity for work is determined by order of the Ministry of Health and Social Development of the Russian Federation dated August 1, 2007 No. 514.

The issuance of such a document will be refused:

the citizen has no signs of the disease;
the citizen undergoes a medical examination as directed by the military commissariat;
the check takes place with a person in custody or a convicted person;
the citizen undergoes periodic medical examination;
a citizen who has a health complication undergoes systematic procedures in an outpatient clinic or clinic.

A certificate is issued for a one-time visit to a doctor for the purpose of undergoing procedures or examination. The document is not required for payment. Allows you to confirm the legality of absence from the enterprise.

Another company name

It is believed that the abbreviated or inaccurate name of the organization is a technical feature of filling out sick leave, therefore such data does not affect the amount of the benefit paid. There is no need to replace the sick leave with a duplicate. If there are such errors, the company can be identified by its registration number in the FSS (Resolution of the AS VSO dated May 24, 2021 No. A19-23241/2017).

But if the corresponding cell contains information from a completely different organization, then such a certificate of incapacity for work is considered spoiled and cannot be accepted for calculation, this is stated in the letter of the State Administration - MRO FSS of the Russian Federation dated July 14, 2021 No. 14-15/7710-1110- LNK.

In what cases is it necessary to replace an old document with a new one?

During the filling process, errors may be made that even the employer, not to mention the doctor, has no right to correct. Therefore, the only correct solution would be to replace the certificate of incapacity with a new one.

Below is a complete list of errors that will require a new form :

Gross errors in the name of the medical organization (for example, the name of the hospital in the act differs from that indicated in other official documents);
Incorrect address and other coordinates of the medical organization that issued the sick leave;
The seal does not meet the requirements of the FSS;
Invalid employer organization name;
The contact details of the employer's organization are entered incorrectly;
There is no position of the doctor who issued the certificate of incapacity for work;
Lack of initials of the attending physician.

If the disability form contains more than two errors from those listed above, then it is replaced with a new one. Please note that it is for a new one, not a duplicate.

Incorrect dates

The incorrect start or end date of the period of incapacity for work became the subject of litigation in court, as a result of which the arbitrators of the court of the East Siberian District indicated that an error of this kind does not prevent the occurrence of an insured event and does not affect the payment of benefits in any way (the arbitrators also noted that the unreliability of the document presented to the authorities FSS did not confirm). In this regard, the company legally paid benefits to the employee (Resolution of the AS VSO dated February 20, 2019 No. A19-11796/2018).

Correcting entries

According to the Procedure for issuing certificates of incapacity for work, approved by order of the Ministry of Health and Social Development of June 29, 2011 No. 624n, if a document is lost or contains errors, a duplicate must be issued. But what happens is that companies and health care providers instead make corrections to the document, such as outlining an entry in black ink or changing data by crossing out previous entries, including with a correction agent.

The FSS authorities recognize such a sheet as damaged, it does not meet the requirements of the established Procedure, and there are no grounds for paying sick leave. But the courts considered that the corrected information does not refute the fact that the employee had an insured event and, despite the corrections, the information on the sick leave remains readable, and the document itself is not damaged; such conclusions follow, for example, from the Resolution of the Nineteenth Arbitration Court of Appeal dated February 7, 2021 of the year No. A14-18229/2018 and the Tenth Arbitration Court of Appeal dated April 4, 2021 No. 10AP-3439/2018.

If the personnel ruined the sick leave

If there are errors in filling out a certificate of incapacity for work, it is considered damaged and a new certificate of incapacity for work is issued in its place. Thus, the certificate of incapacity for work does not allow the correction of errors made by the medical institution, that is, it will not be able to correct the number of the first certificate of incapacity for work in the second sheet in connection with the replacement of the first.

However, incorrect indication of the number of the previous certificate of incapacity for work should be considered as an error, and therefore such a certificate of incapacity for work will not be accepted by the branch of the Federal Social Insurance Fund of the Russian Federation for credit. Undoubtedly, this Procedure is designed for exclusively error-free filling out of certificates of incapacity for work.

And if an error is made, it is very inconvenient for both employers and medical institutions.

Vote:

If the original sick leave is lost or damaged, the FSS will not accept a copy of it; you need to take a duplicate. Duplicate sick leave At the request of an ill employee or a representative of the organization, the hospital or clinic that issued the sick leave issues a duplicate of it. It is issued on the same form as the sheet itself (the form is approved by Order No. 347n).

A duplicate sick leave certificate, a sample of which is shown in the picture, just like the original, contains a unique number. What to do if an employee’s sick leave is lost. He must do this before the original sick leave gets into the employer’s accounting department. Once this is done, no duplicate will be issued.

Otherwise, the Social Insurance Fund will not accept these costs and will not compensate for them.

The courts of three instances allowed the branch of the Federal Social Insurance Fund of Russia not to reimburse the organization for the amount of temporary disability benefits issued on the basis of a sick leave certificate with notes made by the employer. This information will be useful to personnel workers, who should know that sick leaves damaged in this way cannot be restored.

During an on-site inspection of the organization, FSS specialists identified a number of violations. In particular, they discovered the unlawful payment of benefits to an employee based on a certificate of temporary incapacity for work, which was damaged by the organization’s employees.

There were two contradictory notes on the document, as a result of which it appeared to be both “primary” and “continuation”. At the same time, the medical institution that issued the sick leave refused to issue a duplicate of it, since it was damaged by the employer himself.

Five myths about sick leave

Olga [email hidden] Russia, in the forest #12[363223] December 20, 2012, 10:43 Yanka wrote: Lyubov wrote: Elena wrote: The first sheet was spoiled, What should I do now? Elena, in such cases, the clinic writes to the organization that a duplicate was issued to replace the damaged one and indicates the number of the damaged one. We have had such cases. I agree, a cover letter from the clinic about correcting the first LN indicating the number. And on what basis will they correct the second?!!? If we think logically, then the clinic should not correct the second LN. Olga, in your case, as I understand, they didn’t want to issue LN according to the BIR at all, but here the situation is a little different, I gave this as an example))) and everything else is above, I work in a medical institution, we also have such pearls. I want to draw the moderator’s attention to this message, because: A notification is being sent... I live in the present. I am confident in the future.

How to get a duplicate sick leave certificate?

Attention: A sample sick leave certificate is presented here.

Reasons for refusal Citizens of the Russian Federation must understand that a sick leave certificate is a very important document, therefore it is necessary to be especially careful about the information that you provide to medical staff so that they do not make any mistakes.

You also need to handle the form itself carefully so as not to spoil it before you hand it over to the employer.

Although the legislation of the Russian Federation allows for the issuance of duplicate sick leave certificates, there are still situations when this is impossible to do, since a medical institution may refuse this service. This often happens when an organization has lost a document due to the fault of an employee responsible for storing important papers, since in this case the payment of benefits is compensated by the guilty citizen.

If you want to find out how to solve your particular problem, use the online consultant form in the lower right corner of the site or call direct numbers ext. 445 - Moscow - CALL ext. 394 - St. Petersburg - CALL here - if you live in another region . It's fast and free! CONTENT:

What to do if your certificate of incapacity for work is lost?
Is it possible to restore the sheet? What to do if the loss was due to the fault of the employer?
What if the employee is at fault?

conclusions

What to do if your certificate of incapacity for work is lost? Before determining the procedure to follow in the event of loss of a hospital certificate, it is worth referring to the legislation. In 2009, the government of the Russian Federation introduced amendments to Federal Law No. 255-FZ.

In this case, the incorrect entry is crossed out, the correct entry is made on the reverse side with the note “Believe the corrected”, certified by the signatures of the manager, chief accountant and seal. Not everyone knows how to get a duplicate sheet to replace a damaged one. Everything here is generally simple and clear.

The employee must go to the medical organization that issued the primary document and write a statement. You must also present your passport. There is no separate form for duplicates. It is entered on the same form as the primary document, with the appropriate note. The period of incapacity for work is indicated on one line.

There is no need to complete interim renewal entries as is done in the primary document. In the “Date of issue” field the actual date of registration of the duplicate is entered. The spoiled sick leave must be returned to the clinic.

Does the number of corrections on sick leave matter? Inattentiveness of the employer's HR department staff can lead to the fact that one certificate of incapacity for work will contain several errors at once. However, according to the new rules, the maximum number of corrections in a hospital document should not be more than two.

It is worth noting two important nuances:

Source: https://02zakon.ru/esli-kadry-isportili-bolnichnyj/

Other errors

The Supreme Court (Decision of the Supreme Court of the Russian Federation of February 13, 2021 No. 306-KG17-22369) during the consideration of the case came to the conclusion that they do not interfere with the offset of the amount of benefits for certificates of incapacity for work, which contain the following inaccuracies:

extension and issuance of sick leave for a period of more than 15 days, without the permission of the medical commission;
the date of issue of sick leave does not correspond to the date of release from work;
the certificate was issued over the past period, and not on the day the employee applied. However, the signature of the chairman of the medical commission was missing.

The violations identified by the fund do not affect the materiality of the document data; they are minor and remediable. At the same time, the negative consequences of non-compliance with the procedure for issuing sick leave are assigned to the medical institution.

On what basis are recalculations made?

According to labor legislation, the period of temporary incapacity for work is paid:

by the employer - up to three days of absence;
the subsequent time spent in poor health is paid by the Social Insurance Fund (hereinafter referred to as the Social Insurance Fund, the Fund).

Payments are made in the amount of average daily earnings for each day of illness. An employee cannot be fired during illness.

Based on this, we can distinguish two legislative guarantees for employees that the organization cannot violate:

These norms are prescribed in the Labor Code of the Russian Federation.

An important point is that the Fund transfers a volume of funds, the size of which not only corresponds to average income, but is also proportional to the time worked, that is, length of service. So, depending on what insurance time is listed in the employee’s work book, he is paid 60, 80, and 100 percent of the average monthly profit.

Officially employed persons are accrued insurance coverage due to the employer making contributions. Unofficial work deprives a citizen of such a privilege, and he will not be able to count on sick leave.

The company is not required to wait for the subordinate to provide income information. Typically, a standard form is submitted upon hiring, but if this does not happen, the accounting department pays benefits based on the data the company has.

Changing the payment amount is possible:

When providing information about previous earnings - if it is possible to obtain it.
If the enterprise stops working, the citizen has the right to contact the new employer with a request to send a request to the Pension Fund. The procedure for applying to this body with a similar request and sample documents are approved by Order No. 21 n dated January 24, 2011.

Sometimes, when calculating the required amounts, the employer makes incorrect calculations for various reasons.

In any case, the initiators to recalculate the amount of compensation are:

A trade union can also apply, but in this case it will be regarded as an application on behalf of the employee.

The employer may initiate a recalculation of the amount paid in the following cases:

This happens if the doctor made a note on the certificate of incapacity for work that the patient did not adhere to the discipline being treated: did not come to appointments, refused treatment procedures, did not take medications, etc.
Also, unilaterally, management has the right to charge a larger amount than was initially established. This happens when an organization decides to increase payments for a certain position.
If the organization identified errors when accruing sick leave. And also in some other cases.

The list is not closed, as each employer may have its own reasons for recalculation.

To verify the payments made, the employee must write a corresponding statement addressed to the manager. If the subordinate’s request is justified, then the organization will have to pay the missing funds. Often, if a citizen has recently been hired by a company, then to determine his average earnings, salary statements from his former workplace may be needed. To calculate the average salary, the period of the last two years of work is taken. Accordingly, the new employer will need information about income for this period of time.

Recalculation of sick leave for the past period is possible within a three-year period upon presentation of the necessary documentation.

On the employer's side

If an error on the sick leave was made by the employer, then, as a rule, the likelihood of disputes with the Social Insurance Fund is minimized. If the error is not significant, it can be corrected. To do this, you need to cross out the incorrect entry and add the correct one to the back of the form. New information must be confirmed with the entry “corrected to believe”, the signature and seal of the employer, as required by paragraph 65 of the Procedure for issuing certificates of incapacity for work. Examples of such violations are:

incorrect employee TIN;
any clerical error in the data (for example, incorrectly indicated insurance period);
filling in a line that did not need to be filled in;
incorrect amount of average employee earnings.

Also, the legality of payment of benefits will not be affected by the situation associated with filing a certificate of incapacity for work in the archive: when the information from the column was entered in the document (namely, the dates in the “exemption from work” field in the line “from what date”). The Arbitration Court of the Volga-Vyatka District did not consider the violation committed to be significant, since it does not affect the existence of an insured event in any way (Resolution dated June 26, 2021 No. F01-10655/2020).

But if, through the fault of the employer, the certificate of incapacity for work was damaged and the information became unreadable because of this, then the document must be given to the employee for the medical institution to issue a duplicate. However, in judicial practice there are cases when the fact of the presence of a disease can be confirmed in another way.

For example, this may be receiving a written response from a medical institution, which contains information about sick leave issued with series and numbers, full names of sick employees (Determination of the Armed Forces of the Russian Federation dated September 27, 2021 No. 307-KG18-14530).

Due to the new rules for issuing sick leave, we will lose it.

doctors?

Doctors - readers of "KP" inundated the editorial office with complaints [discussion] Share: Change text size:AA Doctors - readers of "KP" inundated the editors with complaints: if they do not stop being tormented by draconian standards for the design of ballots, then mass layoffs will begin in clinics and hospitals.

Together with experts, we’ll figure out why doctors and patients suffer and how to find a way out of difficult situations. For a spoiled ballot - 800 rubles - I have been issuing new sick leave since July 1 and during this time I have lost all my health! - a doctor, a visitor to the website kp.ru, writes in despair - The tension at work during the entire 12-hour shift is hellish.

Constant headaches began, yesterday at the end of the working day the pressure rose to 160. Have you tried to enter text into small cells for hours without any room for error?

And if you ruin a sick leave, the chairman of the VC (medical commission - editor's note) is angry as hell and swears.

My partner and I now go to work as if we were going to Golgotha, we return home “dead,” with one thought in our heads - we need to quit here. If we leave, let them look for volunteers for this hard labor with meager pay.

— And our clinic administration announced that each sick leave costs 800 rubles and for a damaged form, employees will have this money deducted from bonuses and salaries. We are shocked! - says another doctor, a KP reader.