What to do if your employer does not pay sick leave? Where to contact?

In practice, every officially registered employee is insured. How is sick leave paid for an employee who is injured at work or “earns” an occupational disease? In these situations, the main regulatory document is No. 125-FZ “On compulsory social insurance against accidents at work and occupational diseases” dated July 24, 1998 (last edition dated July 29, 2021). Accidents and compensation for occupational diseases are paid from the Social Insurance Fund in the usual manner and are identical to how sick leave is paid in 2021 for other insurance cases.

Procedure for calculating and paying sick leave

In some cases, questions arise about paying 100 percent sick leave if the employee’s length of service allows it. What should employers and HR representatives know? Content

• 1 About general principles
• 2 In what cases is it paid in full?
• 3 About employee experience and average earnings
• 4 How to determine the situation when a 100% payment is due
• 5 If the employer refuses 100% payment
• 6 What changes are expected

About the general grounds Reasons for paying sick leave Not all employees are entitled to pay sick leave in full amount of their salary.

Is the following BL considered one insured event with the primary document?

An insured event is an event upon the occurrence of which the insurer must fulfill its obligations towards the insured person. One disease can be issued with several sick leave certificates.

This is important to know: How to pay sick leave for an external part-time worker in 2021

But this does not mean that there are several insurance cases.

If the BC is a continuation of a previously issued sheet, the primary document and its subsequent parts are considered one insured event. When a new slip is issued, the previous one is processed for the issuance of benefits. If a citizen continues to be ill, a corresponding note is made on the first sheet.

How many days in this case are at the expense of the employer and who pays the second part of the personal income tax?

The answer to this question depends on the order in which the documents were issued. As a continuation in case of long-term illness or independently from each other for different insurance cases. The billing period is determined based on the date of the first sick leave.

If two primary sheets are presented, then this will already be two insured events. You must pay for the first three days of each. Thus, the document issued as a continuation is paid entirely from the Social Insurance Fund.

How is sick leave paid? let's figure it out

• If an error is detected in the calculation, it is recommended to check the calculations;
• if military service is included in the length of service, then this aspect should also be taken into account when calculating;
• if the employer makes an erroneous calculation and refuses to recalculate, the employee has the right to write a claim to the first;
• the employee also has the right to contact the labor inspectorate;
• in some cases, the employee himself is to blame, but for this, immediate management must explain the reason for what happened.

What changes are expected At the legislative level, the projects contain global changes that affect calculations for sick leave payments.

Nuances associated with two sick leaves

Let's consider various features associated with two certificates of incapacity for work:

• If both children fall ill at the same time, one sick leave certificate is issued for the entire period. If one of the children recovers earlier, the document must be extended for one child.
• If an error is made on one of the certificates of incapacity for work, this cannot be grounds for refusal to pay benefits.
• If one of the sheets does not indicate the reason for disability, the document is returned to the employee. The employee must contact the medical institution to get a code.
• If a person violated the hospital regime, a corresponding mark is placed on the sheet. From the date of violation of the regime, restrictions on payments are introduced. The amount accrued per day is equal to the minimum wage divided by the number of days in the month.
• Both sick leaves must be sent to the accounting department no later than 6 months from the end of the period of incapacity for work.

Important! If any controversial issues arise that are not regulated by law, you can act on the basis of local acts.

How is sick leave paid?

But they are not robots, and the human body will malfunction at any moment - he can get sick.

In this case, he must know his rights and have complete and reliable information about how sick leave is paid.

To avoid unforeseen situations and not have to visit the hospital several times, special attention should be paid to its registration, namely, the correspondence of dates and the name of the organization. As for the latter, it is better to call your work and clarify the correct name, since due to incorrectness, the Social Insurance Fund may refuse to pay. After the 2011 reform, payment for temporary disability is made by the Social Insurance Fund.

This is important to know: What does a certificate of incapacity for work look like for pregnancy and childbirth?

It is the responsibility of the employer only to confirm that the employee is registered with him.

Procedure for extending sick leave

According to the text of the order of the Ministry of Health and Social Development dated June 29, 2011 N 624n (as amended on July 2, 2014, a certificate of incapacity for work is issued and extended after examining the patient and recording data on his condition in the medical record. Complaints about poor health that are not confirmed by a medical examination or tests cannot be grounds to extend the bulletin.
The mechanism for extending sick leave can be divided into the following stages:

1. Determining the grounds for extending temporary disability during a medical examination or test results.
2. Petition from the attending physician to the head physician for the purpose of creating a commission.
3. Approval of the composition of the medical group by the appropriate order of the head physician (the minimum number of commission members, in addition to the attending physician, is 2).
4. Meeting of the medical commission. The decision to extend the ballot is recorded in the appropriate protocol.
5. The patient is not present at the meeting itself, but first he must undergo a medical examination. As a rule, during the examination, the patient is examined by all members of the commission, familiarized with the data of his medical record and test results.

The maximum period of sick leave, determined by a medical commission, is 12 months.

But this does not mean that the patient can stay at home carefree all this time. If the sick leave is extended by decision of the medical commission, he is obliged to renew the current certificate of incapacity from the attending physician every 15 days. The conclusion of a medical commission in this case is not required.

If the patient refuses to undergo an examination, the sick leave is closed by the attending physician on the same day.

How is second sick leave per year paid?

Federal Law of December 29, 2006 “On compulsory social insurance in case of temporary disability and in connection with maternity”, taking into account all changes and additions (the latest changes were made by No. 86-FZ of May 1, 2021).

To pay for temporary disability certificate, the employee must experience one of the following insured events:

1. illness or injury of the employee himself;
2. caring for a family member who is sick;
3. quarantine of an employee, his child under 7 years of age or an incapacitated relative;
4. prosthetics, the basis for which is medical indications;
5. follow-up treatment in a sanatorium immediately after inpatient medical care.

A mandatory requirement for all of the above situations is the insurance of the employee by his employer by transferring insurance contributions to the Federal Social Insurance Fund of the Russian Federation (and from 2021 to the Federal Tax Service) in the amounts established by law.

The question automatically arises: “At what length of service is sick leave paid at 100%?” It happens that an employer has the opportunity to pay extra for an employee on sick leave up to the average salary.

But there are a number of other cases when the benefit is paid in full. To do this, it is worth understanding the general principles when calculating earnings.

If an employee brings two sick days: how to pay

If the first sick leave is issued to care for a child during outpatient treatment, you need to remember that all days of such sick leave are paid for from social insurance funds. Therefore, the first sick leave is also paid first. The first three days of the paid period of incapacity for work on the second sick leave (from the day following the day the first sick leave ends) are paid at the expense of the employer. This should be done if the duration of disability due to caring for a sick child does not exceed 10 days.

How is second sick leave per month paid?

The longer the experience, the higher the payment as a percentage:

• 1-5 years – 60% of the average daily wage.
• Up to 8 years – payment will be 80%.
• From 8 years - compensation is made in full of the average daily payment - 100%.

Some nuances The following people can be distinguished into a special group:

• Have never worked anywhere before.
• Unemployed for more than two years.
• People who received benefits from the state employment service.

Their work experience is less than 1 year, and payment for sick leave is made based on the minimum wage (minimum wage). For example: in 2013, the amount was 173 rubles for each day of temporary disability. But today, payments to employees are made on the basis of the current legislative act.

• Accruals for being on sick leave are made when calculating average earnings for the last 2 years of work.
• The length of service will have a direct impact on the accruals made for keeping an employee on sick leave.
• But there are also negative forecasts that this project may worsen the rights of the employee. For information on calculating and paying sick leave, see here: Noticed a mistake? Select it and press Ctrl+Enter to let us know.

How is second sick leave per year paid?

The amount of payments will also depend on how much insurance experience they have, or, more simply put, on how long they work at the enterprise that makes the necessary contributions to the Social Insurance Fund: if the employee’s insurance experience is eight years or more, then payments will amount to 100% of the average earnings; if it is from five to eight years, then the employee can count on payments of 80%; if the employee’s length of service is from six months to a year, then payments to him will be 50% of average earnings.

Having information about the criteria by which sick leave payment in 2014 is calculated by the Social Insurance Fund, you can understand how this happens in the case of internal part-time work. The idea is the same: all accruals that were received in the name of this person will be taken into account when calculating temporary disability benefits.

In addition to accruals for standard wages, interest for internal part-time work will also be taken into account.

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(Clause 2.1 of Article 13 of the Law of December 29, 2006 No. 255-FZ is a little unclear). Best regards, BVM." Your case does not apply to a situation where the employee worked in the same organizations for two calendar years preceding his illness.

This is important to know: Can a paramedic issue a certificate of incapacity for work?

If an external part-time worker works in the same organizations in which he worked in the two calendar years preceding the period of illness, then benefits are paid to him for all places of work (Part.

2 tbsp. 13 of the Law of December 29, 2006 No. 255-FZ)

Rules for paying long sick leave in 2021

The duration of payment of benefits in case of illness or injury of the employee himself is not limited by time. That is, the employer pays for all days of incapacity for work, regardless of how long the certificate was issued and how many sick days the employee had during the year (Part 1, Article 6 of Law No. 255-FZ).

This is important to know: When to return to work after sick leave

From July 1, 2017, legislation introduced the possibility of issuing sick leave not only as a paper document, but also with the written consent of the patient - in electronic form with the affixing of an enhanced qualified electronic signature of the health worker and the medical organization (Law dated May 1, 2017 No. 86-FZ).

At the same time, the form of sick leave in 2021 remained the same (approved by order of the Ministry of Health and Social Development of Russia dated April 26, 2011 No. 347n):

Thus, medical institutions, employers and the Social Insurance Fund are switching to electronic document management for sick leave. However, the procedure for payment remains the same.

The second sick leave per year is paid less

To calculate daily earnings, we take into account that a year ago she received a bonus in the amount of 20 thousand rubles.

- in the case of caring for a sick child under the age of 18 with his illness associated with a post-vaccination complication, with malignant neoplasms, including malignant neoplasms of lymphoid, hematopoietic and related tissues - for the entire period of treatment of the child; - in the case of caring for a sick child under the age of 18 who is HIV-infected - for the entire period of joint stay with the child in a medical organization when providing medical care to him in an inpatient setting.

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1. State clinics and hospitals.
2. Commercial clinics with licenses and permits to conduct medical practice.
3. Doctors of dental clinics, with a license allowing them to engage in medical activities.
4. Doctors of tuberculosis dispensaries with appropriate licenses.

The exception is cases when, after treatment, the patient is sent to a sanatorium-resort treatment, in this case the closure of the sick leave will occur in the institution where the patient will receive further treatment.

A pregnant woman receives a certificate of incapacity for work at a time for a period of 30 weeks (if there are several fetuses - for a period of 28 weeks) for a period of 140 days.

If a woman has a multiple pregnancy, the period increases to 194 days.

If a woman during this period is caring for a child under the age of 3 years, while receiving maternity leave for her second child, then she does not have the right to be refused payment for sick leave, but the care allowance for this period will not be paid .

The same conditions apply to the child's adoptive parents.

If one child is being adopted, the sick leave will last 70 days after the date of adoption.

If there are two children, then this period increases accordingly to 110 days.

• Firstly, it can be issued to any relative who will be with the child.
• Secondly, if several children are sick, then different people can look after them, and each of them will be issued sick leave.

If the child is under 7 years of age, then you must pay for the entire period of sick leave. If the child's age is from 7 to 15 years, you only need to pay for 15 days of illness.

If you are over 15 years old, payment must be made within 3 days.

1. Determination of the average salary for the billing period.
2. Determining the amount of average daily earnings.
3. Determination of the amount of daily allowance.
4. Establishment of the final amount to be paid.

In practice, this means that the accountant will take into account the employee’s earnings within 1,772.

Maximum duration of payment for sick leave

For long-term sick leave, social insurance does not always compensate for the payment of disability benefits in full. In Art. 6 of Law 255-FZ considers various cases for which different lengths of the sick leave payment period are established:

IMPORTANT! Currently, sick leave for caring for children under 7 years of age, disabled children under 18 years of age, as well as for post-vaccination complications, HIV and oncology in children under 18 years of age are issued for the entire period of care, i.e., without time limits (order of the Ministry of Health and Social Development dated November 28, 2017 No. 953n). But keep in mind that these restrictions have been lifted only for “sick leave” periods, but they still need to be taken into account when paying benefits. To do this, you need to organize and keep track of the days of paid “children’s” sick leave.

A sample prepared by ConsultantPlus experts will help you fill out sick leave for child care correctly. Get free access to the system and go to the material.

The reason for disability code entered in the appropriate column will not always help to accurately determine the maximum duration of payment of benefits. Usually some additional information is needed. But still, some cases are clear from this code.

Read about what disease codes are in the publication “What do disability codes mean on a sick leave certificate.”

If you have any doubts about determining the maximum payment for sick leave, you can contact the medical institution that issued the document with a request for clarification of the nuances of a specific certificate of incapacity for work.

We pay sick leave if two children are sick

Shapoval E. A.

If an employee has several children and each of them is sick separately, then determining the amount of benefits and the limit of paid days is not difficult. True, you will have to keep track of paid sick days independently for each employee’s child, since accounting programs do not do this.

But if one child gets sick, and after some time another child or both at once, questions arise: how much should I pay for sick leave and how to determine the limit of paid days?

In such a situation, one sick leave is issued. But if more than two children are sick at the same time, then two certificates of incapacity for work are issued, since in the line of the certificate of incapacity for work “f. And. O. family member being cared for”, you can enter no more than two family members.

The Social Insurance Fund told us how to determine the amount of benefits in this case and the limit on paid days.

From authoritative sources

Ilyukhina Tatyana Mitrofanovna - Head of the Department of Legal Support of Insurance in Case of Temporary Disability and in Connection with Maternity of the Legal Department of the Federal Social Insurance Fund of the Russian Federation

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“The limit on paid calendar days for caring for a sick child, if several children are sick, applies to each child separately. For example, if two children under the age of 7 are sick (if the diseases are not included in the List of Diseases), then in total for a calendar year the limit is 120 calendar days, 60 calendar days for each child. If the second (third) child falls ill during the illness of the first child, the certificate of incapacity for work issued to care for the first child is extended until all children recover, without counting the days that coincided with the days of release from work to care for the first child. At the same time, the current form of a certificate of incapacity for work does not provide in the “Care” block lines for the doctor to indicate the dates (from what date and to what date) when each child individually is sick. Therefore, the employer is not able to determine the onset of illness for each child individually. It is impossible to require from an employee documents other than a sick leave certificate (any certificates or extracts) confirming the time of illness of children, since this is not provided for by law.

In the interests of the insured person, it is necessary to take into account days of temporary disability to care for sick children in order to pay benefits based on the existing limit for each child.”

Taking into account the explanations of the Social Insurance Fund, if an employee brings sick leave to care for two children, we proceed as follows.

Step 1. We determine the total limit of paid days on the day the disability begins based on the balance of the limit for each child.

Step 2. Determine the amount of the benefit.

Step 3. We divide the paid days between the children for further inclusion in the limit of paid days.

Let's look at a specific example.

In what cases are they released from work for more than 120 days?

The minimum duration of disability is several days. Initially, the doctor prescribes a sick leave for 3 days. Then, after a second appointment, the doctor can extend outpatient treatment to 15 days or close the document on temporary disability.

A longer period of release from work is determined by the medical commission. The period for which a person can be issued a sick leave certificate depends on the type of illness. In severe conditions, a bulletin is issued for a period of 4-6 months. For some pathologies, people are released from work for 10 months or a year.

Sick leave for more than 4 months is issued in the following cases:

• tuberculosis . A certificate of incapacity for work can be issued for a period of 4 to 10 months. It all depends on the type and form of the pathology. During the infiltration phase with medium and small lesions, sick leave is given for up to six months. In severe cases, a person may be released from work for 8-10 months;
• brain concussion . In case of severe injury, the employee loses his ability to work for a period of 60-120 days;
• complex fractures of the limbs and spine . After surgery there is a long period of rehabilitation. The person is forced to remain in bed;
• oncology . When such a diagnosis is made, they are immediately given a release from work for up to four months. It all depends on the clinical picture, type and stage of pathology. In case of surgery, the patient’s sick leave is extended for another 120 days without a break. If the condition is unsatisfactory, the employee may lose his ability to work for up to a year.

If a person has been sick for a long time, in case of severe pathology, if there is a persistent loss of organ function, then doctors refer such a patient to undergo a medical and social examination. This usually results in a disability. Then the certificate of incapacity for work is closed.

The duration of a person’s stay on sick leave is given in Order of the Ministry of Health and Social Development of Russia No. 624n dated June 29, 2011.​​​​​​​