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.
What are they needed for?
All the shortcomings have been corrected in the new form, but the important part for basic information remains the same. The procedure for completing the sheet remains the same, but some codes in the new form must be indicated by the manager .
The use of codes on sick leave is convenient for a number of reasons:
- To maintain secrecy.
If a certificate of incapacity for work needs to be passed from hand to hand, then you can be calm and confident that a stranger will not find out about the illness . In the document it will be possible to distinguish only certain letters and numbers, but not the name of the disease.
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Use codes to save space in your document.
A certificate of incapacity for work usually consists of an abundance of information, because... it must be filled out by both the healthcare worker and the employer. All necessary data must be included in the document and be as useful as possible.
The doctor must indicate the specific clinic, patient information, the name of the doctor and the period of time that the employee will remain incapacitated. The employer indicates its necessary information about the employee. Thus, this amount of information takes up a lot of space, and the codes allow you to limit yourself to the size of one sick leave .
It becomes easier for the HR department to work thanks to the presence of codes. Everyone knows that doctors have to see hundreds of patients a day, which is why their handwriting is often difficult to read. Naturally, deciphering the code in this case is much easier than understanding the doctor’s handwriting.
Thanks to the use of codes, it becomes possible to cooperate with hospitals in other countries. The codes refer to the same diseases in all countries. For this reason, clinics abroad can easily understand the records of their foreign colleagues.
Errors are kept to a minimum.
Due to the fact that there is no longer a need to understand doctors’ handwriting, the possibility of making a mistake when reading doctor’s notes is minimized.
to contents
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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What exist and their decoding
On the certificate of incapacity for work, the disease codes mean the following:
01 This code means a disease.
02 This code indicates that an injury is occurring. What kind of injury can be indicated in the comment.
03 The third code is quarantine.
04 Accident at the enterprise. Or this code may mean the consequences of an accident.
05 This code means an employee’s vacation due to pregnancy and childbirth.
06 Prostheses that are installed in a medical institution.
07 A disease that is associated with the profession. This disease is determined by a medical commission.
08 This code means that the employee needed to undergo further treatment in a sanatorium. The referral is issued by the doctor, and it is attached to the sick leave certificate.
09 An employee is caring for a sick loved one.
10 Serious poisoning and undergoing special treatment and procedures in connection with this.
11 Serious illnesses of particular importance to society. The list is given in Government Decree No. 715.
12 Caring for a child who is not yet seven years old but suffers from a serious illness.
13 Caring for a child with a disability.
14 Malaise due to vaccinations, or a malignant neoplasm in a disabled minor. In this case, the code can only be entered if the child’s parents agree. They must express their consent in writing.
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Practitioner lawyer with 7 years of experience. Specialization: civil law. Extensive experience in defense in court.
15 Caring for a child with HIV. Parental permission in writing is also required to enter this code on the sick leave sheet.
These codes have the same meaning for all clinics.
Just illness means code 01 . If a worker with a general illness seeks medical advice, then code 01 is entered on the certificate of incapacity for work and this means that he needs full payments for this reason. Thanks to the code, employees in the accounting department understand what payment is due to a sick employee.
Read our article on how sick leave is calculated.
Absolutely all codes are recorded by medical workers . You need to know that the number 01 can also be written in the code change window. For this reason, the accountant needs to be careful when reviewing all records.
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There is no need to decipher code 01 on the certificate of incapacity for work. Therefore, it may not be recorded, because it is common to many diseases.
The accountant must know what payments to make if code 09
, because care accruals have their limitations, and then the employee is absent from the workplace at his own expense.
If an employee went on sick leave due to an injury, then you need to clarify its type. If the code is 02, then you need to know that there was a domestic injury. If the code is 04, then in this case the employee was injured at work.
Certain diseases fall under several codes at once.
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.
Is a detailed diagnosis written?
When a doctor fills out a sick leave certificate, he must indicate a two-digit code (for example, 03, 11 or another) in the “Cause of disability” column. As a result, the time required to write the diagnosis itself is significantly reduced. It is much more convenient to replace it with a digital designation. The only exceptions are some medical organizations. For example, employees of psychiatric, drug treatment and other specialized clinics are required to indicate not an abbreviated code, but the full name of the disease, its stages and other nuances.
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.
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.
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.
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.
How to correct an error in an electronic sick note
From 07/07/2017, with the consent of the patient, a medical institution has the right to issue an electronic sick leave certificate. Errors in its design are also possible. For example, if the doctor entered the wrong name of the organization, there is no need to ask the employee to re-register the sick leave. Since these data are indicated by the doctor from the patient’s words, an error is possible and therefore is not considered a gross violation. In this case, the employer should use the sick leave number provided by the employee and/or SNILS number to request an electronic certificate of incapacity for work in the fund’s information system and in the “To be completed by the employer” section, enter the correct data on the name of the insured organization.
If the employer made an error when filling out the electronic sick leave, he has the right to make changes and send the corrected ballot to the Social Insurance Fund again. In this case, it is necessary to indicate the reason for the changes and certify the new data with an enhanced qualified electronic signature of the chief accountant and the policyholder (clause 72 of the Procedure).
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).
What to do if your employer ruins your sick leave
According to clause 72 of the Procedure, if an employee of the organization made a mistake in filling out the fields of the certificate of incapacity for work, it is unacceptable to use corrective means. To correct an error, you should cross out the incorrect data and indicate the correct information on the back of the form, which must be certified by the inscription “believe corrected”, the official’s signature and seal (if any).
Important! Recommendation from ConsultantPlus If you filled out a line that should remain blank, cross out the erroneous entry, and on the back of the sick leave write, for example:... For an example of the inscription, see K+. Trial access to the system can be obtained for free.
